Helping Families in Mental Health Crisis Act of 2016

Bill: 114-hr-2646
Sponsor: full_name: Rep. Murphy, Tim [R-PA-18]
Introduced: 2015-06-04
Policy area: Health
Subjects: Administrative remedies

Advisory bodies

Child health

Civil actions and liability

Congressional oversight

Department of Health and Human Services

Disability and health-based discrimination

Domestic violence and child abuse

Drug, alcohol, tobacco use

Education programs funding

Elementary and secondary education

Emergency medical services and trauma care

Executive agency funding and structure

Federal officials

First responders and emergency personnel

Government information and archives

Government studies and investigations

Health care costs and insurance

Health care coverage and access

Health care quality

Health information and medical records

Health personnel

Health programs administration and funding

Health promotion and preventive care

Health technology, devices, supplies

Higher education

Home and outpatient care

Hospital care

Law enforcement officers

Medicaid

Medical education

Medical research

Medical tests and diagnostic methods

Medicare

Mental health

Minority education

Minority health

National Institutes of Health (NIH)

Preschool education

Prescription drugs

Public-private cooperation

Research administration and funding

Right of privacy

Social work, volunteer service, charitable organizations

Student records
Latest action: action_date: 2016-07-14
text: Read twice and referred to the Committee on Health, Education, Labor, and Pensions.

Summaries:
action_date: 2015-06-04
action_desc: Introduced in House
text: <p><b>Helping Families in Mental Health Crisis Act of 2015</b></p> <p>This bill creates the position of Assistant Secretary for Mental Health and Substance Use Disorders to take over the responsibilities of the Administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA). Mental health programs are extended and training regarding mental health is expanded.</p> <p>SAMHSA must establish the National Mental Health Policy Laboratory and the Interagency Serious Mental Illness Coordinating Committee.</p> <p>This bill amends the Public Health Service Act to require the National Institute of Mental Health to translate evidence-based interventions and the best available science into systems of care. </p> <p>Certain mental health care professional volunteers are provided liability protection.</p> <p>Pediatric mental health subspecialists are eligible for National Health Service Corps programs.</p> <p>An underserved population of children or a site for training in child psychiatry can be designated as a health professional shortage area.</p> <p>The protected health information of an individual with a serious mental illness may be disclosed to a caregiver under certain conditions.</p> <p>This bill amends title XIX (Medicaid) of the Social Security Act (SSAct) to conditionally expand coverage of mental health services.</p> <p>Part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the SSAct is amended to require coverage of antidepressants and antipsychotics.</p> <p>If it will not increase Medicare spending, Medicare's 190-day lifetime limit on inpatient psychiatric hospital services is eliminated.</p> <p>Health information technology activities and incentives are expanded to include certain mental health and substance abuse professionals and facilities.</p> This bill restricts the lobbying and counseling activities of protection and advocacy systems for individuals with mental illness. These systems must focus on safeguarding the rights of individuals with mental illness to be free from abuse and neglect.

action_date: 2016-07-06
action_desc: Passed House amended
text: <p><b>Helping Families in Mental Health Crisis Act of 2016</b></p> <p>TITLE I--ASSISTANT SECRETARY FOR MENTAL HEALTH AND SUBSTANCE USE</p> <p>(Sec. 101) This bill amends the Public Health Service Act (PHSA) to rename the position of Administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA) to Assistant Secretary for Mental Health and Substance Use. The bill revises the duties under this position, including to require the review and evaluation of programs related to mental illness and substance use disorders.</p> <p>(Sec. 102) The Office of the Assistant Secretary for Planning and Evaluation must: (1) evaluate programs related to mental illness and substance use disorders, (2) develop an evaluation strategy that identifies priority programs to be evaluated, and (3) make recommendations to improve evaluated programs.</p> <p>(Sec. 103) SAMHSA's Office of Policy, Planning, and Innovation is renamed the National Mental Health and Substance Use Policy Laboratory. The bill specifies responsibilities for the laboratory, including that the laboratory must: (1) facilitate the implementation of policy changes likely to have a significant effect on mental health; (2) collect information from SAMHSA grantees to evaluate and disseminate information on evidence-based practices; and (3) identify federal activities that are duplicative or that are not evidence-based, effective, or efficient.</p> <p>(Sec. 104) The Government Accountability Office (GAO) must study peer-support specialist programs that receive funding from SAMHSA to identify best practices for training and credential requirements.</p> <p>(Sec. 105) This bill amends the Protection and Advocacy for Individuals with Mental Illness Act to prohibit state protection and advocacy systems from using federal funds to lobby.</p> <p>(Sec. 106) State protection and advocacy systems must publish their annual reports. The Department of Health and Human Services (HHS) must include in its biennial reports detailed accounting for each system.</p> <p>(Sec. 107) HHS must establish a grievance procedure for clients and potential clients of state protection and advocacy systems.</p> <p>(Sec. 108) SAMHSA must establish a Center for Behavioral Health Statistics and Quality to: (1) coordinate SAMHSA's integrated data strategy, (2) recommend measurement standards for SAMHSA grant programs, and (3) coordinate efforts to evaluate activities supported by SAMHSA. Every two years, the center must report on the quality of services furnished through SAMHSA grant programs.</p> <p>(Sec. 109) Every five years, SAMHSA must develop, publish, and carry out a strategic plan.</p> <p>(Sec. 110) The bill revises provisions regarding SAMHSA's Center for Mental Health Services and Center for Substance Abuse Treatment, including to require the centers to ensure consistent documentation of the application of grant criteria.</p> <p>(Sec. 111) The bill revises membership requirements for SAMHSA advisory councils.</p> <p>(Sec. 112) The bill revises membership requirements for SAMHSA peer review groups.</p> <p>TITLE II--MEDICAID MENTAL HEALTH COVERAGE</p> <p>(Sec. 201) The bill declares that current law allows a state Medicaid plan to pay for a primary care service and a mental health service furnished to an individual on the same day by providers at the same facility.</p> <p>(Sec. 202) The bill amends title XIX (Medicaid) of the Social Security Act to provide for federal payment under Medicaid, under specified conditions, for capitated payments to Medicaid managed care organizations or prepaid inpatient health plans for individuals between 21 and 65 years old who are receiving inpatient treatment in institutions for mental diseases.</p> <p>(Sec. 203) The Centers for Medicare and Medicaid Services (CMS) must report on Medicaid coverage of services provided through Medicaid managed care organizations or prepaid inpatient health plans to certain enrollees receiving treatment in institutions for mental diseases.</p> <p>(Sec. 204) The CMS must notify state Medicaid programs regarding opportunities to design innovative service delivery systems for individuals with serious mental illness or serious emotional disturbance.</p> <p>(Sec. 205) The CMS must collect and report specified information from states with Medicaid emergency psychiatric demonstration projects, including the extent to which there is a reduction in spending under demonstration projects.</p> <p>(Sec. 206) The bill provides for federal payment under Medicaid for early and periodic screening, diagnostic, and treatment services for children in inpatient psychiatric hospitals, effective January 1, 2019.</p> <p>(Sec. 207) Federal payment under Medicaid for in-home personal care services or home health care services is reduced for states that do not require the use of an electronic visit verification system for such services, effective January 1, 2019. The CMS must pay a specified share of state expenditures attributable to such a system.</p> <p>HHS must disseminate to states best practices for electronic visit verification systems, including training for users.</p> <p>TITLE III--INTERDEPARTMENTAL SERIOUS MENTAL ILLNESS COORDINATING COMMITTEE</p> <p>(Sec. 301) HHS must establish the Interdepartmental Serious Mental Illness Coordinating Committee to report on research, evaluate the effect of federal programs, provide a plan to improve outcomes for individuals, and recommend agency actions to better coordinate administration of mental health services.</p> <p>TITLE IV--COMPASSIONATE COMMUNICATION ON HIPAA</p> <p>(Sec. 402) After finalizing regulations on the confidentiality of alcohol and drug abuse patient records, HHS must convene stakeholders to determine the effect of the regulations on patient care, health outcomes, and patient privacy.</p> <p>(Sec. 403) HHS must promulgate regulations clarifying the circumstances under which an entity may disclose protected health information.</p> <p>(Sec. 404) HHS must develop and disseminate model programs and materials for training: (1) health care providers and legal professionals regarding disclosure of the protected health information of patients with a mental illness, and (2) patients and their families regarding their rights to protect and obtain such information.</p> <p>TITLE V--INCREASING ACCESS TO TREATMENT FOR SERIOUS MENTAL ILLNESS</p> <p>(Sec. 501) SAMHSA must award grants for assertive community treatment programs for individuals with serious mental illness. (Patients in assertive community treatment programs receive care in their community from a multidisciplinary team of providers.)</p> <p>(Sec. 502) SAMHSA must award grants to enhance community-based crisis response systems or for a database of available beds at inpatient psychiatric facilities, crisis stabilization units, and residential community mental health and residential substance use disorder treatment facilities.</p> <p>(Sec. 503) This bill amends the Protecting Access to Medicare Act of 2014 to extend through FY2022 a pilot program for assisted outpatient treatment programs for individuals with serious mental illness.</p> <p>(Sec. 504) A health professional volunteer providing primary health care to an individual at a community health center or through programs or events carried out by a center is deemed to be an employee of the Public Health Service for purposes of any civil action that may arise from providing services to patients. For a volunteer to be covered by this liability protection, HHS must approve the center's application to sponsor the volunteer.</p> <p>TITLE VI--SUPPORTING INNOVATIVE AND EVIDENCE-BASED PROGRAMS</p> <p>Subtitle A--Encouraging the Advancement, Incorporation, and Development of Evidence-Based Practices</p> <p>(Sec. 601) SAMHSA may award grants for the development of evidence-based interventions for mental illness, serious emotional disturbance, substance use disorders, and co-occurring illness or disorders.</p> <p>(Sec. 602) SAMHSA must review and publish information on evidence-based programs and practices.</p> <p>Subtitle B--Supporting the State Response to Mental Health Needs</p> <p>(Sec. 611) The bill revises block grants for community mental health services. States must use at least a specified amount of a block grant to support evidence-based programs for individuals with early serious mental illness. The bill revises the block grant requirement that a state maintain spending on community mental health services.</p> <p>Subtitle C--Strengthening Mental Health Care for Children and Adolescents</p> <p>(Sec. 621) The Health Resources and Services Administration must award grants to promote integration of behavioral health with pediatric primary care.</p> <p>(Sec. 622) HHS must award grants for infant and early childhood mental health promotion, intervention, and treatment programs.</p> <p>(Sec. 623) The bill revises and extends through FY2021 a grant program to address violence-related stress. The program must support the continued operation of the National Child Traumatic Stress Initiative (NCTSI). The NCTSI coordinating center must report on child treatment and outcomes and facilitate training in evidence-based and trauma-informed treatments, interventions, and practices.</p> <p>TITLE VII--GRANT PROGRAMS AND PROGRAM REAUTHORIZATION</p> <p>Subtitle A--Garrett Lee Smith Memorial Act Reauthorization</p> <p>(Sec. 701) The bill revises and extends through FY2021 a technical assistance resource center to prevent suicides. The center's focus is expanded from youth suicides to suicides among all ages, particularly among groups that are at high risk for suicide.</p> <p>(Sec. 702) A program to provide support for youth suicide early intervention and prevention strategies is also revised and extended through FY2021.</p> <p>(Sec. 703) The bill revises and extends through FY2021 SAMHSA grants for mental and behavioral health services at institutions of higher education.</p> <p>Subtitle B--Other Provisions</p> <p>(Sec. 711) SAMHSA must maintain the existing National Suicide Prevention Lifeline program.</p> <p>(Sec. 712) SAMHSA must publish a report on the adult and pediatric mental health and substance use disorder workforce.</p> <p>(Sec. 713) HHS must maintain a Minority Fellowship Program for mental and substance use treatment professionals to improve services for racial and ethnic minority populations.</p> <p>(Sec. 714) The bill repeals various expired SAMHSA programs.</p> <p>(Sec. 715) The Centers for Disease Control and Prevention (CDC) is encouraged to improve the National Violent Death Reporting System.</p> <p>(Sec. 717) HHS must award grants to develop and sustain behavioral health paraprofessional training and education programs, including through tuition support.</p> <p>(Sec. 718) Pediatric mental health subspecialists are eligible for National Health Service Corps programs.</p> <p>(Sec. 719) SAMHSA must award grants for suicide prevention and intervention programs for adults.</p> <p>(Sec. 720) SAMHSA may award grants to: (1) train first responders to recognize and intervene with individuals with mental illness, and (2) establish collaborative law enforcement and mental health programs to provide services during mental health crises.</p> <p>(Sec. 721) SAMHSA may award grants to support the recruitment and training of health services psychology students, interns, and postdoctoral residents in community mental health settings.</p> <p>(Sec. 722) The bill extends through FY2022 a loan repayment program for health professionals who provide pediatric specialty care to underserved areas or populations.</p> <p>(Sec. 723) The bill reduces the authorization of appropriations for CDC facilities.</p> <p>TITLE VIII--MENTAL HEALTH PARITY</p> <p>(Sec. 801) HHS, the Department of Labor, and the Department of the Treasury must: (1) issue guidance to improve the compliance of group health plans and health insurance coverage with requirements for parity between mental health and substance use disorder benefits and medical and surgical benefits, and (2) audit the plan documents of group health plans and health insurers that repeatedly violate parity requirements.</p> <p>The bill amends the PHSA, the Employee Retirement Income Security Act of 1974 (ERISA), and the Internal Revenue Code to require health plan administrators to make available information, including the criteria used to make medical necessity determinations, to demonstrate compliance with parity requirements.</p> <p>(Sec. 802) HHS must convene stakeholders to produce an action plan for improved federal and state coordination regarding enforcement of parity requirements.</p> <p>(Sec. 803) The Employee Benefits Security Administration must report on closed federal investigations that found serious violations of parity requirements.</p> <p>(Sec. 804) The GAO must report on the extent to which group health plans, health insurance coverage, Medicaid managed care plans, and Children's Health Insurance Program (CHIP) health plans comply with parity requirements.</p> <p>(Sec. 805) HHS may: (1) update published information on eating disorders, (2) incorporate public resources into its obesity prevention programs, and (3) advance public awareness of eating disorders.</p> <p>(Sec. 806) HHS may facilitate the identification of programs to educate and train health professionals regarding eating disorders.</p> <p>(Sec. 807) The GAO must report on federal oversight of group health plans, health insurance coverage, and Medicaid managed care plans regarding compliance with parity requirements.</p> (Sec. 808) Eating disorder benefits under group health plans and health insurance coverage must be consistent with parity requirements. <div> <div> </div> <div> </div> <div> </div> </div>

tv_txt: I 114th CONGRESS 1st Session H. R. 2646 IN THE HOUSE OF REPRESENTATIVES June 4, 2015 Mr. Murphy of Pennsylvania (for himself, Ms. Eddie Bernice Johnson of Texas , Mr. Buchanan , Mr. Diaz-Balart , Mr. Bilirakis , Mr. Dold , Mr. Guinta , Mrs. Mimi Walters of California , Mr. Brendan F. Boyle of Pennsylvania , Mrs. Ellmers of North Carolina , Mr. Denham , Mr. Vargas , Mrs. Miller of Michigan , Mr. Hastings , Mr. Calvert , Mr. Nunes , Mr. Hunter , Mr. Blumenauer , and Ms. Sinema ) introduced the following bill; which was referred to the Committee on Energy and Commerce , and in addition to the Committees on Ways and Means and Education and the Workforce , 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 make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis, and for other purposes.

1. Short title; table of contents (a) Short title This Act may be cited as the Helping Families in Mental Health Crisis Act of 2015 . (b) Table of contents The table of contents for this Act is as follows: Sec. 1. Short title; table of contents. Sec. 2. Definitions. Title I—Assistant Secretary for Mental Health and Substance Use Disorders Sec. 101. Assistant Secretary for Mental Health and Substance Use Disorders. Sec. 102. Transfer of SAMHSA authorities. Sec. 103. Reports. Sec. 104. Advisory Council on Graduate Medical Education. Title II—Grant reform and restructuring Sec. 201. National mental health policy laboratory. Sec. 202. Innovation grants. Sec. 203. Demonstration grants. Sec. 204. Early childhood intervention and treatment. Sec. 205. Extension of assisted outpatient treatment grant program for individuals with serious mental illness. Sec. 206. Block grants. Sec. 207. Workforce development. Sec. 208. Authorized grants and programs. Title III—Interagency Serious Mental Illness Coordinating Committee Sec. 301. Interagency Serious Mental Illness Coordinating Committee. Title IV—HIPAA and FERPA caregivers Sec. 401. Promoting appropriate treatment for mentally ill individuals by treating their caregivers as personal representatives for purposes of HIPAA privacy regulations. Sec. 402. Caregivers permitted access to certain education records under FERPA. Sec. 403. Confidentiality of records. Title V—Medicare and Medicaid reforms Sec. 501. Enhanced Medicaid coverage relating to certain mental health services. Sec. 502. Access to mental health prescription drugs under Medicare and Medicaid. Sec. 503. Elimination of 190-day lifetime limit on coverage of inpatient psychiatric hospital services under Medicare. Sec. 504. Modifications to Medicare discharge planning requirements. Sec. 505. Demonstration programs to improve community mental health services. Title VI—Research by National Institute of Mental Health Sec. 601. Increase in funding for certain research. Title VII—Behavioral health information technology Sec. 701. Extension of health information technology assistance for behavioral and mental health and substance abuse. Sec. 702. Extension of eligibility for Medicare and Medicaid health information technology implementation assistance. Title VIII—SAMHSA Reauthorization and Reforms Subtitle A—Organization and general authorities Sec. 801. In general. Sec. 802. Advisory councils. Sec. 803. Peer review. Subtitle B—Protection and advocacy for individuals with mental illness Sec. 811. Prohibition against lobbying by systems accepting Federal funds to protect and advocate the rights of individuals with mental illness. Sec. 812. Ensuring that caregivers of individuals with serious mental illness have access to the protected health information of such individuals. Sec. 813. Protection and advocacy activities to focus exclusively on safeguarding rights to be free from abuse and neglect. Sec. 814. Reporting. Sec. 815. Grievance procedure. Sec. 816. Evidence-based treatment for individuals with serious mental illness. Title IX—Reporting Sec. 901. GAO study on preventing discriminatory coverage limitations for individuals with serious mental illness and substance use disorders. 2. Definitions In this Act: (1) Except as inconsistent with the provisions of this Act, the term Assistant Secretary means the Assistant Secretary for Mental Health and Substance Use Disorders. (2) The term evidence-based means the conscientious, systematic, explicit, and judicious appraisal and use of external, current, reliable, and valid research findings as the basis for making decisions about the effectiveness and efficacy of a program, intervention, or treatment. I Assistant Secretary for Mental Health and Substance Use Disorders 101. Assistant Secretary for Mental Health and Substance Use Disorders (a) In general There shall be in the Department of Health and Human Services an official to be known as the Assistant Secretary for Mental Health and Substance Use Disorders, who shall— (1) report directly to the Secretary; (2) be appointed by the Secretary of Health and Human Services, by and with the advice and consent of the Senate; and (3) be selected from among individuals who— (A) (i) have a doctoral degree in medicine or osteopathic medicine and clinical and research experience in psychiatry; (ii) graduated from an Accreditation Council for Graduate Medical Education-accredited psychiatric residency program; and (iii) have an understanding of biological, psychosocial, and pharmaceutical treatments of mental illness and substance use disorders; or (B) have a doctoral degree in psychology with— (i) clinical and research experience regarding mental illness and substance use disorders; and (ii) an understanding of biological, psychosocial, and pharmaceutical treatments of mental illness and substance use disorders. (b) Duties The Assistant Secretary shall— (1) promote, evaluate, organize, integrate, and coordinate research, treatment, and services across departments, agencies, organizations, and individuals with respect to the problems of individuals suffering from substance use disorders or mental illness; (2) carry out any functions within the Department of Health and Human Services— (A) to improve the treatment of, and related services to, individuals with respect to substance use disorders or mental illness; (B) to improve secondary prevention or tertiary prevention services for such individuals; (C) to ensure access to effective, evidence-based treatment for individuals with mental illnesses and individuals with a substance use disorder; (D) to ensure that grant programs of the Department adhere to scientific standards with an emphasis on secondary prevention and tertiary prevention for individuals with serious mental illness or substance use disorders; and (E) to develop and implement initiatives to encourage individuals to pursue careers (especially in underserved areas and populations) as psychiatrists, psychologists, psychiatric nurse practitioners, clinical social workers, and other licensed mental health professionals specializing in the diagnosis, evaluation, and treatment of individuals with severe mental illness, including individuals— (i) who are vulnerable to crises, psychotic episodes, or suicidal rumination; (ii) whose deterioration can be rapid; or (iii) who require more frequent contact or integration of a variety of services by the treating mental health professional; (3) carry out the administrative and financial management, policy development and planning, evaluation, knowledge dissemination, and public information functions that are required for the implementation of mental health programs, including block grants, treatments, and data collection; (4) conduct and coordinate demonstration projects, evaluations, and service system assessments and other activities necessary to improve the availability and quality of treatment, prevention, and related services related to substance use disorders and mental illness; (5) within the Department of Health and Human Services, oversee and coordinate all programs and activities relating to— (A) the prevention of, or treatment or rehabilitation for, mental health or substance use disorders; (B) parity in health insurance benefits and conditions relating to mental health and substance use disorder; or (C) the reduction of homelessness among individuals with mental illness; (6) across the Federal Government, in conjunction with the Interagency Serious Mental Illness Coordinating Committee under section 501A— (A) review all programs and activities relating to the prevention of, or treatment or rehabilitation for, mental illness or substance use disorders; (B) identify any such programs and activities that are duplicative; (C) identify any such programs and activities that are not evidence-based, effective, or efficient; and (D) formulate recommendations for expanding, coordinating, eliminating, and improving programs and activities identified pursuant to subparagraph (B) or (C) and merging such programs and activities into other, successful programs and activities; (7) identify evidence-based best practices across the Federal Government for treatment and services for those with mental health and substance use disorders by reviewing practices for efficiency, effectiveness, quality, coordination, and cost effectiveness; (8) be the head of and supervise the National Mental Health Policy Laboratory; and (9) not later than one year after the date of enactment of the Helping Families in Mental Health Crisis Act of 2015, submit to the Congress a report containing a nationwide strategy to increase the psychiatric workforce and recruit medical professionals for the treatment of individuals with serious mental illness and substance use disorders. (c) Nationwide strategy The Assistant Secretary shall ensure that the nationwide strategy in the report under subsection (b)(9) is designed— (1) to encourage and incentivize students enrolled in an accredited medical or osteopathic medical school to enter the specialty of psychiatry; (2) to promote greater research-oriented psychiatrist residency training on evidence-based service delivery models for individuals with serious mental illness or substance use disorders; (3) to promote appropriate Federal administrative and fiscal mechanisms that support— (A) evidence-based collaborative care models; and (B) the necessary psychiatric workforce capacity for these models, including psychiatrists (including child and adolescent psychiatrists), psychologists, psychiatric nurse practitioners, clinical social workers, and mental health, peer-support specialists; (4) to increase access to child and adolescent psychiatric services in order to promote early intervention for prevention and mitigation of mental illness; and (5) to identify populations and locations that are the most underserved by mental health professionals and the most in need of psychiatrists (including child and adolescent psychiatrists), psychologists, psychiatric nurse practitioners, clinical social workers, and mental health, peer-support specialists. (d) Prioritization of integration of services, early diagnosis, intervention, and workforce development In carrying out the duties described in subsection (b), the Assistant Secretary shall prioritize— (1) the integration of mental health, substance use, and physical health services for the purpose of diagnosing, preventing, treating, or providing rehabilitation for mental illness or substance use disorders, including any such services provided through the justice system (including departments of correction) or other entities other than the Department of Health and Human Services; (2) crisis intervention for, early diagnosis and intervention services for the prevention of, and treatment and rehabilitation for, serious mental illness or substance use disorders; and (3) workforce development for— (A) appropriate treatment of serious mental illness or substance use disorders; and (B) research activities that advance scientific and clinical understandings of these disorders, including the development and implementation of a continuing nationwide strategy to increase the psychiatric workforce with psychiatrists, child and adolescent psychiatrists, psychologists, psychiatric nurse practitioners, clinical social workers, and mental health peer support specialists. (e) Requirements and restrictions on authority To award grants In awarding any grant or financial assistance, the Assistant Secretary, and any agency or official within the Office of the Assistant Secretary, shall comply with the following: (1) The grant or financial assistance shall be for activities consisting of, or based upon, applied scientific research. (2) Any program to be funded shall be demonstrated— (A) in the case of an ongoing program, to be effective; and (B) in the case of a new program, to have the prospect of being effective. (3) The programs and activities to be funded shall use evidence-based best practices or emerging evidence-based best practices that are translational and can be expanded or replicated to other States, local communities, agencies, or through the Medicaid program under title XIX of the Social Security Act. (4) An application for the grant or financial assistance shall include, as applicable, a scientific justification based on previously demonstrated models, the number of individuals to be served, the population to be targeted, what objective outcomes measures will be used, and details on how the program or activity to be funded can be replicated and by whom. (5) Applicants shall be evaluated and selected through a blind, peer-review process by expert mental health care providers with professional experience in mental health research or treatment and where appropriate or necessary professional experience related to substance abuse and other areas of expertise appropriate to the grant or other financial assistance. (6) No member of a peer-review group conducting a blind, peer-review process, as required by paragraph (5), may be related to anyone who may be applying for the type of award being reviewed, may be a current grant applicant, or may have a financial or employment interested in selecting whom to receive the award. (7) Award recipients may be periodically reviewed and audited at the discretion of the Inspector General of the Department of Health and Human Services or the Comptroller General of the United States to ensure that— (A) the best scientific method for both services and data collection is being followed; and (B) Federal funds are being used as required by the conditions of the award and by applicable guidelines of the NMHPL. (8) Award recipients that fail an audit or fail to provide information pursuant to an audit shall have their awards terminated. (f) Definitions In this section: (1) The term secondary prevention means prevention that is designed to prevent a disease or condition from occurring among individuals or a subpopulation determined to be at risk for the disease or condition. (2) The term tertiary prevention means prevention that is designed to reduce or minimize the consequences of a disease or condition among individuals showing symptoms of the disease or condition. 102. Transfer of SAMHSA authorities (a) In general The Secretary of Health and Human Services shall delegate to the Assistant Secretary all duties and authorities that— (1) as of the day before the date of enactment of this Act, were vested in the Administrator of the Substance Abuse and Mental Health Services Administration; and (2) are not terminated by this Act. (b) Transition This section and the amendments made by this section apply beginning on the day that is 6 months after the date of enactment of this Act. As of such day, the Secretary of Health and Human Services shall provide for the transfer of the personnel, assets, and obligations of the Substance Abuse and Mental Health Services Administration to the Office of the Assistant Secretary. (c) Conforming amendments Title V of the Public Health Service Act ( 42 U.S.C. 290aa et seq. ) is amended— (1) in the title heading, by striking Substance Abuse and Mental Health Services Administration and inserting Mental Health and Substance Use Disorders ; (2) by amending section 501(a) to read as follows: (a) Assistant Secretary The Assistant Secretary for Mental Health and Substance Use Disorders shall have the duties and authorities vested in the Assistant Secretary by this title in addition to the duties and authorities vested in the Assistant Secretary by section 501 of the Helping Families in Mental Health Crisis Act of 2015 and other provisions of law. ; (3) by amending section 501(c) to read as follows: (c) Deputy Assistant Secretary The Assistant Secretary, with the approval of the Secretary, may appoint a Deputy Assistant Secretary and may employ and prescribe the functions of such officers and employees, including attorneys, as are necessary to administer the activities to be carried out under this title. ; (4) by striking subsection (o) (relating to authorization of appropriations); (5) by striking Administrator of the Substance Abuse and Mental Health Services Administration each place it appears and inserting Assistant Secretary for Mental Health and Substance Use Disorders ; (6) by striking Administrator each place it appears and inserting Assistant Secretary , except where the term Administrator appears within the term— (A) Associate Administrator; (B) Administrator of the Health Resources and Services Administration; (C) Administrator of the Centers for Medicare & Medicaid Services; or (D) Administrator of the Office of Juvenile Justice and Delinquency Prevention; (7) by striking Substance Abuse and Mental Health Services Administration each place it appears and inserting Office of the Assistant Secretary ; (8) in section 502, by striking Administration or Center each place it appears and inserting Office or Center ; (9) in section 502, by striking Administration's and inserting Office of the Assistant Secretary’s ; and (10) by striking the term Administration each place it appears and inserting Office of the Assistant Secretary , except in the heading of section 520G(b) and where the term Administration appears with the term— (A) Health Resources and Services Administration; or (B) National Highway Traffic Safety Administration. (d) References After executing subsection (a), subsection (b), and the amendments made by subsection (c)— (1) any reference in statute, regulation, or guidance to the Administrator of the Substance Abuse and Mental Health Services Administration shall be construed to be a reference to the Assistant Secretary for Mental Health and Substance Use Disorders; and (2) any reference in statute, regulation, or guidance to the Substance Abuse and Mental Health Services Administration shall be construed to be a reference to the Office of the Assistant Secretary. 103. Reports (a) Report on investigations regarding parity in mental health and substance use disorder benefits (1) In general Not later than 180 days after the enactment of this Act, and annually thereafter, the Administrator of the Centers for Medicare & Medicaid Services, in collaboration with the Assistant Secretary of Labor of the Employee Benefits Security Administration and the Secretary of the Treasury, and in consultation with the Assistant Secretary for Mental Health and Substance Use Disorders, shall submit to the Congress a report— (A) identifying Federal investigations conducted or completed during the preceding 12-month period regarding compliance with parity in mental health and substance use disorder benefits, including benefits provided to persons with serious mental illness and substance use disorders, under the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (subtitle B of title V of division C of Public Law 110–343 ); and (B) summarizing the results of such investigations. (2) Contents Subject to paragraph (3), each report under paragraph (1) shall include the following information: (A) The number of investigations opened and closed during the covered reporting period. (B) The benefit classification or classifications examined by each investigation. (C) The subject matter or subject matters of each investigation, including quantitative and nonquantitative treatment limitations. (D) A summary of the basis of the final decision rendered for each investigation. (3) Limitation Individually identifiable information shall be excluded from reports under paragraph (1) consistent with Federal privacy protections. (b) Report on best practices for peer-Support specialist programs, training, and certification (1) In general Not later than 1 year after the date of enactment of this Act, and biannually thereafter, the Assistant Secretary shall submit to the Congress and make publicly available a report on best practices and professional standards in States for— (A) establishing and operating health care programs using peer-support specialists; and (B) training and certifying peer-support specialists. (2) Peer-support specialist defined In this subsection, the term peer-support specialist means an individual who— (A) uses his or her lived experience of recovery from mental illness or substance abuse, plus skills learned in formal training, to facilitate support groups, and to work on a one-on-one basis, with individuals with a serious mental illness or a substance use disorder, in consultation with and under the supervision of a licensed mental health or substance use treatment professional; (B) has been an active participant in mental health or substance use treatment for at least the preceding 2 years; (C) does not provide direct medical services; and (D) does not perform services outside of his or her area of training, expertise, competence, or scope of practice. (3) Contents Each report under this subsection shall include information on best practices and standards with regard to the following: (A) Hours of formal work or volunteer experience related to mental health and substance use issues. (B) Types of peer specialist exams required. (C) Code of ethics. (D) Additional training required prior to certification, including in areas such as— (i) psychopharmacology; (ii) integrating physical medicine and mental health supportive services; (iii) ethics; (iv) scope of practice; (v) crisis intervention; (vi) identification and treatment of mental health disorders; (vii) State confidentiality laws; (viii) Federal privacy protections, including under the Health Insurance Portability and Accountability Act of 1996; and (ix) other areas as determined by the Assistant Secretary. (E) Requirements to explain what, where, when, and how to accurately complete all required documentation activities. (F) Required or recommended skill sets, including— (i) identifying consumer risk indicators, including individual stressors, triggers, and indicators of escalating symptoms; (ii) explaining basic de-escalation techniques; (iii) explaining basic suicide prevention concepts and techniques; (iv) identifying indicators that the consumer may be experiencing abuse or neglect; (v) identifying and responding appropriately to personal stressors, triggers, and indicators; (vi) identifying the consumer’s current stage of change or recovery; (vii) explaining the typical process that should be followed to access or participate in community mental health and related services; and (viii) identifying circumstances when it is appropriate to request assistance from other professionals to help meet the consumer’s recovery goals. (G) Requirements for continuing education credits annually. (c) Report on the state of the States in mental health and substance use treatment (1) In general Not later than 1 year after the date of enactment of this Act, and not less than every 2 years thereafter, the Assistant Secretary shall submit to the Congress and make available to the public a report on the state of the States in mental health and substance use treatment, including the following: (A) A detailed report on how Federal mental health and substance use treatment funds are used in each State including: (i) The numbers of individuals with serious mental illness or substance use disorders who are served with Federal funds. (ii) The types of programs made available to individuals with serious mental illness or substance use disorders. (B) A summary of best practice models in the States highlighting programs that are cost effective, provide evidence-based care, increase access to care, integrate physical, psychiatric, psychological, and behavioral medicine, and improve outcomes for individuals with mental illness or substance use disorders. (C) A statistical report of outcome measures in each State, including— (i) rates of suicide, suicide attempts, substance abuse, overdose, overdose deaths, emergency psychiatric hospitalizations, and emergency room boarding; and (ii) for those with mental illness, arrests, incarcerations, victimization, homelessness, joblessness, employment, and enrollment in educational or vocational programs. (D) Outcome measures on State-assisted outpatient treatment programs, including— (i) rates of keeping treatment appointments and compliance with prescribed medications; (ii) participants’ perceived effectiveness of the program; (iii) rates of the programs helping those with serious mental illness gain control over their lives; (iv) alcohol and drug abuse rates; (v) incarceration and arrest rates; (vi) violence against persons or property; (vii) homelessness; and (viii) total treatment costs for compliance with the program. (E) State and counties with assisted outpatient treatment programs For States and counties with assisted outpatient treatment programs, the information reported under this subsection shall include a comparison of the outcomes of individuals with serious mental illness who participated in the programs versus the outcomes of individuals who did not participate but were eligible to do so by nature of their history. (F) States and counties without AOT programs For States and counties without assisted outpatient treatment programs, the information reported under this subsection shall include data on individuals with mental illness who— (i) have a history of violence, incarceration, and arrests; (ii) have a history of emergency psychiatric hospitalizations; (iii) are substantially unlikely to participate in treatment on their own; (iv) may be unable for reasons other than indigence, to provide for any of their basic needs such as food, clothing, shelter, health or safety; (v) have a history of mental illness or condition that is likely to substantially deteriorate if the individual is not provided with timely treatment; and (vi) due to their mental illness, have a lack of capacity to fully understand or lack judgment, or diminished capacity to make informed decisions, regarding their need for treatment, care, or supervision. (2) Definition In this subsection, the term emergency room boarding means the practice of admitting patients to an emergency department and holding them in the department until inpatient psychiatric beds become available. (d) Reporting compliance study (1) In general The Assistant Secretary for Mental Health and Substance Use Disorders shall enter into an arrangement with the Institute of Medicine of the National Academies (or, if the Institute declines, another appropriate entity) under which, not later than 12 months after the date of enactment of this Act, the Institute will submit to the appropriate committees of Congress a report that evaluates the combined paperwork burden of— (A) community mental health centers meeting the criteria specified in section 1913(c) of the Public Health Service Act ( 42 U.S.C. 300x–2 ), including such centers meeting such criteria as in effect on the day before the date of enactment of this Act; and (B) federally qualified community mental health clinics certified pursuant to section 223 of the Protecting Access to Medicare Act of 2014 ( Public Law 113–93 ), as amended by section 505. (2) Scope In preparing the report under subsection (a), the Institute of Medicine (or, if applicable, other appropriate entity) shall examine licensing, certification, service definitions, claims payment, billing codes, and financial auditing requirements used by the Office of Management and Budget, the Centers for Medicare & Medicaid Services, the Health Resources and Services Administration, the Substance Abuse and Mental Health Services Administration, the Office of the Inspector General of the Department of Health and Human Services, State Medicaid agencies, State departments of health, State departments of education, and State and local juvenile justice and social service agencies to— (A) establish an estimate of the combined nationwide cost of complying with such requirements, in terms of both administrative funding and staff time; (B) establish an estimate of the per capita cost to each center or clinic described in subparagraph (A) or (B) of paragraph (1) to comply with such requirements, in terms of both administrative funding and staff time; and (C) make administrative and statutory recommendations to Congress (which recommendations may include a uniform methodology) to reduce the paperwork burden experienced by centers and clinics described in subparagraph (A) or (B) of paragraph (1). 104. Advisory Council on Graduate Medical Education Section 762(b) of the Public Health Service Act ( 42 U.S.C. 294o(b) ) is amended— (1) by redesignating paragraphs (4) through (6) as paragraphs (5) through (7), respectively; and (2) by inserting after paragraph (3) the following: (4) the Assistant Secretary for Mental Health and Substance Use Disorders; . II Grant reform and restructuring 201. National mental health policy laboratory (a) In general (1) Establishment The Assistant Secretary for Mental Health and Substance Use Disorders shall establish, within the Office of the Assistant Secretary, the National Mental Health Policy Laboratory (in this section referred to as the NMHPL ), to be headed by a Director. (2) Duties The Director of the NMHPL shall— (A) identify, coordinate, and implement policy changes and other trends likely to have the most significant impact on mental health services and monitor their impact; (B) collect information from grantees under programs established or amended by this Act and under other mental health programs under the Public Health Service Act, including grantees that are States receiving funds under a block grant under part B of title XIX of the Public Health Service Act ( 42 U.S.C. 300x et seq. ); (C) evaluate and disseminate to such grantees evidence-based practices and services delivery models using the best available science shown to be cost-effective while enhancing the quality of care furnished to individuals; (D) establish standards for the appointment of scientific peer-review panels to evaluate grant applications; and (E) establish standards for grant programs under subsection (b). (3) Evidence-based practices and service delivery models In selecting evidence-based best practices and service delivery models for evaluation and dissemination under paragraph (2)(C), the Director of the NMHPL— (A) shall give preference to models that improve— (i) the coordination between mental health and physical health providers; (ii) the coordination among such providers and the justice and corrections system; and (iii) the cost effectiveness, quality, effectiveness, and efficiency of health care services furnished to individuals with serious mental illness, in mental health crisis, or at risk to themselves, their families, and the general public; and (B) may include clinical protocols and practices used in the Recovery After Initial Schizophrenia Episode (RAISE) project and the North American Prodrome Longitudinal Study (NAPLS) of the National Institute of Mental Health. (4) Deadline for beginning implementation The Director of the NMHPL shall begin implementation of the duties described in this subsection not later than January 1, 2018. (5) Consultation In carrying out the duties under this subsection, the Director of the NMHPL shall consult with— (A) representatives of the National Institute of Mental Health on organization, hiring decisions, and operations, initially and on an ongoing basis; (B) other appropriate Federal agencies; (C) clinical and analytical experts with expertise in medicine, psychiatric and clinical psychological care, health care management, education, corrections health care, and mental health court systems; and (D) other individuals and agencies as determined appropriate by the Assistant Secretary. (b) Standards for grant programs (1) In general The Director of the NMHPL shall set standards for grant programs administered by the Assistant Secretary, and the Assistant Secretary shall comply with such standards, including standards for— (A) the extent to which the grantee must have the capacity to implement the award; (B) the extent to which the grant plan submitted by the grantee as part of its application must explain how the grantee will help to provide comprehensive community mental health or substance use services to adults with serious mental illness and children with serious emotional disturbances; (C) the extent to which the grantee must identify priorities, as well as strategies and performance indicators to address those priorities for the duration of the grant; (D) the extent to which the grantee must submit statements on the extent to which the grantee is meeting annual program priorities with quantifiable, objective, and scientific targets, measures, and outcomes; (E) the extent to which grantees are expected to collaborate with other child-serving systems such as child welfare, education, juvenile justice, and primary care systems; (F) the extent to which the grantee must collect and report data; (G) the extent to which the grantee must use evidence-based practices and the extent to which those evidence-based practices must be used with respect to a population similar to the population for which the evidence-based practices were shown to be effective; and (H) the extent to which a grantee, when possible, must have a control group. (2) Public disclosure of results The Director of the NMHPL— (A) shall make the standards under paragraph (1), and the Director’s findings on compliance by the Assistant Secretary and grantees with such standards, available to the public in a timely fashion; and (B) may establish requirements for States and other entities receiving funds through grants under programs established or amended by this Act and under other mental health programs under the Public Health Service Act, including under a block grant under part B of title XIX of the Public Health Service Act ( 42 U.S.C. 300x et seq. ), to collect information on evidence-based best practices and services delivery models selected under section 101(c)(2), as the Assistant Secretary determines necessary to monitor and evaluate such models. (c) Staffing (1) Composition In selecting the staff of the NMHPL, the Director of the NMHPL, in consultation with the Director of the National Institute of Mental Health, shall ensure the following: (A) At least 20 percent of the staff shall— (i) have a doctoral degree in medicine or osteopathic medicine and clinical and research experience in psychiatry; (ii) have graduated from an Accreditation Council for Graduate Medical Education-accredited psychiatric residency program; and (iii) have an understanding of biological, psychosocial, and pharmaceutical treatments of mental illness and substance use disorders. (B) At least 20 percent of the staff shall have a doctoral degree in psychology with— (i) clinical and research experience regarding mental illness and substance use disorders; and (ii) an understanding of biological, psychosocial, and pharmaceutical treatments of mental illness and substance use disorders. (C) At least 20 percent of the staff shall be professionals or academics with clinical or research expertise in substance use disorders and treatment. (D) At least 20 percent of the staff shall be professionals or academics with expertise in research design and methodologies. (2) Congressional appointments At least 20 percent, or two, whichever is greater, of the members of the staff of the NMHPL shall be appointed by Congress. (d) Report on quality of care Not later than 1 year after the date of enactment of this Act, and every 2 years thereafter, the Director of the NMHPL shall submit to the Congress a report on the quality of care furnished through grant programs administered by the Assistant Secretary under the respective services delivery models, including measurement of patient-level outcomes and public health outcomes such as— (1) reduced rates of suicide, suicide attempts, substance abuse, overdose, overdose deaths, emergency psychiatric hospitalizations, emergency room boarding, incarceration, crime, arrest, victimization, homelessness, and joblessness; (2) rates of employment and enrollment in educational and vocational programs; and (3) such other criteria as the Director may determine. (e) Definition In this section, the term emergency room boarding means the practice of admitting patients to an emergency department and holding them in the department until inpatient psychiatric beds become available. 202. Innovation grants (a) In general The Assistant Secretary shall award grants to State and local governments, educational institutions, and nonprofit organizations for expanding a model that has been scientifically demonstrated to show promise, but would benefit from further applied research, for— (1) enhancing the screening, diagnosis, and treatment of mental illness and serious mental illness; or (2) integrating or coordinating physical, mental health, and substance use services. (b) Duration A grant under this section shall be for a period of not more than 2 years. (c) Limitations Of the amounts made available for carrying out this section for a fiscal year— (1) not more than one-third shall be awarded for use for primary prevention; and (2) not less than one-third shall be awarded for screening, diagnosis, treatment, or services, as described in subsection (a), for individuals (or subpopulations of individuals) who are below the age of 18 when activities funded through the grant award are initiated. (d) Guidelines As a condition on receipt of an award under this section, an applicant shall agree to adhere to guidelines issued by the National Mental Health Policy Laboratory on research designs and data collection. (e) Termination The Assistant Secretary may terminate any award under this section upon a determination that— (1) the recipient is not providing information requested by the National Mental Health Policy Laboratory or the Assistant Secretary in connection with the award; or (2) there is a clear failure in the effectiveness of the recipient’s programs or activities funded through the award. (f) Reporting As a condition on receipt of an award under this section, an applicant shall agree— (1) to report to the National Mental Health Policy Laboratory and the Assistant Secretary the results of programs and activities funded through the award; and (2) to include in such reporting any relevant data requested by the National Mental Health Policy Laboratory and the Assistant Secretary. (g) Definition In this section, the term primary prevention means prevention that is designed to prevent a disease or condition from occurring among the general population without regard to identifying the presence of risk factors or symptoms in the population. (h) Funding Of the amounts made available to carry out sections 501, 509, 516, and 520A of the Public Health Service Act for a fiscal year, 5 percent of such amounts are authorized to be used to carry out this section. 203. Demonstration grants (a) Grants The Assistant Secretary shall award grants to States, counties, local governments, educational institutions, and private nonprofit organizations for the expansion, replication, or scaling of evidence-based programs across a wider area to enhance effective screening, early diagnosis, intervention, and treatment with respect to mental illness and serious mental illness, primarily by— (1) applied delivery of care, including training staff in effective evidence-based treatment; and (2) integrating models of care across specialties and jurisdictions. (b) Duration A grant under this section shall be for a period of not less than 2 years and not more than 5 years. (c) Limitations Of the amounts made available for carrying out this section for a fiscal year— (1) not less than half shall be awarded for screening, diagnosis, intervention, and treatment, as described in subsection (a), for individuals (or subpopulations of individuals) who are below the age of 26 when activities funded through the grant award are initiated; (2) no amounts shall be made available for any program or project that is not evidence-based; (3) no amounts shall be made available for primary prevention; and (4) no amounts shall be made available solely for the purpose of expanding facilities or increasing staff at an existing program. (d) Guidelines As a condition on receipt of an award under this section, an applicant shall agree to adhere to guidelines issued by the National Mental Health Policy Laboratory on research designs and data collection. (e) Termination The Assistant Secretary may terminate any award under this section upon a determination that— (1) the recipient is not providing information requested by the National Mental Health Policy Laboratory or the Assistant Secretary in connection with the award; or (2) there is a clear failure in the effectiveness of the recipient’s programs or activities funded through the award. (f) Reporting As a condition on receipt of an award under this section, an applicant shall agree— (1) to report to the National Mental Health Policy Laboratory and the Assistant Secretary the results of programs and activities funded through the award; and (2) to include in such reporting any relevant data requested by the National Mental Health Policy Laboratory and the Assistant Secretary. (g) Funding Of the amounts made available to carry out sections 501, 509, 516, and 520A of the Public Health Service Act for a fiscal year, 10 percent of such amounts are authorized to be used to carry out this section. 204. Early childhood intervention and treatment (a) Grants The Director of the National Mental Health Policy Laboratory (in this section referred to as the NMHPL ) shall award— (1) grants to eligible entities to initiate and undertake, for eligible children, early childhood intervention and treatment programs, and specialized preschool and elementary school programs, with the goal of preventing chronic and serious mental illness; (2) grants to not more than 3 eligible entities for studying the longitudinal outcomes of programs funded under paragraph (1) on eligible children who were treated 5 or more years prior to the enactment of this Act; and (3) ensure that programs and activities funded through grants under this subsection are based on a sound scientific model that shows evidence and promise and can be replicated in other settings. (b) Eligible entities and children In this section: (1) Eligible entity The term eligible entity means a nonprofit institution that— (A) is duly accredited by State mental health and education agencies, as applicable, for the treatment and education of children from 1 to 10 years of age; and (B) provides services that include early childhood intervention and specialized preschool and elementary school programs focused on children whose primary need is a social or emotional disability (in addition to any learning disability). (2) Eligible child The term eligible child means a child who is at least 0 years old and not more than 12 years old— (A) whose primary need is a social and emotional disability (in addition to any learning disability); (B) who is at risk of developing serious mental illness and/or may show early signs of mental illness; and (C) who could benefit from early childhood intervention and specialized preschool or elementary school programs with the goal of preventing or treating chronic and serious mental illness. (c) Application An eligible entity seeking a grant under subsection (a) shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require. (d) Use of funds for early childhood intervention and treatment programs An eligible entity shall use amounts awarded under a grant under subsection (a)(1) to carry out the following activities: (1) Deliver (or facilitate) for eligible children treatment and education, early childhood intervention, and specialized preschool and elementary school programs, including the provision of medically based child care and early education services. (2) Treat and educate eligible children, including startup, curricula development, operating and capital needs, staff and equipment, assessment and intervention services, administration and medication requirements, enrollment costs, collaboration with primary care physicians and psychiatrists, other related services to meet emergency needs of children, and communication with families and medical professionals concerning the children. (3) Develop and implement other strategies to address identified treatment and educational needs of eligible children that have reliable and valid evaluation modalities built into assess outcomes based on sound scientific metrics as determined by the NMHPL. (e) Use of funds for longitudinal study In conducting a study on longitudinal outcomes through a grant under subsection (a)(2), an eligible entity shall include an analysis of— (1) the individuals treated and educated; (2) the success of such treatment and education in avoiding the onset of serious mental illness or the preparation of such children for the care and management of serious mental illness; (3) any evidence-based best practices generally applicable as a result of such treatment and educational techniques used with such children; and (4) the ability of programs to be replicated as a best practice model of intervention. (f) Requirements In carrying out this section, the Secretary shall ensure that each entity receiving a grant under subsection (a) maintains a written agreement with the Secretary, and provides regular written reports, as required by the Secretary, regarding the quality, efficiency, and effectiveness of intervention and treatment for eligible children preventing or treating the development and onset of serious mental illness. (g) Amount of awards (1) Amounts for early childhood intervention and treatment programs The amount of an award to an eligible entity under subsection (a)(1) shall be not more than $600,000 per fiscal year. (2) Amounts for longitudinal study The total amount of an award to an eligible entity under subsection (a)(2) (for one or more fiscal years) shall be not less than $1,000,000 and not greater than $2,000,000. (h) Project terms The period of a grant— (1) for awards under subsection (a)(1), shall be not less than 3 fiscal years and not more than 10 fiscal years; and (2) for awards under subsection (a)(2), shall be not more than 5 fiscal years. (i) Matching funds The Director of the NMHPL may not award a grant under this section to an eligible entity unless the eligible entity agrees, with respect to the costs to be incurred by the eligible entity in carrying out the activities described in subparagraph (D), to make available non-Federal contributions (in cash or in kind) toward such costs in an amount equal to not less than 10 percent of Federal funds provided in the grant. (j) Definitions In this section: (1) The term emergency room boarding means the practice of admitting patients to an emergency department and holding them in the department until inpatient psychiatric beds become available. (2) The term primary prevention means prevention that is designed to prevent a disease or condition from occurring among the general population without regard to identifying the presence of risk factors or symptoms in the population. (k) Funding Of the amounts made available to carry out part E of title V of the Public Health Service Act ( 42 U.S.C. 290ff et seq. ) for each of fiscal years 2016 through 2021, not more than 5 percent of such amounts are authorized to be appropriated to carry out this section. 205. Extension of assisted outpatient treatment grant program for individuals with serious mental illness Section 224 of the Protecting Access to Medicare Act of 2014 ( 42 U.S.C. 290aa note) is amended— (1) in subsection (e), by striking and 2018 and inserting 2018, 2019, and 2020 ; and (2) in subsection (g)— (A) in paragraph (1), by striking 2018 and inserting 2020 ; (B) in paragraph (2)— (i) by striking $15,000,000 and inserting $20,000,000 ; and (ii) by striking 2018 and inserting 2020 ; and (C) by adding at the end the following: (3) Allocation Of the funds made available to carry out this section for a fiscal year, the Secretary shall allocate— (A) 20 percent of such funds for existing assisted outpatient treatment programs; and (B) 80 percent of such funds for new assisted outpatient treatment programs. . 206. Block grants (a) Best practices in clinical care models Section 1920 of the Public Health Service Act ( 42 U.S.C. 300x–9 ) is amended by adding at the end the following: (c) Best practices in clinical care models The Secretary, acting through the Director of the National Institute of Mental Health, shall obligate 5 percent of the amounts appropriated for a fiscal year under subsection (a) for translating evidence-based (as defined in section 2 of the Helping Families in Mental Health Crisis Act of 2015 ) interventions and best available science into systems of care, such as through models including— (1) the Recovery After an Initial Schizophrenia Episode research project of the National Institute of Mental Health; and (2) the North American Prodrome Longitudinal Study. . (b) Administration of block grants by Assistant Secretary Section 1911(a) of the Public Health Service Act ( 42 U.S.C. 300x ) is amended by striking acting through the Director of the Center for Mental Health Services and inserting acting through the Assistant Secretary for Mental Health and Substance Use Disorders . (c) Additional program requirements (1) Integrated services Subsection (b)(1) of section 1912 of the Public Health Service Act ( 42 U.S.C. 300x–1(b)(1) ) is amended— (A) by striking The plan provides and inserting: (A) The plan provides ; (B) in the subparagraph (A) inserted by paragraph (1), in the second sentence, by striking health and mental health services and inserting integrated physical and mental health services ; (C) in such subparagraph (A), by striking The plan shall include through the period at the end and inserting The plan shall integrate and coordinate services to maximize the efficiency, effectiveness, quality, coordination, and cost effectiveness of those services and programs to produce the best possible outcomes for those with serious mental illness. ; and (D) by adding at the end the following new subparagraph: (B) The plan shall include a separate description of case management services and provide for activities leading to reduction of rates of suicides, suicide attempts, substance abuse, overdose deaths, emergency hospitalizations, incarceration, crimes, arrest, victimization, homelessness, joblessness, medication nonadherence, and education and vocational programs drop outs. The plan must also include a detailed list of services available for eligible patients (as defined in subsection (d)(3)) in each county or county equivalent, including assisted outpatient treatment. . (2) Data collection system Subsection (b)(2) of section 1912 of the Public Health Service Act ( 42 U.S.C. 300x–1(b)(2) ) is amended— (A) by striking The plan contains an estimate of and inserting the following: The plan contains— (A) an estimate of ; (B) in subparagraph (A), as inserted by paragraph (1), by inserting , including reductions in homelessness, emergency hospitalization, incarceration, and unemployment for eligible patients (as defined in subsection (d)(3)), after targets ; (C) in such subparagraph, by striking the period at the end and inserting ; and ; and (D) by adding at the end the following new subparagraph: (B) an agreement by the State to report to the National Mental Health Policy Laboratory such data as may be required by the Secretary concerning— (i) comprehensive community mental health services in the State; and (ii) public health outcomes for persons with serious mental illness in the State, including rates of suicides, suicide attempts, substance abuse, overdose deaths, emergency hospitalizations, incarceration, crimes, arrest, victimization, homelessness, joblessness, medication non-adherence, and education and vocational programs drop outs. . (3) Implementation of plan Subsection (d) of section 1912 of the Public Health Service Act ( 42 U.S.C. 300x–1(d) ) is amended— (A) in paragraph (1)— (i) by striking Except as provided and inserting: (A) Except as provided ; and (ii) by adding at the end the following new subparagraph: (B) For eligible patients receiving treatment through funds awarded under a grant under section 1911, a State shall include in the State plan for the first year beginning after the date of the enactment of this subparagraph and each subsequent year, a de-individualized report, containing information that is open source and de-identified, on the services provided to those individuals, including— (i) outcomes and the overall cost of such treatment provided; and (ii) county or county equivalent level data on such patient population, including overall costs and raw number data on rates of involuntary inpatient and outpatient commitment orders, suicides, suicide attempts, substance abuse, overdose deaths, emergency hospitalizations, incarceration, crimes, arrest, victimization, homelessness, joblessness, medication non-adherence, and education and vocational programs drop outs. ; and (B) by adding at the end the following new paragraph: (3) Definition In this subsection, the term eligible patient means an adult mentally ill person who— (A) may have a history of violence, incarceration, or medically unnecessary hospitalizations; (B) without supervision and treatment, may be a danger to self or others in the community; (C) is substantially unlikely to voluntarily participate in treatment; (D) may be unable, for reasons other than indigence, to provide for any of the basic needs of such person, such as food, clothing, shelter, health, or safety; (E) with a history of mental illness or condition that is likely to substantially deteriorate if the person is not provided with timely treatment; (F) due to mental illness, lacks capacity to fully understand or lacks judgment to make informed decisions regarding his or her need for treatment, care, or supervision; and (G) is likely to improve in mental health and reduce the symptoms of serious mental illness when in treatment. . (4) Treatment under State law (A) In general Section 1912 of the Public Health Service Act ( 42 U.S.C. 300x–1 ) is amended by adding at the end the following new subsections: (e) Assisted outpatient treatment under State law (1) In general A funding agreement for a grant under section 1911 is that the State involved has in effect a law under which a State court may order a treatment plan for an eligible patient that— (A) requires such patient to obtain outpatient mental health treatment while the patient is living in a community; and (B) is designed to improve access and adherence by such patient to intensive behavioral health services in order to— (i) avert relapse, repeated hospitalizations, arrest, incarceration, suicide, property destruction, and violent behavior; and (ii) provide such patient with the opportunity to live in a less restrictive alternative to incarceration or involuntary hospitalization. (2) Certification of State compliance A funding agreement described in paragraph (1) is effective only if the Assistant Secretary for Mental Health and Substance Use Disorders reviews the State law and certifies that it satisfies the criteria specified in such paragraph. (f) Treatment standard under State law (1) In general A funding agreement for a grant under section 1911 is that— (A) the State involved has in effect a law under which, if a State court finds by clear and convincing evidence that an individual, as a result of mental illness, is a danger to self, is a danger to others, is persistently or acutely disabled, or is gravely disabled and in need of treatment, and is either unwilling or unable to accept voluntary treatment, the court must order the individual to undergo inpatient or outpatient treatment; or (B) the State involved has in effect a law under which a State court must order an individual with a mental illness to undergo inpatient or outpatient treatment, the law was in effect on the date of enactment of the Helping Families in Mental Health Crisis Act of 2015 , and the Secretary finds that the law requires a State court to order such treatment across all or a sufficient range of the type of circumstances described in subparagraph (A). (2) Definition For purposes of paragraph (1), the term persistently or acutely disabled refers to a serious mental illness that meets all the following criteria: (A) If not treated, the illness has a substantial probability of causing the individual to suffer or continue to suffer severe and abnormal mental, emotional, or physical harm that significantly impairs judgment, reason, behavior, or capacity to recognize reality. (B) The illness substantially impairs the individual’s capacity to make an informed decision regarding treatment, and this impairment causes the individual to be incapable of understanding and expressing an understanding of the advantages and disadvantages of accepting treatment and understanding and expressing an understanding of the alternatives to the particular treatment offered after the advantages, disadvantages, and alternatives are explained to that individual. (C) The illness has a reasonable prospect of being treatable by outpatient, inpatient, or combined inpatient and outpatient treatment. . (B) Funding increase Section 1918 of the Public Health Service Act ( 42 U.S.C. 300x–7 ) is amended— (i) in subsection (a)(1), by striking subsection (b) and inserting subsections (b) and (d) ; and (ii) by adding at the end the following new subsection: (d) Increase for certain States With respect to fiscal year 2016 and each subsequent fiscal year, in the case of a State that has in effect a law described in subsection (e)(1) or subparagraph (A) or (B) of subsection (f)(1), the amount of the allotment of a State under section 1911 shall be for such fiscal year the amount that would otherwise be determined, without application of this subsection, for such State for such fiscal year, increased by 2 percent. . (5) Evidence-based services delivery models Section 1912 of the Public Health Service Act ( 42 U.S.C. 300x–1 ), as amended by paragraph (4), is further amended by adding at the end the following new subsection: (g) Expansion of models (1) In general Taking into account the results of evaluations under section 201(a)(2)(C) of the Helping Families in Mental Health Crisis Act of 2015, the Assistant Secretary may, by rule, as part of the program of block grants under this subpart, provide for expanded use across the Nation of evidence-based service delivery models by providers funded under such block grants, so long as— (A) the Assistant Secretary for Mental Health and Substance Use Disorders (in this subsection referred to as the Assistant Secretary ) determines that such expansion will— (i) result in more effective use of funds under such block grants without reducing the quality of care; or (ii) improve the quality of patient care without significantly increasing spending; (B) the Director of the National Institute of Mental Health determines that such expansion would improve the quality of patient care; and (C) the Assistant Secretary determines that the change will— (i) significantly reduce severity and duration of symptoms of mental illness; (ii) reduce rates of suicide, suicide attempts, substance abuse, overdose, emergency hospitalizations, emergency room boarding, incarceration, crime, arrest, victimization, homelessness, or joblessness; or (iii) significantly improve the quality of patient care and mental health crisis outcomes without significantly increasing spending. (2) Congressional review Any rule promulgated pursuant to paragraph (1) is deemed to be a major rule subject to congressional review and disapproval under chapter 8 of title 5, United States Code. (3) Definition In this subsection, the term emergency room boarding means the practice of admitting patients to an emergency department and holding them in the department until inpatient psychiatric beds become available. . (d) Period for expenditure of grant funds Section 1913 of the Public Health Service Act ( 42 U.S.C. 300x–2 ), as amended, is further amended by adding at the end the following: (d) Period for expenditure of grant funds In implementing a plan submitted under section 1912(a), a State receiving grant funds under section 1911 may make such funds available to providers of services described in subsection (b) for the provision of services without fiscal year limitation. . (e) Active outreach and engagement Section 1915 of the Public Health Service Act ( 42 U.S.C. 300x–4 ) is amended by adding at the end of the following: (c) Active Outreach and Engagement to Persons with Serious Mental Illness A funding agreement for a grant under section 1911 is that the State involved has in effect active programs, including assisted outpatient treatment, to engage persons with serious mental illness who are substantially unlikely to voluntarily seek treatment, in comprehensive services in order to avert relapse, repeated hospitalizations, arrest, incarceration, and suicide to provide the patient with the opportunity to live in the community through evidence-based (as defined in section 2 of the Helping Families in Mental Health Crisis Act of 2015 ) assertive outreach and engagement services targeting individuals that are homeless, have co-occurring disorders, or have a history of treatment failure. The Assistant Secretary for Mental Health and Substance Use Disorders shall work with the Director of the National Institute of Mental Health to develop a list of such evidence-based (as defined in section 2 of the Helping Families in Mental Health Crisis Act of 2015 ) assertive outreach and engagement services, as well as criteria to be used to assess the scope and effectiveness of such approaches. These programs may include assistant outpatient treatment programs under State law where State courts may order a treatment plan for an eligible patient that requires— (1) such patient to obtain outpatient mental health treatment while the patient is living in the community; and (2) a design to improve access and adherence by such patient to intensive mental health services. . 207. Workforce development (a) Telepsychiatry and primary care physician training grant program (1) In general The Assistant Secretary of Mental Health and Substance Use Disorders (in this subsection referred to as the Assistant Secretary ) shall establish a grant program (in this subsection referred to as the grant program ) under which the Assistant Secretary shall award to 10 eligible States (as described in paragraph (5)) grants for carrying out all of the purposes described in paragraphs (2), (3), and (4). (2) Training program for certain primary care physicians For purposes of paragraph (1), the purpose described in this paragraph, with respect to a grant awarded to a State under the grant program, is for the State to establish a training program to train primary care physicians in— (A) valid and reliable behavioral-health screening tools for violence and suicide risk, early signs of serious mental illness, and untreated substance abuse, including any standardized behavioral-health screening tools that are determined appropriate by the Assistant Secretary; (B) implementing the use of behavioral-health screening tools in their practices; (C) establishment of recommended intervention and treatment protocols for individuals in mental health crisis, especially for individuals whose illness makes them less receptive to mental health services; and (D) implementing the evidence-based collaborative care model of integrated medical-behavioral health care in their practices. (3) Payments for mental health services provided by certain primary care physicians (A) In general For purposes of paragraph (1), the purpose described in this paragraph, with respect to a grant awarded to a State under the grant program, is for the State to provide, in accordance with this paragraph, in the case of a primary care physician who participates in the training program of the State establish pursuant to paragraph (2), payments to the primary care physician for services furnished by the primary care physician. (B) Considerations The Assistant Secretary, in determining the structure, quality, and form of payment under subparagraph (A) shall seek to find innovative payment systems which may take into account— (i) the nature and quality of services rendered; (ii) the patients’ health outcome; (iii) the geographical location where services were provided; (iv) the acuteness of the patient’s medical condition; (v) the duration of services provided; (vi) the feasibility of replicating the payment model in other locations nationwide; and (vii) proper triage and enduring linkage to appropriate treatment provider for subspecialty care in child or forensic issues; family crisis intervention; drug or alcohol rehabilitation; management of suicidal or violent behavior risk, and treatment for serious mental illness. (4) Telehealth services for mental health disorders (A) In general For purposes of paragraph (1), the purpose described in this paragraph, with respect to a grant awarded to a State under the grant program, is for the State to provide, in the case of an individual furnished items and services by a primary care physician during an office visit, for payment for a consultation provided by a psychiatrist or psychologist to such physician with respect to such individual through the use of qualified telehealth technology for the identification, diagnosis, mitigation, or treatment of a mental health disorder if such consultation occurs not later than the first business day that follows such visit. (B) Qualified telehealth technology For purposes of subparagraph (A), the term qualified telehealth technology , with respect to the provision of items and services to a patient by a health care provider, includes the use of interactive audio, audio-only telephone conversation, video, or other telecommunications technology by a health care provider to deliver health care services within the scope of the provider’s practice at a site other than the site where the patient is located, including the use of electronic media for consultation relating to the health care diagnosis or treatment of the patient. (5) Eligible State (A) In general For purposes of this subsection, an eligible State is a State that has submitted to the Assistant Secretary an application under subparagraph (B) and has been selected under subparagraph (D). (B) Application A State seeking to participate in the grant program under this subsection shall submit to the Assistant Secretary, at such time and in such format as the Assistant Secretary requires, an application that includes such information, provisions, and assurances as the Assistant Secretary may require. (C) Matching requirement The Assistant Secretary may not make a grant under the grant program unless the State involved agrees, with respect to the costs to be incurred by the State in carrying out the purposes described in this subsection, to make available non-Federal contributions (in cash or in kind) toward such costs in an amount equal to not less than 20 percent of Federal funds provided in the grant. (D) Selection A State shall be determined eligible for the grant program by the Assistant Secretary on a competitive basis among States with applications meeting the requirements of subparagraphs (B) and (C). In selecting State applications for the grant program, the Secretary shall seek to achieve an appropriate national balance in the geographic distribution of grants awarded under the grant program. (6) Target population In seeking a grant under this subsection, a State shall demonstrate how the grant will improve care for individuals with co-occurring behavioral health and physical health conditions, vulnerable populations, socially isolated populations, rural populations, and other populations who have limited access to qualified mental health providers. (7) Length of grant program The grant program under this subsection shall be conducted for a period of 3 consecutive years. (8) Public availability of findings and conclusions Subject to Federal privacy protections with respect to individually identifiable information, the Assistant Secretary shall make the findings and conclusions resulting from the grant program under this subsection available to the public. (9) Authorization of appropriations Out of any funds in the Treasury not otherwise appropriated, there is authorized to be appropriated to carry out this subsection, $3,000,000 for each of the fiscal years 2016 through 2020. (10) Reports (A) Reports For each fiscal year that grants are awarded under this subsection, the Assistant Secretary and the National Mental Health Policy Laboratory shall conduct a study on the results of the grants and submit to the Congress a report on such results that includes the following: (i) An evaluation of the grant program outcomes, including a summary of activities carried out with the grant and the results achieved through those activities. (ii) Recommendations on how to improve access to mental health services at grantee locations. (iii) An assessment of access to mental health services under the program. (iv) An assessment of the impact of the demonstration project on the costs of the full range of mental health services (including inpatient, emergency and ambulatory care). (v) Recommendations on congressional action to improve the grant. (vi) Recommendations to improve training of primary care physicians. (B) Report Not later than December 31, 2018, the Assistant Secretary and the National Mental Health Policy Laboratory shall submit to Congress and make available to the public a report on the findings of the evaluation under subparagraph (A) and also a policy outline on how Congress can expand the grant program to the national level. (b) Liability protections for health care professional volunteers at community health centers and federally qualified community behavioral health clinics Section 224 of the Public Health Service Act ( 42 U.S.C. 233 ) is amended by adding at the end the following: (q) (1) In this subsection, the term federally qualified community behavioral health clinic means— (A) a federally qualified community behavioral health clinic with a certification in effect under section 223 of the Protecting Access to Medicare Act of 2014; or (B) a community mental health center meeting the criteria specified in section 1913(c) of this Act. (2) For purposes of this section, a health care professional volunteer at an entity described in subsection (g)(4) or a federally qualified community behavioral health clinic shall, in providing health care services eligible for funding under section 330 or subpart I of part B of title XIX to an individual, be deemed to be an employee of the Public Health Service for a calendar year that begins during a fiscal year for which a transfer was made under paragraph (5)(C). The preceding sentence is subject to the provisions of this subsection. (3) In providing a health care service to an individual, a health care professional shall for purposes of this subsection be considered to be a health professional volunteer at an entity described in subsection (g)(4) or at a federally qualified community behavioral health clinic if the following conditions are met: (A) The service is provided to the individual at the facilities of an entity described in subsection (g)(4), at a federally qualified community behavioral health clinic, or through offsite programs or events carried out by the center. (B) The center or entity is sponsoring the health care professional volunteer pursuant to paragraph (4)(B). (C) The health care professional does not receive any compensation for the service from the individual or from any third-party payer (including reimbursement under any insurance policy or health plan, or under any Federal or State health benefits program), except that the health care professional may receive repayment from the entity described in subsection (g)(4) or the center for reasonable expenses incurred by the health care professional in the provision of the service to the individual. (D) Before the service is provided, the health care professional or the center or entity described in subsection (g)(4) posts a clear and conspicuous notice at the site where the service is provided of the extent to which the legal liability of the health care professional is limited pursuant to this subsection. (E) At the time the service is provided, the health care professional is licensed or certified in accordance with applicable law regarding the provision of the service. (4) Subsection (g) (other than paragraphs (3) and (5)) and subsections (h), (i), and (l) apply to a health care professional for purposes of this subsection to the same extent and in the same manner as such subsections apply to an officer, governing board member, employee, or contractor of an entity described in subsection (g)(4), subject to paragraph (5) and subject to the following: (A) The first sentence of paragraph (2) applies in lieu of the first sentence of subsection (g)(1)(A). (B) With respect to an entity described in subsection (g)(4) or a federally qualified community behavioral health clinic, a health care professional is not a health professional volunteer at such center unless the center sponsors the health care professional. For purposes of this subsection, the center shall be considered to be sponsoring the health care professional if— (i) with respect to the health care professional, the center submits to the Secretary an application meeting the requirements of subsection (g)(1)(D); and (ii) the Secretary, pursuant to subsection (g)(1)(E), determines that the health care professional is deemed to be an employee of the Public Health Service. (C) In the case of a health care professional who is determined by the Secretary pursuant to subsection (g)(1)(E) to be a health professional volunteer at such center, this subsection applies to the health care professional (with respect to services described in paragraph (2)) for any cause of action arising from an act or omission of the health care professional occurring on or after the date on which the Secretary makes such determination. (D) Subsection (g)(1)(F) applies to a health professional volunteer for purposes of this subsection only to the extent that, in providing health services to an individual, each of the conditions specified in paragraph (3) is met. (5) (A) Amounts in the fund established under subsection (k)(2) shall be available for transfer under subparagraph (C) for purposes of carrying out this subsection for health professional volunteers at entities described in subsection (g)(4). (B) Not later than May 1 of each fiscal year, the Attorney General, in consultation with the Secretary, shall submit to the Congress a report providing an estimate of the amount of claims (together with related fees and expenses of witnesses) that, by reason of the acts or omissions of health care professional volunteers, will be paid pursuant to this subsection during the calendar year that begins in the following fiscal year. Subsection (k)(1)(B) applies to the estimate under the preceding sentence regarding health care professional volunteers to the same extent and in the same manner as such subsection applies to the estimate under such subsection regarding officers, governing board members, employees, and contractors of entities described in subsection (g)(4). (C) Not later than December 31 of each fiscal year, the Secretary shall transfer from the fund under subsection (k)(2) to the appropriate accounts in the Treasury an amount equal to the estimate made under subparagraph (B) for the calendar year beginning in such fiscal year, subject to the extent of amounts in the fund. (6) (A) This subsection takes effect on October 1, 2017, except as provided in subparagraph (B). (B) Effective on the date of the enactment of this subsection— (i) the Secretary may issue regulations for carrying out this subsection, and the Secretary may accept and consider applications submitted pursuant to paragraph (4)(B); and (ii) reports under paragraph (5)(B) may be submitted to the Congress. . (c) Minority Fellowship Program Title V of the Public Health Service Act ( 42 U.S.C. 290aa et seq. ), as amended, is further amended by adding at the end the following: K Minority Fellowship Program 597. Fellowships (a) In general The Secretary shall maintain a program, to be known as the Minority Fellowship Program, under which the Secretary awards fellowships, which may include stipends, for the purposes of— (1) increasing behavioral health practitioners’ knowledge of issues related to prevention, treatment, and recovery support for mental and substance use disorders among racial and ethnic minority populations; (2) improving the quality of mental and substance use disorder prevention and treatment delivered to ethnic minorities; and (3) increasing the number of culturally competent behavioral health professionals who teach, administer, conduct services research, and provide direct mental health or substance use services to underserved minority populations. (b) Training covered The fellowships under subsection (a) shall be for postbaccalaureate training (including for master’s and doctoral degrees) for mental health professionals, including in the fields of psychiatry, nursing, social work, psychology, marriage and family therapy, and substance use and addiction counseling. (c) Authorization of appropriations To carry out this section, there are authorized to be appropriated $6,000,000 for each of fiscal years 2016 through 2020. . (d) National Health Service Corps (1) Definitions (A) Primary health services Section 331(a)(3)(D) of the Public Health Service Act ( 42 U.S.C. 254d(a)(3) ) is amended by inserting (including pediatric mental health subspecialty services) after pediatrics . (B) Behavioral and mental health professionals Clause (i) of section 331(a)(3)(E)(i) of the Public Health Service Act ( 42 U.S.C. 254d(a)(3)(E)(i) ) is amended by inserting (and pediatric subspecialists thereof) before the period at the end. (C) Health professional shortage area Section 332(a)(1) of the Public Health Service Act is amended by inserting (including children and adolescents) after population group . (D) Medical facility Section 332(a)(2)(A) of the Public Health Service Act is amended by inserting medical residency or fellowship training site for training in child and adolescent psychiatry, before facility operated by a city or county health department, . (2) Eligibility To participate in loan repayment program Section 338A(b)(1)(B) of the Public Health Service Act ( 42 U.S.C. 254l–1(b)(1)(B) ) is amended by inserting , including any physician child and adolescent psychiatry residency or fellowship training program after be enrolled in an approved graduate training program in medicine, osteopathic medicine, dentistry, behavioral and mental health, or other health profession . (e) Crisis Intervention Grants for Police Officers and First Responders (1) Grants The Assistant Secretary may award grants to provide specialized training to law enforcement officers, corrections officers, paramedics, emergency medical services workers, and other first responders (including village public safety officers (as defined in section 247 of the Indian Arts and Crafts Amendments Act of 2010 ( 42 U.S.C. 3796dd note)))— (A) to recognize individuals who have mental illness and how to properly intervene with individuals with mental illness; and (B) to establish programs that enhance the ability of law enforcement agencies to address the mental health, behavioral, and substance use problems of individuals encountered in the line of duty. (2) Funding Of the amounts made available to carry out sections 501, 509, 516, and 520A of the Public Health Service Act for a fiscal year, 5 percent of such amounts are authorized to be used to carry out this subsection. 208. Authorized grants and programs (a) Children’s recovery from trauma Section 582 of the Public Health Service Act ( 42 U.S.C. 290hh–1 ) is amended— (1) in subsection (a), by striking developing programs and all that follows and inserting the following: developing and maintaining programs that provide for— (1) the continued operation of the National Child Traumatic Stress Initiative (referred to in this section as the NCTSI ), which includes a coordinating center, that focuses on the mental, behavioral, and biological aspects of psychological trauma response; and (2) the development of knowledge with regard to evidence-based (as defined in section 2 of the Helping Families in Mental Health Crisis Act of 2015 ) practices for identifying and treating mental, behavioral, and biological disorders of children and youth resulting from witnessing or experiencing a traumatic event. ; (2) in subsection (b)— (A) by striking subsection (a) related and inserting subsection (a)(2) (related ; (B) by striking treating disorders associated with psychological trauma and inserting treating mental, behavioral, and biological disorders associated with psychological trauma) ; and (C) by striking mental health agencies and programs that have established clinical and basic research and inserting universities, hospitals, mental health agencies, and other programs that have established clinical expertise and research ; (3) by redesignating subsections (c) through (g) as subsections (g) through (k), respectively; (4) by inserting after subsection (b), the following: (c) Child outcome data The NCTSI coordinating center shall collect, analyze, and report NCTSI-wide child treatment process and outcome data regarding the early identification and delivery of evidence-based (as defined in section 2 of the Helping Families in Mental Health Crisis Act of 2015 ) treatment and services for children and families served by the NCTSI grantees. (d) Training The NCTSI coordinating center shall facilitate the coordination of training initiatives in evidence-based (as defined in section 2 of the Helping Families in Mental Health Crisis Act of 2015 ) and trauma-informed treatments, interventions, and practices offered to NCTSI grantees, providers, and partners. (e) Dissemination The NCTSI coordinating center shall, as appropriate, collaborate with the Secretary in the dissemination of evidence-based and trauma-informed interventions, treatments, products, and other resources to appropriate stakeholders. (f) Review The Secretary shall, consistent with the peer-review process, ensure that NCTSI applications are reviewed by appropriate experts in the field as part of a consensus review process. The Secretary shall include review criteria related to expertise and experience in child trauma and evidence-based (as defined in section 2 of the Helping Families in Mental Health Crisis Act of 2015 ) practices. ; (5) in subsection (g) (as so redesignated), by striking with respect to centers of excellence are distributed equitably among the regions of the country and inserting are distributed equitably among the regions of the United States ; (6) in subsection (i) (as so redesignated), by striking recipient may not exceed 5 years and inserting recipient shall not be less than 4 years, but shall not exceed 5 years ; and (7) in subsection (j) (as so redesignated), by striking $50,000,000 and all that follows through 2006 and inserting $45,713,000 for each of fiscal years 2014 through 2018 . (b) Reducing the stigma of serious mental illness (1) In general The Secretary of Education, along with the Assistant Secretary for Mental Health and Substance Use Disorders, shall organize a national awareness campaign involving public health organizations, advocacy groups for persons with serious mental illness, and social media companies to assist secondary school students and postsecondary students in— (A) reducing the stigma associated with serious mental illness; (B) understanding how to assist an individual who is demonstrating signs of a serious mental illness; and (C) understanding the importance of seeking treatment from a physician, clinical psychologist, or licensed mental health professional when a student believes the student may be suffering from a serious mental illness or behavioral health disorder. (2) Data collection The Secretary of Education shall— (A) evaluate the program under subsection (a) on public health to determine whether the program has made an impact on public health, including mortality rates of persons with serious mental illness, prevalence of serious mental illness, physician and clinical psychological visits, emergency room visits; and (B) submit a report on the evaluation to the National Mental Health Policy Laboratory created by title I of this Act. (3) Secondary school defined For purposes of this section, the term secondary school has the meaning given the term in section 9101 of the Elementary and Secondary Education Act of 1965 ( 20 U.S.C. 7801 ). (c) Garrett Lee Smith Reauthorization (1) Suicide prevention technical assistance center Section 520C of the Public Health Service Act ( 42 U.S.C. 290bb–34 ) is amended to read as follows: 520C. Suicide prevention technical assistance center (a) Program authorized The Assistant Secretary for Mental Health and Substance Use Disorders shall award a grant for the operation and maintenance of a research, training, and technical assistance resource center to provide appropriate information, training, and technical assistance to States, political subdivisions of States, federally recognized Indian tribes, tribal organizations, institutions of higher education, public organizations, or private nonprofit organizations concerning the prevention of suicide among all ages, particularly among groups that are at high risk for suicide. (b) Responsibilities of the center The center operated and maintained under subsection (a) shall— (1) assist in the development or continuation of statewide and tribal suicide early intervention and prevention strategies for all ages, particularly among groups that are at high risk for suicide; (2) ensure the surveillance of suicide early intervention and prevention strategies for all ages, particularly among groups that are at high risk for suicide; (3) study the costs and effectiveness of statewide and tribal suicide early intervention and prevention strategies in order to provide information concerning relevant issues of importance to State, tribal, and national policymakers; (4) further identify and understand causes and associated risk factors for suicide for all ages, particularly among groups that are at high risk for suicide; (5) analyze the efficacy of new and existing suicide early intervention and prevention techniques and technology for all ages, particularly among groups that are at high risk for suicide; (6) ensure the surveillance of suicidal behaviors and nonfatal suicidal attempts; (7) study the effectiveness of State-sponsored statewide and tribal suicide early intervention and prevention strategies for all ages particularly among groups that are at high risk for suicide on the overall wellness and health promotion strategies related to suicide attempts; (8) promote the sharing of data regarding suicide with Federal agencies involved with suicide early intervention and prevention, and State-sponsored statewide and tribal suicide early intervention and prevention strategies for the purpose of identifying previously unknown mental health causes and associated risk factors for suicide among all ages particularly among groups that are at high risk for suicide; (9) evaluate and disseminate outcomes and best practices of mental health and substance use disorder services at institutions of higher education; and (10) conduct other activities determined appropriate by the Secretary. (c) Authorization of appropriations For the purpose of carrying out this section, there are authorized to be appropriated $4,957,000 for each of the fiscal years 2016 through 2020. . (2) Youth suicide intervention and prevention strategies Section 520E of the Public Health Service Act ( 42 U.S.C. 290bb–36 ) is amended to read as follows: 520E. Youth suicide early intervention and prevention strategies (a) In general The Secretary, acting through the Assistant Secretary, shall award grants or cooperative agreements to eligible entities to— (1) develop and implement State-sponsored statewide or tribal youth suicide early intervention and prevention strategies in schools, educational institutions, juvenile justice systems, substance use disorder programs, mental health programs, foster care systems, and other child and youth support organizations; (2) support public organizations and private nonprofit organizations actively involved in State-sponsored statewide or tribal youth suicide early intervention and prevention strategies and in the development and continuation of State-sponsored statewide youth suicide early intervention and prevention strategies; (3) provide grants to institutions of higher education to coordinate the implementation of State-sponsored or tribal youth suicide early intervention and prevention strategies; (4) collect and analyze data on State-sponsored statewide or tribal youth suicide early intervention and prevention services that can be used to monitor the effectiveness of such services and for research, technical assistance, and policy development; and (5) assist eligible entities, through State-sponsored statewide or tribal youth suicide early intervention and prevention strategies, in achieving targets for youth suicide reductions under title V of the Social Security Act . (b) Eligible entity (1) Definition In this section, the term eligible entity means— (A) a State; (B) a public organization or private nonprofit organization designated by a State to develop or direct the State-sponsored statewide youth suicide early intervention and prevention strategy; or (C) a federally recognized Indian tribe or tribal organization (as defined in the Indian Self-Determination and Education Assistance Act ) or an urban Indian organization (as defined in the Indian Health Care Improvement Act ) that is actively involved in the development and continuation of a tribal youth suicide early intervention and prevention strategy. (2) Limitation In carrying out this section, the Secretary shall ensure that a State does not receive more than one grant or cooperative agreement under this section at any one time. For purposes of the preceding sentence, a State shall be considered to have received a grant or cooperative agreement if the eligible entity involved is the State or an entity designated by the State under paragraph (1)(B). Nothing in this paragraph shall be construed to apply to entities described in paragraph (1)(C). (c) Preference In providing assistance under a grant or cooperative agreement under this section, an eligible entity shall give preference to public organizations, private nonprofit organizations, political subdivisions, institutions of higher education, and tribal organizations actively involved with the State-sponsored statewide or tribal youth suicide early intervention and prevention strategy that— (1) provide early intervention and assessment services, including screening programs, to youth who are at risk for mental or emotional disorders that may lead to a suicide attempt, and that are integrated with school systems, educational institutions, juvenile justice systems, substance use disorder programs, mental health programs, foster care systems, and other child and youth support organizations; (2) demonstrate collaboration among early intervention and prevention services or certify that entities will engage in future collaboration; (3) employ or include in their applications a commitment to evaluate youth suicide early intervention and prevention practices and strategies adapted to the local community; (4) provide timely referrals for appropriate community-based mental health care and treatment of youth who are at risk for suicide in child-serving settings and agencies; (5) provide immediate support and information resources to families of youth who are at risk for suicide; (6) offer access to services and care to youth with diverse linguistic and cultural backgrounds; (7) offer appropriate postsuicide intervention services, care, and information to families, friends, schools, educational institutions, juvenile justice systems, substance use disorder programs, mental health programs, foster care systems, and other child and youth support organizations of youth who recently completed suicide; (8) offer continuous and up-to-date information and awareness campaigns that target parents, family members, child care professionals, community care providers, and the general public and highlight the risk factors associated with youth suicide and the life-saving help and care available from early intervention and prevention services; (9) ensure that information and awareness campaigns on youth suicide risk factors, and early intervention and prevention services, use effective communication mechanisms that are targeted to and reach youth, families, schools, educational institutions, and youth organizations; (10) provide a timely response system to ensure that child-serving professionals and providers are properly trained in youth suicide early intervention and prevention strategies and that child-serving professionals and providers involved in early intervention and prevention services are properly trained in effectively identifying youth who are at risk for suicide; (11) provide continuous training activities for child care professionals and community care providers on the latest youth suicide early intervention and prevention services practices and strategies; (12) conduct annual self-evaluations of outcomes and activities, including consulting with interested families and advocacy organizations; (13) provide services in areas or regions with rates of youth suicide that exceed the national average as determined by the Centers for Disease Control and Prevention; and (14) obtain informed written consent from a parent or legal guardian of an at-risk child before involving the child in a youth suicide early intervention and prevention program. (d) Requirement for direct services Not less than 85 percent of grant funds received under this section shall be used to provide direct services, of which not less than 5 percent shall be used for activities authorized under subsection (a)(3). (e) Consultation and policy development (1) In general In carrying out this section, the Secretary shall collaborate with the Secretary of Education and relevant Federal agencies and suicide working groups responsible for early intervention and prevention services relating to youth suicide. (2) Consultation In carrying out this section, the Secretary shall consult with— (A) State and local agencies, including agencies responsible for early intervention and prevention services under title XIX of the Social Security Act , the State Children's Health Insurance Program under title XXI of the Social Security Act , and programs funded by grants under title V of the Social Security Act ; (B) local and national organizations that serve youth at risk for suicide and their families; (C) relevant national medical and other health and education specialty organizations; (D) youth who are at risk for suicide, who have survived suicide attempts, or who are currently receiving care from early intervention services; (E) families and friends of youth who are at risk for suicide, who have survived suicide attempts, who are currently receiving care from early intervention and prevention services, or who have completed suicide; (F) qualified professionals who possess the specialized knowledge, skills, experience, and relevant attributes needed to serve youth at risk for suicide and their families; and (G) third-party payers, managed care organizations, and related commercial industries. (3) Policy development In carrying out this section, the Secretary shall— (A) coordinate and collaborate on policy development at the Federal level with the relevant Department of Health and Human Services agencies and suicide working groups; and (B) consult on policy development at the Federal level with the private sector, including consumer, medical, suicide prevention advocacy groups, and other health and education professional-based organizations, with respect to State-sponsored statewide or tribal youth suicide early intervention and prevention strategies. (f) Rule of construction; religious and moral accommodation Nothing in this section shall be construed to require suicide assessment, early intervention, or treatment services for youth whose parents or legal guardians object based on the parents' or legal guardians' religious beliefs or moral objections. (g) Evaluations and report (1) Evaluations by eligible entities Not later than 18 months after receiving a grant or cooperative agreement under this section, an eligible entity shall submit to the Secretary the results of an evaluation to be conducted by the entity concerning the effectiveness of the activities carried out under the grant or agreement. (2) Report Not later than 2 years after the date of enactment of this section, the Secretary shall submit to the appropriate committees of Congress a report concerning the results of— (A) the evaluations conducted under paragraph (1); and (B) an evaluation conducted by the Secretary to analyze the effectiveness and efficacy of the activities conducted with grants, collaborations, and consultations under this section. (h) Rule of construction; student medication Nothing in this section shall be construed to allow school personnel to require that a student obtain any medication as a condition of attending school or receiving services. (i) Prohibition Funds appropriated to carry out this section, section 527, or section 529 shall not be used to pay for or refer for abortion. (j) Parental consent States and entities receiving funding under this section shall obtain prior written, informed consent from the child's parent or legal guardian for assessment services, school-sponsored programs, and treatment involving medication related to youth suicide conducted in elementary and secondary schools. The requirement of the preceding sentence does not apply in the following cases: (1) In an emergency, where it is necessary to protect the immediate health and safety of the student or other students. (2) Other instances, as defined by the State, where parental consent cannot reasonably be obtained. (k) Relation to education provisions Nothing in this section shall be construed to supersede section 444 of the General Education Provisions Act, including the requirement of prior parental consent for the disclosure of any education records. Nothing in this section shall be construed to modify or affect parental notification requirements for programs authorized under the Elementary and Secondary Education Act of 1965 (as amended by the No Child Left Behind Act of 2001; Public Law 107–110 ). (l) Definitions In this section: (1) Early intervention The term early intervention means a strategy or approach that is intended to prevent an outcome or to alter the course of an existing condition. (2) Educational institution; institution of higher education; school The term— (A) educational institution means a school or institution of higher education; (B) institution of higher education has the meaning given such term in section 101 of the Higher Education Act of 1965 ; and (C) school means an elementary or secondary school (as such terms are defined in section 9101 of the Elementary and Secondary Education Act of 1965 ). (3) Prevention The term prevention means a strategy or approach that reduces the likelihood or risk of onset, or delays the onset, of adverse health problems that have been known to lead to suicide. (4) Youth The term youth means individuals who are between 10 and 26 years of age. (m) Authorization of appropriations For the purpose of carrying out this section, there are authorized to be appropriated $29,738,000 for each of the fiscal years 2016 through 2020. . (3) Suicide prevention for youth Section 520E–1 of the Public Health Service Act ( 42 U.S.C. 290bb–36a ) is amended— (A) by amending the section heading to read as follows: Suicide prevention for youth ; and (B) by striking subsection (n) and inserting the following: (n) Authorization of appropriations For the purpose of carrying out this section, there is authorized to be appropriated such sums as may be necessary for each of fiscal years 2016 through 2020. . (4) Mental health and substance use disorders services and outreach on campus Section 520E–2 of the Public Health Service Act ( 42 U.S.C. 290bb–36b ) is amended to read as follows: 520E–2. Mental health and substance use disorders services on campus (a) In general The Secretary, acting through the Director of the Center for Mental Health Services and in consultation with the Secretary of Education, shall award grants on a competitive basis to institutions of higher education to enhance services for students with mental health or substance use disorders and to develop best practices for the delivery of such services. (b) Uses of funds Amounts received under a grant under this section shall be used for 1 or more of the following activities: (1) The provision of mental health and substance use disorder services to students, including prevention, promotion of mental health, voluntary screening, early intervention, voluntary assessment, treatment, and management of mental health and substance use disorder issues. (2) The provision of outreach services to notify students about the existence of mental health and substance use disorder services. (3) Educating students, families, faculty, staff, and communities to increase awareness of mental health and substance use disorders. (4) The employment of appropriately trained staff, including administrative staff. (5) The provision of training to students, faculty, and staff to respond effectively to students with mental health and substance use disorders. (6) The creation of a networking infrastructure to link colleges and universities with providers who can treat mental health and substance use disorders. (7) Developing, supporting, evaluating, and disseminating evidence-based and emerging best practices. (c) Implementation of activities using grant funds An institution of higher education that receives a grant under this section may carry out activities under the grant through— (1) college counseling centers; (2) college and university psychological service centers; (3) mental health centers; (4) psychology training clinics; (5) institution of higher education supported, evidence-based, mental health and substance use disorder programs; or (6) any other entity that provides mental health and substance use disorder services at an institution of higher education. (d) Application To be eligible to receive a grant under this section, an institution of higher education shall prepare and submit to the Secretary an application at such time and in such manner as the Secretary may require. At a minimum, such application shall include the following: (1) A description of identified mental health and substance use disorder needs of students at the institution of higher education. (2) A description of Federal, State, local, private, and institutional resources currently available to address the needs described in paragraph (1) at the institution of higher education. (3) A description of the outreach strategies of the institution of higher education for promoting access to services, including a proposed plan for reaching those students most in need of mental health services. (4) A plan, when applicable, to meet the specific mental health and substance use disorder needs of veterans attending institutions of higher education. (5) A plan to seek input from community mental health providers, when available, community groups and other public and private entities in carrying out the program under the grant. (6) A plan to evaluate program outcomes, including a description of the proposed use of funds, the program objectives, and how the objectives will be met. (7) An assurance that the institution will submit a report to the Secretary each fiscal year concerning the activities carried out with the grant and the results achieved through those activities. (e) Special considerations In awarding grants under this section, the Secretary shall give special consideration to applications that describe programs to be carried out under the grant that— (1) demonstrate the greatest need for new or additional mental and substance use disorder services, in part by providing information on current ratios of students to mental health and substance use disorder health professionals; and (2) demonstrate the greatest potential for replication. (f) Requirement of matching funds (1) In general The Secretary may make a grant under this section to an institution of higher education only if the institution agrees to make available (directly or through donations from public or private entities) non-Federal contributions in an amount that is not less than $1 for each $1 of Federal funds provided under the grant, toward the costs of activities carried out with the grant (as described in subsection (b)) and other activities by the institution to reduce student mental health and substance use disorders. (2) Determination of amount contributed Non-Federal contributions required under paragraph (1) may be in cash or in kind. Amounts provided by the Federal Government, or services assisted or subsidized to any significant extent by the Federal Government, may not be included in determining the amount of such non-Federal contributions. (3) Waiver The Secretary may waive the application of paragraph (1) with respect to an institution of higher education if the Secretary determines that extraordinary need at the institution justifies the waiver. (g) Reports For each fiscal year that grants are awarded under this section, the Secretary shall conduct a study on the results of the grants and submit to the Congress a report on such results that includes the following: (1) An evaluation of the grant program outcomes, including a summary of activities carried out with the grant and the results achieved through those activities. (2) Recommendations on how to improve access to mental health and substance use disorder services at institutions of higher education, including efforts to reduce the incidence of suicide and substance use disorders. (h) Definitions In this section: (1) The term evidence-based has the meaning given to such term in section 2 of the Helping Families in Mental Health Crisis Act of 2015 . (2) The term institution of higher education has the meaning given such term in section 101 of the Higher Education Act of 1965. (i) Authorization of appropriations For the purpose of carrying out this section, there are authorized to be appropriated $4,975,000 for each of fiscal years 2016 through 2020. . (5) Suicide lifeline Subpart 3 of part B of title V of the Public Health Service Act is amended by inserting after section 520E–2 of such Act ( 42 U.S.C. 290bb–36b ), as amended, the following: 520E–3. National Suicide Prevention Lifeline Program (a) In general The Secretary shall maintain the National Suicide Prevention Lifeline program, including by— (1) coordinating a network of crisis centers across the United States for providing suicide prevention and crisis intervention services to individuals seeking help at any time, day or night; (2) maintaining a suicide prevention hotline to link callers to local emergency, mental health, and social services resources; and (3) consulting with the Secretary of Veterans Affairs to ensure that veterans calling the suicide prevention hotline have access to a specialized veterans’ suicide prevention hotline. (b) Authorization of appropriations To carry out this section, there are authorized to be appropriated $8,000,000 for each of fiscal years 2016 through 2020. . III Interagency Serious Mental Illness Coordinating Committee 301. Interagency Serious Mental Illness Coordinating Committee Title V of the Public Health Service Act, as amended by section 101, is further amended by inserting after section 501 of such Act the following: 501A. Interagency Serious Mental Illness Coordinating Committee (a) Establishment The Assistant Secretary for Mental Health and Substance Use Disorders (in this section referred to as the Assistant Secretary ) shall establish a committee, to be known as the Interagency Serious Mental Illness Coordinating Committee (in this section referred to as the Committee ), to assist the Assistant Secretary in carrying out the Assistant Secretary’s duties. (b) Responsibilities The Committee shall— (1) develop and annually update a summary of advances in serious mental illness research related to causes, prevention, treatment, early screening, diagnosis or rule out, intervention, and access to services and supports for individuals with serious mental illness; (2) monitor Federal activities with respect to serious mental illness; (3) make recommendations to the Assistant Secretary regarding any appropriate changes to such activities, including recommendations to the Director of NIH with respect to the strategic plan developed under paragraph (5); (4) make recommendations to the Assistant Secretary regarding public participation in decisions relating to serious mental illness; (5) develop and annually update a strategic plan for advancing— (A) public utilization of effective mental health services; and (B) compliance with treatment; (6) develop and annually update a strategic plan for the conduct of, and support for, serious mental illness research, including proposed budgetary requirements; and (7) submit to the Congress such strategic plan and any updates to such plan. (c) Membership (1) In general The Committee shall be composed of— (A) the Assistant Secretary for Mental Health and Substance Use Disorders (or the Assistant Secretary’s designee), who shall serve as the Chair of the Committee; (B) the Director of the National Institute of Mental Health (or the Director’s designee); (C) the Attorney General of the United States (or the Attorney General’s designee); (D) the Director of the Centers for Disease Control and Prevention (or the Director’s designee); (E) the Director of the National Institutes of Health (or the Director’s designee); (F) the directors of such national research institutes of the National Institutes of Health as the Assistant Secretary for Mental Health and Substance Use Disorders determines appropriate (or their designees); (G) a member of the United States Interagency Council on Homelessness; (H) representatives, appointed by the Assistant Secretary, of Federal agencies that are outside of the Department of Health and Human Services and serve individuals with serious mental illness, including representatives of the Bureau of Indian Affairs, the Department of Defense, the Department of Education, the Department of Housing and Urban Development, the Department of Labor, the Department of Veterans Affairs, and the Social Security Administration; (I) 4 members, of which— (i) 1 shall be appointed by the Speaker of the House of Representatives; (ii) 1 shall be appointed by the minority leader of the House of Representatives; (iii) 1 shall be appointed by the majority leader of the Senate; and (iv) 1 shall be appointed by the minority leader of the Senate; and (J) the additional members appointed under paragraph (2). (2) Additional members Not fewer than 14 members of the Committee, or 1/3 of the total membership of the Committee, whichever is greater, shall be composed of non-Federal public members to be appointed by the Assistant Secretary, of which— (A) at least one such member shall be an individual in recovery from a diagnosis of serious mental illness who has benefitted from and is receiving medical treatment under the care of a licensed mental health professional; (B) at least one such member shall be a parent or legal guardian of an individual with a history of serious mental illness who has either attempted suicide or is incarcerated for violence committed while experiencing a serious mental illness; (C) at least one such member shall be a representative of a leading research, advocacy, and service organization for individuals with serious mental illness; (D) at least one such member shall be— (i) a licensed psychiatrist with experience treating serious mental illness; or (ii) a licensed clinical psychologist with experience treating serious mental illness; (E) at least one member shall be a licensed mental health counselor or psychotherapist; (F) at least one member shall be a licensed clinical social worker; (G) at least one member shall be a licensed psychiatric nurse or nurse practitioner; (H) at least one member shall be a mental health professional with a significant focus in his or her practice working with children and adolescents; (I) at least one member shall be a mental health professional who spends a significant concentration of his or her professional time or leadership practicing community mental health; (J) at least one member shall be a mental health professional with substantial experience working with mentally ill individuals who have a history of violence or suicide; (K) at least one such member shall be a State certified mental health peer specialist; (L) at least one member shall be a judge with experiences applying assisted outpatient treatment; (M) at least one member shall be a law enforcement officer with extensive experience in interfacing with psychiatric and psychological disorders or individuals in mental health crisis; and (N) at least one member shall be a corrections officer. (d) Reports to Congress Not later than 1 year after the date of enactment of this Act, and every 2 years thereafter, the Committee shall submit a report to the Congress— (1) analyzing the efficiency, effectiveness, quality, coordination, and cost effectiveness of Federal programs and activities relating to the prevention of, or treatment or rehabilitation for, mental health or substance use disorders, including an accounting of the costs of such programs and activities, with administrative costs disaggregated from the costs of services and care provided; (2) evaluating the impact on public health of projects addressing priority mental health needs of regional and national significance under sections 501, 509, 516, and 520A including measurement of public health outcomes such as— (A) reduced rates of suicide, suicide attempts, substance abuse, overdose, overdose deaths, emergency hospitalizations, emergency room boarding, incarceration, crime, arrest, victimization, homelessness, and joblessness; (B) increased rates of employment and enrollment in educational and vocational programs; and (C) such other criteria as may be determined by the Assistant Secretary; (3) formulating recommendations for the coordination and improvement of Federal programs and activities described in paragraph (2); (4) identifying any such programs and activities that are duplicative; and (5) summarizing all recommendations made, activities carried out, and results achieved pursuant to the workforce development strategy under section 501(b)(9) of the Public Health Service Act, as amended by section 101. (e) Administrative support; terms of service; other provisions The following provisions shall apply with respect to the Committee: (1) The Assistant Secretary shall provide such administrative support to the Committee as may be necessary for the Committee to carry out its responsibilities. (2) Members of the Committee appointed under subsection (c)(2) shall serve for a term of 4 years, and may be reappointed for one or more additional 4-year terms. Any member appointed to fill a vacancy for an unexpired term shall be appointed for the remainder of such term. A member may serve after the expiration of the member’s term until a successor has taken office. (3) The Committee shall meet at the call of the chair or upon the request of the Assistant Secretary. The Committee shall meet not fewer than 2 times each year. (4) All meetings of the Committee shall be public and shall include appropriate time periods for questions and presentations by the public. (f) Subcommittees; establishment and membership In carrying out its functions, the Committee may establish subcommittees and convene workshops and conferences. Such subcommittees shall be composed of Committee members and may hold such meetings as are necessary to enable the subcommittees to carry out their duties. . IV HIPAA and FERPA caregivers 401. Promoting appropriate treatment for mentally ill individuals by treating their caregivers as personal representatives for purposes of HIPAA privacy regulations (a) Caregiver access to information In applying section 164.502(g) of title 45, Code of Federal Regulations, to an individual with serious mental illness an exception for disclosure of specific limited protected health information shall be provided if all of the following criteria are met for the disclosure by a physician (as defined in paragraphs (1) and (2) of section 1861(r) of the Social Security Act ( 42 U.S.C. 1395x(r) )) or other licensed mental health or health care professional to an identified responsible caregiver: (1) Such disclosure is for information limited to the diagnoses, treatment plans, appointment scheduling, medications, and medication-related instructions, but not including any personal psychotherapy notes. (2) Such disclosure is necessary to protect the health, safety, or welfare of the individual or general public. (3) The information to be disclosed will be beneficial to the treatment of the individual if that individual has a co-occurring acute or chronic medical illness. (4) The information to be disclosed is necessary for the continuity of treatment of the medical condition or mental illness of the individual. (5) The absence of such information or treatment will contribute to a worsening prognosis or an acute medical condition. (6) The individual by nature of the severe mental illness has or has had a diminished capacity to fully understand or follow a treatment plan for their medical condition or may become gravely disabled in absence of treatment. (b) Training In applying section 164.530 of title 45, Code of Federal Regulations, the training described in paragraph (b)(1) of such section shall include training with respect to the disclosure of information to a caregiver of an individual pursuant to subsection (a). (c) Age of majority In applying section 164.502(g) of title 45, Code of Federal Regulations, notwithstanding any other provision of law, an unemancipated minor shall be an individual under the age of 18 years. (d) Provider access to information Health care providers may listen to information or review medical history provided by family members or other caregivers who may have concerns about the health and well-being of the patient, so the health care provider can factor that information into the patient’s care. (e) Definitions For purposes of this section: (1) Covered entity The term covered entity has the meaning given such term in section 106.103 of title 45, Code of Federal Regulations. (2) Protected health information The term protected health information has the meaning given such term in section 106.103 of title 45, Code of Federal Regulations. (3) Caregiver The term caregiver means, with respect to an individual with a serious mental illness— (A) an immediate family member of such individual; (B) an individual who assumes primary responsibility for providing a basic need of such individual; (C) a personal representative of the individual as determined by the law of the State in which such individual resides; (D) can establish a longstanding involvement and is responsible with the individual with a serious mental illness and the health care of the individual; and (E) excludes an individual with a documented history of abuse. (4) Individual with a serious mental illness The term individual with a serious mental illness means, with respect to the disclosure to a caregiver of protected health information of an individual, an individual who— (A) is 18 years of age or older; and (B) has, within one year before the date of the disclosure, been evaluated, diagnosed, or treated for a mental, behavioral, or emotional disorder that— (i) is determined by a physician to be of sufficient duration to meet diagnostic criteria specified within the Diagnostic and Statistical Manual of Mental Disorders; and (ii) results in functional impairment of the individual that substantially interferes with or limits one or more major life activities of the individual. Such term includes an individual with autism spectrum disorder or other developmental disability if such individual has a co-occurring mental illness. 402. Caregivers permitted access to certain education records under FERPA Section 444 of the General Education Provisions Act ( 20 U.S.C. 1232g ) is amended by adding at the end the following new subsection: (k) Disclosures to caregivers (1) In general With respect to a student who is 18 years of age or older, an educational agency or institution may disclose to the caregiver of the student, without regard to whether the student has explicitly provided consent to the agency or institution for the disclosure of the student’s education record, the education record of such student if a physician (as defined in paragraphs (1) and (2) of section 1861(r) of the Social Security Act), psychologist, or other recognized mental health professional or paraprofessional acting in his or her professional or paraprofessional capacity, or assisting in that capacity reasonably believes such disclosure to the caregiver is necessary to protect the health, safety, or welfare of such student or the safety of one or more other individuals. (2) Definitions In this subsection: (A) Caregiver The term caregiver means, with respect to a student, a family member or immediate past legal guardian who assumes a primary responsibility for providing a basic need of such student (such as a family member or past legal guardian of the student who has assumed the responsibility of co-signing a loan with the student). (B) Education record Notwithstanding subsection (a)(4)(B), the term education record shall include a record described in clause (iv) of such subsection. . 403. Confidentiality of records Section 543(e) of the Public Health Service Act ( 42 U.S.C. 290dd–2(e) ) is amended— (1) in paragraph (1), by striking ; or and inserting a semicolon; (2) in paragraph (2), by striking the period and inserting ; or ; and (3) after paragraph (2), by inserting the following: (3) within accountable care organizations described in section 1899 of the Social Security Act ( 42 U.S.C. 1395jjj ), health information exchanges (as defined for purposes of section 3013), health homes (as defined in section 1945(h)(3) of such Act 42 U.S.C. 1396w–4(h)(3) ), or other integrated care arrangements (in existence before, on, or after the date of the enactment of this paragraph) involving the interchange of electronic health records (as defined in section 13400 of division A of Public Law 111–5 ) ( 42 U.S.C. 17921(5) ) containing information described in subsection (a) for purposes of attaining interoperability, improving care coordination, reducing health care costs, and securing or providing patient safety. . V Medicare and Medicaid reforms 501. Enhanced Medicaid coverage relating to certain mental health services (a) Medicaid coverage of mental health services and primary care services furnished on the same day (1) In general Section 1902(a) of the Social Security Act ( 42 U.S.C. 1396a(a) ) is amended by inserting after paragraph (77) the following new paragraph: (78) not prohibit payment under the plan for a mental health service or primary care service furnished to an individual at a community mental health center meeting the criteria specified in section 1913(c) of the Public Health Service Act or a federally qualified health center (as defined in section 1861(aa)(3)) for which payment would otherwise be payable under the plan, with respect to such individual, if such service were not a same-day qualifying service (as defined in subsection (ll)); . (2) Same-day qualifying services defined Section 1902 of the Social Security Act ( 42 U.S.C. 1396a ) is amended by adding at the end the following new subsection: (ll) Same-Day qualifying services defined For purposes of subsection (a)(78), the term same-day qualifying service means— (1) a primary care service furnished to an individual by a provider at a facility on the same day a mental health service is furnished to such individual by such provider (or another provider) at the facility; and (2) a mental health service furnished to an individual by a provider at a facility on the same day a primary care service is furnished to such individual by such provider (or another provider) at the facility. . (b) State option To provide medical assistance for certain inpatient psychiatric services to nonelderly adults Section 1905 of the Social Security Act ( 42 U.S.C. 1396d ) is amended— (1) in subsection (a)— (A) in paragraph (16)— (i) by striking effective and inserting (A) effective ; and (ii) by inserting before the semicolon at the end the following: , (B) qualified inpatient psychiatric hospital services (as defined in subsection (h)(3)) for individuals over 21 years of age and under 65 years of age, and (C) psychiatric residential treatment facility services (as defined in subsection (h)(4)) for individuals over 21 years of age and under 65 years of age ; and (B) in the subdivision (B) that follows paragraph (29), by inserting (other than services described in subparagraphs (B) and (C) of paragraph (16) for individuals described in such subparagraphs) after patient in an institution for mental diseases ; and (2) in subsection (h), by adding at the end the following new paragraphs: (3) For purposes of subsection (a)(16)(B), the term qualified inpatient psychiatric hospital services means, with respect to individuals described in such subsection, services described in subparagraphs (A) and (B) of paragraph (1) that are furnished in an acute care psychiatric unit in a State-operated psychiatric hospital or a psychiatric hospital (as defined section 1861(f)) if such unit or hospital, as applicable, has a facilitywide average (determined on an annual basis) length of stay of less than 30 days. (4) For purposes of subsection (a)(16)(C), the term psychiatric residential treatment facility services means, with respect to individuals described in such subsection, services described in subparagraphs (A) and (B) of paragraph (1) that are furnished in a psychiatric residential treatment facility (as defined in section 484.353 of title 42, Code of Federal Regulations, as in effect on December 9, 2013). . (c) Report (1) In general The Assistant Secretary for Mental Health and Substance Use Disorders shall report on the impact of the amendments made by subsection (b) on the funds made available by States for inpatient psychiatric hospital care and for community-based mental health services. Such study shall include an assessment of each of the following: (A) The amount of funds expended annually by States on short-term, acute inpatient psychiatric hospital care. (B) The amount of funds expended annually on short-term, acute inpatient psychiatric hospital care through disproportionate share hospital payments under section 1923 of the Social Security Act ( 42 U.S.C. 1396r–4 ). (C) The reduction in the amount of funds described in subparagraph (A) that is attributable to the amendments made by subsection (b). (D) The reduction in the amount of funds described in subparagraph (B) that is attributable to the amendment made by such subsection. (E) The total amount of the reductions described in subparagraphs (C) and (D). (2) Definition of short-term, acute inpatient psychiatric hospital care For purposes of paragraph (1), the term short-term, acute inpatient psychiatric hospital care means care that is provided in either— (A) an acute-care psychiatric unit with an average annual length of stay of fewer than 30 days that is operated within a psychiatric hospital operated by a State; or (B) a psychiatric hospital with an average annual length of stay of fewer than 30 days. (3) Report Not later than two years after the date of the enactment of this Act, such Assistant Secretary shall submit a report to Congress on the results of the study described in paragraph (1), including recommendations with respect to strategies that can be used to reinvest in community-based mental health services funds equal to the total amount of the reductions described in paragraph (1)(E). (d) Effective date (1) In general Subject to paragraphs (2) and (3), the amendments made by this section shall apply to items and services furnished after the first day of the first calendar year that begins after the date of the enactment of this section. (2) Certification of no increased spending The amendments made by this section shall not be effective unless the Chief Actuary of the Centers for Medicare & Medicaid Services certifies that the inclusion of qualified inpatient psychiatric hospital services and psychiatric residential treatment facility services (as those terms are defined in section 1905(h) of the Social Security Act ( 42 U.S.C. 1396d(h) )) furnished to nonelderly adults as medical assistance under section 1905(a) of the Social Security Act ( 42 U.S.C. 1396d(a) ), as amended by subsection (a), would not result in any increase in net program spending under title XIX of such Act. (3) Exception for State legislation In the case of a State plan under title XIX of the Social Security Act, which the Secretary of Health and Human Services determines requires State legislation in order for the respective plan to meet any requirement imposed by amendments made by this section, the respective plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet such an additional requirement before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of enactment of this section. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of the session shall be considered to be a separate regular session of the State legislature. 502. Access to mental health prescription drugs under Medicare and Medicaid (a) Coverage of prescription drugs used To treat mental health disorders under Medicare Section 1860D–4(b)(3)(G) of the Social Security Act ( 42 U.S.C. 1395w–104(b)(3)(G) ) is amended— (1) in clause (i)(I), by striking in the categories and inserting in the categories and classes of drugs specified in subclauses (II) and (IV) of clause (iv) and in other categories ; (2) in clause (i)(II), by inserting , for categories and classes of drugs other than the categories and classes of drugs specified in subclauses (II) and (IV) of clause (iv), before exceptions ; (3) in clause (ii)(I), by inserting at the end the following new sentence: For purposes of the previous sentence, the categories and classes of drugs specified in subclauses (II) and (IV) of clause (iv) shall be deemed to be of clinical concern. ; and (4) in clause (iv), in the matter preceding subclause (I), by inserting (and in the case of categories and classes of drugs specified in subclauses (II) and (IV), before, on, and after the Secretary establishes such criteria) after clause (ii)(II) . (b) Coverage of prescription drugs used To treat mental health disorders under Medicaid (1) In general Section 1927(d) of the Social Security Act ( 42 U.S.C. 1396r–8(d) ) is amended by adding at the end the following new paragraph: (8) Access to mental health drugs With respect to covered outpatient drugs used for the treatment of a mental health disorder, including major depression, bipolar (manic-depressive) disorder, panic disorder, obsessive-compulsive disorder, schizophrenia, and schizoaffective disorder, a State shall not exclude from coverage or otherwise restrict access to such drugs other than pursuant to a prior authorization program that is consistent with paragraph (5). . (2) Medicaid managed care organizations Section 1932(b) of the Social Security Act ( 42 U.S.C. 1396u–2(b) ) is amended by adding at the end the following new paragraph: (9) Coverage of prescription drugs used to treat mental health disorders Each contract with a managed care entity under section 1903(m) or under section 1905(t)(3) shall require coverage of all covered outpatient drugs used for the treatment of a mental health disorder, in accordance with section 1927(d)(8). . 503. Elimination of 190-day lifetime limit on coverage of inpatient psychiatric hospital services under Medicare (a) In general Section 1812 of the Social Security Act ( 42 U.S.C. 1395d ) is amended— (1) in subsection (b)— (A) in paragraph (1), by adding or at the end; (B) in paragraph (2), by striking ; or at the end and inserting a period; and (C) by striking paragraph (3); and (2) in subsection (c), by striking or in determining the 190-day limit under subsection (b)(3) . (b) Effective date; certification of no increased spending (1) In general Subject to paragraph (2), the amendments made by subsection (a) shall apply to items and services furnished on or after January 1, 2016. (2) Certification of no increased spending The amendments made by subsection (a) shall not be effective unless the Chief Actuary of the Centers for Medicare & Medicaid Services certifies that such amendments will not result in any increase in net Federal expenditures under title XVIII of the Social Security Act. 504. Modifications to Medicare discharge planning requirements Section 1861(ee) of the Social Security Act ( 42 U.S.C. 1395x(ee) ) is amended— (1) in paragraph (1), by inserting and, in the case of a psychiatric hospital or a psychiatric unit (as described in the matter following clause (v) of section 1886(d)(1)(B)), if it also meets the guidelines and standards established by the Secretary under paragraph (3) before the period at the end; and (2) by adding at the end the following new paragraph: (3) The Secretary shall develop guidelines and standards, in addition to those developed under paragraph (2), for the discharge planning process of a psychiatric hospital or a psychiatric unit (as described in the matter following clause (v) of section 1886(d)(1)(B)) in order to ensure a timely and smooth transition to the most appropriate type of and setting for posthospital or rehabilitative care. The Secretary shall issue final regulations implementing such guidelines and standards not later than 24 months after the date of the enactment of this paragraph. The guidelines and standards shall include the following: (A) The hospital or unit must identify the types of services needed upon discharge for the patients being treated by the hospital or unit. (B) The hospital or unit must— (i) identify organizations that offer community services to the community that is served by the hospital or unit and the types of services provided by the organizations; and (ii) must make demonstrated efforts to establish connections, relationships, and partnerships with such organizations. (C) The hospital or unit must arrange (with the participation of the patient and of any other individuals selected by the patient for such purpose) for the development and implementation of a discharge plan for the patient as part of the patient’s overall treatment plan from admission to discharge. Such discharge plan shall meet the requirements described in subparagraphs (G) and (H) of paragraph (2). (D) The hospital or unit shall coordinate with the patient (or assist the patient with) the referral for posthospital or rehabilitative care and as part of that referral the hospital or unit shall include transmitting to the receiving organization, in a timely manner, appropriate information about the care furnished to the patient by the hospital or unit and recommendations for posthospital or rehabilitative care to be furnished to the patient by the organization. . 505. Demonstration programs to improve community mental health services Section 223 of the Protecting Access to Medicare Act of 2014 ( Public Law 113–93 ; 128 Stat. 1077) is amended to read as follows: 223. Demonstration programs to improve community mental health services (a) Criteria for certified community behavioral health clinics To participate in demonstration programs (1) Publication Not later than September 1, 2015, the Secretary shall publish criteria for a clinic to be certified by a State as a certified community behavioral health clinic for purposes of participating in a demonstration program conducted under subsection (d). (2) Requirements The criteria published under this subsection shall include criteria with respect to the following: (A) Staffing Staffing requirements, including criteria that staff have diverse disciplinary backgrounds, have necessary State-required license and accreditation, and are culturally and linguistically trained to serve the needs of the clinic's patient population. (B) Availability and accessibility of services Availability and accessibility of services, including crisis management services that are available and accessible 24 hours a day, the use of a sliding scale for payment, and no rejection for services or limiting of services on the basis of a patient's ability to pay or a place of residence. (C) Care coordination Care coordination, including requirements to coordinate care across settings and providers to ensure seamless transitions for patients across the full spectrum of health services including acute, chronic, and behavioral health needs. Care coordination requirements shall include partnerships or formal contracts with the following: (i) Federally-qualified health centers (and as applicable, rural health clinics) to provide Federally-qualified health center services (and as applicable, rural health clinic services) to the extent such services are not provided directly through the certified community behavioral health clinic. (ii) Inpatient psychiatric facilities and substance use detoxification, post-detoxification step-down services, and residential programs. (iii) Other community or regional services, supports, and providers, including schools, child welfare agencies, juvenile and criminal justice agencies and facilities, Indian Health Service youth regional treatment centers, State-licensed and nationally accredited child placing agencies for therapeutic foster care service, and other social and human services. (iv) Department of Veterans Affairs medical centers, independent outpatient clinics, drop-in centers, and other facilities of the Department as defined in section 1801 of title 38, United States Code. (v) Inpatient acute care hospitals and hospital outpatient clinics. (D) Scope of services Provision (in a manner reflecting person-centered care) of the following services which, if not available directly through the certified community behavioral health clinic, are provided or referred through formal relationships with other providers: (i) Crisis mental health services, including 24-hour mobile crisis teams, emergency crisis intervention services, and crisis stabilization. (ii) Screening, assessment, and diagnosis, including risk assessment. (iii) Patient-centered treatment planning or similar processes, including risk assessment and crisis planning. (iv) Outpatient mental health and substance use services. (v) Outpatient clinic primary care screening and monitoring of key health indicators and health risk. (vi) Targeted case management. (vii) Psychiatric rehabilitation services. (viii) Peer support and counselor services and family supports. (ix) Intensive, community-based mental health care for members of the Armed Forces and veterans, particularly those members and veterans located in rural areas, provided the care is consistent with minimum clinical mental health guidelines promulgated by the Veterans Health Administration including clinical guidelines contained in the Uniform Mental Health Services Handbook of such Administration. (E) Quality and other reporting Reporting of encounter data, clinical outcomes data, quality data, and such other data as the Secretary requires. (F) Organizational authority Criteria that a clinic be a non-profit or part of a local government behavioral health authority or operated under the authority of the Indian Health Service, an Indian tribe or tribal organization pursuant to a contract, grant, cooperative agreement, or compact with the Indian Health Service pursuant to the Indian Self-Determination Act ( 25 U.S.C. 450 et seq. ), or an urban Indian organization pursuant to a grant or contract with the Indian Health Service under title V of the Indian Health Care Improvement Act ( 25 U.S.C. 1601 et seq. ). (b) Guidance on development of prospective payment system for testing under demonstration programs (1) In general Not later than September 1, 2015, the Secretary, through the Administrator of the Centers for Medicare & Medicaid Services, shall issue guidance for the establishment of a prospective payment system that shall only apply to medical assistance for mental health services furnished by a certified community behavioral health clinic participating in a demonstration program under subsection (d). (2) Requirements The guidance issued by the Secretary under paragraph (1) shall provide that— (A) no payment shall be made for inpatient care, residential treatment, room and board expenses, or any other nonambulatory services, as determined by the Secretary; and (B) no payment shall be made to satellite facilities of certified community behavioral health clinics if such facilities are established after the date of enactment of this Act. (c) Planning grants (1) In general Not later than January 1, 2016, the Secretary shall award planning grants to States for the purpose of developing proposals to participate in time-limited demonstration programs described in subsection (d). (2) Use of funds A State awarded a planning grant under this subsection shall— (A) solicit input with respect to the development of such a demonstration program from patients, providers, and other stakeholders; (B) certify clinics as certified community behavioral health clinics for purposes of participating in a demonstration program conducted under subsection (d); and (C) establish a prospective payment system for mental health services furnished by a certified community behavioral health clinic participating in a demonstration program under subsection (d) in accordance with the guidance issued under subsection (b). (d) Demonstration programs (1) In general Not later than September 1, 2017, the Secretary shall select States to participate in demonstration programs that are developed through planning grants awarded under subsection (c), meet the requirements of this subsection, and represent a diverse selection of geographic areas, including rural and underserved areas. (2) Application requirements (A) In general The Secretary shall solicit applications to participate in demonstration programs under this subsection solely from States awarded planning grants under subsection (c). (B) Required information An application for a demonstration program under this subsection shall include the following: (i) The target Medicaid population to be served under the demonstration program. (ii) A list of participating certified community behavioral health clinics. (iii) Verification that the State has certified a participating clinic as a certified community behavioral health clinic in accordance with the requirements of subsection (b). (iv) A description of the scope of the mental health services available under the State Medicaid program that will be paid for under the prospective payment system tested in the demonstration program. (v) Verification that the State has agreed to pay for such services at the rate established under the prospective payment system. (vi) Such other information as the Secretary may require relating to the demonstration program including with respect to determining the soundness of the proposed prospective payment system. (3) Number and length of demonstration programs Not more than 10 States shall be selected for 4-year demonstration programs under this subsection. (4) Requirements for selecting demonstration programs (A) In general The Secretary shall give preference to selecting demonstration programs where participating certified community behavioral health clinics— (i) provide the most complete scope of services described in subsection (a)(2)(D) to individuals eligible for medical assistance under the State Medicaid program; (ii) will improve availability of, access to, and participation in, services described in subsection (a)(2)(D) to individuals eligible for medical assistance under the State Medicaid program; (iii) will improve availability of, access to, and participation in assisted outpatient mental health treatment in the State; or (iv) demonstrate the potential to expand available mental health services in a demonstration area and increase the quality of such services without increasing net Federal spending. (5) Payment for medical assistance for mental health services provided by certified community behavioral health clinics (A) In general The Secretary shall pay a State participating in a demonstration program under this subsection the Federal matching percentage specified in subparagraph (B) for amounts expended by the State to provide medical assistance for mental health services described in the demonstration program application in accordance with paragraph (2)(B)(iv) that are provided by certified community behavioral health clinics to individuals who are enrolled in the State Medicaid program. Payments to States made under this paragraph shall be considered to have been under, and are subject to the requirements of, section 1903 of the Social Security Act ( 42 U.S.C. 1396b ). (B) Federal matching percentage The Federal matching percentage specified in this subparagraph is with respect to medical assistance described in subparagraph (A) that is furnished— (i) to a newly eligible individual described in paragraph (2) of section 1905(y) of the Social Security Act ( 42 U.S.C. 1396d(y) ), the matching rate applicable under paragraph (1) of that section; and (ii) to an individual who is not a newly eligible individual (as so described) but who is eligible for medical assistance under the State Medicaid program, the enhanced FMAP applicable to the State. (C) Limitations (i) In general Payments shall be made under this paragraph to a State only for mental health services— (I) that are described in the demonstration program application in accordance with paragraph (2)(B)(iv); (II) for which payment is available under the State Medicaid program; and (III) that are provided to an individual who is eligible for medical assistance under the State Medicaid program. (ii) Prohibited payments No payment shall be made under this paragraph— (I) for inpatient care, residential treatment, room and board expenses, or any other nonambulatory services, as determined by the Secretary; or (II) with respect to payments made to satellite facilities of certified community behavioral health clinics if such facilities are established after the date of enactment of this Act. (6) Waiver of statewideness requirement The Secretary shall waive section 1902(a)(1) of the Social Security Act ( 42 U.S.C. 1396a(a)(1) ) (relating to statewideness) as may be necessary to conduct demonstration programs in accordance with the requirements of this subsection. (7) Annual reports (A) In general Not later than 1 year after the date on which the first State is selected for a demonstration program under this subsection, and annually thereafter, the Secretary shall submit to Congress an annual report on the use of funds provided under all demonstration programs conducted under this subsection. Each such report shall include— (i) an assessment of access to community-based mental health services under the Medicaid program in the area or areas of a State targeted by a demonstration program compared to other areas of the State; (ii) an assessment of the quality and scope of services provided by certified community behavioral health clinics compared to community-based mental health services provided in States not participating in a demonstration program under this subsection and in areas of a demonstration State that are not participating in the demonstration program; and (iii) an assessment of the impact of the demonstration programs on the Federal and State costs of a full range of mental health services (including inpatient, emergency and ambulatory services). (B) Recommendations Not later than December 31, 2021, the Secretary shall submit to Congress recommendations concerning whether the demonstration programs under this section should be continued, expanded, modified, or terminated. (e) Definitions In this section: (1) Federally-qualified health center services; Federally-qualified health center; rural health clinic services; rural health clinic The terms Federally-qualified health center services , Federally-qualified health center , rural health clinic services , and rural health clinic have the meanings given those terms in section 1905(l) of the Social Security Act ( 42 U.S.C. 1396d(l) ). (2) Enhanced FMAP The term enhanced FMAP has the meaning given that term in section 2105(b) of the Social Security Act ( 42 U.S.C. 1397dd(b) ) but without regard to the second and third sentences of that section. (3) Secretary The term Secretary means the Secretary of Health and Human Services. (4) State The term State has the meaning given such term for purposes of title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ). (f) Funding (1) In general Out of any funds in the Treasury not otherwise appropriated, there is appropriated to the Secretary— (A) for purposes of carrying out subsections (a), (b), and (d)(7), $2,000,000 for fiscal year 2014; and (B) for purposes of awarding planning grants under subsection (c), $25,000,000 for fiscal year 2016. (2) Availability Funds appropriated under paragraph (1) shall remain available until expended. . VI Research by National Institute of Mental Health 601. Increase in funding for certain research Section 402A(a) of the Public Health Service Act ( 42 U.S.C. 282a(a) ) is amended by adding at the end the following: (3) Funding for the brain initiative at the National Institute of Mental Health (A) Funding In addition to amounts made available pursuant to paragraphs (1) and (2), there are authorized to be appropriated to the National Institute of Mental Health for the purpose described in subparagraph (B)(ii) $40,000,000 for each of fiscal years 2016 through 2020. (B) Purposes Amounts appropriated pursuant to subparagraph (A) shall be used exclusively for the purpose of conducting or supporting— (i) research on the determinants of self- and other directed-violence in mental illness, including studies directed at reducing the risk of self harm, suicide, and interpersonal violence; or (ii) brain research through the Brain Research through Advancing Innovative Neurotechnologies Initiative. . VII Behavioral health information technology 701. Extension of health information technology assistance for behavioral and mental health and substance abuse Section 3000(3) of the Public Health Service Act ( 42 U.S.C. 300jj(3) ) is amended by inserting before and any other category the following: behavioral and mental health professionals (as defined in section 331(a)(3)(E)(i)), a substance abuse professional, a psychiatric hospital (as defined in section 1861(f) of the Social Security Act), a community mental health center meeting the criteria specified in section 1913(c), a residential or outpatient mental health or substance use treatment facility, . 702. Extension of eligibility for Medicare and Medicaid health information technology implementation assistance (a) Payment incentives for eligible professionals under Medicare Section 1848 of the Social Security Act ( 42 U.S.C. 1395w–4 ) is amended— (1) in subsection (a)(7)— (A) in subparagraph (E), by adding at the end the following new clause: (iv) Additional eligible professional The term additional eligible professional means a clinical psychologist providing qualified psychologist services (as defined in section 1861(ii)). ; and (B) by adding at the end the following new subparagraph: (F) Application to additional eligible professionals The Secretary shall apply the provisions of this paragraph with respect to an additional eligible professional in the same manner as such provisions apply to an eligible professional, except in applying subparagraph (A)— (i) in clause (i), the reference to 2015 shall be deemed a reference to 2020; (ii) in clause (ii), the references to 2015, 2016, and 2017 shall be deemed references to 2020, 2021, and 2022, respectively; and (iii) in clause (iii), the reference to 2018 shall be deemed a reference to 2023. ; and (2) in subsection (o)— (A) in paragraph (5), by adding at the end the following new subparagraph: (D) Additional eligible professional The term additional eligible professional means a clinical psychologist providing qualified psychologist services (as defined in section 1861(ii)). ; and (B) by adding at the end the following new paragraph: (6) Application to additional eligible professionals The Secretary shall apply the provisions of this subsection with respect to an additional eligible professional in the same manner as such provisions apply to an eligible professional, except in applying— (A) paragraph (1)(A)(ii), the reference to 2016 shall be deemed a reference to 2021; (B) paragraph (1)(B)(ii), the references to 2011 and 2012 shall be deemed references to 2016 and 2017, respectively; (C) paragraph (1)(B)(iii), the references to 2013 shall be deemed references to 2018; (D) paragraph (1)(B)(v), the references to 2014 shall be deemed references to 2019; and (E) paragraph (1)(E), the reference to 2011 shall be deemed a reference to 2016. . (b) Eligible hospitals Section 1886 of the Social Security Act ( 42 U.S.C. 1395ww ) is amended— (1) in subsection (b)(3)(B)(ix), by adding at the end the following new subclause: (V) The Secretary shall apply the provisions of this subsection with respect to an additional eligible hospital (as defined in subsection (n)(6)(C)) in the same manner as such provisions apply to an eligible hospital, except in applying— (aa) subclause (I), the references to 2015, 2016, and 2017 shall be deemed references to 2020, 2021, and 2022, respectively; and (bb) subclause (III), the reference to 2015 shall be deemed a reference to 2020. ; and (2) in subsection (n)— (A) in paragraph (6), by adding at the end the following new subparagraph: (C) Additional eligible hospital The term additional eligible hospital means an inpatient hospital that is a psychiatric hospital (as defined in section 1861(f)). ; and (B) by adding at the end the following new paragraph: (7) Application to additional eligible hospitals The Secretary shall apply the provisions of this subsection with respect to an additional eligible hospital in the same manner as such provisions apply to an eligible hospital, except in applying— (A) paragraph (2)(E)(ii), the references to 2013 and 2015 shall be deemed references to 2018 and 2020, respectively; and (B) paragraph (2)(G)(i), the reference to 2011 shall be deemed a reference to 2016. . (c) Medicaid providers Section 1903(t) of the Social Security Act ( 42 U.S.C. 1396b(t) ) is amended— (1) in paragraph (2)(B)— (A) in clause (i), by striking , or at the end and inserting a semicolon; (B) in clause (ii), by striking the period at the end and inserting a semicolon; and (C) by inserting after clause (ii) the following new clauses: (iii) a public hospital that is principally a psychiatric hospital (as defined in section 1861(f)); (iv) a private hospital that is principally a psychiatric hospital (as defined in section 1861(f)) and that has at least 10 percent of its patient volume (as estimated in accordance with a methodology established by the Secretary) attributable to individuals receiving medical assistance under this title; (v) a community mental health center meeting the criteria specified in section 1913(c) of the Public Health Service Act; or (vi) a residential or outpatient mental health or substance use treatment facility that— (I) is accredited by the Joint Commission on Accreditation of Healthcare Organizations, the Commission on Accreditation of Rehabilitation Facilities, the Council on Accreditation, or any other national accrediting agency recognized by the Secretary; and (II) has at least 10 percent of its patient volume (as estimated in accordance with a methodology established by the Secretary) attributable to individuals receiving medical assistance under this title. ; and (2) in paragraph (3)(B)— (A) in clause (iv), by striking ; and at the end and inserting a semicolon; (B) in clause (v), by striking the period at the end and inserting ; and ; and (C) by adding at the end the following new clause: (vi) clinical psychologist providing qualified psychologist services (as defined in section 1861(ii)), if such clinical psychologist is practicing in an outpatient clinic that— (I) is led by a clinical psychologist; and (II) is not otherwise receiving payment under paragraph (1) as a Medicaid provider described in paragraph (2)(B). . (d) Medicare Advantage organizations Section 1853 of the Social Security Act ( 42 U.S.C. 1395w–23 ) is amended— (1) in subsection (l)— (A) in paragraph (1)— (i) by inserting or additional eligible professionals (as described in paragraph (9)) after paragraph (2) ; and (ii) by inserting and additional eligible professionals before under such sections ; (B) in paragraph (3)(B)— (i) in clause (i) in the matter preceding subclause (I), by inserting or an additional eligible professional described in paragraph (9) after paragraph (2) ; and (ii) in clause (ii)— (I) in the matter preceding subclause (I), by inserting or an additional eligible professional described in paragraph (9) after paragraph (2) ; and (II) in subclause (I), by inserting or an additional eligible professional, respectively, after eligible professional ; (C) in paragraph (3)(C), by inserting and additional eligible professionals after all eligible professionals ; (D) in paragraph (4)(D), by adding at the end the following new sentence: In the case that a qualifying MA organization attests that not all additional eligible professionals of the organization are meaningful EHR users with respect to an applicable year, the Secretary shall apply the payment adjustment under this paragraph based on the proportion of all such additional eligible professionals of the organization that are not meaningful EHR users for such year. ; (E) in paragraph (6)(A), by inserting and, as applicable, each additional eligible professional described in paragraph (9) after paragraph (2) ; (F) in paragraph (6)(B), by inserting and, as applicable, each additional eligible hospital described in paragraph (9) after subsection (m)(1) ; (G) in paragraph (7)(A), by inserting and, as applicable, additional eligible professionals after eligible professionals ; (H) in paragraph (7)(B), by inserting and, as applicable, additional eligible professionals after eligible professionals ; (I) in paragraph (8)(B), by inserting and additional eligible professionals described in paragraph (9) after paragraph (2) ; and (J) by adding at the end the following new paragraph: (9) Additional eligible professional described With respect to a qualifying MA organization, an additional eligible professional described in this paragraph is an additional eligible professional (as defined for purposes of section 1848(o)) who— (A) (i) is employed by the organization; or (ii) (I) is employed by, or is a partner of, an entity that through contract with the organization furnishes at least 80 percent of the entity’s Medicare patient care services to enrollees of such organization; and (II) furnishes at least 80 percent of the professional services of the additional eligible professional covered under this title to enrollees of the organization; and (B) furnishes, on average, at least 20 hours per week of patient care services. ; and (2) in subsection (m)— (A) in paragraph (1)— (i) by inserting or additional eligible hospitals (as described in paragraph (7)) after paragraph (2) ; and (ii) by inserting and additional eligible hospitals before under such sections ; (B) in paragraph (3)(A)(i), by inserting or additional eligible hospital after eligible hospital ; (C) in paragraph (3)(A)(ii), by inserting or an additional eligible hospital after eligible hospital in each place it occurs; (D) in paragraph (3)(B)— (i) in clause (i), by inserting or an additional eligible hospital described in paragraph (7) after paragraph (2) ; and (ii) in clause (ii)— (I) in the matter preceding subclause (I), by inserting or an additional eligible hospital described in paragraph (7) after paragraph (2) ; and (II) in subclause (I), by inserting or an additional eligible hospital, respectively, after eligible hospital ; (E) in paragraph (4)(A), by inserting or one or more additional eligible hospitals (as defined in section 1886(n)), as appropriate, after section 1886(n)(6)(A)) ; (F) in paragraph (4)(D), by adding at the end the following new sentence: In the case that a qualifying MA organization attests that not all additional eligible hospitals of the organization are meaningful EHR users with respect to an applicable period, the Secretary shall apply the payment adjustment under this paragraph based on the methodology specified by the Secretary, taking into account the proportion of such additional eligible hospitals, or discharges from such hospitals, that are not meaningful EHR users for such period. ; (G) in paragraph (5)(A), by inserting and, as applicable, each additional eligible hospital described in paragraph (7) after paragraph (2) ; (H) in paragraph (5)(B), by inserting and additional eligible hospitals, as applicable, after eligible hospitals ; (I) in paragraph (6)(B), by inserting and additional eligible hospitals described in paragraph (7) after paragraph (2) ; and (J) by adding at the end the following new paragraph: (7) Additional eligible hospital described With respect to a qualifying MA organization, an additional eligible hospital described in this paragraph is an additional eligible hospital (as defined in section 1886(n)(6)(C)) that is under common corporate governance with such organization and serves individuals enrolled under an MA plan offered by such organization. . VIII SAMHSA Reauthorization and Reforms A Organization and general authorities 801. In general Section 501 of the Public Health Service Act ( 42 U.S.C. 290aa ) is amended— (1) in subsection (h), by inserting at the end the following: For any such peer-review group reviewing a proposal or grant related to mental illness, no fewer than half of the members of the group shall have a medical degree, or a corresponding doctoral degree in psychology and clinical experience. ; and (2) in subsection (l)— (A) in paragraph (2), by striking and at the end; (B) in paragraph (3), by striking the period at the end and inserting ; and ; and (C) by adding at the end the following: (4) At least 60 days before awarding a grant, cooperative agreement, or contract, the Assistant Secretary shall give written notice of the award to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate. . 802. Advisory councils Paragraph (3) of section 502(b) of the Public Health Service Act ( 42 U.S.C. 290aa–1(b) ) is amended by adding at the end the following: (C) No fewer than half of the members of an advisory council shall be mental health care providers with— (i) experience in mental health research or treatment; and (ii) expertise in the fields on which they are advising. (D) None of the appointed members may have at any point been a recipient of any grant, or participated in any program, about which the members are to advise. (E) None of the appointed members may be related to anyone who has been a recipient of any grant, or participated in any program, about which the members are to advise. (F) None of the appointed members may have a financial interest in any grant or program with respect to which they advise, or receive funding separately through the Office of Assistant Secretary. (G) Each advisory committee must include at least one member of the National Institute of Mental Health and one member from any Federal agency that has a program serving a similar population. . 803. Peer review Section 504 of the Public Health Service Act ( 42 U.S.C. 290aa–3 ) is amended— (1) by adding at the end of subsection (b) the following: At least half of the members of any peer-review group established under subsection (a) shall have a degree in medicine, or a corresponding doctoral degree in psychology, or be a licensed mental health professional. Before awarding a grant, cooperative agreement, or contract, the Secretary shall provide a list of the members of the peer-review group responsible for reviewing the award to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate. ; and (2) by adding at the end the following: (e) Scientific controls and standards Peer review under this section shall ensure that any research concerning an intervention is based on scientific controls and standards indicating whether the intervention reduces symptoms, improves medical or behavioral outcomes, and improves social functioning. . B Protection and advocacy for individuals with mental illness 811. Prohibition against lobbying by systems accepting Federal funds to protect and advocate the rights of individuals with mental illness Section 105(a) of the Protection and Advocacy for Individuals with Mental Illness Act ( 42 U.S.C. 10805(a) ) is amended— (1) in paragraph (9), by striking and at the end; (2) in paragraph (10), by striking the period at the end and inserting a semicolon; and (3) by adding at the end the following: (11) agree to refrain, during any period for which funding is provided to the system under this part, from— (A) lobbying or retaining a lobbyist for the purpose of influencing a Federal, State, or local governmental entity or officer; and (B) counseling an individual with a serious mental illness who lacks insight into their condition on refusing medical treatment or acting against the wishes of such individual’s caregiver; . 812. Ensuring that caregivers of individuals with serious mental illness have access to the protected health information of such individuals Section 105(a) of the Protection and Advocacy for Individuals with Mental Illness Act ( 42 U.S.C. 10805(a) ), as amended by section 811, is further amended by adding at the end the following: (12) ensure that caregivers (as defined in section 201 of the Helping Families in Mental Health Crisis Act of 2015 ) of individuals with serious mental illness (as defined in such section 201) have access to the protected health information of such individuals consistent with such section 201; . 813. Protection and advocacy activities to focus exclusively on safeguarding rights to be free from abuse and neglect (a) Purposes Section 101(b) of the Protection and Advocacy for Individuals with Mental Illness Act ( 42 U.S.C. 10801(b) ) is amended— (1) in paragraph (1), by inserting to be free from abuse and neglect before are protected ; and (2) in paragraph (2)(A), by inserting to be free from abuse and neglect before through activities to ensure . (b) Allotments Section 103(2)(A) of the Protection and Advocacy for Individuals with Mental Illness Act ( 42 U.S.C. 10803(2)(A) ) is amended by inserting to be free from abuse and neglect before the semicolon. (c) Use of allotments Section 104(a)(1) of the Protection and Advocacy for Individuals with Mental Illness Act ( 42 U.S.C. 10804(a)(1) ) is amended— (1) in subparagraph (A), by striking and at the end; (2) in subparagraph (B), by striking the semicolon at the end and inserting to be free from abuse and neglect; and ; and (3) by adding at the end the following: (C) the protection and advocacy activities of such an agency or organization shall be exclusively focused on safeguarding the rights of individuals with mental illness to be free from abuse and neglect. . (d) System requirements Section 105 of the Protection and Advocacy for Individuals with Mental Illness Act ( 42 U.S.C. 10805 ), as amended by sections 811 and 812, is further amended— (1) in subsection (a)— (A) in the matter before paragraph (1), by inserting to be free from abuse and neglect before shall ; (B) in paragraph (6)(A), by inserting to be free from abuse and neglect before the semicolon; and (C) by adding at the end the following: (13) be exclusively focused on safeguarding the rights of individuals with mental illness to be free from abuse and neglect; and ; and (2) in subsection (c)(1)(A), by inserting to be free from abuse and neglect before shall have a governing authority . (e) Applications Section 111(a) of the Protection and Advocacy for Individuals with Mental Illness Act ( 42 U.S.C. 10821(a) ) is amended— (1) in paragraph (1), by inserting to be free from abuse and neglect before the semicolon; (2) in paragraph (3), by striking and at the end; (3) by redesignating paragraph (4) as paragraph (5); and (4) by inserting after paragraph (3) the following: (4) assurances that such system, and any State agency or nonprofit organization with which such system may enter into a contract under section 10804(a), will be exclusively focused on safeguarding the rights of individuals with mental illness to be free from abuse and neglect; and . (f) Reports by Secretary Section 114(a) of the Protection and Advocacy for Individuals with Mental Illness Act ( 42 U.S.C. 10824(a) ) is amended— (1) in paragraph (1) in the matter before subparagraph (A), by inserting to be free from abuse and neglect before supported with payments ; (2) in paragraph (2)(A), by inserting to be free from abuse and neglect before supported with payments ; and (3) in paragraph (4), by inserting to be free from abuse and neglect before and a description . 814. Reporting (a) Public availability of reports Section 105(a)(7) of the Protection and Advocacy for Individuals with Mental Illness Act ( 42 U.S.C. 10805(a)(7) ) is amended by striking is located a report and inserting is located, and make publicly available, a report . (b) Detailed accounting Section 114(a) of the Protection and Advocacy for Individuals with Mental Illness Act ( 42 U.S.C. 10824(a) ), as amended, is further amended— (1) in paragraph (3), by striking and at the end; (2) in paragraph (4), by striking the period at the end and inserting ; and ; and (3) by adding at the end the following: (5) a detailed accounting, for each system funded under this title, of how funds are spent, disaggregated according to whether the funds were received from the Federal Government, the State government, a local government, or a private entity. . 815. Grievance procedure Section 105 of the Protection and Advocacy for Individuals with Mental Illness Act ( 42 U.S.C. 10805 ), as amended, is further amended by adding at the end the following: (d) Grievance procedure The Assistant Secretary shall establish an independent grievance procedure for the types of claims to be adjudicated, at the request of persons described in subsection (a)(9), through a system’s grievance procedure established under such subsection. . 816. Evidence-based treatment for individuals with serious mental illness Section 105(a) of the Protection and Advocacy for Individuals with Mental Illness Act ( 42 U.S.C. 10805(a) ), as amended by sections 811, 812, and 813, is further amended by adding at the end the following: (14) ensure that individuals with serious mental illness have access to and can obtain evidence-based treatment for their serious mental illness. . IX Reporting 901. GAO study on preventing discriminatory coverage limitations for individuals with serious mental illness and substance use disorders Not later than 1 year after the date of the enactment of this Act, the Comptroller General of the United States, in consultation with the Assistant Secretary for Mental Health and Substance Use Disorders, the Secretary of Health and Human Services, the Secretary of Labor, and the Secretary of the Treasury, shall submit to Congress a report detailing the extent to which covered group health plans (or health insurance coverage offered in connection with such plans), including Medicaid managed care plans under section 1903 of the Social Security Act ( 42 U.S.C. 1396b ), comply with the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (subtitle B of title V of division C of Public Law 110–343 ) (in this section referred to as the law ), including— (1) how nonquantitative treatment limitations, including medical necessity criteria, of covered group health plans comply with the law; (2) how the responsible Federal departments and agencies ensure that plans comply with the law; and (3) how proper enforcement, education, and coordination activities within responsible Federal departments and agencies can be used to ensure full compliance with the law, including educational activities directed to State insurance commissioners.

tv_txt: I 114th CONGRESS 2d Session H. R. 2646 IN THE HOUSE OF REPRESENTATIVES AN ACT To make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis, and for other purposes.

1. Short title; table of contents (a) Short title This Act may be cited as the Helping Families in Mental Health Crisis Act of 2016 . (b) Table of contents The table of contents for this Act is as follows: Sec. 1. Short title; table of contents. Title I—Assistant Secretary for Mental Health and Substance Use Sec. 101. Assistant Secretary for Mental Health and Substance Use. Sec. 102. Improving oversight of mental health and substance use programs. Sec. 103. National Mental Health and Substance Use Policy Laboratory. Sec. 104. Peer-support specialist programs. Sec. 105. Prohibition against lobbying using Federal funds by systems accepting Federal funds to protect and advocate the rights of individuals with mental illness. Sec. 106. Reporting for protection and advocacy organizations. Sec. 107. Grievance procedure. Sec. 108. Center for Behavioral Health Statistics and Quality. Sec. 109. Strategic plan. Sec. 110. Authorities of centers for mental health services and substance abuse treatment. Sec. 111. Advisory councils. Sec. 112. Peer review. Title II—Medicaid Mental Health Coverage Sec. 201. Rule of construction related to Medicaid coverage of mental health services and primary care services furnished on the same day. Sec. 202. Optional limited coverage of inpatient services furnished in institutions for mental diseases. Sec. 203. Study and report related to Medicaid managed care regulation. Sec. 204. Guidance on opportunities for innovation. Sec. 205. Study and report on Medicaid emergency psychiatric demonstration project. Sec. 206. Providing EPSDT services to children in IMDs. Sec. 207. Electronic visit verification system required for personal care services and home health care services under Medicaid. Title III—Interdepartmental Serious Mental Illness Coordinating Committee Sec. 301. Interdepartmental Serious Mental Illness Coordinating Committee. Title IV—Compassionate Communication on HIPAA Sec. 401. Sense of Congress. Sec. 402. Confidentiality of records. Sec. 403. Clarification of circumstances under which disclosure of protected health information is permitted. Sec. 404. Development and dissemination of model training programs. Title V—Increasing Access to Treatment for Serious Mental Illness Sec. 501. Assertive community treatment grant program for individuals with serious mental illness. Sec. 502. Strengthening community crisis response systems. Sec. 503. Increased and extended funding for assisted outpatient grant program for individuals with serious mental illness. Sec. 504. Liability protections for health professional volunteers at community health centers. Title VI—Supporting Innovative and Evidence-Based Programs Subtitle A—Encouraging the Advancement, Incorporation, and Development of Evidence-Based Practices Sec. 601. Encouraging innovation and evidence-based programs. Sec. 602. Promoting access to information on evidence-based programs and practices. Sec. 603. Sense of Congress. Subtitle B—Supporting the State Response to Mental Health Needs Sec. 611. Community Mental Health Services Block Grant. Subtitle C—Strengthening Mental Health Care for Children and Adolescents Sec. 621. Tele-mental health care access grants. Sec. 622. Infant and early childhood mental health promotion, intervention, and treatment. Sec. 623. National Child Traumatic Stress Initiative. Title VII—Grant programs and program reauthorization Subtitle A—Garrett Lee Smith Memorial Act reauthorization Sec. 701. Youth interagency research, training, and technical assistance centers. Sec. 702. Youth suicide early intervention and prevention strategies. Sec. 703. Mental health and substance use disorder services on campus. Subtitle B—Other provisions Sec. 711. National Suicide Prevention Lifeline Program. Sec. 712. Workforce development studies and reports. Sec. 713. Minority Fellowship Program. Sec. 714. Center and program repeals. Sec. 715. National violent death reporting system. Sec. 716. Sense of Congress on prioritizing Native American youth and suicide prevention programs. Sec. 717. Peer professional workforce development grant program. Sec. 718. National Health Service Corps. Sec. 719. Adult suicide prevention. Sec. 720. Crisis intervention grants for police officers and first responders. Sec. 721. Demonstration grant program to train health service psychologists in community-based mental health. Sec. 722. Investment in tomorrow’s pediatric health care workforce. Sec. 723. CUTGO compliance. Title VIII—Mental Health Parity Sec. 801. Enhanced compliance with mental health and substance use disorder coverage requirements. Sec. 802. Action plan for enhanced enforcement of mental health and substance use disorder coverage. Sec. 803. Report on investigations regarding parity in mental health and substance use disorder benefits. Sec. 804. GAO study on parity in mental health and substance use disorder benefits. Sec. 805. Information and awareness on eating disorders. Sec. 806. Education and training on eating disorders. Sec. 807. GAO study on preventing discriminatory coverage limitations for individuals with serious mental illness and substance use disorders. Sec. 808. Clarification of existing parity rules. I Assistant Secretary for Mental Health and Substance Use 101. Assistant Secretary for Mental Health and Substance Use (a) Assistant Secretary Section 501(c) of the Public Health Service Act ( 42 U.S.C. 290aa ) is amended to read as follows: (c) Assistant Secretary and Deputy Assistant Secretary (1) Assistant Secretary (A) Appointment The Administration shall be headed by an official to be known as the Assistant Secretary for Mental Health and Substance Use (hereinafter in this title referred to as the Assistant Secretary ) who shall be appointed by the President, by and with the advice and consent of the Senate. (B) Qualifications In selecting the Assistant Secretary, the President shall give preference to individuals who have— (i) a doctoral degree in medicine, osteopathic medicine, or psychology; (ii) clinical and research experience regarding mental health and substance use disorders; and (iii) an understanding of biological, psychosocial, and pharmaceutical treatments of mental illness and substance use disorders. (2) Deputy Assistant Secretary The Assistant Secretary, with the approval of the Secretary, may appoint a Deputy Assistant Secretary and may employ and prescribe the functions of such officers and employees, including attorneys, as are necessary to administer the activities to be carried out through the Administration. . (b) Transfer of authorities The Secretary of Health and Human Services shall delegate to the Assistant Secretary for Mental Health and Substance Use all duties and authorities that— (1) as of the day before the date of enactment of this Act, were vested in the Administrator of the Substance Abuse and Mental Health Services Administration; and (2) are not terminated by this Act. (c) Evaluation Section 501(d) of the Public Health Service Act ( 42 U.S.C. 290aa(d) ) is amended— (1) in paragraph (17), by striking and at the end; (2) in paragraph (18), by striking the period at the end and inserting a semicolon; and (3) by adding at the end the following: (19) evaluate, in consultation with the Assistant Secretary for Financial Resources, the information used for oversight of grants under programs related to mental illness and substance use disorders, including co-occurring illness or disorders, administered by the Center for Mental Health Services; (20) periodically review Federal programs and activities relating to the diagnosis or prevention of, or treatment or rehabilitation for, mental illness and substance use disorders to identify any such programs or activities that have proven to be effective or efficient in improving outcomes or increasing access to evidence-based programs; (21) establish standards for the appointment of peer-review panels to evaluate grant applications and recommend standards for mental health grant programs; and . (d) Standards for grant programs Section 501(d) of the Public Health Service Act ( 42 U.S.C. 290aa(d) ), as amended by subsection (c), is further amended by adding at the end the following: (22) in consultation with the National Mental Health and Substance Use Policy Laboratory, and after providing an opportunity for public input, set standards for grant programs under this title for mental health and substance use services, which may address— (A) the capacity of the grantee to implement the award; (B) requirements for the description of the program implementation approach; (C) the extent to which the grant plan submitted by the grantee as part of its application must explain how the grantee will reach the population of focus and provide a statement of need, including to what extent the grantee will increase the number of clients served and the estimated percentage of clients receiving services who report positive functioning after 6 months or no past-month substance use, as applicable; (D) the extent to which the grantee must collect and report on required performance measures; and (E) the extent to which the grantee is proposing evidence-based practices and the extent to which— (i) those evidence-based practices must be used with respect to a population similar to the population for which the evidence-based practices were shown to be effective; or (ii) if no evidence-based practice exists for a population of focus, the way in which the grantee will implement adaptations of evidence-based practices, promising practices, or cultural practices. . (e) Emergency response Section 501(m) of the Public Health Service Act ( 42 U.S.C. 290aa(m) ) is amended by adding at the end the following: (4) Availability of funds through following fiscal year Amounts made available for carrying out this subsection shall remain available through the end of the fiscal year following the fiscal year for which such amounts are appropriated. . (f) Member of Council on Graduate Medical Education Section 762 of the Public Health Service Act ( 42 U.S.C. 290o ) is amended— (1) in subsection (b)— (A) by redesignating paragraphs (4), (5), and (6) as paragraphs (5), (6), and (7), respectively; and (B) by inserting after paragraph (3) the following: (4) the Assistant Secretary for Mental Health and Substance Use; ; and (2) in subsection (c), by striking (4), (5), and (6) each place it appears and inserting (5), (6), and (7) . (g) Conforming amendments Title V of the Public Health Service Act ( 42 U.S.C. 290aa et seq. ), as amended by the previous provisions of this section, is further amended— (1) by striking Administrator of the Substance Abuse and Mental Health Services Administration each place it appears and inserting Assistant Secretary for Mental Health and Substance Use ; and (2) by striking Administrator each place it appears (including in any headings) and inserting Assistant Secretary , except where the term Administrator appears— (A) in each of subsections (e) and (f) of section 501 of such Act ( 42 U.S.C. 290aa ), including the headings of such subsections, within the term Associate Administrator ; (B) in section 507(b)(6) of such Act ( 42 U.S.C. 290bb(b)(6) ), within the term Administrator of the Health Resources and Services Administration ; (C) in section 507(b)(6) of such Act ( 42 U.S.C. 290bb(b)(6) ), within the term Administrator of the Centers for Medicare & Medicaid Services ; (D) in section 519B(c)(1)(B) of such Act (42 U.S.C. 290bb–25b(c)(1)(B)), within the term Administrator of the National Highway Traffic Safety Administration ; or (E) in each of sections 519B(c)(1)(B), 520C(a), and 520D(a) of such Act (42 U.S.C. 290bb–25b(c)(1)(B), 290bb–34(a), 290bb–35(a)), within the term Administrator of the Office of Juvenile Justice and Delinquency Prevention . (h) References After executing subsections (a), (b), and (f), any reference in statute, regulation, or guidance to the Administrator of the Substance Abuse and Mental Health Services Administration shall be construed to be a reference to the Assistant Secretary for Mental Health and Substance Use. 102. Improving oversight of mental health and substance use programs Title V of the Public Health Service Act is amended by inserting after section 501 of such Act ( 42 U.S.C. 290aa ) the following: 501A. Improving oversight of mental health and substance use programs (a) Activities For the purpose of ensuring efficient and effective planning and evaluation of mental illness and substance use disorder programs and related activities, the Assistant Secretary for Planning and Evaluation, in consultation with the Assistant Secretary for Mental Health and Substance Use, shall— (1) collect and organize relevant data on homelessness, involvement with the criminal justice system, hospitalizations, mortality outcomes, and other measures the Secretary deems appropriate from across Federal departments and agencies; (2) evaluate programs related to mental illness and substance use disorders, including co-occurring illness or disorders, across Federal departments and agencies, as appropriate, including programs related to— (A) prevention, intervention, treatment, and recovery support services, including such services for individuals with a serious mental illness or serious emotional disturbance; (B) the reduction of homelessness and involvement with the criminal justice system among individuals with a mental illness or substance use disorder; and (C) public health and health services; and (3) consult, as appropriate, with the Assistant Secretary, the Behavioral Health Coordinating Council of the Department of Health and Human Services, other agencies within the Department of Health and Human Services, and other relevant Federal departments. (b) Recommendations The Assistant Secretary for Planning and Evaluation shall develop an evaluation strategy that identifies priority programs to be evaluated by the Assistant Secretary and priority programs to be evaluated by other relevant agencies within the Department of Health and Human Services. The Assistant Secretary for Planning and Evaluation shall provide recommendations on improving programs and activities based on the evaluation described in subsection (a)(2) as needing improvement. . 103. National Mental Health and Substance Use Policy Laboratory Title V of the Public Health Service Act ( 42 U.S.C. 290aa et seq. ) is amended by inserting after section 501A, as added by section 102 of this Act, the following: 501B. National Mental Health and Substance Use Policy Laboratory (a) In general There shall be established within the Administration a National Mental Health and Substance Use Policy Laboratory (referred to in this section as the Laboratory ). (b) Responsibilities The Laboratory shall— (1) continue to carry out the authorities and activities that were in effect for the Office of Policy, Planning, and Innovation as such Office existed prior to the date of enactment of the Helping Families in Mental Health Crisis Act of 2016 ; (2) identify, coordinate, and facilitate the implementation of policy changes likely to have a significant effect on mental health, mental illness, and the prevention and treatment of substance use disorder services; (3) collect, as appropriate, information from grantees under programs operated by the Administration in order to evaluate and disseminate information on evidence-based practices, including culturally and linguistically appropriate services, as appropriate, and service delivery models; (4) provide leadership in identifying and coordinating policies and programs, including evidence-based programs, related to mental illness and substance use disorders; (5) recommend ways in which payers may implement program and policy findings of the Administration and the Laboratory to improve outcomes and reduce per capita program costs; (6) in consultation with the Assistant Secretary for Planning and Evaluation, as appropriate, periodically review Federal programs and activities relating to the diagnosis or prevention of, or treatment or rehabilitation for, mental illness and substance use disorders, including by— (A) identifying any such programs or activities that are duplicative; (B) identifying any such programs or activities that are not evidence-based, effective, or efficient; and (C) formulating recommendations for coordinating, eliminating, or improving programs or activities identified under subparagraph (A) or (B) and merging such programs or activities into other successful programs or activities; and (7) carry out other activities as deemed necessary to continue to encourage innovation and disseminate evidence-based programs and practices, including programs and practices with scientific merit. (c) Evidence-Based practices and service delivery models (1) In general In selecting evidence-based best practices and service delivery models for evaluation and dissemination, the Laboratory— (A) shall give preference to models that improve— (i) the coordination between mental health and physical health providers; (ii) the coordination among such providers and the justice and corrections system; and (iii) the cost effectiveness, quality, effectiveness, and efficiency of health care services furnished to individuals with serious mental illness or serious emotional disturbance, in mental health crisis, or at risk to themselves, their families, and the general public; and (B) may include clinical protocols and practices used in the Recovery After Initial Schizophrenia Episode (RAISE) project and the North American Prodrome Longitudinal Study (NAPLS) of the National Institute of Mental Health. (2) Deadline for beginning implementation The Laboratory shall begin implementation of the duties described in this section not later than January 1, 2018. (3) Consultation In carrying out the duties under this section, the Laboratory shall consult with— (A) representatives of the National Institute of Mental Health, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism, on an ongoing basis; (B) other appropriate Federal agencies; (C) clinical and analytical experts with expertise in psychiatric medical care and clinical psychological care, health care management, education, corrections health care, and mental health court systems, as appropriate; and (D) other individuals and agencies as determined appropriate by the Assistant Secretary. . 104. Peer-support specialist programs (a) In general Not later than 2 years after the date of enactment of this Act, the Comptroller General of the United States shall conduct a study on peer-support specialist programs in up to 10 States (to be selected by the Comptroller General) that receive funding from the Substance Abuse and Mental Health Services Administration and submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives a report containing the results of such study. (b) Contents of study In conducting the study under subsection (a), the Comptroller General of the United States shall examine and identify best practices in the selected States related to training and credential requirements for peer-support specialist programs, such as— (1) hours of formal work or volunteer experience related to mental illness and substance use disorders conducted through such programs; (2) types of peer-support specialist exams required for such programs in the States; (3) codes of ethics used by such programs in the States; (4) required or recommended skill sets of such programs in the State; and (5) requirements for continuing education. 105. Prohibition against lobbying using Federal funds by systems accepting Federal funds to protect and advocate the rights of individuals with mental illness Section 105(a) of the Protection and Advocacy for Individuals with Mental Illness Act ( 42 U.S.C. 10805(a) ) is amended— (1) in paragraph (9), by striking and at the end; (2) in paragraph (10), by striking the period at the end and inserting ; and ; and (3) by adding at the end the following: (11) agree to refrain, during any period for which funding is provided to the system under this part, from using Federal funds to pay the salary or expenses of any grant or contract recipient, or agent acting for such recipient, related to any activity designed to influence the enactment of legislation, appropriations, regulation, administrative action, or Executive order proposed or pending before the Congress or any State or local government, including any legislative body, other than for normal and recognized executive-legislative relationships or participation by an agency or officer of a State, local, or tribal government in policymaking and administrative processes within the executive branch of that government. . 106. Reporting for protection and advocacy organizations (a) Public availability of reports Section 105(a)(7) of the Protection and Advocacy for Individuals with Mental Illness Act ( 42 U.S.C. 10805(a)(7) ) is amended by striking is located a report and inserting is located, and make publicly available, a report . (b) Detailed accounting Section 114(a) of the Protection and Advocacy for Individuals with Mental Illness Act ( 42 U.S.C. 10824(a) ) is amended— (1) in paragraph (3), by striking and at the end; (2) in paragraph (4), by striking the period at the end and inserting ; and ; and (3) by adding at the end the following: (5) using data from the existing required annual program progress reports submitted by each system funded under this title, a detailed accounting for each such system of how funds are spent, disaggregated according to whether the funds were received from the Federal Government, the State government, a local government, or a private entity. . 107. Grievance procedure Section 105 of the Protection and Advocacy for Individuals with Mental Illness Act ( 42 U.S.C. 10805 ), as amended, is further amended by adding at the end the following: (d) Grievance procedure The Secretary shall establish an independent grievance procedure for persons described in subsection (a)(9). . 108. Center for Behavioral Health Statistics and Quality Title V of the Public Health Service Act ( 42 U.S.C. 290aa et seq. ) is amended— (1) in section 501(b) ( 42 U.S.C. 290aa(b) ), by adding at the end the following: (4) The Center for Behavioral Health Statistics and Quality. ; (2) in section 502(a)(1) ( 42 U.S.C. 290aa–1(a)(1) )— (A) in subparagraph (C), by striking and at the end; (B) in subparagraph (D), by striking the period at the end and inserting ; and ; and (C) by inserting after subparagraph (D) the following: (E) the Center for Behavioral Health Statistics and Quality. ; and (3) in part B ( 42 U.S.C. 290bb et seq. ) by adding at the end the following new subpart: 4 Center for Behavioral Health Statistics and Quality 520L. Center for Behavioral Health Statistics and Quality (a) Establishment There is established in the Administration a Center for Behavioral Health Statistics and Quality (in this section referred to as the Center ). The Center shall be headed by a Director (in this section referred to as the Director ) appointed by the Secretary from among individuals with extensive experience and academic qualifications in research and analysis in behavioral health care or related fields. (b) Duties The Director of the Center shall— (1) coordinate the Administration’s integrated data strategy by coordinating— (A) surveillance and data collection (including that authorized by section 505); (B) evaluation; (C) statistical and analytic support; (D) service systems research; and (E) performance and quality information systems; (2) recommend a core set of measurement standards for grant programs administered by the Administration; and (3) coordinate evaluation efforts for the grant programs, contracts, and collaborative agreements of the Administration. (c) Biannual report to Congress Not later than 2 years after the date of enactment of this section, and every 2 years thereafter, the Director of the Center shall submit to Congress a report on the quality of services furnished through grant programs of the Administration, including applicable measures of outcomes for individuals and public outcomes such as— (1) the number of patients screened positive for unhealthy alcohol use who receive brief counseling as appropriate; the number of patients screened positive for tobacco use and receiving smoking cessation interventions; the number of patients with a new diagnosis of major depressive episode who are assessed for suicide risk; the number of patients screened positive for clinical depression with a documented followup plan; and the number of patients with a documented pain assessment that have a followup treatment plan when pain is present; and satisfaction with care; (2) the incidence and prevalence of mental illness and substance use disorders; the number of suicide attempts and suicide completions; overdoses seen in emergency rooms resulting from alcohol and drug use; emergency room boarding; overdose deaths; emergency psychiatric hospitalizations; new criminal justice involvement while in treatment; stable housing; and rates of involvement in employment, education, and training; and (3) such other measures for outcomes of services as the Director may determine. (d) Staffing Composition The staff of the Center may include individuals with advanced degrees and field expertise as well as clinical and research experience in mental illness and substance use disorders such as— (1) professionals with clinical and research expertise in the prevention and treatment of, and recovery from, mental illness and substance use disorders; (2) professionals with training and expertise in statistics or research and survey design and methodologies; and (3) other related fields in the social and behavioral sciences, as specified by relevant position descriptions. (e) Grants and contracts In carrying out the duties established in subsection (b), the Director may make grants to, and enter into contracts and cooperative agreements with, public and nonprofit private entities. (f) Definition In this section, the term emergency room boarding means the practice of admitting patients to an emergency department and holding such patients in the department until inpatient psychiatric beds become available. . 109. Strategic plan Section 501 of the Public Health Service Act ( 42 U.S.C. 290aa ) is further amended— (1) by redesignating subsections (l) through (o) as subsections (m) through (p), respectively; and (2) by inserting after subsection (k) the following: (l) Strategic plan (1) In general Not later than December 1, 2017, and every 5 years thereafter, the Assistant Secretary shall develop and carry out a strategic plan in accordance with this subsection for the planning and operation of evidence-based programs and grants carried out by the Administration. (2) Coordination In developing and carrying out the strategic plan under this section, the Assistant Secretary shall take into consideration the report of the Interdepartmental Serious Mental Illness Coordinating Committee under section 301 of the Helping Families in Mental Health Crisis Act of 2016. (3) Publication of plan Not later than December 1, 2017, and every 5 years thereafter, the Assistant Secretary shall— (A) submit the strategic plan developed under paragraph (1) to the appropriate committees of Congress; and (B) post such plan on the Internet website of the Administration. (4) Contents The strategic plan developed under paragraph (1) shall— (A) identify strategic priorities, goals, and measurable objectives for mental illness and substance use disorder activities and programs operated and supported by the Administration, including priorities to prevent or eliminate the burden of mental illness and substance use disorders; (B) identify ways to improve services for individuals with a mental illness or substance use disorder, including services related to the prevention of, diagnosis of, intervention in, treatment of, and recovery from, mental illness or substance use disorders, including serious mental illness or serious emotional disturbance, and access to services and supports for individuals with a serious mental illness or serious emotional disturbance; (C) ensure that programs provide, as appropriate, access to effective and evidence-based prevention, diagnosis, intervention, treatment, and recovery services, including culturally and linguistically appropriate services, as appropriate, for individuals with a mental illness or substance use disorder; (D) identify opportunities to collaborate with the Health Resources and Services Administration to develop or improve— (i) initiatives to encourage individuals to pursue careers (especially in rural and underserved areas and populations) as psychiatrists, psychologists, psychiatric nurse practitioners, physician assistants, occupational therapists, clinical social workers, certified peer-support specialists, licensed professional counselors, or other licensed or certified mental health professionals, including such professionals specializing in the diagnosis, evaluation, or treatment of individuals with a serious mental illness or serious emotional disturbance; and (ii) a strategy to improve the recruitment, training, and retention of a workforce for the treatment of individuals with mental illness or substance use disorders, or co-occurring illness or disorders; (E) identify opportunities to improve collaboration with States, local governments, communities, and Indian tribes and tribal organizations (as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act ( 25 U.S.C. 450b )); and (F) specify a strategy to disseminate evidenced-based and promising best practices related to prevention, diagnosis, early intervention, treatment, and recovery services related to mental illness, particularly for individuals with a serious mental illness and children and adolescents with a serious emotional disturbance, and substance use disorders. . 110. Authorities of centers for mental health services and substance abuse treatment (a) Center for mental health services Section 520(b) of the Public Health Service Act ( 42 U.S.C. 290bb–31(b) ) is amended— (1) by redesignating paragraphs (3) through (15) as paragraphs (4) through (16), respectively; (2) by inserting after paragraph (2) the following: (3) collaborate with the Director of the National Institute of Mental Health to ensure that, as appropriate, programs related to the prevention and treatment of mental illness and the promotion of mental health are carried out in a manner that reflects the best available science and evidence-based practices, including culturally and linguistically appropriate services; ; (3) in paragraph (5), as so redesignated, by inserting through policies and programs that reduce risk and promote resiliency before the semicolon; (4) in paragraph (6), as so redesignated, by inserting in collaboration with the Director of the National Institute of Mental Health, before develop ; (5) in paragraph (8), as so redesignated, by inserting , increase meaningful participation of individuals with mental illness in programs and activities of the Administration, before and protect the legal ; (6) in paragraph (10), as so redesignated, by striking professional and paraprofessional personnel pursuant to section 303 and inserting paraprofessional personnel and health professionals ; (7) in paragraph (11), as so redesignated, by inserting and telemental health, after rural mental health, ; (8) in paragraph (12), as so redesignated, by striking establish a clearinghouse for mental health information to assure the widespread dissemination of such information and inserting disseminate mental health information, including evidenced-based practices, ; (9) in paragraph (15), as so redesignated, by striking and at the end; (10) in paragraph (16), as so redesignated, by striking the period and inserting ; and ; and (11) by adding at the end the following: (17) consult with other agencies and offices of the Department of Health and Human Services to ensure, with respect to each grant awarded by the Center for Mental Health Services, the consistent documentation of the application of criteria when awarding grants and the ongoing oversight of grantees after such grants are awarded. . (b) Director of the center for substance abuse treatment Section 507 of the Public Health Service Act ( 42 U.S.C. 290bb ) is amended— (1) in subsection (a)— (A) by striking treatment of substance abuse and inserting treatment of substance use disorders ; and (B) by striking abuse treatment systems and inserting use disorder treatment systems ; and (2) in subsection (b)— (A) in paragraph (3), by striking abuse and inserting use disorder ; (B) in paragraph (4), by striking individuals who abuse drugs and inserting individuals who use drugs ; (C) in paragraph (9), by striking carried out by the Director ; (D) by striking paragraph (10); (E) by redesignating paragraphs (11) through (14) as paragraphs (10) through (13), respectively; (F) in paragraph (12), as so redesignated, by striking ; and and inserting a semicolon; and (G) by striking paragraph (13), as so redesignated, and inserting the following: (13) ensure the consistent documentation of the application of criteria when awarding grants and the ongoing oversight of grantees after such grants are awarded; and (14) work with States, providers, and individuals in recovery, and their families, to promote the expansion of recovery support services and systems of care oriented towards recovery. . 111. Advisory councils Section 502(b) of the Public Health Service Act ( 42 U.S.C. 290aa–1(b) ) is amended— (1) in paragraph (2)— (A) in subparagraph (E), by striking and after the semicolon; (B) by redesignating subparagraph (F) as subparagraph (I); and (C) by inserting after subparagraph (E), the following: (F) for the advisory councils appointed under subsections (a)(1)(A) and (a)(1)(D), the Director of the National Institute of Mental Health; (G) for the advisory councils appointed under subsections (a)(1)(A), (a)(1)(B), and (a)(1)(C), the Director of the National Institute on Drug Abuse; (H) for the advisory councils appointed under subsections (a)(1)(A), (a)(1)(B), and (a)(1)(C), the Director of the National Institute on Alcohol Abuse and Alcoholism; and ; and (2) in paragraph (3), by adding at the end the following: (C) Not less than half of the members of the advisory council appointed under subsection (a)(1)(D)— (i) shall have— (I) a medical degree; (II) a doctoral degree in psychology; or (III) an advanced degree in nursing or social work from an accredited graduate school or be a certified physician assistant; and (ii) shall specialize in the mental health field. . 112. Peer review Section 504(b) of the Public Health Service Act ( 42 U.S.C. 290aa–3(b) ) is amended by adding at the end the following: In the case of any such peer review group that is reviewing a grant, cooperative agreement, or contract related to mental illness treatment, not less than half of the members of such peer review group shall be licensed and experienced professionals in the prevention, diagnosis, or treatment of, or recovery from, mental illness or substance use disorders and have a medical degree, a doctoral degree in psychology, or an advanced degree in nursing or social work from an accredited program. . II Medicaid Mental Health Coverage 201. Rule of construction related to Medicaid coverage of mental health services and primary care services furnished on the same day Nothing in title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ) shall be construed as prohibiting separate payment under the State plan under such title (or under a waiver of the plan) for the provision of a mental health service or primary care service under such plan, with respect to an individual, because such service is— (1) a primary care service furnished to the individual by a provider at a facility on the same day a mental health service is furnished to such individual by such provider (or another provider) at the facility; or (2) a mental health service furnished to the individual by a provider at a facility on the same day a primary care service is furnished to such individual by such provider (or another provider) at the facility. 202. Optional limited coverage of inpatient services furnished in institutions for mental diseases (a) In general Section 1903(m)(2) of the Social Security Act ( 42 U.S.C. 1396b(m)(2) ) is amended by adding at the end the following new subparagraph: (I) (i) Notwithstanding the limitation specified in the subdivision (B) following paragraph (29) of section 1905(a) and subject to clause (ii), a State may, under a risk contract entered into by the State under this title (or under section 1115) with a medicaid managed care organization or a prepaid inpatient health plan (as defined in section 438.2 of title 42, Code of Federal Regulations (or any successor regulation)), make a monthly capitation payment to such organization or plan for enrollees with the organization or plan who are over 21 years of age and under 65 years of age and are receiving inpatient treatment in an institution for mental diseases (as defined in section 1905(i)), so long as each of the following conditions is met: (I) The institution is a hospital providing inpatient psychiatric or substance use disorder services or a sub-acute facility providing psychiatric or substance use disorder crisis residential services. (II) The length of stay in such an institution for such treatment is for a short-term stay of no more than 15 days during the period of the monthly capitation payment. (III) The provision of such treatment meets the following criteria for consideration as services or settings that are provided in lieu of services or settings covered under the State plan: (aa) The State determines that the alternative service or setting is a medically appropriate and cost-effective substitute for the service or setting covered under the State plan. (bb) The enrollee is not required by the managed care organization or prepaid inpatient health plan to use the alternative service or setting. (cc) Such treatment is authorized and identified in such contract, and will be offered to such enrollees at the option of the managed care organization or prepaid inpatient health plan. (ii) For purposes of setting the amount of such a monthly capitation payment, a State may use the utilization of services provided to an individual under this subparagraph when developing the inpatient psychiatric or substance use disorder component of such payment, but the amount of such payment for such services may not exceed the cost of the same services furnished through providers included under the State plan. . (b) Effective date The amendment made by subsection (a) shall apply beginning on July 5, 2016, or the date of the enactment of this Act, whichever is later. 203. Study and report related to Medicaid managed care regulation (a) Study The Secretary of Health and Human Services, acting through the Administrator of the Centers for Medicare & Medicaid Services, shall conduct a study on coverage under the Medicaid program under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ) of services provided through a medicaid managed care organization (as defined in section 1903(m) of such Act ( 42 U.S.C. 1396b(m) ) or a prepaid inpatient health plan (as defined in section 438.2 of title 42, Code of Federal Regulations (or any successor regulation)) with respect to individuals over the age of 21 and under the age of 65 for the treatment of a mental health disorder in institutions for mental diseases (as defined in section 1905(i) of such Act ( 42 U.S.C. 1396d(i) )). Such study shall include information on the following: (1) The extent to which States, including the District of Columbia and each territory or possession of the United States, are providing capitated payments to such organizations or plans for enrollees who are receiving services in institutions for mental diseases. (2) The number of individuals receiving medical assistance under a State plan under such title XIX, or a waiver of such plan, who receive services in institutions for mental diseases through such organizations and plans. (3) The range of and average number of months, and the length of stay during such months, that such individuals are receiving such services in such institutions. (4) How such organizations or plans determine when to provide for the furnishing of such services through an institution for mental diseases in lieu of other benefits (including the full range of community-based services) under their contract with the State agency administering the State plan under such title XIX, or a waiver of such plan, to address psychiatric or substance use disorder treatment. (5) The extent to which the provision of services within such institutions has affected the capitated payments for such organizations or plans. (b) Report Not later than 3 years after the date of the enactment of this Act, the Secretary shall submit to Congress a report on the study conducted under subsection (a). 204. Guidance on opportunities for innovation Not later than 1 year after the date of the enactment of this Act, the Administrator of the Centers for Medicare & Medicaid Services shall issue a State Medicaid Director letter regarding opportunities to design innovative service delivery systems, including systems for providing community-based services, for individuals with serious mental illness or serious emotional disturbance who are receiving medical assistance under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ). The letter shall include opportunities for demonstration projects under section 1115 of such Act ( 42 U.S.C. 1315 ), to improve care for such individuals. 205. Study and report on Medicaid emergency psychiatric demonstration project (a) Collection of information The Secretary of Health and Human Services, acting through the Administrator of the Centers for Medicare & Medicaid Services, shall, with respect to each State that has participated in the demonstration project established under section 2707 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 1396a note), collect from each such State information on the following: (1) The number of institutions for mental diseases (as defined in section 1905(i) of the Social Security Act ( 42 U.S.C. 1396d(i) )) and beds in such institutions that received payment for the provision of services to individuals who receive medical assistance under a State plan under the Medicaid program under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ) (or under a waiver of such plan) through the demonstration project in each such State as compared to the total number of institutions for mental diseases and beds in the State. (2) The extent to which there is a reduction in expenditures under the Medicaid program under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ) or other spending on the full continuum of physical or mental health care for individuals who receive treatment in an institution for mental diseases under the demonstration project, including outpatient, inpatient, emergency, and ambulatory care, that is attributable to such individuals receiving treatment in institutions for mental diseases under the demonstration project. (3) The number of forensic psychiatric hospitals, the number of beds in such hospitals, and the number of forensic psychiatric beds in other hospitals in such State, based on the most recent data available, to the extent practical, as determined by such Administrator. (4) The amount of any disproportionate share hospital payments under section 1923 of the Social Security Act ( 42 U.S.C. 1396r–4 ) that institutions for mental diseases in the State received during the period beginning on July 1, 2012, and ending on June 30, 2015, and the extent to which the demonstration project reduced the amount of such payments. (5) The most recent data regarding all facilities or sites in the State in which any individuals with serious mental illness who are receiving medical assistance under a State plan under the Medicaid program under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ) (or under a waiver of such plan) are treated during the period referred to in paragraph (4), to the extent practical, as determined by the Administrator, including— (A) the types of such facilities or sites (such as an institution for mental diseases, a hospital emergency department, or other inpatient hospital); (B) the average length of stay in such a facility or site by such an individual, disaggregated by facility type; and (C) the payment rate under the State plan (or a waivers of such plan) for services furnished to such an individual for that treatment, disaggregated by facility type, during the period in which the demonstration project is in operation. (6) The extent to which the utilization of hospital emergency departments during the period in which the demonstration project was is in operation differed, with respect to individuals who are receiving medical assistance under a State plan under the Medicaid program under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ) (or under a waiver of such plan), between— (A) those individuals who received treatment in an institution for mental diseases under the demonstration project; (B) those individuals who met the eligibility requirements for the demonstration project but who did not receive treatment in an institution for mental diseases under the demonstration project; and (C) those individuals with serious mental illness who did not meet such eligibility requirements and did not receive treatment for such illness in an institution for mental diseases. (b) Report Not later than 2 years after the date of the enactment of this Act, the Secretary of Health and Human Services shall submit to Congress a report that summarizes and analyzes the information collected under subsection (a). Such report may be submitted as part of the report required under section 2707(f) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 1396a note) or separately. 206. Providing EPSDT services to children in IMDs (a) In general Section 1905(a)(16) of the Social Security Act ( 42 U.S.C. 1396d(a)(16) ) is amended— (1) by striking effective January 1, 1973 and inserting (A) effective January 1, 1973 ; and (2) by inserting before the semicolon at the end the following: , and, (B) for individuals receiving services described in subparagraph (A), early and periodic screening, diagnostic, and treatment services (as defined in subsection (r)), whether or not such screening, diagnostic, and treatment services are furnished by the provider of the services described in such subparagraph . (b) Effective date The amendment made by subsection (a) shall apply with respect to items and services furnished in calendar quarters beginning on or after January 1, 2019. 207. Electronic visit verification system required for personal care services and home health care services under Medicaid (a) In general Section 1903 of the Social Security Act ( 42 U.S.C. 1396b ) is amended by inserting after subsection (k) the following new subsection: (l) (1) Subject to paragraphs (3) and (4), with respect to any amount expended for personal care services or home health care services requiring an in-home visit by a provider that are provided under a State plan under this title (or under a waiver of the plan) and furnished in a calendar quarter beginning on or after January 1, 2019 (or, in the case of home health care services, on or after January 1, 2023), unless a State requires the use of an electronic visit verification system for such services furnished in such quarter under the plan or such waiver, the Federal medical assistance percentage shall be reduced— (A) in the case of personal care services— (i) for calendar quarters in 2019 and 2020, by .25 percentage points; (ii) for calendar quarters in 2021, by .5 percentage points; (iii) for calendar quarters in 2022, by .75 percentage points; and (iv) for calendar quarters in 2023 and each year thereafter, by 1 percentage point; and (B) in the case of home health care services— (i) for calendar quarters in 2023 and 2024, by .25 percentage points; (ii) for calendar quarters in 2025, by .5 percentage points; (iii) for calendar quarters in 2026, by .75 percentage points; and (iv) for calendar quarters in 2027 and each year thereafter, by 1 percentage point. (2) Subject to paragraphs (3) and (4), in implementing the requirement for the use of an electronic visit verification system under paragraph (1), a State shall— (A) consult with agencies and entities that provide personal care services, home health care services, or both under the State plan (or under a waiver of the plan) to ensure that such system— (i) is minimally burdensome; (ii) takes into account existing best practices and electronic visit verification systems in use in the State; and (iii) is conducted in accordance with the requirements of HIPAA privacy and security law (as defined in section 3009 of the Public Health Service Act); (B) take into account a stakeholder process that includes input from beneficiaries, family caregivers, individuals who furnish personal care services or home health care services, and other stakeholders, as determined by the State in accordance with guidance from the Secretary; and (C) ensure that individuals who furnish personal care services, home health care services, or both under the State plan (or under a waiver of the plan) are provided the opportunity for training on the use of such system. (3) Paragraphs (1) and (2) shall not apply in the case of a State that, as of the date of the enactment of this subsection, requires the use of any system for the electronic verification of visits conducted as part of both personal care services and home health care services, so long as the State continues to require the use of such system with respect to the electronic verification of such visits. (4) (A) In the case of a State described in subparagraph (B), the reduction under paragraph (1) shall not apply— (i) in the case of personal care services, for calendar quarters in 2019; and (ii) in the case of home health care services, for calendar quarters in 2023. (B) For purposes of subparagraph (A), a State described in this subparagraph is a State that demonstrates to the Secretary that the State— (i) has made a good faith effort to comply with the requirements of paragraphs (1) and (2) (including by taking steps to adopt the technology used for an electronic visit verification system); or (ii) in implementing such a system, has encountered unavoidable system delays. (5) In this subsection: (A) The term electronic visit verification system means, with respect to personal care services or home health care services, a system under which visits conducted as part of such services are electronically verified with respect to— (i) the type of service performed; (ii) the individual receiving the service; (iii) the date of the service; (iv) the location of service delivery; (v) the individual providing the service; and (vi) the time the service begins and ends. (B) The term home health care services means services described in section 1905(a)(7) provided under a State plan under this title (or under a waiver of the plan). (C) The term personal care services means personal care services provided under a State plan under this title (or under a waiver of the plan), including services provided under section 1905(a)(24), 1915(c), 1915(i), 1915(j), or 1915(k) or under a wavier under section 1115. (6) (A) In the case in which a State requires personal care service and home health care service providers to utilize an electronic visit verification system operated by the State or a contractor on behalf of the State, the Secretary shall pay to the State, for each quarter, an amount equal to 90 per centum of so much of the sums expended during such quarter as are attributable to the design, development, or installation of such system, and 75 per centum of so much of the sums for the operation and maintenance of such system. (B) Subparagraph (A) shall not apply in the case in which a State requires personal care service and home health care service providers to utilize an electronic visit verification system that is not operated by the State or a contractor on behalf of the State. . (b) Collection and dissemination of best practices Not later than January 1, 2018, the Secretary of Health and Human Services shall, with respect to electronic visit verification systems (as defined in subsection (l)(5) of section 1903 of the Social Security Act ( 42 U.S.C. 1396b ), as inserted by subsection (a)), collect and disseminate best practices to State Medicaid Directors with respect to— (1) training individuals who furnish personal care services, home health care services, or both under the State plan under title XIX of such Act (or under a waiver of the plan) on such systems and the operation of such systems and the prevention of fraud with respect to the provision of personal care services or home health care services (as defined in such subsection (l)(5)); and (2) the provision of notice and educational materials to family caregivers and beneficiaries with respect to the use of such electronic visit verification systems and other means to prevent such fraud. (c) Rules of construction (1) No employer-employee relationship established Nothing in the amendment made by this section may be construed as establishing an employer-employee relationship between the agency or entity that provides for personal care services or home health care services and the individuals who, under a contract with such an agency or entity, furnish such services for purposes of part 552 of title 29, Code of Federal Regulations (or any successor regulations). (2) No particular or uniform electronic visit verification system required Nothing in the amendment made by this section shall be construed to require the use of a particular or uniform electronic visit verification system (as defined in subsection (l)(5) of section 1903 of the Social Security Act ( 42 U.S.C. 1396b ), as inserted by subsection (a)) by all agencies or entities that provide personal care services or home health care under a State plan under title XIX of the Social Security Act (or under a waiver of the plan) ( 42 U.S.C. 1396 et seq. ). (3) No limits on provision of care Nothing in the amendment made by this section may be construed to limit, with respect to personal care services or home health care services provided under a State plan under title XIX of the Social Security Act (or under a waiver of the plan) ( 42 U.S.C. 1396 et seq. ), provider selection, constrain beneficiaries’ selection of a caregiver, or impede the manner in which care is delivered. (4) No prohibition on State quality measures requirements Nothing in the amendment made by this section shall be construed as prohibiting a State, in implementing an electronic visit verification system (as defined in subsection (l)(5) of section 1903 of the Social Security Act ( 42 U.S.C. 1396b ), as inserted by subsection (a)), from establishing requirements related to quality measures for such system. III Interdepartmental Serious Mental Illness Coordinating Committee 301. Interdepartmental Serious Mental Illness Coordinating Committee (a) Establishment (1) In general Not later than 3 months after the date of enactment of this Act, the Secretary of Health and Human Services, or the designee of the Secretary, shall establish a committee to be known as the Interdepartmental Serious Mental Illness Coordinating Committee (in this section referred to as the Committee ). (2) Federal Advisory Committee Act Except as provided in this section, the provisions of the Federal Advisory Committee Act (5 U.S.C. App.) shall apply to the Committee. (b) Meetings The Committee shall meet not fewer than two times each year. (c) Responsibilities Not later than 1 year after the date of enactment of this Act, and 5 years after such date of enactment, the Committee shall submit to Congress a report including— (1) a summary of advances in serious mental illness and serious emotional disturbance research related to the prevention of, diagnosis of, intervention in, and treatment and recovery of, serious mental illnesses, serious emotional disturbances, and advances in access to services and support for individuals with a serious mental illness or serious emotional disturbance; (2) an evaluation of the effect on public health of Federal programs related to serious mental illness or serious emotional disturbance, including measurements of public health outcomes such as— (A) rates of suicide, suicide attempts, prevalence of serious mental illness, serious emotional disturbances, and substance use disorders, overdose, overdose deaths, emergency hospitalizations, emergency room boarding, preventable emergency room visits, involvement with the criminal justice system, crime, homelessness, and unemployment; (B) increased rates of employment and enrollment in educational and vocational programs; (C) quality of mental illness and substance use disorder treatment services; and (D) any other criteria as may be determined by the Secretary; (3) a plan to improve outcomes for individuals with serious mental illness or serious emotional disturbances, including reducing incarceration for such individuals, reducing homelessness, and increasing employment; and (4) specific recommendations for actions that agencies can take to better coordinate the administration of mental health services for people with serious mental illness or serious emotional disturbances. (d) Committee extension Upon the submission of the second report under subsection (c), the Secretary shall submit a recommendation to Congress on whether to extend the operation of the Committee. (e) Membership (1) Federal members The Committee shall be composed of the following Federal representatives, or their designees: (A) The Secretary of Health and Human Services, who shall serve as the Chair of the Committee. (B) The Director of the National Institutes of Health. (C) The Assistant Secretary for Health of the Department of Health and Human Services. (D) The Assistant Secretary for Mental Health and Substance Use. (E) The Attorney General of the United States. (F) The Secretary of Veterans Affairs. (G) The Secretary of Defense. (H) The Secretary of Housing and Urban Development. (I) The Secretary of Education. (J) The Secretary of Labor. (K) The Commissioner of Social Security. (L) The Administrator of the Centers for Medicare & Medicaid Services. (2) Non-Federal members The Committee shall also include not less than 14 non-Federal public members appointed by the Secretary of Health and Human Services, of which— (A) at least two members shall be individuals with lived experience with serious mental illness or serious emotional disturbance; (B) at least one member shall be a parent or legal guardian of an individual with a history of a serious mental illness or serious emotional disturbance; (C) at least one member shall be a representative of a leading research, advocacy, or service organization for individuals with serious mental illness or serious emotional disturbance; (D) at least two members shall be— (i) a licensed psychiatrist with experience treating serious mental illnesses or serious emotional disturbances; (ii) a licensed psychologist with experience treating serious mental illnesses or serious emotional disturbances; (iii) a licensed clinical social worker with experience treating serious mental illness or serious emotional disturbances; or (iv) a licensed psychiatric nurse, nurse practitioner, or physician assistant with experience treating serious mental illnesses or serious emotional disturbances; (E) at least one member shall be a licensed mental health professional with a specialty in treating children and adolescents with serious emotional disturbances; (F) at least one member shall be a mental health professional who has research or clinical mental health experience working with minorities; (G) at least one member shall be a mental health professional who has research or clinical mental health experience working with medically underserved populations; (H) at least one member shall be a State certified mental health peer-support specialist; (I) at least one member shall be a judge with experience adjudicating cases within a mental health court; (J) at least one member shall be a law enforcement officer or corrections officer with extensive experience in interfacing with individuals with a serious mental illness or serious emotional disturbance, or in a mental health crisis; and (K) at least one member shall be a homeless services provider with experience working with individuals with serious mental illness, with serious emotional disturbance, or having mental health crisis. (3) Terms A member of the Committee appointed under paragraph (2) shall serve for a term of 3 years, and may be reappointed for one or more additional 3-year terms. Any member appointed to fill a vacancy for an unexpired term shall be appointed for the remainder of such term. A member may serve after the expiration of the member’s term until a successor has been appointed. (f) Working groups In carrying out its functions, the Committee may establish working groups. Such working groups shall be composed of Committee members, or their designees, and may hold such meetings as are necessary. (g) Sunset The Committee shall terminate on the date that is 6 years after the date on which the Committee is established under subsection (a)(1). IV Compassionate Communication on HIPAA 401. Sense of Congress (a) Findings Congress finds the following: (1) The vast majority of individuals with mental illness are capable of understanding their illness and caring for themselves. (2) Persons with serious mental illness (in this section referred to as SMI ), including schizophrenia spectrum, bipolar disorders, and major depressive disorder, may be significantly impaired in their ability to understand or make sound decisions for their care and needs. By nature of their illness, cognitive impairments in reasoning and judgment, as well as the presence of hallucinations, delusions, and severe emotional distortions, they may lack the awareness they even have a mental illness (a condition known as anosognosia), and thus may be unable to make sound decisions regarding their care, nor follow through consistently and effectively on their care needs. (3) Persons with mental illness or SMI may require and benefit from mental health treatment in order to recover to the fullest extent of their ability; these beneficial interventions may include psychiatric care, psychological care, medication, peer support, educational support, employment support, and housing support. (4) Persons with SMI who are provided with professional and supportive services may still experience times when their symptoms may greatly impair their abilities to make sound decisions for their personal care or may discontinue their care as a result of this impaired decisionmaking resulting in a further deterioration of their condition. They may experience a temporary or prolonged impairment as a result of their diminished capacity to care for themselves. (5) Episodes of psychiatric crises among those with SMI can result in neurological harm to the individual’s brain. (6) Persons with SMI— (A) are at high risk for other chronic physical illnesses, with approximately 50 percent having two or more co-occurring chronic physical illnesses such as cardiac, pulmonary, cancer, and endocrine disorders; and (B) have three times the odds of having chronic bronchitis, five times the odds of having emphysema, and four times the odds of having COPD, are more than four times as likely to have fluid and electrolyte disorders, and are nearly three times as likely to be nicotine dependent. (7) Some psychotropic medications, such as second generation antipsychotics, significantly increase risk for chronic illnesses such as diabetes and cardiovascular disease. (8) When the individual fails to seek or maintain treatment for these physical conditions over a long term, it can result in the individual becoming gravely disabled, or developing life-threatening illnesses. Early and consistent treatment can ameliorate or reduce symptoms or cure the disease. (9) Persons with SMI die 7 to 24 years earlier than their age cohorts primarily because of complications from their chronic physical illness and failure to seek or maintain treatment resulting from emotional and cognitive impairments from their SMI. (10) It is beneficial to the person with SMI and chronic illness to seek and maintain continuity of medical care and treatment for their mental illness to prevent further deterioration and harm to their own safety. (11) When the individual with SMI is significantly diminished in their capacity to care for themselves long term or acutely, other supportive interventions to assist their care may be necessary to protect their health and safety. (12) Prognosis for the physical and psychiatric health of those with SMI may improve when responsible caregivers facilitate and participate in care. (13) When an individual with SMI is chronically incapacitated in their ability to care for themselves, caregivers can pursue legal guardianship to facilitate care in appropriate areas while being mindful to allow the individual to make decisions for themselves in areas where they are capable. (14) Individuals with SMI who have prolonged periods of being significantly functional can, during such periods, design and sign an advanced directive to predefine and choose medications, providers, treatment plans, and hospitals, and provide caregivers with guardianship the ability to help in those times when a patient’s psychiatric symptoms worsen to the point of making them incapacitated or leaving them with a severely diminished capacity to make informed decisions about their care which may result in harm to their physical and mental health. (15) All professional and support efforts should be made to help the individual with SMI and acute or chronic physical illnesses to understand and follow through on treatment. (16) When individuals with SMI, even after efforts to help them understand, have failed to care for themselves, there exists confusion in the health care community around what is currently permissible under HIPAA rules. This confusion may hinder communication with responsible caregivers who may be able to facilitate care for the patient with SMI in instances when the individual does not give permission for disclosure. (b) Sense of Congress It is the sense of the Congress that, for the sake of the health and safety of persons with serious mental illness, more clarity is needed surrounding the existing HIPAA privacy rule promulgated pursuant to section 264(c) of the Health Insurance Portability and Accountability Act ( 42 U.S.C. 1320d–2 note) to permit health care professionals to communicate, when necessary, with responsible known caregivers of such persons, the limited, appropriate protected health information of such persons in order to facilitate treatment, but not including psychotherapy notes. 402. Confidentiality of records Not later than 1 year after the date on which the Secretary of Health and Human Services first finalizes regulations updating part 2 of title 42, Code of Federal Regulations (relating to confidentiality of alcohol and drug abuse patient records) after the date of enactment of this Act, the Secretary shall convene relevant stakeholders to determine the effect of such regulations on patient care, health outcomes, and patient privacy. The Secretary shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate, and make publicly available, a report on the findings of such stakeholders. 403. Clarification of circumstances under which disclosure of protected health information is permitted (a) In general Not later than 1 year after the date of enactment of this section, the Secretary of Health and Human Services shall promulgate final regulations clarifying the circumstances under which, consistent with the provisions of subpart C of title XI of the Social Security Act ( 42 U.S.C. 1320d et seq. ) and regulations promulgated pursuant to section 264(c) of the Health Insurance Portability and Accountability Act of 1996 ( 42 U.S.C. 1320d–2 note), a health care provider or covered entity may disclose the protected health information of a patient with a mental illness, including for purposes of— (1) communicating (including with respect to treatment, side effects, risk factors, and the availability of community resources) with a family member of such patient, caregiver of such patient, or other individual to the extent that such family member, caregiver, or individual is involved in the care of the patient; (2) communicating with a family member of the patient, caregiver of such patient, or other individual involved in the care of the patient in the case that the patient is an adult; (3) communicating with the parent or caregiver of a patient in the case that the patient is a minor; (4) considering the patient’s capacity to agree or object to the sharing of the protected health information of the patient; (5) communicating and sharing information with the family or caregivers of the patient when— (A) the patient consents; (B) the patient does not consent, but the patient lacks the capacity to agree or object and the communication or sharing of information is in the patient’s best interest; (C) the patient does not consent and the patient is not incapacitated or in an emergency circumstance, but the ability of the patient to make rational health care decisions is significantly diminished by reason of the physical or mental health condition of the patient; and (D) the patient does not consent, but such communication and sharing of information is necessary to prevent impending and serious deterioration of the patient’s mental or physical health; (6) involving a patient’s family members, caregivers, or others involved in the patient’s care or care plan, including facilitating treatment and medication adherence, in dealing with patient failures to adhere to medication or other therapy; (7) listening to or receiving information with respect to the patient from the family or caregiver of such patient receiving mental illness treatment; (8) communicating with family members of the patient, caregivers of the patient, law enforcement, or others when the patient presents a serious and imminent threat of harm to self or others; and (9) communicating to law enforcement and family members of the patient or caregivers of the patient about the admission of the patient to receive care at a facility or the release of a patient who was admitted to a facility for an emergency psychiatric hold or involuntary treatment. (b) Coordination The Secretary of Health and Human Services shall carry out this section in coordination with the Director of the Office for Civil Rights within the Department of Health and Human Services. (c) Consistency with guidance The Secretary of Health and Human Services shall ensure that the regulations under this section are consistent with the guidance entitled HIPAA Privacy Rule and Sharing Information Related to Mental Health , issued by the Department of Health and Human Services on February 20, 2014. 404. Development and dissemination of model training programs (a) Initial programs and materials Not later than 1 year after the date of the enactment of this Act, the Secretary of Health and Human Services (in this section referred to as the Secretary ) shall develop and disseminate— (1) a model program and materials for training health care providers (including physicians, emergency medical personnel, psychologists, counselors, therapists, behavioral health facilities and clinics, care managers, and hospitals) regarding the circumstances under which, consistent with the standards governing the privacy and security of individually identifiable health information promulgated by the Secretary under subpart C of title XI of the Social Security Act ( 42 U.S.C. 1320d et seq. ) and regulations promulgated pursuant to section 264(c) of the Health Insurance Portability and Accountability Act of 1996 ( 42 U.S.C. 1320d–2 note), the protected health information of patients with a mental illness may be disclosed with and without patient consent; (2) a model program and materials for training lawyers and others in the legal profession on such circumstances; and (3) a model program and materials for training patients and their families regarding their rights to protect and obtain information under the standards specified in paragraph (1). (b) Periodic updates The Secretary shall— (1) periodically review and update the model programs and materials developed under subsection (a); and (2) disseminate the updated model programs and materials. (c) Contents The programs and materials developed under subsection (a) shall address the guidance entitled HIPAA Privacy Rule and Sharing Information Related to Mental Health , issued by the Department of Health and Human Services on February 20, 2014. (d) Coordination The Secretary shall carry out this section in coordination with the Director of the Office for Civil Rights within the Department of Health and Human Services, the Assistant Secretary for Mental Health and Substance Use, the Administrator of the Health Resources and Services Administration, and the heads of other relevant agencies within the Department of Health and Human Services. (e) Input of certain entities In developing the model programs and materials required by subsections (a) and (b), the Secretary shall solicit the input of relevant national, State, and local associations, medical societies, and licensing boards. (f) Funding There are authorized to be appropriated to carry out this section $4,000,000 for fiscal year 2018, $2,000,000 for each of fiscal years 2019 and 2020, and $1,000,000 for each of fiscal years 2021 and 2022. V Increasing Access to Treatment for Serious Mental Illness 501. Assertive community treatment grant program for individuals with serious mental illness Part B of title V of the Public Health Service Act ( 42 U.S.C. 290bb et seq. ) is amended by inserting after section 520L the following: 520M. Assertive community treatment grant program for individuals with serious mental illness (a) In general The Assistant Secretary shall award grants to eligible entities— (1) to establish assertive community treatment programs for individuals with serious mental illness; or (2) to maintain or expand such programs. (b) Eligible entities To be eligible to receive a grant under this section, an entity shall be a State, county, city, tribe, tribal organization, mental health system, health care facility, or any other entity the Assistant Secretary deems appropriate. (c) Special Consideration In selecting among applicants for a grant under this section, the Assistant Secretary may give special consideration to the potential of the applicant’s program to reduce hospitalization, homelessness, and involvement with the criminal justice system while improving the health and social outcomes of the patient. (d) Additional Activities The Assistant Secretary shall— (1) not later than the end of fiscal year 2021, submit a report to the appropriate congressional committees on the grant program under this section, including an evaluation of— (A) cost savings and public health outcomes such as mortality, suicide, substance abuse, hospitalization, and use of services; (B) rates of involvement with the criminal justice system of patients; (C) rates of homelessness among patients; and (D) patient and family satisfaction with program participation; and (2) provide appropriate information, training, and technical assistance to grant recipients under this section to help such recipients to establish, maintain, or expand their assertive community treatment programs. (e) Authorization of appropriations (1) In general To carry out this section, there is authorized to be appropriated $5,000,000 for the period of fiscal years 2018 through 2022. (2) Use of Certain Funds Of the funds appropriated to carry out this section in any fiscal year, no more than 5 percent shall be available to the Assistant Secretary for carrying out subsection (d). . 502. 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— (1) to State and local governments and Indian tribes and tribal organizations to enhance community-based crisis response systems; or (2) to States to develop, maintain, or enhance a database of beds at inpatient psychiatric facilities, crisis stabilization units, and residential community mental health and residential substance use disorder treatment facilities, for individuals with serious mental illness, serious emotional disturbance, or substance use disorders. (b) Application (1) In general To receive a grant or cooperative agreement 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)(1) shall include a plan for— (A) promoting integration and coordination between local public and private entities engaged in crisis response, including first responders, emergency health care providers, primary care providers, law enforcement, court systems, health care payers, social service providers, and behavioral health providers; (B) developing a plan for entering into memoranda of understanding with public and private entities to implement crisis response services; (C) expanding the continuum of community-based services to address crisis intervention and prevention; and (D) developing models for minimizing hospital readmissions, including through appropriate discharge planning. (3) Beds database plan An application for a grant under subsection (a)(2) shall include a plan for developing, maintaining, or enhancing a real-time Internet-based bed database to collect, aggregate, and display information about beds in 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 facilities for the temporary treatment of individuals in mental or substance use disorder crisis. (c) Database requirements A bed database described in this section is a database that— (1) includes information on inpatient psychiatric facilities, crisis stabilization units, and residential community mental health and residential substance use disorder facilities in the State involved, including contact information for the facility or unit; (2) provides real-time information about the number of beds available at each facility or unit and, for each available bed, the type of patient that may be admitted, the level of security provided, and any other information that may be necessary to allow for the proper identification of appropriate facilities for treatment of individuals in mental or substance use disorder crisis; and (3) enables searches of the database to identify available beds that are appropriate for the treatment of individuals in mental or substance use disorder crisis. (d) Evaluation An entity receiving a grant under subsection (a)(1) 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 of individuals receiving crisis planning and early intervention supports; (2) individuals reporting improved functional outcomes; and (3) individuals receiving regular followup care following a crisis. (e) Authorization of appropriations There is authorized to be appropriated to carry out this section, $5,000,000 for the period of fiscal years 2018 through 2022. . 503. Increased and extended funding for assisted outpatient grant program for individuals with serious mental illness Section 224(g) of the Protecting Access to Medicare Act of 2014 ( 42 U.S.C. 290aa note) is amended— (1) in paragraph (1), by striking 2018 and inserting 2022 ; and (2) in paragraph (2), by striking is authorized to be appropriated to carry out this section $15,000,000 for each of fiscal years 2015 through 2018 and inserting are authorized to be appropriated to carry out this section $15,000,000 for each of fiscal years 2015 through 2017, $20,000,000 for fiscal year 2018, $19,000,000 for each of fiscal years 2019 and 2020, and $18,000,000 for each of fiscal years 2021 and 2022 . 504. Liability protections for health professional volunteers at community health centers Section 224 of the Public Health Service Act ( 42 U.S.C. 233 ) is amended by adding at the end the following: (q) (1) For purposes of this section, a health professional volunteer at an entity described in subsection (g)(4) shall, in providing a health professional service eligible for funding under section 330 to an individual, be deemed to be an employee of the Public Health Service for a calendar year that begins during a fiscal year for which a transfer was made under paragraph (4)(C). The preceding sentence is subject to the provisions of this subsection. (2) In providing a health service to an individual, a health care practitioner shall for purposes of this subsection be considered to be a health professional volunteer at an entity described in subsection (g)(4) if the following conditions are met: (A) The service is provided to the individual at the facilities of an entity described in subsection (g)(4), or through offsite programs or events carried out by the entity. (B) The entity is sponsoring the health care practitioner pursuant to paragraph (3)(B). (C) The health care practitioner does not receive any compensation for the service from the individual or from any third-party payer (including reimbursement under any insurance policy or health plan, or under any Federal or State health benefits program), except that the health care practitioner may receive repayment from the entity described in subsection (g)(4) for reasonable expenses incurred by the health care practitioner in the provision of the service to the individual. (D) Before the service is provided, the health care practitioner or the entity described in subsection (g)(4) posts a clear and conspicuous notice at the site where the service is provided of the extent to which the legal liability of the health care practitioner is limited pursuant to this subsection. (E) At the time the service is provided, the health care practitioner is licensed or certified in accordance with applicable law regarding the provision of the service. (3) Subsection (g) (other than paragraphs (3) and (5)) and subsections (h), (i), and (l) apply to a health care practitioner for purposes of this subsection to the same extent and in the same manner as such subsections apply to an officer, governing board member, employee, or contractor of an entity described in subsection (g)(4), subject to paragraph (4) and subject to the following: (A) The first sentence of paragraph (1) applies in lieu of the first sentence of subsection (g)(1)(A). (B) With respect to an entity described in subsection (g)(4), a health care practitioner is not a health professional volunteer at such entity unless the entity sponsors the health care practitioner. For purposes of this subsection, the entity shall be considered to be sponsoring the health care practitioner if— (i) with respect to the health care practitioner, the entity submits to the Secretary an application meeting the requirements of subsection (g)(1)(D); and (ii) the Secretary, pursuant to subsection (g)(1)(E), determines that the health care practitioner is deemed to be an employee of the Public Health Service. (C) In the case of a health care practitioner who is determined by the Secretary pursuant to subsection (g)(1)(E) to be a health professional volunteer at such entity, this subsection applies to the health care practitioner (with respect to services performed on behalf of the entity sponsoring the health care practitioner pursuant to subparagraph (B)) for any cause of action arising from an act or omission of the health care practitioner occurring on or after the date on which the Secretary makes such determination. (D) Subsection (g)(1)(F) applies to a health care practitioner for purposes of this subsection only to the extent that, in providing health services to an individual, each of the conditions specified in paragraph (2) is met. (4) (A) Amounts in the fund established under subsection (k)(2) shall be available for transfer under subparagraph (C) for purposes of carrying out this subsection. (B) Not later May 1 of each fiscal year, the Attorney General, in consultation with the Secretary, shall submit to the Congress a report providing an estimate of the amount of claims (together with related fees and expenses of witnesses) that, by reason of the acts or omissions of health professional volunteers, will be paid pursuant to this section during the calendar year that begins in the following fiscal year. Subsection (k)(1)(B) applies to the estimate under the preceding sentence regarding health professional volunteers to the same extent and in the same manner as such subsection applies to the estimate under such subsection regarding officers, governing board members, employees, and contractors of entities described in subsection (g)(4). (C) Not later than December 31 of each fiscal year, the Secretary shall transfer from the fund under subsection (k)(2) to the appropriate accounts in the Treasury an amount equal to the estimate made under subparagraph (B) for the calendar year beginning in such fiscal year, subject to the extent of amounts in the fund. (5) (A) This subsection takes effect on October 1, 2017, except as provided in subparagraph (B). (B) Effective on the date of the enactment of this subsection— (i) the Secretary may issue regulations for carrying out this subsection, and the Secretary may accept and consider applications submitted pursuant to paragraph (3)(B); and (ii) reports under paragraph (4)(B) may be submitted to the Congress. . VI Supporting Innovative and Evidence-Based Programs A Encouraging the Advancement, Incorporation, and Development of Evidence-Based Practices 601. Encouraging innovation and evidence-based programs Section 501B of the Public Health Service Act, as inserted by section 103, is further amended, by inserting after subsection (c) the following new subsection: (d) Promoting innovation (1) In general The Assistant Secretary, in coordination with the Laboratory, may award grants to States, local governments, Indian tribes or tribal organizations (as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act), educational institutions, and nonprofit organizations to develop evidence-based interventions, including culturally and linguistically appropriate services, as appropriate, for— (A) evaluating a model that has been scientifically demonstrated to show promise, but would benefit from further applied development, for— (i) enhancing the prevention, diagnosis, intervention, treatment, and recovery of mental illness, serious emotional disturbance, substance use disorders, and co-occurring illness or disorders; or (ii) integrating or coordinating physical health services and mental illness and substance use disorder services; and (B) expanding, replicating, or scaling evidence-based programs across a wider area to enhance effective screening, early diagnosis, intervention, and treatment with respect to mental illness, serious mental illness, and serious emotional disturbance, primarily by— (i) applying delivery of care, including training staff in effective evidence-based treatment; or (ii) integrating models of care across specialties and jurisdictions. (2) Consultation In awarding grants under this paragraph, the Assistant Secretary shall, as appropriate, consult with the advisory councils described in section 502, the National Institute of Mental Health, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism, as appropriate. (3) Authorization of appropriations There are authorized to be appropriated— (A) to carry out paragraph (1)(A), $7,000,000 for the period of fiscal years 2018 through 2020; and (B) to carry out paragraph (1)(B), $7,000,000 for the period of fiscal years 2018 through 2020. . 602. Promoting access to information on evidence-based programs and practices Part D of title V of the Public Health Service Act is amended by inserting after section 543 of such Act (42 U.S.C. 290dd–2 ) the following: 544. Promoting access to information on evidence-based programs and practices (a) In general The Assistant Secretary shall improve access to reliable and valid information on evidence-based programs and practices, including information on the strength of evidence associated with such programs and practices, related to mental illness and substance use disorders for States, local communities, nonprofit entities, and other stakeholders by posting on the website of the National Registry of Evidence-Based Programs and Practices evidence-based programs and practices that have been reviewed by the Assistant Secretary pursuant to the requirements of this section. (b) Notice (1) Periods In carrying out subsection (a), the Assistant Secretary may establish an initial period for the submission of applications for evidence-based programs and practices to be posted publicly in accordance with subsection (a) (and may establish subsequent such periods). The Assistant Secretary shall publish notice of such application periods in the Federal Register. (2) Addressing gaps Such notice may solicit applications for evidence-based practices and programs to address gaps in information identified by the Assistant Secretary, the Assistant Secretary for Planning and Evaluation, the Assistant Secretary for Financial Resources, or the National Mental Health and Substance Use Policy Laboratory, including pursuant to priorities identified in the strategic plan established under section 501(l). (c) Requirements The Assistant Secretary shall establish minimum requirements for applications referred to in this section, including applications related to the submission of research and evaluation. (d) Review and rating The Assistant Secretary shall review applications prior to public posting, and may prioritize the review of applications for evidence-based practices and programs that are related to topics included in the notice established under subsection (b). The Assistant Secretary shall utilize a rating and review system, which shall include information on the strength of evidence associated with such programs and practices and a rating of the methodological rigor of the research supporting the application. The Assistant Secretary shall make the metrics used to evaluate applications and the resulting ratings publicly available. . 603. Sense of Congress It is the sense of the Congress that the National Institute of Mental Health should conduct or support research on the determinants of self-directed and other violence connected to mental illness. B Supporting the State Response to Mental Health Needs 611. Community Mental Health Services Block Grant (a) Formula grants Section 1911(b) of the Public Health Service Act ( 42 U.S.C. 300x(b) ) is amended— (1) by redesignating paragraphs (1) through (3) as paragraphs (2) through (4), respectively; and (2) by inserting before paragraph (2) (as so redesignated), the following: (1) providing community mental health services for adults with a serious mental illness and children with a serious emotional disturbance as defined in accordance with section 1912(c); . (b) State plan Subsection (b) of section 1912 of the Public Health Service Act ( 42 U.S.C. 300x–1 ) is amended to read as follows: (b) Criteria for Plan The criteria specified in this subsection are as follows: (1) System of care The plan provides a description of the system of care of the State, including as follows: (A) Comprehensive community-based health systems The plan shall— (i) identify the single State agency to be responsible for the administration of the program under the grant and any third party with whom the agency will contract (subject to such third party complying with the requirements of this part) for administering mental health services through such program; (ii) provide for an organized community-based system of care for individuals with mental illness, and describe available services and resources in a comprehensive system of care, including services for individuals with mental health and behavioral health co-occurring illness or disorders; (iii) include a description of the manner in which the State and local entities will coordinate services to maximize the efficiency, effectiveness, quality, and cost effectiveness of services and programs to produce the best possible outcomes (including health services, rehabilitation services, employment services, housing services, educational services, substance use disorder services, legal services, law enforcement services, social services, child welfare services, medical and dental care services, and other support services to be provided with Federal, State, and local public and private resources) with other agencies to enable individuals receiving services to function outside of inpatient or residential institutions, to the maximum extent of their capabilities, including services to be provided by local school systems under the Individuals with Disabilities Education Act; (iv) include a description of how the State— (I) promotes evidence-based practices, including those evidence-based programs that address the needs of individuals with early serious mental illness regardless of the age of the individual at onset; (II) provides comprehensive individualized treatment; or (III) integrates mental and physical health services; (v) include a description of case management services in the State; (vi) include a description of activities that seek to engage individuals with serious mental illness or serious emotional disturbance and their caregivers where appropriate in making health care decisions, including activities that enhance communication between individuals, families, caregivers, and treatment providers; and (vii) as appropriate to and reflective of the uses the State proposes for the block grant monies— (I) a description of the activities intended to reduce hospitalizations and hospital stays using the block grant monies; (II) a description of the activities intended to reduce incidents of suicide using the block grant monies; and (III) a description of how the State integrates mental health and primary care using the block grant monies. (B) Mental health system data and epidemiology The plan shall contain an estimate of the incidence and prevalence in the State of serious mental illness among adults and serious emotional disturbance among children and presents quantitative targets and outcome measures for programs and services provided under this subpart. (C) Children’s services In the case of children with serious emotional disturbance (as defined in accordance with subsection (c)), the plan shall provide for a system of integrated social services, educational services, child welfare services, juvenile justice services, law enforcement services, and substance use disorder services that, together with health and mental health services, will be provided in order for such children to receive care appropriate for their multiple needs (such system to include services provided under the Individuals with Disabilities Education Act). (D) Targeted services to rural and homeless populations The plan shall describe the State’s outreach to and services for individuals who are homeless and how community-based services will be provided to individuals residing in rural areas. (E) Management services The plan shall— (i) describe the financial resources available, the existing mental health workforce, and the workforce trained in treating individuals with co-occurring mental illness and substance use disorders; (ii) provide for the training of providers of emergency health services regarding mental health; (iii) describe the manner in which the State intends to expend the grant under section 1911 for the fiscal year involved; and (iv) describe the manner in which the State intends to comply with each of the funding agreements in this subpart and subpart III. (2) Goals and objectives The plan establishes goals and objectives for the period of the plan, including targets and milestones that are intended to be met, and the activities that will be undertaken to achieve those goals and objectives. . (c) Best practices in clinical care models Section 1920 of the Public Health Service Act ( 42 U.S.C. 300x–9 ) is amended by adding at the end the following: (c) Best practices in clinical care models A State shall expend not less than 10 percent of the amount the State receives for carrying out this subpart in each fiscal year to support evidence-based programs that address the needs of individuals with early serious mental illness, including psychotic disorders, regardless of the age of the individual at the onset of such illness. . (d) Additional provisions Section 1915(b) of the Public Health Service Act ( 42 U.S.C. 300x–4(b) ) is amended— (1) by amending paragraph (1) to read as follows: (1) In general A funding agreement for a grant under section 1911 is that the State involved will maintain State expenditures for community mental health services at a level that is not less than the average of the amounts prescribed by this paragraph (prior to any waiver under paragraph (3)) for such expenditures by such State for each of the 2 fiscal years immediately preceding the fiscal year for which the State is applying for the grant. ; (2) in paragraph (2)— (A) by striking under subsection (a) and inserting specified in paragraph (1) ; and (B) by striking principle and inserting principal ; (3) by amending paragraph (3) to read as follows: (3) Waiver (A) In general The Secretary may, upon the request of a State, waive the requirement established in paragraph (1) in whole or in part, if the Secretary determines that extraordinary economic conditions in the State in the fiscal year involved or in the previous fiscal year justify the waiver. (B) Date certain for action upon request The Secretary shall approve or deny a request for a waiver under this paragraph not later than 120 days after the date on which the request is made. (C) Applicability of waiver A waiver provided by the Secretary under this paragraph shall be applicable only to the fiscal year involved. ; and (4) in paragraph (4)— (A) by amending subparagraph (A) to read as follows: (A) In general (i) Determination and reduction The Secretary shall determine, in the case of each State, and for each fiscal year, whether the State maintained material compliance with the agreement made under paragraph (1). If the Secretary determines that a State has failed to maintain such compliance for a fiscal year, the Secretary shall reduce the amount of the allotment under section 1911 for the State, for the first fiscal year beginning after such determination is final, by an amount equal to the amount constituting such failure for the previous fiscal year about which the determination was made. (ii) Alternative sanction The Secretary may by regulation provide for an alternative method of imposing a sanction for a failure by a State to maintain material compliance with the agreement under paragraph (1) if the Secretary determines that such alternative method would be more equitable and would be a more effective incentive for States to maintain such material compliance. ; and (B) in subparagraph (B)— (i) by inserting after the subparagraph designation the following: Submission of information to the secretary.— ; and (ii) by striking subparagraph (A) and inserting subparagraph (A)(i) . (e) Application for grant Section 1917(a) of the Public Health Service Act ( 42 U.S.C. 300x–6(a) ) is amended— (1) in paragraph (1), by striking 1941 and inserting 1942(a) ; and (2) in paragraph (5), by striking 1915(b)(3)(B) and inserting 1915(b) . C Strengthening Mental Health Care for Children and Adolescents 621. Tele-mental health care access grants Title III of the Public Health Service Act is amended by inserting after section 330L of such Act ( 42 U.S.C. 254c–18 ) the following new section: 330M. Tele-mental health care access grants (a) In General The Secretary, acting through the Administrator of the Health Resources and Services Administration and in coordination with other relevant Federal agencies, shall award grants to States, political subdivisions of States, Indian tribes, and tribal organizations (for purposes of this section, as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act ( 25 U.S.C. 450b )) to promote behavioral health integration in pediatric primary care by— (1) supporting the development of statewide child mental health care access programs; and (2) supporting the improvement of existing statewide child mental health care access programs. (b) Program Requirements (1) In general A child mental health care access program referred to in subsection (a), with respect to which a grant under such subsection may be used, shall— (A) be a statewide network of pediatric mental health teams that provide support to pediatric primary care sites as an integrated team; (B) support and further develop organized State networks of child and adolescent psychiatrists and psychologists to provide consultative support to pediatric primary care sites; (C) conduct an assessment of critical behavioral consultation needs among pediatric providers and such providers’ preferred mechanisms for receiving consultation and training and technical assistance; (D) develop an online database and communication mechanisms, including telehealth, to facilitate consultation support to pediatric practices; (E) provide rapid statewide clinical telephone or telehealth consultations when requested between the pediatric mental health teams and pediatric primary care providers; (F) conduct training and provide technical assistance to pediatric primary care providers to support the early identification, diagnosis, treatment, and referral of children with behavioral health conditions or co-occurring intellectual and other developmental disabilities; (G) provide information to pediatric providers about, and assist pediatric providers in accessing, child psychiatry and psychology consultations and in scheduling and conducting technical assistance; (H) assist with referrals to specialty care and community or behavioral health resources; and (I) establish mechanisms for measuring and monitoring increased access to child and adolescent psychiatric and psychology services by pediatric primary care providers and expanded capacity of pediatric primary care providers to identify, treat, and refer children with mental health problems. (2) Pediatric mental health teams In this subsection, the term pediatric mental health team means a team of case coordinators, child and adolescent psychiatrists, and licensed clinical mental health professionals, such as a psychologist, social worker, or mental health counselor. (c) Application A State, political subdivision of a State, Indian tribe, or tribal organization seeking a grant under this section shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require, including a plan for the rigorous evaluation of activities that are carried out with funds received under such grant. (d) Evaluation A State, political subdivision of a State, Indian tribe, or tribal organization that receives a grant under this section shall prepare and submit an evaluation of activities carried out with funds received under such grant to the Secretary at such time, in such manner, and containing such information as the Secretary may reasonably require, including a process and outcome evaluation. (e) Matching Requirement The Secretary may not award a grant under this section unless the State, political subdivision of a State, Indian tribe, or tribal organization involved agrees, with respect to the costs to be incurred by the State, political subdivision of a State, Indian tribe, or tribal organization in carrying out the purpose described in this section, to make available non-Federal contributions (in cash or in kind) toward such costs in an amount that is not less than 20 percent of Federal funds provided in the grant. (f) Authorization of appropriations To carry this section, there are authorized to be appropriated $9,000,000 for the period of fiscal years 2018 through 2020. . 622. Infant and early childhood mental health promotion, intervention, and treatment Part Q of title III of the Public Health Service Act ( 42 U.S.C. 290h et seq. ) is amended by adding at the end the following: 399Z–2. Infant and early childhood mental health promotion, intervention, and treatment (a) Grants The Secretary shall— (1) award grants to eligible entities, including human services agencies, to develop, maintain, or enhance infant and early childhood mental health promotion, intervention, and treatment programs, including— (A) programs for infants and children at significant risk of developing, showing early signs of, or having been diagnosed with mental illness including serious emotional disturbance; and (B) multigenerational therapy and other services that support the caregiving relationship; and (2) ensure that programs funded through grants under this section are evidence-informed or evidence-based models, practices, and methods that are, as appropriate, culturally and linguistically appropriate, and can be replicated in other appropriate settings. (b) Eligible children and entities In this section: (1) Eligible child The term eligible child means a child from birth to not more than 5 years of age who— (A) is at risk for, shows early signs of, or has been diagnosed with a mental illness, including serious emotional disturbance; and (B) may benefit from infant and early childhood intervention or treatment programs or specialized preschool or elementary school programs that are evidence-based or that have been scientifically demonstrated to show promise but would benefit from further applied development. (2) Eligible entity The term eligible entity means a nonprofit institution that— (A) is accredited or approved by a State mental health or education agency, as applicable, to provide for children from infancy to 5 years of age mental health promotion, intervention, or treatment services that are evidence-based or that have been scientifically demonstrated to show promise but would benefit from further applied development; and (B) provides programs described in subsection (a) that are evidence-based or that have been scientifically demonstrated to show promise but would benefit from further applied development. (c) Application An eligible entity seeking a grant under subsection (a) shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require. (d) Use of funds for early intervention and treatment programs An eligible entity may use amounts awarded under a grant under subsection (a)(1) to carry out the following: (1) Provide age-appropriate mental health promotion and early intervention services or mental illness treatment services, which may include specialized programs, for eligible children at significant risk of developing, showing early signs of, or having been diagnosed with a mental illness, including serious emotional disturbance. Such services may include social and behavioral services as well as multigenerational therapy and other services ‎that support the caregiving relationship. (2) Provide training for health care professionals with expertise in infant and early childhood mental health care with respect to appropriate and relevant integration with other disciplines such as primary care clinicians, early intervention specialists, child welfare staff, home visitors, early care and education providers, and others who work with young children and families. (3) Provide mental health consultation to personnel of early care and education programs (including licensed or regulated center-based and home-based child care, home visiting, preschool special education, and early intervention programs) who work with children and families. (4) Provide training for mental health clinicians in infant and early childhood in promising and evidence-based practices and models for infant and early childhood mental health treatment and early intervention, including with regard to practices for identifying and treating mental illness and behavioral disorders of infants and children resulting from exposure or repeated exposure to adverse childhood experiences or childhood trauma. (5) Provide age-appropriate assessment, diagnostic, and intervention services for eligible children, including early mental health promotion, intervention, and treatment services. (e) Matching funds The Secretary may not award a grant under this section to an eligible entity unless the eligible entity agrees, with respect to the costs to be incurred by the eligible entity in carrying out the activities described in subsection (d), to make available non-Federal contributions (in cash or in kind) toward such costs in an amount that is not less than 10 percent of the total amount of Federal funds provided in the grant. (f) Authorization of appropriations To carry this section, there are authorized to be appropriated $20,000,000 for the period of fiscal years 2018 through 2022. . 623. National Child Traumatic Stress Initiative Section 582 of the Public Health Service Act ( 42 U.S.C. 290hh–1 ; relating to grants to address the problems of persons who experience violence related stress) is amended— (1) in subsection (a), by striking developing programs and all that follows and inserting the following: developing and maintaining programs that provide for— (1) the continued operation of the National Child Traumatic Stress Initiative (referred to in this section as the NCTSI ), which includes a coordinating center that focuses on the mental, behavioral, and biological aspects of psychological trauma response; and (2) the development of knowledge with regard to evidence-based practices for identifying and treating mental illness, behavioral disorders, and physical health conditions of children and youth resulting from witnessing or experiencing a traumatic event. ; (2) in subsection (b)— (A) by striking subsection (a) related and inserting subsection (a)(2) (related ; (B) by striking treating disorders associated with psychological trauma and inserting treating mental illness and behavioral and biological disorders associated with psychological trauma) ; and (C) by striking mental health agencies and programs that have established clinical and basic research and inserting universities, hospitals, mental health agencies, and other programs that have established clinical expertise and research ; (3) by redesignating subsections (c) through (g) as subsections (g) through (k), respectively; (4) by inserting after subsection (b), the following: (c) Child outcome data The NCTSI coordinating center shall collect, analyze, report, and make publicly available NCTSI-wide child treatment process and outcome data regarding the early identification and delivery of evidence-based treatment and services for children and families served by the NCTSI grantees. (d) Training The NCTSI coordinating center shall facilitate the coordination of training initiatives in evidence-based and trauma-informed treatments, interventions, and practices offered to NCTSI grantees, providers, and partners. (e) Dissemination The NCTSI coordinating center shall, as appropriate, collaborate with the Secretary in the dissemination of evidence-based and trauma-informed interventions, treatments, products, and other resources to appropriate stakeholders. (f) Review The Secretary shall, consistent with the peer-review process, ensure that NCTSI applications are reviewed by appropriate experts in the field as part of a consensus review process. The Secretary shall include review criteria related to expertise and experience in child trauma and evidence-based practices. ; (5) in subsection (g) (as so redesignated), by striking with respect to centers of excellence are distributed equitably among the regions of the country and inserting are distributed equitably among the regions of the United States ; (6) in subsection (i) (as so redesignated), by striking recipient may not exceed 5 years and inserting recipient shall not be less than 4 years, but shall not exceed 5 years ; and (7) in subsection (j) (as so redesignated), by striking $50,000,000 and all that follows through 2006 and inserting $46,887,000 for each of fiscal years 2017 through 2021 . VII Grant programs and program reauthorization A Garrett Lee Smith Memorial Act reauthorization 701. Youth interagency research, training, and technical assistance centers Section 520C of the Public Health Service Act ( 42 U.S.C. 290bb–34 ) is amended— (1) by striking the section heading and inserting Suicide prevention technical assistance center. ; (2) in subsection (a), by striking and in consultation with and all that follows through the period at the end of paragraph (2) and inserting shall establish a research, training, and technical assistance resource center to provide appropriate information, training, and technical assistance to States, political subdivisions of States, federally recognized Indian tribes, tribal organizations, institutions of higher education, public organizations, or private nonprofit organizations regarding the prevention of suicide among all ages, particularly among groups that are at high risk for suicide. ; (3) by striking subsections (b) and (c); (4) by redesignating subsection (d) as subsection (b); (5) in subsection (b), as so redesignated— (A) by striking the subsection heading and inserting Responsibilities of the center.— ; (B) in the matter preceding paragraph (1), by striking The additional research and all that follows through nonprofit organizations for and inserting The center established under subsection (a) shall conduct activities for the purpose of ; (C) by striking youth suicide each place such term appears and inserting suicide ; (D) in paragraph (1)— (i) by striking the development or continuation of and inserting developing and continuing ; and (ii) by inserting for all ages, particularly among groups that are at high risk for suicide before the semicolon at the end; (E) in paragraph (2), by inserting for all ages, particularly among groups that are at high risk for suicide before the semicolon at the end; (F) in paragraph (3), by inserting and tribal after statewide ; (G) in paragraph (5), by inserting and prevention after intervention ; (H) in paragraph (8), by striking in youth ; (I) in paragraph (9), by striking and behavioral health and inserting health and substance use disorder ; and (J) in paragraph (10), by inserting conducting before other ; and (6) by striking subsection (e) and inserting the following: (c) Authorization of appropriations For the purpose of carrying out this section, there are authorized to be appropriated $5,988,000 for each of fiscal years 2017 through 2021. (d) Report Not later than 2 years after the date of enactment of the Helping Families in Mental Health Crisis Act of 2016 , the Secretary shall submit to Congress a report on the activities carried out by the center established under subsection (a) during the year involved, including the potential effects of such activities, and the States, organizations, and institutions that have worked with the center. . 702. Youth suicide early intervention and prevention strategies Section 520E of the Public Health Service Act ( 42 U.S.C. 290bb–36 ) is amended— (1) in paragraph (1) of subsection (a) and in subsection (c), by striking substance abuse each place such term appears and inserting substance use disorder ; (2) in subsection (b)(2)— (A) by striking each State is awarded only 1 grant or cooperative agreement under this section and inserting a State does not receive more than one grant or cooperative agreement under this section at any one time ; and (B) by striking been awarded and inserting received ; and (3) by striking subsection (m) and inserting the following: (m) Authorization of appropriations For the purpose of carrying out this section, there are authorized to be appropriated $35,427,000 for each of fiscal years 2017 through 2021. . 703. Mental health and substance use disorder services on campus Section 520E–2 of the Public Health Service Act ( 42 U.S.C. 290bb–36b ) is amended— (1) in the section heading, by striking and behavioral health and inserting health and substance use disorder ; (2) in subsection (a)— (A) by striking Services, and inserting Services and ; (B) by striking and behavioral health problems and inserting health or substance use disorders ; and (C) by striking substance abuse and inserting substance use disorders ; (3) in subsection (b)— (A) in the matter preceding paragraph (1), by striking for— and inserting for one or more of the following: ; and (B) by striking paragraphs (1) through (6) and inserting the following: (1) Educating students, families, faculty, and staff to increase awareness of mental health and substance use disorders. (2) The operation of hotlines. (3) Preparing informational material. (4) Providing outreach services to notify students about available mental health and substance use disorder services. (5) Administering voluntary mental health and substance use disorder screenings and assessments. (6) Supporting the training of students, faculty, and staff to respond effectively to students with mental health and substance use disorders. (7) Creating a network infrastructure to link colleges and universities with health care providers who treat mental health and substance use disorders. ; (4) in subsection (c)(5), by striking substance abuse and inserting substance use disorder ; (5) in subsection (d)— (A) in the matter preceding paragraph (1), by striking An institution of higher education desiring a grant under this section and inserting To be eligible to receive a grant under this section, an institution of higher education ; (B) in paragraph (1)— (i) by striking and behavioral health and inserting health and substance use disorder ; and (ii) by inserting , including veterans whenever possible and appropriate, after students ; and (C) in paragraph (2), by inserting , which may include, as appropriate and in accordance with subsection (b)(7), a plan to seek input from relevant stakeholders in the community, including appropriate public and private entities, in order to carry out the program under the grant before the period at the end; (6) in subsection (e)(1), by striking and behavioral health problems and inserting health and substance use disorders ; (7) in subsection (f)(2)— (A) by striking and behavioral health and inserting health and substance use disorder ; and (B) by striking suicide and substance abuse and inserting suicide and substance use disorders ; and (8) in subsection (h), by striking $5,000,000 for fiscal year 2005 and all that follows through the period at the end and inserting $6,488,000 for each of fiscal years 2017 through 2021. . B Other provisions 711. National Suicide Prevention Lifeline Program 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 inserting after section 520E–2 ( 42 U.S.C. 290bb–36b ) the following: 520E–3. National Suicide Prevention Lifeline Program (a) In general The Secretary, acting through the Assistant Secretary, shall maintain the National Suicide Prevention Lifeline Program (referred to in this section as the Program ), authorized under section 520A and in effect prior to the date of enactment of the Helping Families in Mental Health Crisis Act of 2016 . (b) Activities In maintaining the Program, the activities of the Secretary shall include— (1) coordinating a network of crisis centers across the United States for providing suicide prevention and crisis intervention services to individuals seeking help at any time, day or night; (2) maintaining a suicide prevention hotline to link callers to local emergency, mental health, and social services resources; and (3) consulting with the Secretary of Veterans Affairs to ensure that veterans calling the suicide prevention hotline have access to a specialized veterans’ suicide prevention hotline. (c) Authorization of appropriations To carry out this section, there are authorized to be appropriated $7,198,000 for each of fiscal years 2017 through 2021. . 712. Workforce development studies and reports (a) In general Not later than 2 years after the date of enactment of this Act, the Assistant Secretary for Mental Health and Substance Use, in consultation with the Administrator of the Health Resources and Services Administration, shall conduct a study, and publicly post on the appropriate Internet website of the Department of Health and Human Services a report, on the mental health and substance use disorder workforce in order to inform Federal, State, and local efforts related to workforce enhancement. (b) Contents The report under this section shall contain— (1) national and State-level projections of the supply and demand of mental health and substance use disorder health workers, including the number of individuals practicing in fields deemed relevant by the Secretary; (2) an assessment of the mental health and substance use disorder workforce capacity, strengths, and weaknesses as of the date of the report, including the capacity of primary care to prevent, screen, treat, or refer for mental health and substance use disorders; (3) information on trends within the mental health and substance use disorder provider workforce, including the number of individuals entering the mental health workforce over the next 5 years; (4) information on the gaps in workforce development for mental health providers and professionals, including those who serve pediatric, adult, and geriatric patients; and (5) any additional information determined by the Assistant Secretary for Mental Health and Substance Use, in consultation with the Administrator of the Health Resources and Services Administration, to be relevant to the mental health and substance use disorder provider workforce. 713. Minority Fellowship Program Title V of the Public Health Service Act ( 42 U.S.C. 290aa et seq. ) is amended by adding at the end the following: K Minority Fellowship Program 597. Fellowships (a) In general The Secretary shall maintain a program, to be known as the Minority Fellowship Program, under which the Secretary awards fellowships, which may include stipends, for the purposes of— (1) increasing behavioral health practitioners’ knowledge of issues related to prevention, treatment, and recovery support for mental illness and substance use disorders among racial and ethnic minority populations; (2) improving the quality of mental illness and substance use disorder prevention and treatment delivered to racial and ethnic minorities; and (3) increasing the number of culturally competent behavioral health professionals and school personnel who teach, administer, conduct services research, and provide direct mental health or substance use services to racial and ethnic minority populations. (b) Training covered The fellowships under subsection (a) shall be for postbaccalaureate training (including for master’s and doctoral degrees) for mental health professionals, including in the fields of psychiatry, nursing, social work, psychology, marriage and family therapy, mental health counseling, and substance use and addiction counseling. (c) Authorization of appropriations To carry out this section, there are authorized to be appropriated $12,669,000 for each of fiscal years 2017, 2018, and 2019 and $13,669,000 for each of fiscal years 2020 and 2021. . 714. Center and program repeals Part B of title V of the Public Health Service Act ( 42 U.S.C. 290bb et seq. ) is amended by striking the second section 514 ( 42 U.S.C. 290bb–9 ), relating to methamphetamine and amphetamine treatment initiatives, and sections 514A, 517, 519A, 519C, 519E, 520D, and 520H ( 42 U.S.C. 290bb–8 , 290bb–23, 290bb–25a, 290bb–25c, 290bb–25e, 290bb–35, and 290bb–39). 715. National violent death reporting system The Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control and Prevention, is encouraged to improve, particularly through the inclusion of additional States, the National Violent Death Reporting System as authorized by title III of the Public Health Service Act ( 42 U.S.C. 241 et seq. ). Participation in the system by the States shall be voluntary. 716. Sense of Congress on prioritizing Native American youth and suicide prevention programs (a) Findings The Congress finds as follows: (1) Suicide is the eighth leading cause of death among American Indians and Alaska Natives across all ages. (2) Among American Indians and Alaska Natives who are 10 to 34 years of age, suicide is the second leading cause of death. (3) The suicide rate among American Indian and Alaska Native adolescents and young adults ages 15 to 34 (19.5 per 100,000) is 1.5 times higher than the national average for that age group (12.9 per 100,000). (b) Sense of Congress It is the sense of Congress that the Secretary of Health and Human Services, in carrying out programs for Native American youth and suicide prevention programs for youth suicide intervention, should prioritize programs and activities for individuals who have a high risk or disproportional burden of suicide, such as Native Americans. 717. Peer professional workforce development grant program (a) In general For the purposes described in subsection (b), the Secretary of Health and Human Services shall award grants to develop and sustain behavioral health paraprofessional training and education programs, including through tuition support. (b) Purposes The purposes of grants under this section are— (1) to increase the number of behavioral health paraprofessionals, including trained peers, recovery coaches, mental health and addiction specialists, prevention specialists, and pre-masters-level addiction counselors; and (2) to help communities develop the infrastructure to train and certify peers as behavioral health paraprofessionals. (c) Eligible entities To be eligible to receive a grant under this section, an entity shall be a community college or other entity the Secretary deems appropriate. (d) Geographic distribution In awarding grants under this section, the Secretary shall seek to achieve an appropriate national balance in the geographic distribution of such awards. (e) Special consideration In awarding grants under this section, the Secretary may give special consideration to proposed and existing programs targeting peer professionals serving youth ages 16 to 25. (f) Authorization of appropriations To carry out this section, there is authorized to be appropriated $10,000,000 for the period of fiscal years 2018 through 2022. 718. National Health Service Corps (a) Definitions (1) Primary health services Section 331(a)(3)(D) of the Public Health Service Act ( 42 U.S.C. 254d(a)(3) ) is amended by inserting (including pediatric mental health subspecialty services) after pediatrics . (2) Behavioral and mental health professionals Clause (i) of section 331(a)(3)(E) of the Public Health Service Act ( 42 U.S.C. 254d(a)(3)(E) ) is amended by inserting (and pediatric subspecialists thereof) before the period at the end. (b) Eligibility To participate in loan repayment program Section 338B(b)(1)(B) of the Public Health Service Act ( 42 U.S.C. 254l–1(b)(1)(B) ) is amended by inserting , including any physician child and adolescent psychiatry residency or fellowship training program after be enrolled in an approved graduate training program in medicine, osteopathic medicine, dentistry, behavioral and mental health, or other health profession . 719. Adult suicide prevention (a) Grants (1) Authority The Assistant Secretary for Mental Health and Substance Use (referred to in this section as the Assistant Secretary ) may award grants to eligible entities in order to implement suicide prevention efforts amongst adults 25 and older. (2) Purpose The grant program under this section shall be designed to raise suicide awareness, establish referral processes, and improve clinical care practice standards for treating suicide ideation, plans, and attempts among adults. (3) Recipients To be eligible to receive a grant under this section, an entity shall be a community-based primary care or behavioral health care setting, an emergency department, a State mental health agency, an Indian tribe, a tribal organization, or any other entity the Assistant Secretary deems appropriate. (4) Nature of activities The grants awarded under paragraph (1) shall be used to implement programs that— (A) screen for suicide risk in adults and provide intervention and referral to treatment; (B) implement evidence-based practices to treat individuals who are at suicide risk, including appropriate followup services; and (C) raise awareness, reduce stigma, and foster open dialogue about suicide prevention. (b) Additional activities The Assistant Secretary shall— (1) evaluate the activities supported by grants awarded under subsection (a) in order to further the Nation’s understanding of effective interventions to prevent suicide in adults; (2) disseminate the findings from the evaluation as the Assistant Secretary considers appropriate; and (3) provide appropriate information, training, and technical assistance to eligible entities that receive a grant under this section, in order to help such entities to meet the requirements of this section, including assistance with— (A) selection and implementation of evidence-based interventions and frameworks to prevent suicide, such as the Zero Suicide framework; and (B) other activities as the Assistant Secretary determines appropriate. (c) Duration A grant under this section shall be for a period of not more than 5 years. (d) Authorization of appropriations (1) In general There is authorized to be appropriated to carry out this section $30,000,000 for the period of fiscal years 2018 through 2022. (2) Use of certain funds Of the funds appropriated to carry out this section in any fiscal year, the lesser of 5 percent of such funds or $500,000 shall be available to the Assistant Secretary for purposes of carrying out subsection (b). 720. Crisis intervention grants for police officers and first responders (a) In general The Assistant Secretary for Mental Health and Substance Use may award grants to entities such as law enforcement agencies and first responders— (1) to provide specialized training to law enforcement officers, corrections officers, paramedics, emergency medical services workers, and other first responders (including village public safety officers (as defined in section 247 of the Indian Arts and Crafts Amendments Act of 2010 ( 42 U.S.C. 3796dd note)))— (A) to recognize individuals who have mental illness and how to properly intervene with individuals with mental illness; and (B) to establish programs that enhance the ability of law enforcement agencies to address the mental health, behavioral, and substance use problems of individuals encountered in the line of duty; and (2) to establish collaborative law enforcement and mental health programs, including behavioral health response teams and mental health crisis intervention teams comprised of mental health professionals, law enforcement officers, and other first responders, as appropriate, to provide on-site, face-to-face, mental and behavioral health care services during a mental health crisis, and to connect the individual in crisis to appropriate community-based treatment services in lieu of unnecessary hospitalization or further involvement with the criminal justice system. (b) Authorization of appropriations There are authorized to be appropriated to carry out this section $9,000,000 for the period of fiscal years 2018 through 2020. 721. Demonstration grant program to train health service psychologists in community-based mental health (a) Establishment The Secretary of Health and Human Services shall establish a grant program under which the Assistant Secretary of Mental Health and Substance Use Disorders may award grants to eligible institutions to support the recruitment, education, and clinical training experiences of health services psychology students, interns, and postdoctoral residents for education and clinical experience in community mental health settings. (b) Eligible institutions For purposes of this section, the term eligible institutions includes American Psychological Association-accredited doctoral, internship, and postdoctoral residency schools or programs in health service psychology that— (1) are focused on the development and implementation of interdisciplinary training of psychology graduate students and postdoctoral fellows in providing mental and behavioral health services to address substance use disorders, serious emotional disturbance, and serious illness, as well as developing faculty and implementing curriculum to prepare psychologists to work with underserved populations; and (2) demonstrate an ability to train health service psychologists in psychiatric hospitals, forensic hospitals, community mental health centers, community health centers, federally qualified health centers, or adult and juvenile correctional facilities. (c) Priorities In selecting grant recipients under this section, the Secretary shall give priority to eligible institutions in which training focuses on the needs of individuals with serious mental illness, serious emotional disturbance, justice-involved youth, and individuals with or at high risk for substance use disorders. (d) Authorization of appropriations There is authorized to be appropriated to carry out this section $12,000,000 for the period of fiscal years 2018 through 2022. 722. Investment in tomorrow’s pediatric health care workforce Section 775(e) of the Public Health Service Act ( 42 U.S.C. 295f(e) ) is amended to read as follows: (e) Authorization of appropriations To carry out this section, there is authorized to be appropriated $12,000,000 for the period of fiscal years 2018 through 2022. . 723. CUTGO compliance Section 319D(f) of the Public Health Service Act ( 42 U.S.C. 247d–4(f) ) is amended by striking $138,300,000 for each of fiscal years 2014 through 2018 and inserting $138,300,000 for each of fiscal years 2014 through 2016 and $58,000,000 for each of fiscal years 2017 and 2018 . VIII Mental Health Parity 801. Enhanced compliance with mental health and substance use disorder coverage requirements (a) Compliance program guidance document Section 2726(a) of the Public Health Service Act ( 42 U.S.C. 300gg–26(a) ) is amended by adding at the end the following: (6) Compliance program guidance document (A) In general Not later than 12 months after the date of enactment of the Helping Families in Mental Health Crisis Act of 2016 , the Secretary, the Secretary of Labor, and the Secretary of the Treasury, in consultation with the Inspector General of the Department of Health and Human Services, shall issue a compliance program guidance document to help improve compliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, and section 9812 of the Internal Revenue Code of 1986, as applicable. (B) Examples illustrating compliance and noncompliance (i) In general The compliance program guidance document required under this paragraph shall provide illustrative, de-identified examples (that do not disclose any protected health information or individually identifiable information) of previous findings of compliance and noncompliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable, based on investigations of violations of such sections, including— (I) examples illustrating requirements for information disclosures and nonquantitative treatment limitations; and (II) descriptions of the violations uncovered during the course of such investigations. (ii) Nonquantitative treatment limitations To the extent that any example described in clause (i) involves a finding of compliance or noncompliance with regard to any requirement for nonquantitative treatment limitations, the example shall provide sufficient detail to fully explain such finding, including a full description of the criteria involved for medical and surgical benefits and the criteria involved for mental health and substance use disorder benefits. (iii) Access to additional information regarding compliance In developing and issuing the compliance program guidance document required under this paragraph, the Secretaries specified in subparagraph (A)— (I) shall enter into interagency agreements with the Inspector General of the Department of Health and Human Services, the Inspector General of the Department of Labor, and the Inspector General of the Department of the Treasury to share findings of compliance and noncompliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable; and (II) shall seek to enter into an agreement with a State to share information on findings of compliance and noncompliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable. (C) Recommendations The compliance program guidance document shall include recommendations to comply with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable, and encourage the development and use of internal controls to monitor adherence to applicable statutes, regulations, and program requirements. Such internal controls may include a compliance checklist with illustrative examples of nonquantitative treatment limitations on mental health and substance use disorder benefits, which may fail to comply with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable, in relation to nonquantitative treatment limitations on medical and surgical benefits. (D) Updating the compliance program guidance document The compliance program guidance document shall be updated every 2 years to include illustrative, de-identified examples (that do not disclose any protected health information or individually identifiable information) of previous findings of compliance and noncompliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable. . (b) Additional guidance Section 2726(a) of the Public Health Service Act ( 42 U.S.C. 300gg–26(a) ), as amended by subsection (a), is further amended by adding at the end the following: (7) Additional guidance (A) In general Not later than 1 year after the date of enactment of the Helping Families in Mental Health Crisis Act of 2016 , the Secretary, in coordination with the Secretary of Labor and the Secretary of the Treasury, shall issue guidance to group health plans and health insurance issuers offering group or individual health insurance coverage to assist such plans and issuers in satisfying the requirements of this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable,. (B) Disclosure (i) Guidance for plans and issuers The guidance issued under this paragraph shall include clarifying information and illustrative examples of methods that group health plans and health insurance issuers offering group or individual health insurance coverage may use for disclosing information to ensure compliance with the requirements under this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable, (and any regulations promulgated pursuant to such sections, as applicable). (ii) Documents for participants, beneficiaries, contracting providers, or authorized representatives The guidance issued under this paragraph shall include clarifying information and illustrative examples of methods that group health plans and health insurance issuers offering group or individual health insurance coverage may use to provide any participant, beneficiary, contracting provider, or authorized representative, as applicable, with documents containing information that the health plans or issuers are required to disclose to participants, beneficiaries, contracting providers, or authorized representatives to ensure compliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable; any regulation issued pursuant to such respective section, or any other applicable law or regulation, including information that is comparative in nature with respect to— (I) nonquantitative treatment limitations for both medical and surgical benefits and mental health and substance use disorder benefits; (II) the processes, strategies, evidentiary standards, and other factors used to apply the limitations described in subclause (I); and (III) the application of the limitations described in subclause (I) to ensure that such limitations are applied in parity with respect to both medical and surgical benefits and mental health and substance use disorder benefits. (C) Nonquantitative treatment limitations The guidance issued under this paragraph shall include clarifying information and illustrative examples of methods, processes, strategies, evidentiary standards, and other factors that group health plans and health insurance issuers offering group or individual health insurance coverage may use regarding the development and application of nonquantitative treatment limitations to ensure compliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable, (and any regulations promulgated pursuant to such respective section), including— (i) examples of methods of determining appropriate types of nonquantitative treatment limitations with respect to both medical and surgical benefits and mental health and substance use disorder benefits, including nonquantitative treatment limitations pertaining to— (I) medical management standards based on medical necessity or appropriateness, or whether a treatment is experimental or investigative; (II) limitations with respect to prescription drug formulary design; and (III) use of fail-first or step therapy protocols; (ii) examples of methods of determining— (I) network admission standards (such as credentialing); and (II) factors used in provider reimbursement methodologies (such as service type, geographic market, demand for services, and provider supply, practice size, training, experience, and licensure) as such factors apply to network adequacy; (iii) examples of sources of information that may serve as evidentiary standards for the purposes of making determinations regarding the development and application of nonquantitative treatment limitations; (iv) examples of specific factors, and the evidentiary standards used to evaluate such factors, used by such plans or issuers in performing a nonquantitative treatment limitation analysis; (v) examples of how specific evidentiary standards may be used to determine whether treatments are considered experimental or investigative; (vi) examples of how specific evidentiary standards may be applied to each service category or classification of benefits; (vii) examples of methods of reaching appropriate coverage determinations for new mental health or substance use disorder treatments, such as evidence-based early intervention programs for individuals with a serious mental illness and types of medical management techniques; (viii) examples of methods of reaching appropriate coverage determinations for which there is an indirect relationship between the covered mental health or substance use disorder benefit and a traditional covered medical and surgical benefit, such as residential treatment or hospitalizations involving voluntary or involuntary commitment; and (ix) additional illustrative examples of methods, processes, strategies, evidentiary standards, and other factors for which the Secretary determines that additional guidance is necessary to improve compliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable. (D) Public comment Prior to issuing any final guidance under this paragraph, the Secretary shall provide a public comment period of not less than 60 days during which any member of the public may provide comments on a draft of the guidance. . (c) Availability of plan information (1) PHSA amendment Paragraph (4) of section 2726(a) of the Public Health Service Act ( 42 U.S.C. 300gg–26(a) ) is amended to read as follows: (4) Availability of plan information The criteria for medical necessity determinations made under the plan or health insurance coverage with respect to mental health or substance use disorder benefits or medical or surgical benefits, the reason for denial of any such benefits, and any other information appropriate to demonstrate compliance under this section (including any such medical and surgical information) shall be made available by the plan administrator (or the health insurance issuer offering such coverage) in accordance with applicable regulations to the current or potential participant, beneficiary, or contracting provider involved upon request. The Secretary may promulgate any such regulations, including interim final regulations or temporary regulations, as may be appropriate to carry out this paragraph. . (2) ERISA amendment Paragraph (4) of section 712(a) of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1185a(a) ) is amended to read as follows: (4) Availability of plan information The criteria for medical necessity determinations made under the plan with respect to mental health or substance use disorder benefits or medical or surgical benefits (or the health insurance coverage offered in connection with the plan with respect to such benefits), the reason for denial of any such benefits, and any other information appropriate to demonstrate compliance under this section (including any such medical and surgical information) shall be made available by the plan administrator (or the health insurance issuer offering such coverage) in accordance with applicable regulations to the current or potential participant, beneficiary, or contracting provider involved upon request. The Secretary may promulgate any such regulations, including interim final regulations or temporary regulations, as may be appropriate to carry out this paragraph. . (3) IRC amendment Paragraph (4) of section 9812(a) of the Internal Revenue Code of 1986 is amended to read as follows: (4) Availability of plan information The criteria for medical necessity determinations made under the plan with respect to mental health or substance use disorder benefits or medical or surgical benefits, the reason for denial of any such benefits, and any other information appropriate to demonstrate compliance under this section (including any such medical and surgical information) shall be made available by the plan administrator in accordance with applicable regulations to the current or potential participant, beneficiary, or contracting provider involved upon request. The Secretary may promulgate any such regulations, including interim final regulations or temporary regulations, as may be appropriate to carry out this paragraph. . (d) Improving compliance (1) In general In the case that the Secretary of Health and Human Services, the Secretary of Labor, or the Secretary of the Treasury determines that a group health plan or health insurance issuer offering group or individual health insurance coverage has violated, at least five times, section 2726 of the Public Health Service Act ( 42 U.S.C. 300gg–26 ), section 712 of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1185a ), or section 9812 of the Internal Revenue Code of 1986, respectively, the appropriate Secretary shall audit plan documents for such health plan or issuer in the plan year following the Secretary’s determination in order to help improve compliance with such section. (2) Rule of construction Nothing in this subsection shall be construed to limit the authority, as in effect on the day before the date of enactment of this Act, of the Secretary of Health and Human Services, the Secretary of Labor, or the Secretary of the Treasury to audit documents of health plans or health insurance issuers. 802. Action plan for enhanced enforcement of mental health and substance use disorder coverage (a) Public meeting (1) In general Not later than 6 months after the date of enactment of this Act, the Secretary of Health and Human Services shall convene a public meeting of stakeholders described in paragraph (2) to produce an action plan for improved Federal and State coordination related to the enforcement of section 2726 of the Public Health Service Act ( 42 U.S.C. 300gg–26 ), section 712 of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1185a ), and section 9812 of the Internal Revenue Code of 1986, and any comparable provisions of State law (in this section collectively referred to as mental health parity and addiction equity requirements ). (2) Stakeholders The stakeholders described in this paragraph shall include each of the following: (A) The Federal Government, including representatives from— (i) the Department of Health and Human Services; (ii) the Department of the Treasury; (iii) the Department of Labor; and (iv) the Department of Justice. (B) State governments, including— (i) State health insurance commissioners; (ii) appropriate State agencies, including agencies on public health or mental health; and (iii) State attorneys general or other representatives of State entities involved in the enforcement of mental health parity and addiction equity requirements. (C) Representatives from key stakeholder groups, including— (i) the National Association of Insurance Commissioners; (ii) health insurance providers; (iii) providers of mental health and substance use disorder treatment; (iv) employers; and (v) patients or their advocates. (b) Action plan Not later than 6 months after the conclusion of the public meeting under subsection (a), the Secretary of Health and Human Services shall finalize the action plan described in such subsection and make it plainly available on the Internet website of the Department of Health and Human Services. (c) Content The action plan under this section shall— (1) reflect the input of the stakeholders participating in the public meeting under subsection (a); (2) identify specific strategic objectives regarding how the various Federal and State agencies charged with enforcement of mental health parity and addiction equity requirements will collaborate to improve enforcement of such requirements; (3) provide a timeline for implementing the action plan; and (4) provide specific examples of how such objectives may be met, which may include— (A) providing common educational information and documents to patients about their rights under mental health parity and addiction equity requirements; (B) facilitating the centralized collection of, monitoring of, and response to patient complaints or inquiries relating to mental health parity and addiction equity requirements, which may be through the development and administration of a single, toll-free telephone number and an Internet website portal; (C) Federal and State law enforcement agencies entering into memoranda of understanding to better coordinate enforcement responsibilities and information sharing, including whether such agencies should make the results of enforcement actions related to mental health parity and addiction equity requirements publicly available; and (D) recommendations to the Congress regarding the need for additional legal authority to improve enforcement of mental health parity and addiction equity requirements, including the need for additional legal authority to ensure that nonquantitative treatment limitations are applied, and the extent and frequency of the applications of such limitations, both to medical and surgical benefits and to mental health and substance use disorder benefits in a comparable manner. 803. Report on investigations regarding parity in mental health and substance use disorder benefits (a) In general Not later than 1 year after the date of enactment of this Act, and annually thereafter for the subsequent 5 years, the Administrator of the Centers for Medicare & Medicaid Services, in collaboration with the Assistant Secretary of Labor of the Employee Benefits Security Administration and the Secretary of the Treasury, shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate a report summarizing the results of all closed Federal investigations completed during the preceding 12-month period with findings of any serious violation regarding compliance with mental health and substance use disorder coverage requirements under section 2726 of the Public Health Service Act ( 42 U.S.C. 300gg–26 ), section 712 of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1185a ), and section 9812 of the Internal Revenue Code of 1986. (b) Contents Subject to subsection (c), a report under subsection (a) shall, with respect to investigations described in such subsection, include each of the following: (1) The number of closed Federal investigations conducted during the covered reporting period. (2) Each benefit classification examined by any such investigation conducted during the covered reporting period. (3) Each subject matter, including compliance with requirements for quantitative and nonquantitative treatment limitations, of any such investigation conducted during the covered reporting period. (4) A summary of the basis of the final decision rendered for each closed investigation conducted during the covered reporting period that resulted in a finding of a serious violation. (c) Limitation Any individually identifiable information shall be excluded from reports under subsection (a) consistent with protections under the health privacy and security rules promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996 ( 42 U.S.C. 1320d–2 note). 804. GAO study on parity in mental health and substance use disorder benefits Not later than 3 years after the date of enactment of this Act, the Comptroller General of the United States, in consultation with the Secretary of Health and Human Services, the Secretary of Labor, and the Secretary of the Treasury, shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate a report detailing the extent to which group health plans or health insurance issuers offering group or individual health insurance coverage that provides both medical and surgical benefits and mental health or substance use disorder benefits, medicaid managed care organizations with a contract under section 1903(m) of the Social Security Act ( 42 U.S.C. 1396b(m) ), and health plans provided under the State Children’s Health Insurance Program under title XXI of the Social Security Act ( 42 U.S.C. 1397aa et seq. ) comply with section 2726 of the Public Health Service Act ( 42 U.S.C. 300gg–26 ), section 712 of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1185a ), and section 9812 of the Internal Revenue Code of 1986, including— (1) how nonquantitative treatment limitations, including medical necessity criteria, of such plans or issuers comply with such sections; (2) how the responsible Federal departments and agencies ensure that such plans or issuers comply with such sections, including an assessment of how the Secretary of Health and Human Services has used its authority to conduct audits of such plans to ensure compliance; (3) a review of how the various Federal and State agencies responsible for enforcing mental health parity requirements have improved enforcement of such requirements in accordance with the objectives and timeline described in the action plan under section 802; and (4) recommendations for how additional enforcement, education, and coordination activities by responsible Federal and State departments and agencies could better ensure compliance with such sections, including recommendations regarding the need for additional legal authority. 805. Information and awareness on eating disorders (a) Information The Secretary of Health and Human Services (in this section referred to as the Secretary ) may— (1) update information, related fact sheets, and resource lists related to eating disorders that are available on the public Internet website of the National Women's Health Information Center sponsored by the Office on Women's Health, to include— (A) updated findings and current research related to eating disorders, as appropriate; and (B) information about eating disorders, including information related to males and females; (2) incorporate, as appropriate, and in coordination with the Secretary of Education, information from publicly available resources into appropriate obesity prevention programs developed by the Office on Women's Health; and (3) make publicly available (through a public Internet website or other method) information, related fact sheets and resource lists, as updated under paragraph (1), and the information incorporated into appropriate obesity prevention programs, as updated under paragraph (2). (b) Awareness The Secretary may advance public awareness on— (1) the types of eating disorders; (2) the seriousness of eating disorders, including prevalence, comorbidities, and physical and mental health consequences; (3) methods to identify, intervene, refer for treatment, and prevent behaviors that may lead to the development of eating disorders; (4) discrimination and bullying based on body size; (5) the effects of media on self-esteem and body image; and (6) the signs and symptoms of eating disorders. 806. Education and training on eating disorders The Secretary of Health and Human Services may facilitate the identification of programs to educate and train health professionals and school personnel in effective strategies to— (1) identify individuals with eating disorders; (2) provide early intervention services for individuals with eating disorders; (3) refer patients with eating disorders for appropriate treatment; (4) prevent the development of eating disorders; or (5) provide appropriate treatment services for individuals with eating disorders. 807. GAO study on preventing discriminatory coverage limitations for individuals with serious mental illness and substance use disorders Not later than 2 years after the date of the enactment of this Act, the Comptroller General of the United States shall submit to Congress and make publicly available a report detailing Federal oversight of group health plans and health insurance coverage offered in the individual or group market (as such terms are defined in section 2791 of the Public Health Service Act ( 42 U.S.C. 300gg–91 )), including Medicaid managed care plans under section 1903 of the Social Security Act ( 42 U.S.C. 1396b ), to ensure compliance of such plans and coverage with sections 2726 of the Public Health Service Act ( 42 U.S.C. 300gg–26 ), 712 of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1185a ), and 9812 of the Internal Revenue Code of 1986 (in this section collectively referred to as the parity law ), including— (1) a description of how Federal regulations and guidance consider nonquantitative treatment limitations, including medical necessity criteria and application of such criteria to medical, surgical, and primary care, of such plans and coverage in ensuring compliance by such plans and coverage with the parity law; (2) a description of actions that Federal departments and agencies are taking to ensure that such plans and coverage comply with the parity law; and (3) the identification of enforcement, education, and coordination activities within Federal departments and agencies, including educational activities directed to State insurance commissioners, and a description of how such proper activities can be used to ensure full compliance with the parity law. 808. Clarification of existing parity rules If a group health plan or a health insurance issuer offering group or individual health insurance coverage provides coverage for eating disorder benefits, including residential treatment, such group health plan or health insurance issuer shall provide such benefits consistent with the requirements of section 2726 of the Public Health Service Act ( 42 U.S.C. 300gg–26 ), section 712 of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1185a ), and section 9812 of the Internal Revenue Code of 1986.

Passed the House of Representatives July 6, 2016. Karen L. Haas, Clerk.

tv_txt: II 114th CONGRESS 2d Session H. R. 2646 IN THE SENATE OF THE UNITED STATES July 7, 2016 Received AN ACT To make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis, and for other purposes.

1. Short title; table of contents (a) Short title This Act may be cited as the Helping Families in Mental Health Crisis Act of 2016 . (b) Table of contents The table of contents for this Act is as follows: Sec. 1. Short title; table of contents. Title I—Assistant Secretary for Mental Health and Substance Use Sec. 101. Assistant Secretary for Mental Health and Substance Use. Sec. 102. Improving oversight of mental health and substance use programs. Sec. 103. National Mental Health and Substance Use Policy Laboratory. Sec. 104. Peer-support specialist programs. Sec. 105. Prohibition against lobbying using Federal funds by systems accepting Federal funds to protect and advocate the rights of individuals with mental illness. Sec. 106. Reporting for protection and advocacy organizations. Sec. 107. Grievance procedure. Sec. 108. Center for Behavioral Health Statistics and Quality. Sec. 109. Strategic plan. Sec. 110. Authorities of centers for mental health services and substance abuse treatment. Sec. 111. Advisory councils. Sec. 112. Peer review. Title II—Medicaid Mental Health Coverage Sec. 201. Rule of construction related to Medicaid coverage of mental health services and primary care services furnished on the same day. Sec. 202. Optional limited coverage of inpatient services furnished in institutions for mental diseases. Sec. 203. Study and report related to Medicaid managed care regulation. Sec. 204. Guidance on opportunities for innovation. Sec. 205. Study and report on Medicaid emergency psychiatric demonstration project. Sec. 206. Providing EPSDT services to children in IMDs. Sec. 207. Electronic visit verification system required for personal care services and home health care services under Medicaid. Title III—Interdepartmental Serious Mental Illness Coordinating Committee Sec. 301. Interdepartmental Serious Mental Illness Coordinating Committee. Title IV—Compassionate Communication on HIPAA Sec. 401. Sense of Congress. Sec. 402. Confidentiality of records. Sec. 403. Clarification of circumstances under which disclosure of protected health information is permitted. Sec. 404. Development and dissemination of model training programs. Title V—Increasing Access to Treatment for Serious Mental Illness Sec. 501. Assertive community treatment grant program for individuals with serious mental illness. Sec. 502. Strengthening community crisis response systems. Sec. 503. Increased and extended funding for assisted outpatient grant program for individuals with serious mental illness. Sec. 504. Liability protections for health professional volunteers at community health centers. Title VI—Supporting Innovative and Evidence-Based Programs Subtitle A—Encouraging the Advancement, Incorporation, and Development of Evidence-Based Practices Sec. 601. Encouraging innovation and evidence-based programs. Sec. 602. Promoting access to information on evidence-based programs and practices. Sec. 603. Sense of Congress. Subtitle B—Supporting the State Response to Mental Health Needs Sec. 611. Community Mental Health Services Block Grant. Subtitle C—Strengthening Mental Health Care for Children and Adolescents Sec. 621. Tele-mental health care access grants. Sec. 622. Infant and early childhood mental health promotion, intervention, and treatment. Sec. 623. National Child Traumatic Stress Initiative. Title VII—Grant programs and program reauthorization Subtitle A—Garrett Lee Smith Memorial Act reauthorization Sec. 701. Youth interagency research, training, and technical assistance centers. Sec. 702. Youth suicide early intervention and prevention strategies. Sec. 703. Mental health and substance use disorder services on campus. Subtitle B—Other provisions Sec. 711. National Suicide Prevention Lifeline Program. Sec. 712. Workforce development studies and reports. Sec. 713. Minority Fellowship Program. Sec. 714. Center and program repeals. Sec. 715. National violent death reporting system. Sec. 716. Sense of Congress on prioritizing Native American youth and suicide prevention programs. Sec. 717. Peer professional workforce development grant program. Sec. 718. National Health Service Corps. Sec. 719. Adult suicide prevention. Sec. 720. Crisis intervention grants for police officers and first responders. Sec. 721. Demonstration grant program to train health service psychologists in community-based mental health. Sec. 722. Investment in tomorrow’s pediatric health care workforce. Sec. 723. CUTGO compliance. Title VIII—Mental Health Parity Sec. 801. Enhanced compliance with mental health and substance use disorder coverage requirements. Sec. 802. Action plan for enhanced enforcement of mental health and substance use disorder coverage. Sec. 803. Report on investigations regarding parity in mental health and substance use disorder benefits. Sec. 804. GAO study on parity in mental health and substance use disorder benefits. Sec. 805. Information and awareness on eating disorders. Sec. 806. Education and training on eating disorders. Sec. 807. GAO study on preventing discriminatory coverage limitations for individuals with serious mental illness and substance use disorders. Sec. 808. Clarification of existing parity rules. I Assistant Secretary for Mental Health and Substance Use 101. Assistant Secretary for Mental Health and Substance Use (a) Assistant Secretary Section 501(c) of the Public Health Service Act ( 42 U.S.C. 290aa ) is amended to read as follows: (c) Assistant Secretary and Deputy Assistant Secretary (1) Assistant Secretary (A) Appointment The Administration shall be headed by an official to be known as the Assistant Secretary for Mental Health and Substance Use (hereinafter in this title referred to as the Assistant Secretary ) who shall be appointed by the President, by and with the advice and consent of the Senate. (B) Qualifications In selecting the Assistant Secretary, the President shall give preference to individuals who have— (i) a doctoral degree in medicine, osteopathic medicine, or psychology; (ii) clinical and research experience regarding mental health and substance use disorders; and (iii) an understanding of biological, psychosocial, and pharmaceutical treatments of mental illness and substance use disorders. (2) Deputy Assistant Secretary The Assistant Secretary, with the approval of the Secretary, may appoint a Deputy Assistant Secretary and may employ and prescribe the functions of such officers and employees, including attorneys, as are necessary to administer the activities to be carried out through the Administration. . (b) Transfer of authorities The Secretary of Health and Human Services shall delegate to the Assistant Secretary for Mental Health and Substance Use all duties and authorities that— (1) as of the day before the date of enactment of this Act, were vested in the Administrator of the Substance Abuse and Mental Health Services Administration; and (2) are not terminated by this Act. (c) Evaluation Section 501(d) of the Public Health Service Act ( 42 U.S.C. 290aa(d) ) is amended— (1) in paragraph (17), by striking and at the end; (2) in paragraph (18), by striking the period at the end and inserting a semicolon; and (3) by adding at the end the following: (19) evaluate, in consultation with the Assistant Secretary for Financial Resources, the information used for oversight of grants under programs related to mental illness and substance use disorders, including co-occurring illness or disorders, administered by the Center for Mental Health Services; (20) periodically review Federal programs and activities relating to the diagnosis or prevention of, or treatment or rehabilitation for, mental illness and substance use disorders to identify any such programs or activities that have proven to be effective or efficient in improving outcomes or increasing access to evidence-based programs; (21) establish standards for the appointment of peer-review panels to evaluate grant applications and recommend standards for mental health grant programs; and . (d) Standards for grant programs Section 501(d) of the Public Health Service Act ( 42 U.S.C. 290aa(d) ), as amended by subsection (c), is further amended by adding at the end the following: (22) in consultation with the National Mental Health and Substance Use Policy Laboratory, and after providing an opportunity for public input, set standards for grant programs under this title for mental health and substance use services, which may address— (A) the capacity of the grantee to implement the award; (B) requirements for the description of the program implementation approach; (C) the extent to which the grant plan submitted by the grantee as part of its application must explain how the grantee will reach the population of focus and provide a statement of need, including to what extent the grantee will increase the number of clients served and the estimated percentage of clients receiving services who report positive functioning after 6 months or no past-month substance use, as applicable; (D) the extent to which the grantee must collect and report on required performance measures; and (E) the extent to which the grantee is proposing evidence-based practices and the extent to which— (i) those evidence-based practices must be used with respect to a population similar to the population for which the evidence-based practices were shown to be effective; or (ii) if no evidence-based practice exists for a population of focus, the way in which the grantee will implement adaptations of evidence-based practices, promising practices, or cultural practices. . (e) Emergency response Section 501(m) of the Public Health Service Act ( 42 U.S.C. 290aa(m) ) is amended by adding at the end the following: (4) Availability of funds through following fiscal year Amounts made available for carrying out this subsection shall remain available through the end of the fiscal year following the fiscal year for which such amounts are appropriated. . (f) Member of Council on Graduate Medical Education Section 762 of the Public Health Service Act ( 42 U.S.C. 290o ) is amended— (1) in subsection (b)— (A) by redesignating paragraphs (4), (5), and (6) as paragraphs (5), (6), and (7), respectively; and (B) by inserting after paragraph (3) the following: (4) the Assistant Secretary for Mental Health and Substance Use; ; and (2) in subsection (c), by striking (4), (5), and (6) each place it appears and inserting (5), (6), and (7) . (g) Conforming amendments Title V of the Public Health Service Act ( 42 U.S.C. 290aa et seq. ), as amended by the previous provisions of this section, is further amended— (1) by striking Administrator of the Substance Abuse and Mental Health Services Administration each place it appears and inserting Assistant Secretary for Mental Health and Substance Use ; and (2) by striking Administrator each place it appears (including in any headings) and inserting Assistant Secretary , except where the term Administrator appears— (A) in each of subsections (e) and (f) of section 501 of such Act ( 42 U.S.C. 290aa ), including the headings of such subsections, within the term Associate Administrator ; (B) in section 507(b)(6) of such Act ( 42 U.S.C. 290bb(b)(6) ), within the term Administrator of the Health Resources and Services Administration ; (C) in section 507(b)(6) of such Act ( 42 U.S.C. 290bb(b)(6) ), within the term Administrator of the Centers for Medicare & Medicaid Services ; (D) in section 519B(c)(1)(B) of such Act (42 U.S.C. 290bb–25b(c)(1)(B)), within the term Administrator of the National Highway Traffic Safety Administration ; or (E) in each of sections 519B(c)(1)(B), 520C(a), and 520D(a) of such Act (42 U.S.C. 290bb–25b(c)(1)(B), 290bb–34(a), 290bb–35(a)), within the term Administrator of the Office of Juvenile Justice and Delinquency Prevention . (h) References After executing subsections (a), (b), and (f), any reference in statute, regulation, or guidance to the Administrator of the Substance Abuse and Mental Health Services Administration shall be construed to be a reference to the Assistant Secretary for Mental Health and Substance Use. 102. Improving oversight of mental health and substance use programs Title V of the Public Health Service Act is amended by inserting after section 501 of such Act ( 42 U.S.C. 290aa ) the following: 501A. Improving oversight of mental health and substance use programs (a) Activities For the purpose of ensuring efficient and effective planning and evaluation of mental illness and substance use disorder programs and related activities, the Assistant Secretary for Planning and Evaluation, in consultation with the Assistant Secretary for Mental Health and Substance Use, shall— (1) collect and organize relevant data on homelessness, involvement with the criminal justice system, hospitalizations, mortality outcomes, and other measures the Secretary deems appropriate from across Federal departments and agencies; (2) evaluate programs related to mental illness and substance use disorders, including co-occurring illness or disorders, across Federal departments and agencies, as appropriate, including programs related to— (A) prevention, intervention, treatment, and recovery support services, including such services for individuals with a serious mental illness or serious emotional disturbance; (B) the reduction of homelessness and involvement with the criminal justice system among individuals with a mental illness or substance use disorder; and (C) public health and health services; and (3) consult, as appropriate, with the Assistant Secretary, the Behavioral Health Coordinating Council of the Department of Health and Human Services, other agencies within the Department of Health and Human Services, and other relevant Federal departments. (b) Recommendations The Assistant Secretary for Planning and Evaluation shall develop an evaluation strategy that identifies priority programs to be evaluated by the Assistant Secretary and priority programs to be evaluated by other relevant agencies within the Department of Health and Human Services. The Assistant Secretary for Planning and Evaluation shall provide recommendations on improving programs and activities based on the evaluation described in subsection (a)(2) as needing improvement. . 103. National Mental Health and Substance Use Policy Laboratory Title V of the Public Health Service Act ( 42 U.S.C. 290aa et seq. ) is amended by inserting after section 501A, as added by section 102 of this Act, the following: 501B. National Mental Health and Substance Use Policy Laboratory (a) In general There shall be established within the Administration a National Mental Health and Substance Use Policy Laboratory (referred to in this section as the Laboratory ). (b) Responsibilities The Laboratory shall— (1) continue to carry out the authorities and activities that were in effect for the Office of Policy, Planning, and Innovation as such Office existed prior to the date of enactment of the Helping Families in Mental Health Crisis Act of 2016 ; (2) identify, coordinate, and facilitate the implementation of policy changes likely to have a significant effect on mental health, mental illness, and the prevention and treatment of substance use disorder services; (3) collect, as appropriate, information from grantees under programs operated by the Administration in order to evaluate and disseminate information on evidence-based practices, including culturally and linguistically appropriate services, as appropriate, and service delivery models; (4) provide leadership in identifying and coordinating policies and programs, including evidence-based programs, related to mental illness and substance use disorders; (5) recommend ways in which payers may implement program and policy findings of the Administration and the Laboratory to improve outcomes and reduce per capita program costs; (6) in consultation with the Assistant Secretary for Planning and Evaluation, as appropriate, periodically review Federal programs and activities relating to the diagnosis or prevention of, or treatment or rehabilitation for, mental illness and substance use disorders, including by— (A) identifying any such programs or activities that are duplicative; (B) identifying any such programs or activities that are not evidence-based, effective, or efficient; and (C) formulating recommendations for coordinating, eliminating, or improving programs or activities identified under subparagraph (A) or (B) and merging such programs or activities into other successful programs or activities; and (7) carry out other activities as deemed necessary to continue to encourage innovation and disseminate evidence-based programs and practices, including programs and practices with scientific merit. (c) Evidence-Based practices and service delivery models (1) In general In selecting evidence-based best practices and service delivery models for evaluation and dissemination, the Laboratory— (A) shall give preference to models that improve— (i) the coordination between mental health and physical health providers; (ii) the coordination among such providers and the justice and corrections system; and (iii) the cost effectiveness, quality, effectiveness, and efficiency of health care services furnished to individuals with serious mental illness or serious emotional disturbance, in mental health crisis, or at risk to themselves, their families, and the general public; and (B) may include clinical protocols and practices used in the Recovery After Initial Schizophrenia Episode (RAISE) project and the North American Prodrome Longitudinal Study (NAPLS) of the National Institute of Mental Health. (2) Deadline for beginning implementation The Laboratory shall begin implementation of the duties described in this section not later than January 1, 2018. (3) Consultation In carrying out the duties under this section, the Laboratory shall consult with— (A) representatives of the National Institute of Mental Health, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism, on an ongoing basis; (B) other appropriate Federal agencies; (C) clinical and analytical experts with expertise in psychiatric medical care and clinical psychological care, health care management, education, corrections health care, and mental health court systems, as appropriate; and (D) other individuals and agencies as determined appropriate by the Assistant Secretary. . 104. Peer-support specialist programs (a) In general Not later than 2 years after the date of enactment of this Act, the Comptroller General of the United States shall conduct a study on peer-support specialist programs in up to 10 States (to be selected by the Comptroller General) that receive funding from the Substance Abuse and Mental Health Services Administration and submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives a report containing the results of such study. (b) Contents of study In conducting the study under subsection (a), the Comptroller General of the United States shall examine and identify best practices in the selected States related to training and credential requirements for peer-support specialist programs, such as— (1) hours of formal work or volunteer experience related to mental illness and substance use disorders conducted through such programs; (2) types of peer-support specialist exams required for such programs in the States; (3) codes of ethics used by such programs in the States; (4) required or recommended skill sets of such programs in the State; and (5) requirements for continuing education. 105. Prohibition against lobbying using Federal funds by systems accepting Federal funds to protect and advocate the rights of individuals with mental illness Section 105(a) of the Protection and Advocacy for Individuals with Mental Illness Act ( 42 U.S.C. 10805(a) ) is amended— (1) in paragraph (9), by striking and at the end; (2) in paragraph (10), by striking the period at the end and inserting ; and ; and (3) by adding at the end the following: (11) agree to refrain, during any period for which funding is provided to the system under this part, from using Federal funds to pay the salary or expenses of any grant or contract recipient, or agent acting for such recipient, related to any activity designed to influence the enactment of legislation, appropriations, regulation, administrative action, or Executive order proposed or pending before the Congress or any State or local government, including any legislative body, other than for normal and recognized executive-legislative relationships or participation by an agency or officer of a State, local, or tribal government in policymaking and administrative processes within the executive branch of that government. . 106. Reporting for protection and advocacy organizations (a) Public availability of reports Section 105(a)(7) of the Protection and Advocacy for Individuals with Mental Illness Act ( 42 U.S.C. 10805(a)(7) ) is amended by striking is located a report and inserting is located, and make publicly available, a report . (b) Detailed accounting Section 114(a) of the Protection and Advocacy for Individuals with Mental Illness Act ( 42 U.S.C. 10824(a) ) is amended— (1) in paragraph (3), by striking and at the end; (2) in paragraph (4), by striking the period at the end and inserting ; and ; and (3) by adding at the end the following: (5) using data from the existing required annual program progress reports submitted by each system funded under this title, a detailed accounting for each such system of how funds are spent, disaggregated according to whether the funds were received from the Federal Government, the State government, a local government, or a private entity. . 107. Grievance procedure Section 105 of the Protection and Advocacy for Individuals with Mental Illness Act ( 42 U.S.C. 10805 ), as amended, is further amended by adding at the end the following: (d) Grievance procedure The Secretary shall establish an independent grievance procedure for persons described in subsection (a)(9). . 108. Center for Behavioral Health Statistics and Quality Title V of the Public Health Service Act ( 42 U.S.C. 290aa et seq. ) is amended— (1) in section 501(b) ( 42 U.S.C. 290aa(b) ), by adding at the end the following: (4) The Center for Behavioral Health Statistics and Quality. ; (2) in section 502(a)(1) ( 42 U.S.C. 290aa–1(a)(1) )— (A) in subparagraph (C), by striking and at the end; (B) in subparagraph (D), by striking the period at the end and inserting ; and ; and (C) by inserting after subparagraph (D) the following: (E) the Center for Behavioral Health Statistics and Quality. ; and (3) in part B ( 42 U.S.C. 290bb et seq. ) by adding at the end the following new subpart: 4 Center for Behavioral Health Statistics and Quality 520L. Center for Behavioral Health Statistics and Quality (a) Establishment There is established in the Administration a Center for Behavioral Health Statistics and Quality (in this section referred to as the Center ). The Center shall be headed by a Director (in this section referred to as the Director ) appointed by the Secretary from among individuals with extensive experience and academic qualifications in research and analysis in behavioral health care or related fields. (b) Duties The Director of the Center shall— (1) coordinate the Administration’s integrated data strategy by coordinating— (A) surveillance and data collection (including that authorized by section 505); (B) evaluation; (C) statistical and analytic support; (D) service systems research; and (E) performance and quality information systems; (2) recommend a core set of measurement standards for grant programs administered by the Administration; and (3) coordinate evaluation efforts for the grant programs, contracts, and collaborative agreements of the Administration. (c) Biannual report to Congress Not later than 2 years after the date of enactment of this section, and every 2 years thereafter, the Director of the Center shall submit to Congress a report on the quality of services furnished through grant programs of the Administration, including applicable measures of outcomes for individuals and public outcomes such as— (1) the number of patients screened positive for unhealthy alcohol use who receive brief counseling as appropriate; the number of patients screened positive for tobacco use and receiving smoking cessation interventions; the number of patients with a new diagnosis of major depressive episode who are assessed for suicide risk; the number of patients screened positive for clinical depression with a documented followup plan; and the number of patients with a documented pain assessment that have a followup treatment plan when pain is present; and satisfaction with care; (2) the incidence and prevalence of mental illness and substance use disorders; the number of suicide attempts and suicide completions; overdoses seen in emergency rooms resulting from alcohol and drug use; emergency room boarding; overdose deaths; emergency psychiatric hospitalizations; new criminal justice involvement while in treatment; stable housing; and rates of involvement in employment, education, and training; and (3) such other measures for outcomes of services as the Director may determine. (d) Staffing Composition The staff of the Center may include individuals with advanced degrees and field expertise as well as clinical and research experience in mental illness and substance use disorders such as— (1) professionals with clinical and research expertise in the prevention and treatment of, and recovery from, mental illness and substance use disorders; (2) professionals with training and expertise in statistics or research and survey design and methodologies; and (3) other related fields in the social and behavioral sciences, as specified by relevant position descriptions. (e) Grants and contracts In carrying out the duties established in subsection (b), the Director may make grants to, and enter into contracts and cooperative agreements with, public and nonprofit private entities. (f) Definition In this section, the term emergency room boarding means the practice of admitting patients to an emergency department and holding such patients in the department until inpatient psychiatric beds become available. . 109. Strategic plan Section 501 of the Public Health Service Act ( 42 U.S.C. 290aa ) is further amended— (1) by redesignating subsections (l) through (o) as subsections (m) through (p), respectively; and (2) by inserting after subsection (k) the following: (l) Strategic plan (1) In general Not later than December 1, 2017, and every 5 years thereafter, the Assistant Secretary shall develop and carry out a strategic plan in accordance with this subsection for the planning and operation of evidence-based programs and grants carried out by the Administration. (2) Coordination In developing and carrying out the strategic plan under this section, the Assistant Secretary shall take into consideration the report of the Interdepartmental Serious Mental Illness Coordinating Committee under section 301 of the Helping Families in Mental Health Crisis Act of 2016. (3) Publication of plan Not later than December 1, 2017, and every 5 years thereafter, the Assistant Secretary shall— (A) submit the strategic plan developed under paragraph (1) to the appropriate committees of Congress; and (B) post such plan on the Internet website of the Administration. (4) Contents The strategic plan developed under paragraph (1) shall— (A) identify strategic priorities, goals, and measurable objectives for mental illness and substance use disorder activities and programs operated and supported by the Administration, including priorities to prevent or eliminate the burden of mental illness and substance use disorders; (B) identify ways to improve services for individuals with a mental illness or substance use disorder, including services related to the prevention of, diagnosis of, intervention in, treatment of, and recovery from, mental illness or substance use disorders, including serious mental illness or serious emotional disturbance, and access to services and supports for individuals with a serious mental illness or serious emotional disturbance; (C) ensure that programs provide, as appropriate, access to effective and evidence-based prevention, diagnosis, intervention, treatment, and recovery services, including culturally and linguistically appropriate services, as appropriate, for individuals with a mental illness or substance use disorder; (D) identify opportunities to collaborate with the Health Resources and Services Administration to develop or improve— (i) initiatives to encourage individuals to pursue careers (especially in rural and underserved areas and populations) as psychiatrists, psychologists, psychiatric nurse practitioners, physician assistants, occupational therapists, clinical social workers, certified peer-support specialists, licensed professional counselors, or other licensed or certified mental health professionals, including such professionals specializing in the diagnosis, evaluation, or treatment of individuals with a serious mental illness or serious emotional disturbance; and (ii) a strategy to improve the recruitment, training, and retention of a workforce for the treatment of individuals with mental illness or substance use disorders, or co-occurring illness or disorders; (E) identify opportunities to improve collaboration with States, local governments, communities, and Indian tribes and tribal organizations (as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act ( 25 U.S.C. 450b )); and (F) specify a strategy to disseminate evidenced-based and promising best practices related to prevention, diagnosis, early intervention, treatment, and recovery services related to mental illness, particularly for individuals with a serious mental illness and children and adolescents with a serious emotional disturbance, and substance use disorders. . 110. Authorities of centers for mental health services and substance abuse treatment (a) Center for mental health services Section 520(b) of the Public Health Service Act ( 42 U.S.C. 290bb–31(b) ) is amended— (1) by redesignating paragraphs (3) through (15) as paragraphs (4) through (16), respectively; (2) by inserting after paragraph (2) the following: (3) collaborate with the Director of the National Institute of Mental Health to ensure that, as appropriate, programs related to the prevention and treatment of mental illness and the promotion of mental health are carried out in a manner that reflects the best available science and evidence-based practices, including culturally and linguistically appropriate services; ; (3) in paragraph (5), as so redesignated, by inserting through policies and programs that reduce risk and promote resiliency before the semicolon; (4) in paragraph (6), as so redesignated, by inserting in collaboration with the Director of the National Institute of Mental Health, before develop ; (5) in paragraph (8), as so redesignated, by inserting , increase meaningful participation of individuals with mental illness in programs and activities of the Administration, before and protect the legal ; (6) in paragraph (10), as so redesignated, by striking professional and paraprofessional personnel pursuant to section 303 and inserting paraprofessional personnel and health professionals ; (7) in paragraph (11), as so redesignated, by inserting and telemental health, after rural mental health, ; (8) in paragraph (12), as so redesignated, by striking establish a clearinghouse for mental health information to assure the widespread dissemination of such information and inserting disseminate mental health information, including evidenced-based practices, ; (9) in paragraph (15), as so redesignated, by striking and at the end; (10) in paragraph (16), as so redesignated, by striking the period and inserting ; and ; and (11) by adding at the end the following: (17) consult with other agencies and offices of the Department of Health and Human Services to ensure, with respect to each grant awarded by the Center for Mental Health Services, the consistent documentation of the application of criteria when awarding grants and the ongoing oversight of grantees after such grants are awarded. . (b) Director of the center for substance abuse treatment Section 507 of the Public Health Service Act ( 42 U.S.C. 290bb ) is amended— (1) in subsection (a)— (A) by striking treatment of substance abuse and inserting treatment of substance use disorders ; and (B) by striking abuse treatment systems and inserting use disorder treatment systems ; and (2) in subsection (b)— (A) in paragraph (3), by striking abuse and inserting use disorder ; (B) in paragraph (4), by striking individuals who abuse drugs and inserting individuals who use drugs ; (C) in paragraph (9), by striking carried out by the Director ; (D) by striking paragraph (10); (E) by redesignating paragraphs (11) through (14) as paragraphs (10) through (13), respectively; (F) in paragraph (12), as so redesignated, by striking ; and and inserting a semicolon; and (G) by striking paragraph (13), as so redesignated, and inserting the following: (13) ensure the consistent documentation of the application of criteria when awarding grants and the ongoing oversight of grantees after such grants are awarded; and (14) work with States, providers, and individuals in recovery, and their families, to promote the expansion of recovery support services and systems of care oriented towards recovery. . 111. Advisory councils Section 502(b) of the Public Health Service Act ( 42 U.S.C. 290aa–1(b) ) is amended— (1) in paragraph (2)— (A) in subparagraph (E), by striking and after the semicolon; (B) by redesignating subparagraph (F) as subparagraph (I); and (C) by inserting after subparagraph (E), the following: (F) for the advisory councils appointed under subsections (a)(1)(A) and (a)(1)(D), the Director of the National Institute of Mental Health; (G) for the advisory councils appointed under subsections (a)(1)(A), (a)(1)(B), and (a)(1)(C), the Director of the National Institute on Drug Abuse; (H) for the advisory councils appointed under subsections (a)(1)(A), (a)(1)(B), and (a)(1)(C), the Director of the National Institute on Alcohol Abuse and Alcoholism; and ; and (2) in paragraph (3), by adding at the end the following: (C) Not less than half of the members of the advisory council appointed under subsection (a)(1)(D)— (i) shall have— (I) a medical degree; (II) a doctoral degree in psychology; or (III) an advanced degree in nursing or social work from an accredited graduate school or be a certified physician assistant; and (ii) shall specialize in the mental health field. . 112. Peer review Section 504(b) of the Public Health Service Act ( 42 U.S.C. 290aa–3(b) ) is amended by adding at the end the following: In the case of any such peer review group that is reviewing a grant, cooperative agreement, or contract related to mental illness treatment, not less than half of the members of such peer review group shall be licensed and experienced professionals in the prevention, diagnosis, or treatment of, or recovery from, mental illness or substance use disorders and have a medical degree, a doctoral degree in psychology, or an advanced degree in nursing or social work from an accredited program. . II Medicaid Mental Health Coverage 201. Rule of construction related to Medicaid coverage of mental health services and primary care services furnished on the same day Nothing in title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ) shall be construed as prohibiting separate payment under the State plan under such title (or under a waiver of the plan) for the provision of a mental health service or primary care service under such plan, with respect to an individual, because such service is— (1) a primary care service furnished to the individual by a provider at a facility on the same day a mental health service is furnished to such individual by such provider (or another provider) at the facility; or (2) a mental health service furnished to the individual by a provider at a facility on the same day a primary care service is furnished to such individual by such provider (or another provider) at the facility. 202. Optional limited coverage of inpatient services furnished in institutions for mental diseases (a) In general Section 1903(m)(2) of the Social Security Act ( 42 U.S.C. 1396b(m)(2) ) is amended by adding at the end the following new subparagraph: (I) (i) Notwithstanding the limitation specified in the subdivision (B) following paragraph (29) of section 1905(a) and subject to clause (ii), a State may, under a risk contract entered into by the State under this title (or under section 1115) with a medicaid managed care organization or a prepaid inpatient health plan (as defined in section 438.2 of title 42, Code of Federal Regulations (or any successor regulation)), make a monthly capitation payment to such organization or plan for enrollees with the organization or plan who are over 21 years of age and under 65 years of age and are receiving inpatient treatment in an institution for mental diseases (as defined in section 1905(i)), so long as each of the following conditions is met: (I) The institution is a hospital providing inpatient psychiatric or substance use disorder services or a sub-acute facility providing psychiatric or substance use disorder crisis residential services. (II) The length of stay in such an institution for such treatment is for a short-term stay of no more than 15 days during the period of the monthly capitation payment. (III) The provision of such treatment meets the following criteria for consideration as services or settings that are provided in lieu of services or settings covered under the State plan: (aa) The State determines that the alternative service or setting is a medically appropriate and cost-effective substitute for the service or setting covered under the State plan. (bb) The enrollee is not required by the managed care organization or prepaid inpatient health plan to use the alternative service or setting. (cc) Such treatment is authorized and identified in such contract, and will be offered to such enrollees at the option of the managed care organization or prepaid inpatient health plan. (ii) For purposes of setting the amount of such a monthly capitation payment, a State may use the utilization of services provided to an individual under this subparagraph when developing the inpatient psychiatric or substance use disorder component of such payment, but the amount of such payment for such services may not exceed the cost of the same services furnished through providers included under the State plan. . (b) Effective date The amendment made by subsection (a) shall apply beginning on July 5, 2016, or the date of the enactment of this Act, whichever is later. 203. Study and report related to Medicaid managed care regulation (a) Study The Secretary of Health and Human Services, acting through the Administrator of the Centers for Medicare & Medicaid Services, shall conduct a study on coverage under the Medicaid program under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ) of services provided through a medicaid managed care organization (as defined in section 1903(m) of such Act ( 42 U.S.C. 1396b(m) ) or a prepaid inpatient health plan (as defined in section 438.2 of title 42, Code of Federal Regulations (or any successor regulation)) with respect to individuals over the age of 21 and under the age of 65 for the treatment of a mental health disorder in institutions for mental diseases (as defined in section 1905(i) of such Act ( 42 U.S.C. 1396d(i) )). Such study shall include information on the following: (1) The extent to which States, including the District of Columbia and each territory or possession of the United States, are providing capitated payments to such organizations or plans for enrollees who are receiving services in institutions for mental diseases. (2) The number of individuals receiving medical assistance under a State plan under such title XIX, or a waiver of such plan, who receive services in institutions for mental diseases through such organizations and plans. (3) The range of and average number of months, and the length of stay during such months, that such individuals are receiving such services in such institutions. (4) How such organizations or plans determine when to provide for the furnishing of such services through an institution for mental diseases in lieu of other benefits (including the full range of community-based services) under their contract with the State agency administering the State plan under such title XIX, or a waiver of such plan, to address psychiatric or substance use disorder treatment. (5) The extent to which the provision of services within such institutions has affected the capitated payments for such organizations or plans. (b) Report Not later than 3 years after the date of the enactment of this Act, the Secretary shall submit to Congress a report on the study conducted under subsection (a). 204. Guidance on opportunities for innovation Not later than 1 year after the date of the enactment of this Act, the Administrator of the Centers for Medicare & Medicaid Services shall issue a State Medicaid Director letter regarding opportunities to design innovative service delivery systems, including systems for providing community-based services, for individuals with serious mental illness or serious emotional disturbance who are receiving medical assistance under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ). The letter shall include opportunities for demonstration projects under section 1115 of such Act ( 42 U.S.C. 1315 ), to improve care for such individuals. 205. Study and report on Medicaid emergency psychiatric demonstration project (a) Collection of information The Secretary of Health and Human Services, acting through the Administrator of the Centers for Medicare & Medicaid Services, shall, with respect to each State that has participated in the demonstration project established under section 2707 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 1396a note), collect from each such State information on the following: (1) The number of institutions for mental diseases (as defined in section 1905(i) of the Social Security Act ( 42 U.S.C. 1396d(i) )) and beds in such institutions that received payment for the provision of services to individuals who receive medical assistance under a State plan under the Medicaid program under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ) (or under a waiver of such plan) through the demonstration project in each such State as compared to the total number of institutions for mental diseases and beds in the State. (2) The extent to which there is a reduction in expenditures under the Medicaid program under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ) or other spending on the full continuum of physical or mental health care for individuals who receive treatment in an institution for mental diseases under the demonstration project, including outpatient, inpatient, emergency, and ambulatory care, that is attributable to such individuals receiving treatment in institutions for mental diseases under the demonstration project. (3) The number of forensic psychiatric hospitals, the number of beds in such hospitals, and the number of forensic psychiatric beds in other hospitals in such State, based on the most recent data available, to the extent practical, as determined by such Administrator. (4) The amount of any disproportionate share hospital payments under section 1923 of the Social Security Act ( 42 U.S.C. 1396r–4 ) that institutions for mental diseases in the State received during the period beginning on July 1, 2012, and ending on June 30, 2015, and the extent to which the demonstration project reduced the amount of such payments. (5) The most recent data regarding all facilities or sites in the State in which any individuals with serious mental illness who are receiving medical assistance under a State plan under the Medicaid program under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ) (or under a waiver of such plan) are treated during the period referred to in paragraph (4), to the extent practical, as determined by the Administrator, including— (A) the types of such facilities or sites (such as an institution for mental diseases, a hospital emergency department, or other inpatient hospital); (B) the average length of stay in such a facility or site by such an individual, disaggregated by facility type; and (C) the payment rate under the State plan (or a waivers of such plan) for services furnished to such an individual for that treatment, disaggregated by facility type, during the period in which the demonstration project is in operation. (6) The extent to which the utilization of hospital emergency departments during the period in which the demonstration project was is in operation differed, with respect to individuals who are receiving medical assistance under a State plan under the Medicaid program under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ) (or under a waiver of such plan), between— (A) those individuals who received treatment in an institution for mental diseases under the demonstration project; (B) those individuals who met the eligibility requirements for the demonstration project but who did not receive treatment in an institution for mental diseases under the demonstration project; and (C) those individuals with serious mental illness who did not meet such eligibility requirements and did not receive treatment for such illness in an institution for mental diseases. (b) Report Not later than 2 years after the date of the enactment of this Act, the Secretary of Health and Human Services shall submit to Congress a report that summarizes and analyzes the information collected under subsection (a). Such report may be submitted as part of the report required under section 2707(f) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 1396a note) or separately. 206. Providing EPSDT services to children in IMDs (a) In general Section 1905(a)(16) of the Social Security Act ( 42 U.S.C. 1396d(a)(16) ) is amended— (1) by striking effective January 1, 1973 and inserting (A) effective January 1, 1973 ; and (2) by inserting before the semicolon at the end the following: , and, (B) for individuals receiving services described in subparagraph (A), early and periodic screening, diagnostic, and treatment services (as defined in subsection (r)), whether or not such screening, diagnostic, and treatment services are furnished by the provider of the services described in such subparagraph . (b) Effective date The amendment made by subsection (a) shall apply with respect to items and services furnished in calendar quarters beginning on or after January 1, 2019. 207. Electronic visit verification system required for personal care services and home health care services under Medicaid (a) In general Section 1903 of the Social Security Act ( 42 U.S.C. 1396b ) is amended by inserting after subsection (k) the following new subsection: (l) (1) Subject to paragraphs (3) and (4), with respect to any amount expended for personal care services or home health care services requiring an in-home visit by a provider that are provided under a State plan under this title (or under a waiver of the plan) and furnished in a calendar quarter beginning on or after January 1, 2019 (or, in the case of home health care services, on or after January 1, 2023), unless a State requires the use of an electronic visit verification system for such services furnished in such quarter under the plan or such waiver, the Federal medical assistance percentage shall be reduced— (A) in the case of personal care services— (i) for calendar quarters in 2019 and 2020, by .25 percentage points; (ii) for calendar quarters in 2021, by .5 percentage points; (iii) for calendar quarters in 2022, by .75 percentage points; and (iv) for calendar quarters in 2023 and each year thereafter, by 1 percentage point; and (B) in the case of home health care services— (i) for calendar quarters in 2023 and 2024, by .25 percentage points; (ii) for calendar quarters in 2025, by .5 percentage points; (iii) for calendar quarters in 2026, by .75 percentage points; and (iv) for calendar quarters in 2027 and each year thereafter, by 1 percentage point. (2) Subject to paragraphs (3) and (4), in implementing the requirement for the use of an electronic visit verification system under paragraph (1), a State shall— (A) consult with agencies and entities that provide personal care services, home health care services, or both under the State plan (or under a waiver of the plan) to ensure that such system— (i) is minimally burdensome; (ii) takes into account existing best practices and electronic visit verification systems in use in the State; and (iii) is conducted in accordance with the requirements of HIPAA privacy and security law (as defined in section 3009 of the Public Health Service Act); (B) take into account a stakeholder process that includes input from beneficiaries, family caregivers, individuals who furnish personal care services or home health care services, and other stakeholders, as determined by the State in accordance with guidance from the Secretary; and (C) ensure that individuals who furnish personal care services, home health care services, or both under the State plan (or under a waiver of the plan) are provided the opportunity for training on the use of such system. (3) Paragraphs (1) and (2) shall not apply in the case of a State that, as of the date of the enactment of this subsection, requires the use of any system for the electronic verification of visits conducted as part of both personal care services and home health care services, so long as the State continues to require the use of such system with respect to the electronic verification of such visits. (4) (A) In the case of a State described in subparagraph (B), the reduction under paragraph (1) shall not apply— (i) in the case of personal care services, for calendar quarters in 2019; and (ii) in the case of home health care services, for calendar quarters in 2023. (B) For purposes of subparagraph (A), a State described in this subparagraph is a State that demonstrates to the Secretary that the State— (i) has made a good faith effort to comply with the requirements of paragraphs (1) and (2) (including by taking steps to adopt the technology used for an electronic visit verification system); or (ii) in implementing such a system, has encountered unavoidable system delays. (5) In this subsection: (A) The term electronic visit verification system means, with respect to personal care services or home health care services, a system under which visits conducted as part of such services are electronically verified with respect to— (i) the type of service performed; (ii) the individual receiving the service; (iii) the date of the service; (iv) the location of service delivery; (v) the individual providing the service; and (vi) the time the service begins and ends. (B) The term home health care services means services described in section 1905(a)(7) provided under a State plan under this title (or under a waiver of the plan). (C) The term personal care services means personal care services provided under a State plan under this title (or under a waiver of the plan), including services provided under section 1905(a)(24), 1915(c), 1915(i), 1915(j), or 1915(k) or under a wavier under section 1115. (6) (A) In the case in which a State requires personal care service and home health care service providers to utilize an electronic visit verification system operated by the State or a contractor on behalf of the State, the Secretary shall pay to the State, for each quarter, an amount equal to 90 per centum of so much of the sums expended during such quarter as are attributable to the design, development, or installation of such system, and 75 per centum of so much of the sums for the operation and maintenance of such system. (B) Subparagraph (A) shall not apply in the case in which a State requires personal care service and home health care service providers to utilize an electronic visit verification system that is not operated by the State or a contractor on behalf of the State. . (b) Collection and dissemination of best practices Not later than January 1, 2018, the Secretary of Health and Human Services shall, with respect to electronic visit verification systems (as defined in subsection (l)(5) of section 1903 of the Social Security Act ( 42 U.S.C. 1396b ), as inserted by subsection (a)), collect and disseminate best practices to State Medicaid Directors with respect to— (1) training individuals who furnish personal care services, home health care services, or both under the State plan under title XIX of such Act (or under a waiver of the plan) on such systems and the operation of such systems and the prevention of fraud with respect to the provision of personal care services or home health care services (as defined in such subsection (l)(5)); and (2) the provision of notice and educational materials to family caregivers and beneficiaries with respect to the use of such electronic visit verification systems and other means to prevent such fraud. (c) Rules of construction (1) No employer-employee relationship established Nothing in the amendment made by this section may be construed as establishing an employer-employee relationship between the agency or entity that provides for personal care services or home health care services and the individuals who, under a contract with such an agency or entity, furnish such services for purposes of part 552 of title 29, Code of Federal Regulations (or any successor regulations). (2) No particular or uniform electronic visit verification system required Nothing in the amendment made by this section shall be construed to require the use of a particular or uniform electronic visit verification system (as defined in subsection (l)(5) of section 1903 of the Social Security Act ( 42 U.S.C. 1396b ), as inserted by subsection (a)) by all agencies or entities that provide personal care services or home health care under a State plan under title XIX of the Social Security Act (or under a waiver of the plan) ( 42 U.S.C. 1396 et seq. ). (3) No limits on provision of care Nothing in the amendment made by this section may be construed to limit, with respect to personal care services or home health care services provided under a State plan under title XIX of the Social Security Act (or under a waiver of the plan) ( 42 U.S.C. 1396 et seq. ), provider selection, constrain beneficiaries’ selection of a caregiver, or impede the manner in which care is delivered. (4) No prohibition on State quality measures requirements Nothing in the amendment made by this section shall be construed as prohibiting a State, in implementing an electronic visit verification system (as defined in subsection (l)(5) of section 1903 of the Social Security Act ( 42 U.S.C. 1396b ), as inserted by subsection (a)), from establishing requirements related to quality measures for such system. III Interdepartmental Serious Mental Illness Coordinating Committee 301. Interdepartmental Serious Mental Illness Coordinating Committee (a) Establishment (1) In general Not later than 3 months after the date of enactment of this Act, the Secretary of Health and Human Services, or the designee of the Secretary, shall establish a committee to be known as the Interdepartmental Serious Mental Illness Coordinating Committee (in this section referred to as the Committee ). (2) Federal Advisory Committee Act Except as provided in this section, the provisions of the Federal Advisory Committee Act (5 U.S.C. App.) shall apply to the Committee. (b) Meetings The Committee shall meet not fewer than two times each year. (c) Responsibilities Not later than 1 year after the date of enactment of this Act, and 5 years after such date of enactment, the Committee shall submit to Congress a report including— (1) a summary of advances in serious mental illness and serious emotional disturbance research related to the prevention of, diagnosis of, intervention in, and treatment and recovery of, serious mental illnesses, serious emotional disturbances, and advances in access to services and support for individuals with a serious mental illness or serious emotional disturbance; (2) an evaluation of the effect on public health of Federal programs related to serious mental illness or serious emotional disturbance, including measurements of public health outcomes such as— (A) rates of suicide, suicide attempts, prevalence of serious mental illness, serious emotional disturbances, and substance use disorders, overdose, overdose deaths, emergency hospitalizations, emergency room boarding, preventable emergency room visits, involvement with the criminal justice system, crime, homelessness, and unemployment; (B) increased rates of employment and enrollment in educational and vocational programs; (C) quality of mental illness and substance use disorder treatment services; and (D) any other criteria as may be determined by the Secretary; (3) a plan to improve outcomes for individuals with serious mental illness or serious emotional disturbances, including reducing incarceration for such individuals, reducing homelessness, and increasing employment; and (4) specific recommendations for actions that agencies can take to better coordinate the administration of mental health services for people with serious mental illness or serious emotional disturbances. (d) Committee extension Upon the submission of the second report under subsection (c), the Secretary shall submit a recommendation to Congress on whether to extend the operation of the Committee. (e) Membership (1) Federal members The Committee shall be composed of the following Federal representatives, or their designees: (A) The Secretary of Health and Human Services, who shall serve as the Chair of the Committee. (B) The Director of the National Institutes of Health. (C) The Assistant Secretary for Health of the Department of Health and Human Services. (D) The Assistant Secretary for Mental Health and Substance Use. (E) The Attorney General of the United States. (F) The Secretary of Veterans Affairs. (G) The Secretary of Defense. (H) The Secretary of Housing and Urban Development. (I) The Secretary of Education. (J) The Secretary of Labor. (K) The Commissioner of Social Security. (L) The Administrator of the Centers for Medicare & Medicaid Services. (2) Non-Federal members The Committee shall also include not less than 14 non-Federal public members appointed by the Secretary of Health and Human Services, of which— (A) at least two members shall be individuals with lived experience with serious mental illness or serious emotional disturbance; (B) at least one member shall be a parent or legal guardian of an individual with a history of a serious mental illness or serious emotional disturbance; (C) at least one member shall be a representative of a leading research, advocacy, or service organization for individuals with serious mental illness or serious emotional disturbance; (D) at least two members shall be— (i) a licensed psychiatrist with experience treating serious mental illnesses or serious emotional disturbances; (ii) a licensed psychologist with experience treating serious mental illnesses or serious emotional disturbances; (iii) a licensed clinical social worker with experience treating serious mental illness or serious emotional disturbances; or (iv) a licensed psychiatric nurse, nurse practitioner, or physician assistant with experience treating serious mental illnesses or serious emotional disturbances; (E) at least one member shall be a licensed mental health professional with a specialty in treating children and adolescents with serious emotional disturbances; (F) at least one member shall be a mental health professional who has research or clinical mental health experience working with minorities; (G) at least one member shall be a mental health professional who has research or clinical mental health experience working with medically underserved populations; (H) at least one member shall be a State certified mental health peer-support specialist; (I) at least one member shall be a judge with experience adjudicating cases within a mental health court; (J) at least one member shall be a law enforcement officer or corrections officer with extensive experience in interfacing with individuals with a serious mental illness or serious emotional disturbance, or in a mental health crisis; and (K) at least one member shall be a homeless services provider with experience working with individuals with serious mental illness, with serious emotional disturbance, or having mental health crisis. (3) Terms A member of the Committee appointed under paragraph (2) shall serve for a term of 3 years, and may be reappointed for one or more additional 3-year terms. Any member appointed to fill a vacancy for an unexpired term shall be appointed for the remainder of such term. A member may serve after the expiration of the member’s term until a successor has been appointed. (f) Working groups In carrying out its functions, the Committee may establish working groups. Such working groups shall be composed of Committee members, or their designees, and may hold such meetings as are necessary. (g) Sunset The Committee shall terminate on the date that is 6 years after the date on which the Committee is established under subsection (a)(1). IV Compassionate Communication on HIPAA 401. Sense of Congress (a) Findings Congress finds the following: (1) The vast majority of individuals with mental illness are capable of understanding their illness and caring for themselves. (2) Persons with serious mental illness (in this section referred to as SMI ), including schizophrenia spectrum, bipolar disorders, and major depressive disorder, may be significantly impaired in their ability to understand or make sound decisions for their care and needs. By nature of their illness, cognitive impairments in reasoning and judgment, as well as the presence of hallucinations, delusions, and severe emotional distortions, they may lack the awareness they even have a mental illness (a condition known as anosognosia), and thus may be unable to make sound decisions regarding their care, nor follow through consistently and effectively on their care needs. (3) Persons with mental illness or SMI may require and benefit from mental health treatment in order to recover to the fullest extent of their ability; these beneficial interventions may include psychiatric care, psychological care, medication, peer support, educational support, employment support, and housing support. (4) Persons with SMI who are provided with professional and supportive services may still experience times when their symptoms may greatly impair their abilities to make sound decisions for their personal care or may discontinue their care as a result of this impaired decisionmaking resulting in a further deterioration of their condition. They may experience a temporary or prolonged impairment as a result of their diminished capacity to care for themselves. (5) Episodes of psychiatric crises among those with SMI can result in neurological harm to the individual’s brain. (6) Persons with SMI— (A) are at high risk for other chronic physical illnesses, with approximately 50 percent having two or more co-occurring chronic physical illnesses such as cardiac, pulmonary, cancer, and endocrine disorders; and (B) have three times the odds of having chronic bronchitis, five times the odds of having emphysema, and four times the odds of having COPD, are more than four times as likely to have fluid and electrolyte disorders, and are nearly three times as likely to be nicotine dependent. (7) Some psychotropic medications, such as second generation antipsychotics, significantly increase risk for chronic illnesses such as diabetes and cardiovascular disease. (8) When the individual fails to seek or maintain treatment for these physical conditions over a long term, it can result in the individual becoming gravely disabled, or developing life-threatening illnesses. Early and consistent treatment can ameliorate or reduce symptoms or cure the disease. (9) Persons with SMI die 7 to 24 years earlier than their age cohorts primarily because of complications from their chronic physical illness and failure to seek or maintain treatment resulting from emotional and cognitive impairments from their SMI. (10) It is beneficial to the person with SMI and chronic illness to seek and maintain continuity of medical care and treatment for their mental illness to prevent further deterioration and harm to their own safety. (11) When the individual with SMI is significantly diminished in their capacity to care for themselves long term or acutely, other supportive interventions to assist their care may be necessary to protect their health and safety. (12) Prognosis for the physical and psychiatric health of those with SMI may improve when responsible caregivers facilitate and participate in care. (13) When an individual with SMI is chronically incapacitated in their ability to care for themselves, caregivers can pursue legal guardianship to facilitate care in appropriate areas while being mindful to allow the individual to make decisions for themselves in areas where they are capable. (14) Individuals with SMI who have prolonged periods of being significantly functional can, during such periods, design and sign an advanced directive to predefine and choose medications, providers, treatment plans, and hospitals, and provide caregivers with guardianship the ability to help in those times when a patient’s psychiatric symptoms worsen to the point of making them incapacitated or leaving them with a severely diminished capacity to make informed decisions about their care which may result in harm to their physical and mental health. (15) All professional and support efforts should be made to help the individual with SMI and acute or chronic physical illnesses to understand and follow through on treatment. (16) When individuals with SMI, even after efforts to help them understand, have failed to care for themselves, there exists confusion in the health care community around what is currently permissible under HIPAA rules. This confusion may hinder communication with responsible caregivers who may be able to facilitate care for the patient with SMI in instances when the individual does not give permission for disclosure. (b) Sense of Congress It is the sense of the Congress that, for the sake of the health and safety of persons with serious mental illness, more clarity is needed surrounding the existing HIPAA privacy rule promulgated pursuant to section 264(c) of the Health Insurance Portability and Accountability Act ( 42 U.S.C. 1320d–2 note) to permit health care professionals to communicate, when necessary, with responsible known caregivers of such persons, the limited, appropriate protected health information of such persons in order to facilitate treatment, but not including psychotherapy notes. 402. Confidentiality of records Not later than 1 year after the date on which the Secretary of Health and Human Services first finalizes regulations updating part 2 of title 42, Code of Federal Regulations (relating to confidentiality of alcohol and drug abuse patient records) after the date of enactment of this Act, the Secretary shall convene relevant stakeholders to determine the effect of such regulations on patient care, health outcomes, and patient privacy. The Secretary shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate, and make publicly available, a report on the findings of such stakeholders. 403. Clarification of circumstances under which disclosure of protected health information is permitted (a) In general Not later than 1 year after the date of enactment of this section, the Secretary of Health and Human Services shall promulgate final regulations clarifying the circumstances under which, consistent with the provisions of subpart C of title XI of the Social Security Act ( 42 U.S.C. 1320d et seq. ) and regulations promulgated pursuant to section 264(c) of the Health Insurance Portability and Accountability Act of 1996 ( 42 U.S.C. 1320d–2 note), a health care provider or covered entity may disclose the protected health information of a patient with a mental illness, including for purposes of— (1) communicating (including with respect to treatment, side effects, risk factors, and the availability of community resources) with a family member of such patient, caregiver of such patient, or other individual to the extent that such family member, caregiver, or individual is involved in the care of the patient; (2) communicating with a family member of the patient, caregiver of such patient, or other individual involved in the care of the patient in the case that the patient is an adult; (3) communicating with the parent or caregiver of a patient in the case that the patient is a minor; (4) considering the patient’s capacity to agree or object to the sharing of the protected health information of the patient; (5) communicating and sharing information with the family or caregivers of the patient when— (A) the patient consents; (B) the patient does not consent, but the patient lacks the capacity to agree or object and the communication or sharing of information is in the patient’s best interest; (C) the patient does not consent and the patient is not incapacitated or in an emergency circumstance, but the ability of the patient to make rational health care decisions is significantly diminished by reason of the physical or mental health condition of the patient; and (D) the patient does not consent, but such communication and sharing of information is necessary to prevent impending and serious deterioration of the patient’s mental or physical health; (6) involving a patient’s family members, caregivers, or others involved in the patient’s care or care plan, including facilitating treatment and medication adherence, in dealing with patient failures to adhere to medication or other therapy; (7) listening to or receiving information with respect to the patient from the family or caregiver of such patient receiving mental illness treatment; (8) communicating with family members of the patient, caregivers of the patient, law enforcement, or others when the patient presents a serious and imminent threat of harm to self or others; and (9) communicating to law enforcement and family members of the patient or caregivers of the patient about the admission of the patient to receive care at a facility or the release of a patient who was admitted to a facility for an emergency psychiatric hold or involuntary treatment. (b) Coordination The Secretary of Health and Human Services shall carry out this section in coordination with the Director of the Office for Civil Rights within the Department of Health and Human Services. (c) Consistency with guidance The Secretary of Health and Human Services shall ensure that the regulations under this section are consistent with the guidance entitled HIPAA Privacy Rule and Sharing Information Related to Mental Health , issued by the Department of Health and Human Services on February 20, 2014. 404. Development and dissemination of model training programs (a) Initial programs and materials Not later than 1 year after the date of the enactment of this Act, the Secretary of Health and Human Services (in this section referred to as the Secretary ) shall develop and disseminate— (1) a model program and materials for training health care providers (including physicians, emergency medical personnel, psychologists, counselors, therapists, behavioral health facilities and clinics, care managers, and hospitals) regarding the circumstances under which, consistent with the standards governing the privacy and security of individually identifiable health information promulgated by the Secretary under subpart C of title XI of the Social Security Act ( 42 U.S.C. 1320d et seq. ) and regulations promulgated pursuant to section 264(c) of the Health Insurance Portability and Accountability Act of 1996 ( 42 U.S.C. 1320d–2 note), the protected health information of patients with a mental illness may be disclosed with and without patient consent; (2) a model program and materials for training lawyers and others in the legal profession on such circumstances; and (3) a model program and materials for training patients and their families regarding their rights to protect and obtain information under the standards specified in paragraph (1). (b) Periodic updates The Secretary shall— (1) periodically review and update the model programs and materials developed under subsection (a); and (2) disseminate the updated model programs and materials. (c) Contents The programs and materials developed under subsection (a) shall address the guidance entitled HIPAA Privacy Rule and Sharing Information Related to Mental Health , issued by the Department of Health and Human Services on February 20, 2014. (d) Coordination The Secretary shall carry out this section in coordination with the Director of the Office for Civil Rights within the Department of Health and Human Services, the Assistant Secretary for Mental Health and Substance Use, the Administrator of the Health Resources and Services Administration, and the heads of other relevant agencies within the Department of Health and Human Services. (e) Input of certain entities In developing the model programs and materials required by subsections (a) and (b), the Secretary shall solicit the input of relevant national, State, and local associations, medical societies, and licensing boards. (f) Funding There are authorized to be appropriated to carry out this section $4,000,000 for fiscal year 2018, $2,000,000 for each of fiscal years 2019 and 2020, and $1,000,000 for each of fiscal years 2021 and 2022. V Increasing Access to Treatment for Serious Mental Illness 501. Assertive community treatment grant program for individuals with serious mental illness Part B of title V of the Public Health Service Act ( 42 U.S.C. 290bb et seq. ) is amended by inserting after section 520L the following: 520M. Assertive community treatment grant program for individuals with serious mental illness (a) In general The Assistant Secretary shall award grants to eligible entities— (1) to establish assertive community treatment programs for individuals with serious mental illness; or (2) to maintain or expand such programs. (b) Eligible entities To be eligible to receive a grant under this section, an entity shall be a State, county, city, tribe, tribal organization, mental health system, health care facility, or any other entity the Assistant Secretary deems appropriate. (c) Special Consideration In selecting among applicants for a grant under this section, the Assistant Secretary may give special consideration to the potential of the applicant’s program to reduce hospitalization, homelessness, and involvement with the criminal justice system while improving the health and social outcomes of the patient. (d) Additional Activities The Assistant Secretary shall— (1) not later than the end of fiscal year 2021, submit a report to the appropriate congressional committees on the grant program under this section, including an evaluation of— (A) cost savings and public health outcomes such as mortality, suicide, substance abuse, hospitalization, and use of services; (B) rates of involvement with the criminal justice system of patients; (C) rates of homelessness among patients; and (D) patient and family satisfaction with program participation; and (2) provide appropriate information, training, and technical assistance to grant recipients under this section to help such recipients to establish, maintain, or expand their assertive community treatment programs. (e) Authorization of appropriations (1) In general To carry out this section, there is authorized to be appropriated $5,000,000 for the period of fiscal years 2018 through 2022. (2) Use of Certain Funds Of the funds appropriated to carry out this section in any fiscal year, no more than 5 percent shall be available to the Assistant Secretary for carrying out subsection (d). . 502. 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— (1) to State and local governments and Indian tribes and tribal organizations to enhance community-based crisis response systems; or (2) to States to develop, maintain, or enhance a database of beds at inpatient psychiatric facilities, crisis stabilization units, and residential community mental health and residential substance use disorder treatment facilities, for individuals with serious mental illness, serious emotional disturbance, or substance use disorders. (b) Application (1) In general To receive a grant or cooperative agreement 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)(1) shall include a plan for— (A) promoting integration and coordination between local public and private entities engaged in crisis response, including first responders, emergency health care providers, primary care providers, law enforcement, court systems, health care payers, social service providers, and behavioral health providers; (B) developing a plan for entering into memoranda of understanding with public and private entities to implement crisis response services; (C) expanding the continuum of community-based services to address crisis intervention and prevention; and (D) developing models for minimizing hospital readmissions, including through appropriate discharge planning. (3) Beds database plan An application for a grant under subsection (a)(2) shall include a plan for developing, maintaining, or enhancing a real-time Internet-based bed database to collect, aggregate, and display information about beds in 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 facilities for the temporary treatment of individuals in mental or substance use disorder crisis. (c) Database requirements A bed database described in this section is a database that— (1) includes information on inpatient psychiatric facilities, crisis stabilization units, and residential community mental health and residential substance use disorder facilities in the State involved, including contact information for the facility or unit; (2) provides real-time information about the number of beds available at each facility or unit and, for each available bed, the type of patient that may be admitted, the level of security provided, and any other information that may be necessary to allow for the proper identification of appropriate facilities for treatment of individuals in mental or substance use disorder crisis; and (3) enables searches of the database to identify available beds that are appropriate for the treatment of individuals in mental or substance use disorder crisis. (d) Evaluation An entity receiving a grant under subsection (a)(1) 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 of individuals receiving crisis planning and early intervention supports; (2) individuals reporting improved functional outcomes; and (3) individuals receiving regular followup care following a crisis. (e) Authorization of appropriations There is authorized to be appropriated to carry out this section, $5,000,000 for the period of fiscal years 2018 through 2022. . 503. Increased and extended funding for assisted outpatient grant program for individuals with serious mental illness Section 224(g) of the Protecting Access to Medicare Act of 2014 ( 42 U.S.C. 290aa note) is amended— (1) in paragraph (1), by striking 2018 and inserting 2022 ; and (2) in paragraph (2), by striking is authorized to be appropriated to carry out this section $15,000,000 for each of fiscal years 2015 through 2018 and inserting are authorized to be appropriated to carry out this section $15,000,000 for each of fiscal years 2015 through 2017, $20,000,000 for fiscal year 2018, $19,000,000 for each of fiscal years 2019 and 2020, and $18,000,000 for each of fiscal years 2021 and 2022 . 504. Liability protections for health professional volunteers at community health centers Section 224 of the Public Health Service Act ( 42 U.S.C. 233 ) is amended by adding at the end the following: (q) (1) For purposes of this section, a health professional volunteer at an entity described in subsection (g)(4) shall, in providing a health professional service eligible for funding under section 330 to an individual, be deemed to be an employee of the Public Health Service for a calendar year that begins during a fiscal year for which a transfer was made under paragraph (4)(C). The preceding sentence is subject to the provisions of this subsection. (2) In providing a health service to an individual, a health care practitioner shall for purposes of this subsection be considered to be a health professional volunteer at an entity described in subsection (g)(4) if the following conditions are met: (A) The service is provided to the individual at the facilities of an entity described in subsection (g)(4), or through offsite programs or events carried out by the entity. (B) The entity is sponsoring the health care practitioner pursuant to paragraph (3)(B). (C) The health care practitioner does not receive any compensation for the service from the individual or from any third-party payer (including reimbursement under any insurance policy or health plan, or under any Federal or State health benefits program), except that the health care practitioner may receive repayment from the entity described in subsection (g)(4) for reasonable expenses incurred by the health care practitioner in the provision of the service to the individual. (D) Before the service is provided, the health care practitioner or the entity described in subsection (g)(4) posts a clear and conspicuous notice at the site where the service is provided of the extent to which the legal liability of the health care practitioner is limited pursuant to this subsection. (E) At the time the service is provided, the health care practitioner is licensed or certified in accordance with applicable law regarding the provision of the service. (3) Subsection (g) (other than paragraphs (3) and (5)) and subsections (h), (i), and (l) apply to a health care practitioner for purposes of this subsection to the same extent and in the same manner as such subsections apply to an officer, governing board member, employee, or contractor of an entity described in subsection (g)(4), subject to paragraph (4) and subject to the following: (A) The first sentence of paragraph (1) applies in lieu of the first sentence of subsection (g)(1)(A). (B) With respect to an entity described in subsection (g)(4), a health care practitioner is not a health professional volunteer at such entity unless the entity sponsors the health care practitioner. For purposes of this subsection, the entity shall be considered to be sponsoring the health care practitioner if— (i) with respect to the health care practitioner, the entity submits to the Secretary an application meeting the requirements of subsection (g)(1)(D); and (ii) the Secretary, pursuant to subsection (g)(1)(E), determines that the health care practitioner is deemed to be an employee of the Public Health Service. (C) In the case of a health care practitioner who is determined by the Secretary pursuant to subsection (g)(1)(E) to be a health professional volunteer at such entity, this subsection applies to the health care practitioner (with respect to services performed on behalf of the entity sponsoring the health care practitioner pursuant to subparagraph (B)) for any cause of action arising from an act or omission of the health care practitioner occurring on or after the date on which the Secretary makes such determination. (D) Subsection (g)(1)(F) applies to a health care practitioner for purposes of this subsection only to the extent that, in providing health services to an individual, each of the conditions specified in paragraph (2) is met. (4) (A) Amounts in the fund established under subsection (k)(2) shall be available for transfer under subparagraph (C) for purposes of carrying out this subsection. (B) Not later May 1 of each fiscal year, the Attorney General, in consultation with the Secretary, shall submit to the Congress a report providing an estimate of the amount of claims (together with related fees and expenses of witnesses) that, by reason of the acts or omissions of health professional volunteers, will be paid pursuant to this section during the calendar year that begins in the following fiscal year. Subsection (k)(1)(B) applies to the estimate under the preceding sentence regarding health professional volunteers to the same extent and in the same manner as such subsection applies to the estimate under such subsection regarding officers, governing board members, employees, and contractors of entities described in subsection (g)(4). (C) Not later than December 31 of each fiscal year, the Secretary shall transfer from the fund under subsection (k)(2) to the appropriate accounts in the Treasury an amount equal to the estimate made under subparagraph (B) for the calendar year beginning in such fiscal year, subject to the extent of amounts in the fund. (5) (A) This subsection takes effect on October 1, 2017, except as provided in subparagraph (B). (B) Effective on the date of the enactment of this subsection— (i) the Secretary may issue regulations for carrying out this subsection, and the Secretary may accept and consider applications submitted pursuant to paragraph (3)(B); and (ii) reports under paragraph (4)(B) may be submitted to the Congress. . VI Supporting Innovative and Evidence-Based Programs A Encouraging the Advancement, Incorporation, and Development of Evidence-Based Practices 601. Encouraging innovation and evidence-based programs Section 501B of the Public Health Service Act, as inserted by section 103, is further amended, by inserting after subsection (c) the following new subsection: (d) Promoting innovation (1) In general The Assistant Secretary, in coordination with the Laboratory, may award grants to States, local governments, Indian tribes or tribal organizations (as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act), educational institutions, and nonprofit organizations to develop evidence-based interventions, including culturally and linguistically appropriate services, as appropriate, for— (A) evaluating a model that has been scientifically demonstrated to show promise, but would benefit from further applied development, for— (i) enhancing the prevention, diagnosis, intervention, treatment, and recovery of mental illness, serious emotional disturbance, substance use disorders, and co-occurring illness or disorders; or (ii) integrating or coordinating physical health services and mental illness and substance use disorder services; and (B) expanding, replicating, or scaling evidence-based programs across a wider area to enhance effective screening, early diagnosis, intervention, and treatment with respect to mental illness, serious mental illness, and serious emotional disturbance, primarily by— (i) applying delivery of care, including training staff in effective evidence-based treatment; or (ii) integrating models of care across specialties and jurisdictions. (2) Consultation In awarding grants under this paragraph, the Assistant Secretary shall, as appropriate, consult with the advisory councils described in section 502, the National Institute of Mental Health, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism, as appropriate. (3) Authorization of appropriations There are authorized to be appropriated— (A) to carry out paragraph (1)(A), $7,000,000 for the period of fiscal years 2018 through 2020; and (B) to carry out paragraph (1)(B), $7,000,000 for the period of fiscal years 2018 through 2020. . 602. Promoting access to information on evidence-based programs and practices Part D of title V of the Public Health Service Act is amended by inserting after section 543 of such Act (42 U.S.C. 290dd–2 ) the following: 544. Promoting access to information on evidence-based programs and practices (a) In general The Assistant Secretary shall improve access to reliable and valid information on evidence-based programs and practices, including information on the strength of evidence associated with such programs and practices, related to mental illness and substance use disorders for States, local communities, nonprofit entities, and other stakeholders by posting on the website of the National Registry of Evidence-Based Programs and Practices evidence-based programs and practices that have been reviewed by the Assistant Secretary pursuant to the requirements of this section. (b) Notice (1) Periods In carrying out subsection (a), the Assistant Secretary may establish an initial period for the submission of applications for evidence-based programs and practices to be posted publicly in accordance with subsection (a) (and may establish subsequent such periods). The Assistant Secretary shall publish notice of such application periods in the Federal Register. (2) Addressing gaps Such notice may solicit applications for evidence-based practices and programs to address gaps in information identified by the Assistant Secretary, the Assistant Secretary for Planning and Evaluation, the Assistant Secretary for Financial Resources, or the National Mental Health and Substance Use Policy Laboratory, including pursuant to priorities identified in the strategic plan established under section 501(l). (c) Requirements The Assistant Secretary shall establish minimum requirements for applications referred to in this section, including applications related to the submission of research and evaluation. (d) Review and rating The Assistant Secretary shall review applications prior to public posting, and may prioritize the review of applications for evidence-based practices and programs that are related to topics included in the notice established under subsection (b). The Assistant Secretary shall utilize a rating and review system, which shall include information on the strength of evidence associated with such programs and practices and a rating of the methodological rigor of the research supporting the application. The Assistant Secretary shall make the metrics used to evaluate applications and the resulting ratings publicly available. . 603. Sense of Congress It is the sense of the Congress that the National Institute of Mental Health should conduct or support research on the determinants of self-directed and other violence connected to mental illness. B Supporting the State Response to Mental Health Needs 611. Community Mental Health Services Block Grant (a) Formula grants Section 1911(b) of the Public Health Service Act ( 42 U.S.C. 300x(b) ) is amended— (1) by redesignating paragraphs (1) through (3) as paragraphs (2) through (4), respectively; and (2) by inserting before paragraph (2) (as so redesignated), the following: (1) providing community mental health services for adults with a serious mental illness and children with a serious emotional disturbance as defined in accordance with section 1912(c); . (b) State plan Subsection (b) of section 1912 of the Public Health Service Act ( 42 U.S.C. 300x–1 ) is amended to read as follows: (b) Criteria for Plan The criteria specified in this subsection are as follows: (1) System of care The plan provides a description of the system of care of the State, including as follows: (A) Comprehensive community-based health systems The plan shall— (i) identify the single State agency to be responsible for the administration of the program under the grant and any third party with whom the agency will contract (subject to such third party complying with the requirements of this part) for administering mental health services through such program; (ii) provide for an organized community-based system of care for individuals with mental illness, and describe available services and resources in a comprehensive system of care, including services for individuals with mental health and behavioral health co-occurring illness or disorders; (iii) include a description of the manner in which the State and local entities will coordinate services to maximize the efficiency, effectiveness, quality, and cost effectiveness of services and programs to produce the best possible outcomes (including health services, rehabilitation services, employment services, housing services, educational services, substance use disorder services, legal services, law enforcement services, social services, child welfare services, medical and dental care services, and other support services to be provided with Federal, State, and local public and private resources) with other agencies to enable individuals receiving services to function outside of inpatient or residential institutions, to the maximum extent of their capabilities, including services to be provided by local school systems under the Individuals with Disabilities Education Act; (iv) include a description of how the State— (I) promotes evidence-based practices, including those evidence-based programs that address the needs of individuals with early serious mental illness regardless of the age of the individual at onset; (II) provides comprehensive individualized treatment; or (III) integrates mental and physical health services; (v) include a description of case management services in the State; (vi) include a description of activities that seek to engage individuals with serious mental illness or serious emotional disturbance and their caregivers where appropriate in making health care decisions, including activities that enhance communication between individuals, families, caregivers, and treatment providers; and (vii) as appropriate to and reflective of the uses the State proposes for the block grant monies— (I) a description of the activities intended to reduce hospitalizations and hospital stays using the block grant monies; (II) a description of the activities intended to reduce incidents of suicide using the block grant monies; and (III) a description of how the State integrates mental health and primary care using the block grant monies. (B) Mental health system data and epidemiology The plan shall contain an estimate of the incidence and prevalence in the State of serious mental illness among adults and serious emotional disturbance among children and presents quantitative targets and outcome measures for programs and services provided under this subpart. (C) Children’s services In the case of children with serious emotional disturbance (as defined in accordance with subsection (c)), the plan shall provide for a system of integrated social services, educational services, child welfare services, juvenile justice services, law enforcement services, and substance use disorder services that, together with health and mental health services, will be provided in order for such children to receive care appropriate for their multiple needs (such system to include services provided under the Individuals with Disabilities Education Act). (D) Targeted services to rural and homeless populations The plan shall describe the State’s outreach to and services for individuals who are homeless and how community-based services will be provided to individuals residing in rural areas. (E) Management services The plan shall— (i) describe the financial resources available, the existing mental health workforce, and the workforce trained in treating individuals with co-occurring mental illness and substance use disorders; (ii) provide for the training of providers of emergency health services regarding mental health; (iii) describe the manner in which the State intends to expend the grant under section 1911 for the fiscal year involved; and (iv) describe the manner in which the State intends to comply with each of the funding agreements in this subpart and subpart III. (2) Goals and objectives The plan establishes goals and objectives for the period of the plan, including targets and milestones that are intended to be met, and the activities that will be undertaken to achieve those goals and objectives. . (c) Best practices in clinical care models Section 1920 of the Public Health Service Act ( 42 U.S.C. 300x–9 ) is amended by adding at the end the following: (c) Best practices in clinical care models A State shall expend not less than 10 percent of the amount the State receives for carrying out this subpart in each fiscal year to support evidence-based programs that address the needs of individuals with early serious mental illness, including psychotic disorders, regardless of the age of the individual at the onset of such illness. . (d) Additional provisions Section 1915(b) of the Public Health Service Act ( 42 U.S.C. 300x–4(b) ) is amended— (1) by amending paragraph (1) to read as follows: (1) In general A funding agreement for a grant under section 1911 is that the State involved will maintain State expenditures for community mental health services at a level that is not less than the average of the amounts prescribed by this paragraph (prior to any waiver under paragraph (3)) for such expenditures by such State for each of the 2 fiscal years immediately preceding the fiscal year for which the State is applying for the grant. ; (2) in paragraph (2)— (A) by striking under subsection (a) and inserting specified in paragraph (1) ; and (B) by striking principle and inserting principal ; (3) by amending paragraph (3) to read as follows: (3) Waiver (A) In general The Secretary may, upon the request of a State, waive the requirement established in paragraph (1) in whole or in part, if the Secretary determines that extraordinary economic conditions in the State in the fiscal year involved or in the previous fiscal year justify the waiver. (B) Date certain for action upon request The Secretary shall approve or deny a request for a waiver under this paragraph not later than 120 days after the date on which the request is made. (C) Applicability of waiver A waiver provided by the Secretary under this paragraph shall be applicable only to the fiscal year involved. ; and (4) in paragraph (4)— (A) by amending subparagraph (A) to read as follows: (A) In general (i) Determination and reduction The Secretary shall determine, in the case of each State, and for each fiscal year, whether the State maintained material compliance with the agreement made under paragraph (1). If the Secretary determines that a State has failed to maintain such compliance for a fiscal year, the Secretary shall reduce the amount of the allotment under section 1911 for the State, for the first fiscal year beginning after such determination is final, by an amount equal to the amount constituting such failure for the previous fiscal year about which the determination was made. (ii) Alternative sanction The Secretary may by regulation provide for an alternative method of imposing a sanction for a failure by a State to maintain material compliance with the agreement under paragraph (1) if the Secretary determines that such alternative method would be more equitable and would be a more effective incentive for States to maintain such material compliance. ; and (B) in subparagraph (B)— (i) by inserting after the subparagraph designation the following: Submission of information to the secretary.— ; and (ii) by striking subparagraph (A) and inserting subparagraph (A)(i) . (e) Application for grant Section 1917(a) of the Public Health Service Act ( 42 U.S.C. 300x–6(a) ) is amended— (1) in paragraph (1), by striking 1941 and inserting 1942(a) ; and (2) in paragraph (5), by striking 1915(b)(3)(B) and inserting 1915(b) . C Strengthening Mental Health Care for Children and Adolescents 621. Tele-mental health care access grants Title III of the Public Health Service Act is amended by inserting after section 330L of such Act ( 42 U.S.C. 254c–18 ) the following new section: 330M. Tele-mental health care access grants (a) In General The Secretary, acting through the Administrator of the Health Resources and Services Administration and in coordination with other relevant Federal agencies, shall award grants to States, political subdivisions of States, Indian tribes, and tribal organizations (for purposes of this section, as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act ( 25 U.S.C. 450b )) to promote behavioral health integration in pediatric primary care by— (1) supporting the development of statewide child mental health care access programs; and (2) supporting the improvement of existing statewide child mental health care access programs. (b) Program Requirements (1) In general A child mental health care access program referred to in subsection (a), with respect to which a grant under such subsection may be used, shall— (A) be a statewide network of pediatric mental health teams that provide support to pediatric primary care sites as an integrated team; (B) support and further develop organized State networks of child and adolescent psychiatrists and psychologists to provide consultative support to pediatric primary care sites; (C) conduct an assessment of critical behavioral consultation needs among pediatric providers and such providers’ preferred mechanisms for receiving consultation and training and technical assistance; (D) develop an online database and communication mechanisms, including telehealth, to facilitate consultation support to pediatric practices; (E) provide rapid statewide clinical telephone or telehealth consultations when requested between the pediatric mental health teams and pediatric primary care providers; (F) conduct training and provide technical assistance to pediatric primary care providers to support the early identification, diagnosis, treatment, and referral of children with behavioral health conditions or co-occurring intellectual and other developmental disabilities; (G) provide information to pediatric providers about, and assist pediatric providers in accessing, child psychiatry and psychology consultations and in scheduling and conducting technical assistance; (H) assist with referrals to specialty care and community or behavioral health resources; and (I) establish mechanisms for measuring and monitoring increased access to child and adolescent psychiatric and psychology services by pediatric primary care providers and expanded capacity of pediatric primary care providers to identify, treat, and refer children with mental health problems. (2) Pediatric mental health teams In this subsection, the term pediatric mental health team means a team of case coordinators, child and adolescent psychiatrists, and licensed clinical mental health professionals, such as a psychologist, social worker, or mental health counselor. (c) Application A State, political subdivision of a State, Indian tribe, or tribal organization seeking a grant under this section shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require, including a plan for the rigorous evaluation of activities that are carried out with funds received under such grant. (d) Evaluation A State, political subdivision of a State, Indian tribe, or tribal organization that receives a grant under this section shall prepare and submit an evaluation of activities carried out with funds received under such grant to the Secretary at such time, in such manner, and containing such information as the Secretary may reasonably require, including a process and outcome evaluation. (e) Matching Requirement The Secretary may not award a grant under this section unless the State, political subdivision of a State, Indian tribe, or tribal organization involved agrees, with respect to the costs to be incurred by the State, political subdivision of a State, Indian tribe, or tribal organization in carrying out the purpose described in this section, to make available non-Federal contributions (in cash or in kind) toward such costs in an amount that is not less than 20 percent of Federal funds provided in the grant. (f) Authorization of appropriations To carry this section, there are authorized to be appropriated $9,000,000 for the period of fiscal years 2018 through 2020. . 622. Infant and early childhood mental health promotion, intervention, and treatment Part Q of title III of the Public Health Service Act ( 42 U.S.C. 290h et seq. ) is amended by adding at the end the following: 399Z–2. Infant and early childhood mental health promotion, intervention, and treatment (a) Grants The Secretary shall— (1) award grants to eligible entities, including human services agencies, to develop, maintain, or enhance infant and early childhood mental health promotion, intervention, and treatment programs, including— (A) programs for infants and children at significant risk of developing, showing early signs of, or having been diagnosed with mental illness including serious emotional disturbance; and (B) multigenerational therapy and other services that support the caregiving relationship; and (2) ensure that programs funded through grants under this section are evidence-informed or evidence-based models, practices, and methods that are, as appropriate, culturally and linguistically appropriate, and can be replicated in other appropriate settings. (b) Eligible children and entities In this section: (1) Eligible child The term eligible child means a child from birth to not more than 5 years of age who— (A) is at risk for, shows early signs of, or has been diagnosed with a mental illness, including serious emotional disturbance; and (B) may benefit from infant and early childhood intervention or treatment programs or specialized preschool or elementary school programs that are evidence-based or that have been scientifically demonstrated to show promise but would benefit from further applied development. (2) Eligible entity The term eligible entity means a nonprofit institution that— (A) is accredited or approved by a State mental health or education agency, as applicable, to provide for children from infancy to 5 years of age mental health promotion, intervention, or treatment services that are evidence-based or that have been scientifically demonstrated to show promise but would benefit from further applied development; and (B) provides programs described in subsection (a) that are evidence-based or that have been scientifically demonstrated to show promise but would benefit from further applied development. (c) Application An eligible entity seeking a grant under subsection (a) shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require. (d) Use of funds for early intervention and treatment programs An eligible entity may use amounts awarded under a grant under subsection (a)(1) to carry out the following: (1) Provide age-appropriate mental health promotion and early intervention services or mental illness treatment services, which may include specialized programs, for eligible children at significant risk of developing, showing early signs of, or having been diagnosed with a mental illness, including serious emotional disturbance. Such services may include social and behavioral services as well as multigenerational therapy and other services ‎that support the caregiving relationship. (2) Provide training for health care professionals with expertise in infant and early childhood mental health care with respect to appropriate and relevant integration with other disciplines such as primary care clinicians, early intervention specialists, child welfare staff, home visitors, early care and education providers, and others who work with young children and families. (3) Provide mental health consultation to personnel of early care and education programs (including licensed or regulated center-based and home-based child care, home visiting, preschool special education, and early intervention programs) who work with children and families. (4) Provide training for mental health clinicians in infant and early childhood in promising and evidence-based practices and models for infant and early childhood mental health treatment and early intervention, including with regard to practices for identifying and treating mental illness and behavioral disorders of infants and children resulting from exposure or repeated exposure to adverse childhood experiences or childhood trauma. (5) Provide age-appropriate assessment, diagnostic, and intervention services for eligible children, including early mental health promotion, intervention, and treatment services. (e) Matching funds The Secretary may not award a grant under this section to an eligible entity unless the eligible entity agrees, with respect to the costs to be incurred by the eligible entity in carrying out the activities described in subsection (d), to make available non-Federal contributions (in cash or in kind) toward such costs in an amount that is not less than 10 percent of the total amount of Federal funds provided in the grant. (f) Authorization of appropriations To carry this section, there are authorized to be appropriated $20,000,000 for the period of fiscal years 2018 through 2022. . 623. National Child Traumatic Stress Initiative Section 582 of the Public Health Service Act ( 42 U.S.C. 290hh–1 ; relating to grants to address the problems of persons who experience violence related stress) is amended— (1) in subsection (a), by striking developing programs and all that follows and inserting the following: developing and maintaining programs that provide for— (1) the continued operation of the National Child Traumatic Stress Initiative (referred to in this section as the NCTSI ), which includes a coordinating center that focuses on the mental, behavioral, and biological aspects of psychological trauma response; and (2) the development of knowledge with regard to evidence-based practices for identifying and treating mental illness, behavioral disorders, and physical health conditions of children and youth resulting from witnessing or experiencing a traumatic event. ; (2) in subsection (b)— (A) by striking subsection (a) related and inserting subsection (a)(2) (related ; (B) by striking treating disorders associated with psychological trauma and inserting treating mental illness and behavioral and biological disorders associated with psychological trauma) ; and (C) by striking mental health agencies and programs that have established clinical and basic research and inserting universities, hospitals, mental health agencies, and other programs that have established clinical expertise and research ; (3) by redesignating subsections (c) through (g) as subsections (g) through (k), respectively; (4) by inserting after subsection (b), the following: (c) Child outcome data The NCTSI coordinating center shall collect, analyze, report, and make publicly available NCTSI-wide child treatment process and outcome data regarding the early identification and delivery of evidence-based treatment and services for children and families served by the NCTSI grantees. (d) Training The NCTSI coordinating center shall facilitate the coordination of training initiatives in evidence-based and trauma-informed treatments, interventions, and practices offered to NCTSI grantees, providers, and partners. (e) Dissemination The NCTSI coordinating center shall, as appropriate, collaborate with the Secretary in the dissemination of evidence-based and trauma-informed interventions, treatments, products, and other resources to appropriate stakeholders. (f) Review The Secretary shall, consistent with the peer-review process, ensure that NCTSI applications are reviewed by appropriate experts in the field as part of a consensus review process. The Secretary shall include review criteria related to expertise and experience in child trauma and evidence-based practices. ; (5) in subsection (g) (as so redesignated), by striking with respect to centers of excellence are distributed equitably among the regions of the country and inserting are distributed equitably among the regions of the United States ; (6) in subsection (i) (as so redesignated), by striking recipient may not exceed 5 years and inserting recipient shall not be less than 4 years, but shall not exceed 5 years ; and (7) in subsection (j) (as so redesignated), by striking $50,000,000 and all that follows through 2006 and inserting $46,887,000 for each of fiscal years 2017 through 2021 . VII Grant programs and program reauthorization A Garrett Lee Smith Memorial Act reauthorization 701. Youth interagency research, training, and technical assistance centers Section 520C of the Public Health Service Act ( 42 U.S.C. 290bb–34 ) is amended— (1) by striking the section heading and inserting Suicide prevention technical assistance center. ; (2) in subsection (a), by striking and in consultation with and all that follows through the period at the end of paragraph (2) and inserting shall establish a research, training, and technical assistance resource center to provide appropriate information, training, and technical assistance to States, political subdivisions of States, federally recognized Indian tribes, tribal organizations, institutions of higher education, public organizations, or private nonprofit organizations regarding the prevention of suicide among all ages, particularly among groups that are at high risk for suicide. ; (3) by striking subsections (b) and (c); (4) by redesignating subsection (d) as subsection (b); (5) in subsection (b), as so redesignated— (A) by striking the subsection heading and inserting Responsibilities of the center.— ; (B) in the matter preceding paragraph (1), by striking The additional research and all that follows through nonprofit organizations for and inserting The center established under subsection (a) shall conduct activities for the purpose of ; (C) by striking youth suicide each place such term appears and inserting suicide ; (D) in paragraph (1)— (i) by striking the development or continuation of and inserting developing and continuing ; and (ii) by inserting for all ages, particularly among groups that are at high risk for suicide before the semicolon at the end; (E) in paragraph (2), by inserting for all ages, particularly among groups that are at high risk for suicide before the semicolon at the end; (F) in paragraph (3), by inserting and tribal after statewide ; (G) in paragraph (5), by inserting and prevention after intervention ; (H) in paragraph (8), by striking in youth ; (I) in paragraph (9), by striking and behavioral health and inserting health and substance use disorder ; and (J) in paragraph (10), by inserting conducting before other ; and (6) by striking subsection (e) and inserting the following: (c) Authorization of appropriations For the purpose of carrying out this section, there are authorized to be appropriated $5,988,000 for each of fiscal years 2017 through 2021. (d) Report Not later than 2 years after the date of enactment of the Helping Families in Mental Health Crisis Act of 2016 , the Secretary shall submit to Congress a report on the activities carried out by the center established under subsection (a) during the year involved, including the potential effects of such activities, and the States, organizations, and institutions that have worked with the center. . 702. Youth suicide early intervention and prevention strategies Section 520E of the Public Health Service Act ( 42 U.S.C. 290bb–36 ) is amended— (1) in paragraph (1) of subsection (a) and in subsection (c), by striking substance abuse each place such term appears and inserting substance use disorder ; (2) in subsection (b)(2)— (A) by striking each State is awarded only 1 grant or cooperative agreement under this section and inserting a State does not receive more than one grant or cooperative agreement under this section at any one time ; and (B) by striking been awarded and inserting received ; and (3) by striking subsection (m) and inserting the following: (m) Authorization of appropriations For the purpose of carrying out this section, there are authorized to be appropriated $35,427,000 for each of fiscal years 2017 through 2021. . 703. Mental health and substance use disorder services on campus Section 520E–2 of the Public Health Service Act ( 42 U.S.C. 290bb–36b ) is amended— (1) in the section heading, by striking and behavioral health and inserting health and substance use disorder ; (2) in subsection (a)— (A) by striking Services, and inserting Services and ; (B) by striking and behavioral health problems and inserting health or substance use disorders ; and (C) by striking substance abuse and inserting substance use disorders ; (3) in subsection (b)— (A) in the matter preceding paragraph (1), by striking for— and inserting for one or more of the following: ; and (B) by striking paragraphs (1) through (6) and inserting the following: (1) Educating students, families, faculty, and staff to increase awareness of mental health and substance use disorders. (2) The operation of hotlines. (3) Preparing informational material. (4) Providing outreach services to notify students about available mental health and substance use disorder services. (5) Administering voluntary mental health and substance use disorder screenings and assessments. (6) Supporting the training of students, faculty, and staff to respond effectively to students with mental health and substance use disorders. (7) Creating a network infrastructure to link colleges and universities with health care providers who treat mental health and substance use disorders. ; (4) in subsection (c)(5), by striking substance abuse and inserting substance use disorder ; (5) in subsection (d)— (A) in the matter preceding paragraph (1), by striking An institution of higher education desiring a grant under this section and inserting To be eligible to receive a grant under this section, an institution of higher education ; (B) in paragraph (1)— (i) by striking and behavioral health and inserting health and substance use disorder ; and (ii) by inserting , including veterans whenever possible and appropriate, after students ; and (C) in paragraph (2), by inserting , which may include, as appropriate and in accordance with subsection (b)(7), a plan to seek input from relevant stakeholders in the community, including appropriate public and private entities, in order to carry out the program under the grant before the period at the end; (6) in subsection (e)(1), by striking and behavioral health problems and inserting health and substance use disorders ; (7) in subsection (f)(2)— (A) by striking and behavioral health and inserting health and substance use disorder ; and (B) by striking suicide and substance abuse and inserting suicide and substance use disorders ; and (8) in subsection (h), by striking $5,000,000 for fiscal year 2005 and all that follows through the period at the end and inserting $6,488,000 for each of fiscal years 2017 through 2021. . B Other provisions 711. National Suicide Prevention Lifeline Program 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 inserting after section 520E–2 ( 42 U.S.C. 290bb–36b ) the following: 520E–3. National Suicide Prevention Lifeline Program (a) In general The Secretary, acting through the Assistant Secretary, shall maintain the National Suicide Prevention Lifeline Program (referred to in this section as the Program ), authorized under section 520A and in effect prior to the date of enactment of the Helping Families in Mental Health Crisis Act of 2016 . (b) Activities In maintaining the Program, the activities of the Secretary shall include— (1) coordinating a network of crisis centers across the United States for providing suicide prevention and crisis intervention services to individuals seeking help at any time, day or night; (2) maintaining a suicide prevention hotline to link callers to local emergency, mental health, and social services resources; and (3) consulting with the Secretary of Veterans Affairs to ensure that veterans calling the suicide prevention hotline have access to a specialized veterans’ suicide prevention hotline. (c) Authorization of appropriations To carry out this section, there are authorized to be appropriated $7,198,000 for each of fiscal years 2017 through 2021. . 712. Workforce development studies and reports (a) In general Not later than 2 years after the date of enactment of this Act, the Assistant Secretary for Mental Health and Substance Use, in consultation with the Administrator of the Health Resources and Services Administration, shall conduct a study, and publicly post on the appropriate Internet website of the Department of Health and Human Services a report, on the mental health and substance use disorder workforce in order to inform Federal, State, and local efforts related to workforce enhancement. (b) Contents The report under this section shall contain— (1) national and State-level projections of the supply and demand of mental health and substance use disorder health workers, including the number of individuals practicing in fields deemed relevant by the Secretary; (2) an assessment of the mental health and substance use disorder workforce capacity, strengths, and weaknesses as of the date of the report, including the capacity of primary care to prevent, screen, treat, or refer for mental health and substance use disorders; (3) information on trends within the mental health and substance use disorder provider workforce, including the number of individuals entering the mental health workforce over the next 5 years; (4) information on the gaps in workforce development for mental health providers and professionals, including those who serve pediatric, adult, and geriatric patients; and (5) any additional information determined by the Assistant Secretary for Mental Health and Substance Use, in consultation with the Administrator of the Health Resources and Services Administration, to be relevant to the mental health and substance use disorder provider workforce. 713. Minority Fellowship Program Title V of the Public Health Service Act ( 42 U.S.C. 290aa et seq. ) is amended by adding at the end the following: K Minority Fellowship Program 597. Fellowships (a) In general The Secretary shall maintain a program, to be known as the Minority Fellowship Program, under which the Secretary awards fellowships, which may include stipends, for the purposes of— (1) increasing behavioral health practitioners’ knowledge of issues related to prevention, treatment, and recovery support for mental illness and substance use disorders among racial and ethnic minority populations; (2) improving the quality of mental illness and substance use disorder prevention and treatment delivered to racial and ethnic minorities; and (3) increasing the number of culturally competent behavioral health professionals and school personnel who teach, administer, conduct services research, and provide direct mental health or substance use services to racial and ethnic minority populations. (b) Training covered The fellowships under subsection (a) shall be for postbaccalaureate training (including for master’s and doctoral degrees) for mental health professionals, including in the fields of psychiatry, nursing, social work, psychology, marriage and family therapy, mental health counseling, and substance use and addiction counseling. (c) Authorization of appropriations To carry out this section, there are authorized to be appropriated $12,669,000 for each of fiscal years 2017, 2018, and 2019 and $13,669,000 for each of fiscal years 2020 and 2021. . 714. Center and program repeals Part B of title V of the Public Health Service Act ( 42 U.S.C. 290bb et seq. ) is amended by striking the second section 514 ( 42 U.S.C. 290bb–9 ), relating to methamphetamine and amphetamine treatment initiatives, and sections 514A, 517, 519A, 519C, 519E, 520D, and 520H ( 42 U.S.C. 290bb–8 , 290bb–23, 290bb–25a, 290bb–25c, 290bb–25e, 290bb–35, and 290bb–39). 715. National violent death reporting system The Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control and Prevention, is encouraged to improve, particularly through the inclusion of additional States, the National Violent Death Reporting System as authorized by title III of the Public Health Service Act ( 42 U.S.C. 241 et seq. ). Participation in the system by the States shall be voluntary. 716. Sense of Congress on prioritizing Native American youth and suicide prevention programs (a) Findings The Congress finds as follows: (1) Suicide is the eighth leading cause of death among American Indians and Alaska Natives across all ages. (2) Among American Indians and Alaska Natives who are 10 to 34 years of age, suicide is the second leading cause of death. (3) The suicide rate among American Indian and Alaska Native adolescents and young adults ages 15 to 34 (19.5 per 100,000) is 1.5 times higher than the national average for that age group (12.9 per 100,000). (b) Sense of Congress It is the sense of Congress that the Secretary of Health and Human Services, in carrying out programs for Native American youth and suicide prevention programs for youth suicide intervention, should prioritize programs and activities for individuals who have a high risk or disproportional burden of suicide, such as Native Americans. 717. Peer professional workforce development grant program (a) In general For the purposes described in subsection (b), the Secretary of Health and Human Services shall award grants to develop and sustain behavioral health paraprofessional training and education programs, including through tuition support. (b) Purposes The purposes of grants under this section are— (1) to increase the number of behavioral health paraprofessionals, including trained peers, recovery coaches, mental health and addiction specialists, prevention specialists, and pre-masters-level addiction counselors; and (2) to help communities develop the infrastructure to train and certify peers as behavioral health paraprofessionals. (c) Eligible entities To be eligible to receive a grant under this section, an entity shall be a community college or other entity the Secretary deems appropriate. (d) Geographic distribution In awarding grants under this section, the Secretary shall seek to achieve an appropriate national balance in the geographic distribution of such awards. (e) Special consideration In awarding grants under this section, the Secretary may give special consideration to proposed and existing programs targeting peer professionals serving youth ages 16 to 25. (f) Authorization of appropriations To carry out this section, there is authorized to be appropriated $10,000,000 for the period of fiscal years 2018 through 2022. 718. National Health Service Corps (a) Definitions (1) Primary health services Section 331(a)(3)(D) of the Public Health Service Act ( 42 U.S.C. 254d(a)(3) ) is amended by inserting (including pediatric mental health subspecialty services) after pediatrics . (2) Behavioral and mental health professionals Clause (i) of section 331(a)(3)(E) of the Public Health Service Act ( 42 U.S.C. 254d(a)(3)(E) ) is amended by inserting (and pediatric subspecialists thereof) before the period at the end. (b) Eligibility To participate in loan repayment program Section 338B(b)(1)(B) of the Public Health Service Act ( 42 U.S.C. 254l–1(b)(1)(B) ) is amended by inserting , including any physician child and adolescent psychiatry residency or fellowship training program after be enrolled in an approved graduate training program in medicine, osteopathic medicine, dentistry, behavioral and mental health, or other health profession . 719. Adult suicide prevention (a) Grants (1) Authority The Assistant Secretary for Mental Health and Substance Use (referred to in this section as the Assistant Secretary ) may award grants to eligible entities in order to implement suicide prevention efforts amongst adults 25 and older. (2) Purpose The grant program under this section shall be designed to raise suicide awareness, establish referral processes, and improve clinical care practice standards for treating suicide ideation, plans, and attempts among adults. (3) Recipients To be eligible to receive a grant under this section, an entity shall be a community-based primary care or behavioral health care setting, an emergency department, a State mental health agency, an Indian tribe, a tribal organization, or any other entity the Assistant Secretary deems appropriate. (4) Nature of activities The grants awarded under paragraph (1) shall be used to implement programs that— (A) screen for suicide risk in adults and provide intervention and referral to treatment; (B) implement evidence-based practices to treat individuals who are at suicide risk, including appropriate followup services; and (C) raise awareness, reduce stigma, and foster open dialogue about suicide prevention. (b) Additional activities The Assistant Secretary shall— (1) evaluate the activities supported by grants awarded under subsection (a) in order to further the Nation’s understanding of effective interventions to prevent suicide in adults; (2) disseminate the findings from the evaluation as the Assistant Secretary considers appropriate; and (3) provide appropriate information, training, and technical assistance to eligible entities that receive a grant under this section, in order to help such entities to meet the requirements of this section, including assistance with— (A) selection and implementation of evidence-based interventions and frameworks to prevent suicide, such as the Zero Suicide framework; and (B) other activities as the Assistant Secretary determines appropriate. (c) Duration A grant under this section shall be for a period of not more than 5 years. (d) Authorization of appropriations (1) In general There is authorized to be appropriated to carry out this section $30,000,000 for the period of fiscal years 2018 through 2022. (2) Use of certain funds Of the funds appropriated to carry out this section in any fiscal year, the lesser of 5 percent of such funds or $500,000 shall be available to the Assistant Secretary for purposes of carrying out subsection (b). 720. Crisis intervention grants for police officers and first responders (a) In general The Assistant Secretary for Mental Health and Substance Use may award grants to entities such as law enforcement agencies and first responders— (1) to provide specialized training to law enforcement officers, corrections officers, paramedics, emergency medical services workers, and other first responders (including village public safety officers (as defined in section 247 of the Indian Arts and Crafts Amendments Act of 2010 ( 42 U.S.C. 3796dd note)))— (A) to recognize individuals who have mental illness and how to properly intervene with individuals with mental illness; and (B) to establish programs that enhance the ability of law enforcement agencies to address the mental health, behavioral, and substance use problems of individuals encountered in the line of duty; and (2) to establish collaborative law enforcement and mental health programs, including behavioral health response teams and mental health crisis intervention teams comprised of mental health professionals, law enforcement officers, and other first responders, as appropriate, to provide on-site, face-to-face, mental and behavioral health care services during a mental health crisis, and to connect the individual in crisis to appropriate community-based treatment services in lieu of unnecessary hospitalization or further involvement with the criminal justice system. (b) Authorization of appropriations There are authorized to be appropriated to carry out this section $9,000,000 for the period of fiscal years 2018 through 2020. 721. Demonstration grant program to train health service psychologists in community-based mental health (a) Establishment The Secretary of Health and Human Services shall establish a grant program under which the Assistant Secretary of Mental Health and Substance Use Disorders may award grants to eligible institutions to support the recruitment, education, and clinical training experiences of health services psychology students, interns, and postdoctoral residents for education and clinical experience in community mental health settings. (b) Eligible institutions For purposes of this section, the term eligible institutions includes American Psychological Association-accredited doctoral, internship, and postdoctoral residency schools or programs in health service psychology that— (1) are focused on the development and implementation of interdisciplinary training of psychology graduate students and postdoctoral fellows in providing mental and behavioral health services to address substance use disorders, serious emotional disturbance, and serious illness, as well as developing faculty and implementing curriculum to prepare psychologists to work with underserved populations; and (2) demonstrate an ability to train health service psychologists in psychiatric hospitals, forensic hospitals, community mental health centers, community health centers, federally qualified health centers, or adult and juvenile correctional facilities. (c) Priorities In selecting grant recipients under this section, the Secretary shall give priority to eligible institutions in which training focuses on the needs of individuals with serious mental illness, serious emotional disturbance, justice-involved youth, and individuals with or at high risk for substance use disorders. (d) Authorization of appropriations There is authorized to be appropriated to carry out this section $12,000,000 for the period of fiscal years 2018 through 2022. 722. Investment in tomorrow’s pediatric health care workforce Section 775(e) of the Public Health Service Act ( 42 U.S.C. 295f(e) ) is amended to read as follows: (e) Authorization of appropriations To carry out this section, there is authorized to be appropriated $12,000,000 for the period of fiscal years 2018 through 2022. . 723. CUTGO compliance Section 319D(f) of the Public Health Service Act ( 42 U.S.C. 247d–4(f) ) is amended by striking $138,300,000 for each of fiscal years 2014 through 2018 and inserting $138,300,000 for each of fiscal years 2014 through 2016 and $58,000,000 for each of fiscal years 2017 and 2018 . VIII Mental Health Parity 801. Enhanced compliance with mental health and substance use disorder coverage requirements (a) Compliance program guidance document Section 2726(a) of the Public Health Service Act ( 42 U.S.C. 300gg–26(a) ) is amended by adding at the end the following: (6) Compliance program guidance document (A) In general Not later than 12 months after the date of enactment of the Helping Families in Mental Health Crisis Act of 2016 , the Secretary, the Secretary of Labor, and the Secretary of the Treasury, in consultation with the Inspector General of the Department of Health and Human Services, shall issue a compliance program guidance document to help improve compliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, and section 9812 of the Internal Revenue Code of 1986, as applicable. (B) Examples illustrating compliance and noncompliance (i) In general The compliance program guidance document required under this paragraph shall provide illustrative, de-identified examples (that do not disclose any protected health information or individually identifiable information) of previous findings of compliance and noncompliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable, based on investigations of violations of such sections, including— (I) examples illustrating requirements for information disclosures and nonquantitative treatment limitations; and (II) descriptions of the violations uncovered during the course of such investigations. (ii) Nonquantitative treatment limitations To the extent that any example described in clause (i) involves a finding of compliance or noncompliance with regard to any requirement for nonquantitative treatment limitations, the example shall provide sufficient detail to fully explain such finding, including a full description of the criteria involved for medical and surgical benefits and the criteria involved for mental health and substance use disorder benefits. (iii) Access to additional information regarding compliance In developing and issuing the compliance program guidance document required under this paragraph, the Secretaries specified in subparagraph (A)— (I) shall enter into interagency agreements with the Inspector General of the Department of Health and Human Services, the Inspector General of the Department of Labor, and the Inspector General of the Department of the Treasury to share findings of compliance and noncompliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable; and (II) shall seek to enter into an agreement with a State to share information on findings of compliance and noncompliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable. (C) Recommendations The compliance program guidance document shall include recommendations to comply with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable, and encourage the development and use of internal controls to monitor adherence to applicable statutes, regulations, and program requirements. Such internal controls may include a compliance checklist with illustrative examples of nonquantitative treatment limitations on mental health and substance use disorder benefits, which may fail to comply with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable, in relation to nonquantitative treatment limitations on medical and surgical benefits. (D) Updating the compliance program guidance document The compliance program guidance document shall be updated every 2 years to include illustrative, de-identified examples (that do not disclose any protected health information or individually identifiable information) of previous findings of compliance and noncompliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable. . (b) Additional guidance Section 2726(a) of the Public Health Service Act ( 42 U.S.C. 300gg–26(a) ), as amended by subsection (a), is further amended by adding at the end the following: (7) Additional guidance (A) In general Not later than 1 year after the date of enactment of the Helping Families in Mental Health Crisis Act of 2016 , the Secretary, in coordination with the Secretary of Labor and the Secretary of the Treasury, shall issue guidance to group health plans and health insurance issuers offering group or individual health insurance coverage to assist such plans and issuers in satisfying the requirements of this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable,. (B) Disclosure (i) Guidance for plans and issuers The guidance issued under this paragraph shall include clarifying information and illustrative examples of methods that group health plans and health insurance issuers offering group or individual health insurance coverage may use for disclosing information to ensure compliance with the requirements under this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable, (and any regulations promulgated pursuant to such sections, as applicable). (ii) Documents for participants, beneficiaries, contracting providers, or authorized representatives The guidance issued under this paragraph shall include clarifying information and illustrative examples of methods that group health plans and health insurance issuers offering group or individual health insurance coverage may use to provide any participant, beneficiary, contracting provider, or authorized representative, as applicable, with documents containing information that the health plans or issuers are required to disclose to participants, beneficiaries, contracting providers, or authorized representatives to ensure compliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable; any regulation issued pursuant to such respective section, or any other applicable law or regulation, including information that is comparative in nature with respect to— (I) nonquantitative treatment limitations for both medical and surgical benefits and mental health and substance use disorder benefits; (II) the processes, strategies, evidentiary standards, and other factors used to apply the limitations described in subclause (I); and (III) the application of the limitations described in subclause (I) to ensure that such limitations are applied in parity with respect to both medical and surgical benefits and mental health and substance use disorder benefits. (C) Nonquantitative treatment limitations The guidance issued under this paragraph shall include clarifying information and illustrative examples of methods, processes, strategies, evidentiary standards, and other factors that group health plans and health insurance issuers offering group or individual health insurance coverage may use regarding the development and application of nonquantitative treatment limitations to ensure compliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable, (and any regulations promulgated pursuant to such respective section), including— (i) examples of methods of determining appropriate types of nonquantitative treatment limitations with respect to both medical and surgical benefits and mental health and substance use disorder benefits, including nonquantitative treatment limitations pertaining to— (I) medical management standards based on medical necessity or appropriateness, or whether a treatment is experimental or investigative; (II) limitations with respect to prescription drug formulary design; and (III) use of fail-first or step therapy protocols; (ii) examples of methods of determining— (I) network admission standards (such as credentialing); and (II) factors used in provider reimbursement methodologies (such as service type, geographic market, demand for services, and provider supply, practice size, training, experience, and licensure) as such factors apply to network adequacy; (iii) examples of sources of information that may serve as evidentiary standards for the purposes of making determinations regarding the development and application of nonquantitative treatment limitations; (iv) examples of specific factors, and the evidentiary standards used to evaluate such factors, used by such plans or issuers in performing a nonquantitative treatment limitation analysis; (v) examples of how specific evidentiary standards may be used to determine whether treatments are considered experimental or investigative; (vi) examples of how specific evidentiary standards may be applied to each service category or classification of benefits; (vii) examples of methods of reaching appropriate coverage determinations for new mental health or substance use disorder treatments, such as evidence-based early intervention programs for individuals with a serious mental illness and types of medical management techniques; (viii) examples of methods of reaching appropriate coverage determinations for which there is an indirect relationship between the covered mental health or substance use disorder benefit and a traditional covered medical and surgical benefit, such as residential treatment or hospitalizations involving voluntary or involuntary commitment; and (ix) additional illustrative examples of methods, processes, strategies, evidentiary standards, and other factors for which the Secretary determines that additional guidance is necessary to improve compliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable. (D) Public comment Prior to issuing any final guidance under this paragraph, the Secretary shall provide a public comment period of not less than 60 days during which any member of the public may provide comments on a draft of the guidance. . (c) Availability of plan information (1) PHSA amendment Paragraph (4) of section 2726(a) of the Public Health Service Act ( 42 U.S.C. 300gg–26(a) ) is amended to read as follows: (4) Availability of plan information The criteria for medical necessity determinations made under the plan or health insurance coverage with respect to mental health or substance use disorder benefits or medical or surgical benefits, the reason for denial of any such benefits, and any other information appropriate to demonstrate compliance under this section (including any such medical and surgical information) shall be made available by the plan administrator (or the health insurance issuer offering such coverage) in accordance with applicable regulations to the current or potential participant, beneficiary, or contracting provider involved upon request. The Secretary may promulgate any such regulations, including interim final regulations or temporary regulations, as may be appropriate to carry out this paragraph. . (2) ERISA amendment Paragraph (4) of section 712(a) of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1185a(a) ) is amended to read as follows: (4) Availability of plan information The criteria for medical necessity determinations made under the plan with respect to mental health or substance use disorder benefits or medical or surgical benefits (or the health insurance coverage offered in connection with the plan with respect to such benefits), the reason for denial of any such benefits, and any other information appropriate to demonstrate compliance under this section (including any such medical and surgical information) shall be made available by the plan administrator (or the health insurance issuer offering such coverage) in accordance with applicable regulations to the current or potential participant, beneficiary, or contracting provider involved upon request. The Secretary may promulgate any such regulations, including interim final regulations or temporary regulations, as may be appropriate to carry out this paragraph. . (3) IRC amendment Paragraph (4) of section 9812(a) of the Internal Revenue Code of 1986 is amended to read as follows: (4) Availability of plan information The criteria for medical necessity determinations made under the plan with respect to mental health or substance use disorder benefits or medical or surgical benefits, the reason for denial of any such benefits, and any other information appropriate to demonstrate compliance under this section (including any such medical and surgical information) shall be made available by the plan administrator in accordance with applicable regulations to the current or potential participant, beneficiary, or contracting provider involved upon request. The Secretary may promulgate any such regulations, including interim final regulations or temporary regulations, as may be appropriate to carry out this paragraph. . (d) Improving compliance (1) In general In the case that the Secretary of Health and Human Services, the Secretary of Labor, or the Secretary of the Treasury determines that a group health plan or health insurance issuer offering group or individual health insurance coverage has violated, at least five times, section 2726 of the Public Health Service Act ( 42 U.S.C. 300gg–26 ), section 712 of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1185a ), or section 9812 of the Internal Revenue Code of 1986, respectively, the appropriate Secretary shall audit plan documents for such health plan or issuer in the plan year following the Secretary’s determination in order to help improve compliance with such section. (2) Rule of construction Nothing in this subsection shall be construed to limit the authority, as in effect on the day before the date of enactment of this Act, of the Secretary of Health and Human Services, the Secretary of Labor, or the Secretary of the Treasury to audit documents of health plans or health insurance issuers. 802. Action plan for enhanced enforcement of mental health and substance use disorder coverage (a) Public meeting (1) In general Not later than 6 months after the date of enactment of this Act, the Secretary of Health and Human Services shall convene a public meeting of stakeholders described in paragraph (2) to produce an action plan for improved Federal and State coordination related to the enforcement of section 2726 of the Public Health Service Act ( 42 U.S.C. 300gg–26 ), section 712 of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1185a ), and section 9812 of the Internal Revenue Code of 1986, and any comparable provisions of State law (in this section collectively referred to as mental health parity and addiction equity requirements ). (2) Stakeholders The stakeholders described in this paragraph shall include each of the following: (A) The Federal Government, including representatives from— (i) the Department of Health and Human Services; (ii) the Department of the Treasury; (iii) the Department of Labor; and (iv) the Department of Justice. (B) State governments, including— (i) State health insurance commissioners; (ii) appropriate State agencies, including agencies on public health or mental health; and (iii) State attorneys general or other representatives of State entities involved in the enforcement of mental health parity and addiction equity requirements. (C) Representatives from key stakeholder groups, including— (i) the National Association of Insurance Commissioners; (ii) health insurance providers; (iii) providers of mental health and substance use disorder treatment; (iv) employers; and (v) patients or their advocates. (b) Action plan Not later than 6 months after the conclusion of the public meeting under subsection (a), the Secretary of Health and Human Services shall finalize the action plan described in such subsection and make it plainly available on the Internet website of the Department of Health and Human Services. (c) Content The action plan under this section shall— (1) reflect the input of the stakeholders participating in the public meeting under subsection (a); (2) identify specific strategic objectives regarding how the various Federal and State agencies charged with enforcement of mental health parity and addiction equity requirements will collaborate to improve enforcement of such requirements; (3) provide a timeline for implementing the action plan; and (4) provide specific examples of how such objectives may be met, which may include— (A) providing common educational information and documents to patients about their rights under mental health parity and addiction equity requirements; (B) facilitating the centralized collection of, monitoring of, and response to patient complaints or inquiries relating to mental health parity and addiction equity requirements, which may be through the development and administration of a single, toll-free telephone number and an Internet website portal; (C) Federal and State law enforcement agencies entering into memoranda of understanding to better coordinate enforcement responsibilities and information sharing, including whether such agencies should make the results of enforcement actions related to mental health parity and addiction equity requirements publicly available; and (D) recommendations to the Congress regarding the need for additional legal authority to improve enforcement of mental health parity and addiction equity requirements, including the need for additional legal authority to ensure that nonquantitative treatment limitations are applied, and the extent and frequency of the applications of such limitations, both to medical and surgical benefits and to mental health and substance use disorder benefits in a comparable manner. 803. Report on investigations regarding parity in mental health and substance use disorder benefits (a) In general Not later than 1 year after the date of enactment of this Act, and annually thereafter for the subsequent 5 years, the Administrator of the Centers for Medicare & Medicaid Services, in collaboration with the Assistant Secretary of Labor of the Employee Benefits Security Administration and the Secretary of the Treasury, shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate a report summarizing the results of all closed Federal investigations completed during the preceding 12-month period with findings of any serious violation regarding compliance with mental health and substance use disorder coverage requirements under section 2726 of the Public Health Service Act ( 42 U.S.C. 300gg–26 ), section 712 of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1185a ), and section 9812 of the Internal Revenue Code of 1986. (b) Contents Subject to subsection (c), a report under subsection (a) shall, with respect to investigations described in such subsection, include each of the following: (1) The number of closed Federal investigations conducted during the covered reporting period. (2) Each benefit classification examined by any such investigation conducted during the covered reporting period. (3) Each subject matter, including compliance with requirements for quantitative and nonquantitative treatment limitations, of any such investigation conducted during the covered reporting period. (4) A summary of the basis of the final decision rendered for each closed investigation conducted during the covered reporting period that resulted in a finding of a serious violation. (c) Limitation Any individually identifiable information shall be excluded from reports under subsection (a) consistent with protections under the health privacy and security rules promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996 ( 42 U.S.C. 1320d–2 note). 804. GAO study on parity in mental health and substance use disorder benefits Not later than 3 years after the date of enactment of this Act, the Comptroller General of the United States, in consultation with the Secretary of Health and Human Services, the Secretary of Labor, and the Secretary of the Treasury, shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate a report detailing the extent to which group health plans or health insurance issuers offering group or individual health insurance coverage that provides both medical and surgical benefits and mental health or substance use disorder benefits, medicaid managed care organizations with a contract under section 1903(m) of the Social Security Act ( 42 U.S.C. 1396b(m) ), and health plans provided under the State Children’s Health Insurance Program under title XXI of the Social Security Act ( 42 U.S.C. 1397aa et seq. ) comply with section 2726 of the Public Health Service Act ( 42 U.S.C. 300gg–26 ), section 712 of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1185a ), and section 9812 of the Internal Revenue Code of 1986, including— (1) how nonquantitative treatment limitations, including medical necessity criteria, of such plans or issuers comply with such sections; (2) how the responsible Federal departments and agencies ensure that such plans or issuers comply with such sections, including an assessment of how the Secretary of Health and Human Services has used its authority to conduct audits of such plans to ensure compliance; (3) a review of how the various Federal and State agencies responsible for enforcing mental health parity requirements have improved enforcement of such requirements in accordance with the objectives and timeline described in the action plan under section 802; and (4) recommendations for how additional enforcement, education, and coordination activities by responsible Federal and State departments and agencies could better ensure compliance with such sections, including recommendations regarding the need for additional legal authority. 805. Information and awareness on eating disorders (a) Information The Secretary of Health and Human Services (in this section referred to as the Secretary ) may— (1) update information, related fact sheets, and resource lists related to eating disorders that are available on the public Internet website of the National Women's Health Information Center sponsored by the Office on Women's Health, to include— (A) updated findings and current research related to eating disorders, as appropriate; and (B) information about eating disorders, including information related to males and females; (2) incorporate, as appropriate, and in coordination with the Secretary of Education, information from publicly available resources into appropriate obesity prevention programs developed by the Office on Women's Health; and (3) make publicly available (through a public Internet website or other method) information, related fact sheets and resource lists, as updated under paragraph (1), and the information incorporated into appropriate obesity prevention programs, as updated under paragraph (2). (b) Awareness The Secretary may advance public awareness on— (1) the types of eating disorders; (2) the seriousness of eating disorders, including prevalence, comorbidities, and physical and mental health consequences; (3) methods to identify, intervene, refer for treatment, and prevent behaviors that may lead to the development of eating disorders; (4) discrimination and bullying based on body size; (5) the effects of media on self-esteem and body image; and (6) the signs and symptoms of eating disorders. 806. Education and training on eating disorders The Secretary of Health and Human Services may facilitate the identification of programs to educate and train health professionals and school personnel in effective strategies to— (1) identify individuals with eating disorders; (2) provide early intervention services for individuals with eating disorders; (3) refer patients with eating disorders for appropriate treatment; (4) prevent the development of eating disorders; or (5) provide appropriate treatment services for individuals with eating disorders. 807. GAO study on preventing discriminatory coverage limitations for individuals with serious mental illness and substance use disorders Not later than 2 years after the date of the enactment of this Act, the Comptroller General of the United States shall submit to Congress and make publicly available a report detailing Federal oversight of group health plans and health insurance coverage offered in the individual or group market (as such terms are defined in section 2791 of the Public Health Service Act ( 42 U.S.C. 300gg–91 )), including Medicaid managed care plans under section 1903 of the Social Security Act ( 42 U.S.C. 1396b ), to ensure compliance of such plans and coverage with sections 2726 of the Public Health Service Act ( 42 U.S.C. 300gg–26 ), 712 of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1185a ), and 9812 of the Internal Revenue Code of 1986 (in this section collectively referred to as the parity law ), including— (1) a description of how Federal regulations and guidance consider nonquantitative treatment limitations, including medical necessity criteria and application of such criteria to medical, surgical, and primary care, of such plans and coverage in ensuring compliance by such plans and coverage with the parity law; (2) a description of actions that Federal departments and agencies are taking to ensure that such plans and coverage comply with the parity law; and (3) the identification of enforcement, education, and coordination activities within Federal departments and agencies, including educational activities directed to State insurance commissioners, and a description of how such proper activities can be used to ensure full compliance with the parity law. 808. Clarification of existing parity rules If a group health plan or a health insurance issuer offering group or individual health insurance coverage provides coverage for eating disorder benefits, including residential treatment, such group health plan or health insurance issuer shall provide such benefits consistent with the requirements of section 2726 of the Public Health Service Act ( 42 U.S.C. 300gg–26 ), section 712 of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1185a ), and section 9812 of the Internal Revenue Code of 1986.

Passed the House of Representatives July 6, 2016. Karen L. Haas, Clerk

tv_txt: IB Union Calendar No. 517 114th CONGRESS 2d Session H. R. 2646 [Report No. 114–667, Part I] IN THE HOUSE OF REPRESENTATIVES June 4, 2015 Mr. Murphy of Pennsylvania (for himself, Ms. Eddie Bernice Johnson of Texas , Mr. Buchanan , Mr. Diaz-Balart , Mr. Bilirakis , Mr. Dold , Mr. Guinta , Mrs. Mimi Walters of California , Mr. Brendan F. Boyle of Pennsylvania , Mrs. Ellmers of North Carolina , Mr. Denham , Mr. Vargas , Mrs. Miller of Michigan , Mr. Hastings , Mr. Calvert , Mr. Nunes , Mr. Hunter , Mr. Blumenauer , and Ms. Sinema ) introduced the following bill; which was referred to the Committee on Energy and Commerce , and in addition to the Committees on Ways and Means and Education and the Workforce , 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 July 6, 2016 Additional sponsors: Mr. Hudson , Mr. Connolly , Mr. Katko , Mr. McKinley , Mr. Hinojosa , Mr. Cramer , Mr. Fortenberry , Mr. Guthrie , Mr. Duncan of Tennessee , Mr. Lance , Mr. Rangel , Mr. Wenstrup , Mr. Whitfield , Mr. Barr , Mr. Trott , Mr. Webster of Florida , Mr. Carter of Georgia , Mr. Hanna , Mrs. Blackburn , Mr. Amodei , Mr. Crawford , Mr. Wilson of South Carolina , Ms. McSally , Mr. Jeffries , Ms. Bass , Mr. Rush , Mr. Roe of Tennessee , Mr. Peterson , Mr. Barletta , Mr. Walz , Mr. Thompson of Mississippi , Ms. Brown of Florida , Mr. Joyce , Mr. Lowenthal , Mr. Mullin , Mr. Bera , Mr. LaMalfa , Mr. Collins of New York , Mrs. Black , Mr. Fleischmann , Mr. Michael F. Doyle of Pennsylvania , Ms. Kaptur , Mr. Olson , Mr. Carter of Texas , Mr. Cuellar , Mr. Roskam , Mr. Bucshon , Mrs. Brooks of Indiana , Mr. Duffy , Mr. Sensenbrenner , Mr. Thompson of Pennsylvania , Mr. Johnson of Ohio , Mr. Franks of Arizona , Ms. Judy Chu of California , Mrs. Lawrence , Mr. Gibson , Ms. Plaskett , Mr. Nolan , Mr. Salmon , Mr. Coffman , Mr. Paulsen , Mr. Kelly of Pennsylvania , Mr. Shuster , Mr. Costello of Pennsylvania , Mr. Fitzpatrick , Mr. Dent , Mr. Benishek , Ms. Titus , Mrs. Roby , Mr. Messer , Mr. Turner , Mr. Boustany , Mrs. Noem , Mrs. Lummis , Mrs. Hartzler , Mr. Mica , Mr. Cole , Mr. Lucas , Mr. Kinzinger of Illinois , Mr. Harris , Mr. Stivers , Mr. Smith of New Jersey , Mr. Rothfus , Mrs. Walorski , Mr. Heck of Washington , Mr. Ted Lieu of California , Mr. Peters , Mr. Bishop of Michigan , Mr. Byrne , Mr. O'Rourke , Mr. Rodney Davis of Illinois , Mr. Quigley , Ms. Eshoo , Mr. Reed , Mr. Huizenga of Michigan , Mr. Swalwell of California , Ms. Lee , Mrs. Comstock , Mr. Long , Mr. DeSaulnier , Ms. Norton , Ms. Bonamici , Ms. Herrera Beutler , Mr. Curbelo of Florida , Mr. Reichert , Mr. McHenry , Mr. Pierluisi , Mr. Sessions , Mr. Scalise , Mr. Israel , Mr. Tom Price of Georgia , Mr. Fincher , Ms. Stefanik , Mr. Crenshaw , Mr. Chabot , Mr. Schweikert , Mr. King of New York , Mr. Rouzer , Mr. Ashford , Mr. Simpson , Mr. Stewart , Mr. Royce , Mr. DeFazio , Mr. Hill , Mr. Zinke , Mr. Fattah , Mr. Pompeo , Mr. Walden , Mr. Harper , Mr. Meeks , Mr. Graves of Missouri , Ms. Ros-Lehtinen , Mr. Young of Iowa , Mr. Meehan , Mr. Jolly , Mr. Shimkus , Mr. Deutch , Mr. Luetkemeyer , Mr. Cohen , Mr. Goodlatte , Mr. Abraham , Mr. Emmer of Minnesota , Mr. Rooney of Florida , Ms. Speier , Mr. Austin Scott of Georgia , Mr. LoBiondo , Mr. Palazzo , Mr. Hurt of Virginia , Mr. Brady of Pennsylvania , Mr. LaHood , Mr. Ross , Mr. Ribble , Mr. Frelinghuysen , Ms. McCollum , Mr. Young of Indiana , Mr. Tipton , Mr. Perry , Mr. Pittenger , Mr. Rigell , Mr. McDermott , Mr. Cook , Mr. Marino , Mr. Poliquin , Mr. Zeldin , Mr. Cooper , Mr. Rice of South Carolina , Mr. Donovan , Mr. Cartwright , Mr. Bost , Mr. Young of Alaska , Ms. Velázquez , Mr. Knight , Mr. Farr , Mr. Moolenaar , Ms. Granger , Mr. Valadao , Mr. Thompson of California , Mr. Bishop of Georgia , Mr. Grayson , Mr. Kline , Ms. Hahn , Mr. Graves of Louisiana , Mr. Chaffetz , Ms. Jenkins of Kansas , Ms. Kuster , Mr. Williams , Mr. Richmond , Mr. Hardy , and Mr. Norcross July 6, 2016 Deleted sponsors: Mr. DeSantis (added July 21, 2015; deleted July 22, 2015), Mrs. Beatty (added July 21, 2015; deleted July 22, 2015), Ms. Lofgren (added July 21, 2015; deleted July 22, 2015), and Mr. Yoder (added October 7, 2015; deleted November 30, 2015). July 6, 2016 Reported from the Committee on Energy and Commerce with an amendment Strike out all after the enacting clause and insert the part printed in italic July 6, 2016 The Committees on Ways and Means and Education and the Workforce discharged; committed to the Committee of the Whole House on the State of the Union and ordered to be printed For text of introduced bill, see copy of bill as introduced on June 4, 2016 A BILL To make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis, and for other purposes.

1. Short title; table of contents (a) Short title This Act may be cited as the Helping Families in Mental Health Crisis Act of 2016 . (b) Table of contents The table of contents for this Act is as follows: Sec. 1. Short title; table of contents. Title I—Assistant Secretary for Mental Health and Substance Use Sec. 101. Assistant Secretary for Mental Health and Substance Use. Sec. 102. Improving oversight of mental health and substance use programs. Sec. 103. National Mental Health and Substance Use Policy Laboratory. Sec. 104. Peer-support specialist programs. Sec. 105. Prohibition against lobbying using Federal funds by systems accepting Federal funds to protect and advocate the rights of individuals with mental illness. Sec. 106. Reporting for protection and advocacy organizations. Sec. 107. Grievance procedure. Sec. 108. Center for Behavioral Health Statistics and Quality. Sec. 109. Strategic plan. Sec. 110. Authorities of centers for mental health services and substance abuse treatment. Sec. 111. Advisory councils. Sec. 112. Peer review. Title II—Medicaid Mental Health Coverage Sec. 201. Rule of construction related to Medicaid coverage of mental health services and primary care services furnished on the same day. Sec. 202. Optional limited coverage of inpatient services furnished in institutions for mental diseases. Sec. 203. Study and report related to Medicaid managed care regulation. Sec. 204. Guidance on opportunities for innovation. Sec. 205. Study and report on Medicaid emergency psychiatric demonstration project. Sec. 206. Providing full-range of EPSDT services to children in IMDs. Sec. 207. Electronic visit verification system required for personal care services and home health care services under Medicaid. Title III—Interdepartmental Serious Mental Illness Coordinating Committee Sec. 301. Interdepartmental Serious Mental Illness Coordinating Committee. Title IV—Compassionate Communication on HIPAA Sec. 401. Sense of Congress. Sec. 402. Confidentiality of records. Sec. 403. Clarification of circumstances under which disclosure of protected health information is permitted. Sec. 404. Development and dissemination of model training programs. Title V—Increasing Access to Treatment for Serious Mental Illness Sec. 501. Assertive community treatment grant program for individuals with serious mental illness. Sec. 502. Strengthening community crisis response systems. Sec. 503. Increased and extended funding for assisted outpatient grant program for individuals with serious mental illness. Sec. 504. Liability protections for health professional volunteers at community health centers. Title VI—Supporting Innovative and Evidence-Based Programs Subtitle A—Encouraging the Advancement, Incorporation, and Development of Evidence-Based Practices Sec. 601. Encouraging innovation and evidence-based programs. Sec. 602. Promoting access to information on evidence-based programs and practices. Sec. 603. Sense of Congress. Subtitle B—Supporting the State Response to Mental Health Needs Sec. 611. Community Mental Health Services Block Grant. Subtitle C—Strengthening Mental Health Care for Children and Adolescents Sec. 621. Telehealth child psychiatry access grants. Sec. 622. Infant and early childhood mental health promotion, intervention, and treatment. Sec. 623. National Child Traumatic Stress Initiative. Title VII—Grant programs and program reauthorization Subtitle A—Garrett Lee Smith Memorial Act reauthorization Sec. 701. Youth interagency research, training, and technical assistance centers. Sec. 702. Youth suicide early intervention and prevention strategies. Sec. 703. Mental health and substance use disorder services on campus. Subtitle B—Other provisions Sec. 711. National Suicide Prevention Lifeline Program. Sec. 712. Workforce development studies and reports. Sec. 713. Minority Fellowship Program. Sec. 714. Center and program repeals. Sec. 715. National violent death reporting system. Sec. 716. Sense of Congress on prioritizing Native American youth and suicide prevention programs. Sec. 717. Peer professional workforce development grant program. Sec. 718. National Health Service Corps. Sec. 719. Adult suicide prevention. Sec. 720. Crisis intervention grants for police officers and first responders. Sec. 721. Demonstration grant program to train health service psychologists in community-based mental health. Sec. 722. Investment in tomorrow’s pediatric health care workforce. Sec. 723. CUTGO compliance. Title VIII—Mental Health Parity Sec. 801. Enhanced compliance with mental health and substance use disorder coverage requirements. Sec. 802. Action plan for enhanced enforcement of mental health and substance use disorder coverage. Sec. 803. Report on investigations regarding parity in mental health and substance use disorder benefits. Sec. 804. GAO study on parity in mental health and substance use disorder benefits. Sec. 805. Information and awareness on eating disorders. Sec. 806. Education and training on eating disorders. Sec. 807. GAO study on preventing discriminatory coverage limitations for individuals with serious mental illness and substance use disorders. Sec. 808. Clarification of existing parity rules. I Assistant Secretary for Mental Health and Substance Use 101. Assistant Secretary for Mental Health and Substance Use (a) Assistant Secretary Section 501(c) of the Public Health Service Act ( 42 U.S.C. 290aa ) is amended to read as follows: (c) Assistant Secretary and Deputy Assistant Secretary (1) Assistant Secretary (A) Appointment The Administration shall be headed by an official to be known as the Assistant Secretary for Mental Health and Substance Use (hereinafter in this title referred to as the Assistant Secretary ) who shall be appointed by the President, by and with the advice and consent of the Senate. (B) Qualifications In selecting the Assistant Secretary, the President shall give preference to individuals who have— (i) a doctoral degree in medicine, osteopathic medicine, or psychology; (ii) clinical and research experience regarding mental health and substance use disorders; and (iii) an understanding of biological, psychosocial, and pharmaceutical treatments of mental illness and substance use disorders. (2) Deputy Assistant Secretary The Assistant Secretary, with the approval of the Secretary, may appoint a Deputy Assistant Secretary and may employ and prescribe the functions of such officers and employees, including attorneys, as are necessary to administer the activities to be carried out through the Administration. . (b) Transfer of authorities The Secretary of Health and Human Services shall delegate to the Assistant Secretary for Mental Health and Substance Use all duties and authorities that— (1) as of the day before the date of enactment of this Act, were vested in the Administrator of the Substance Abuse and Mental Health Services Administration; and (2) are not terminated by this Act. (c) Evaluation Section 501(d) of the Public Health Service Act ( 42 U.S.C. 290aa(d) ) is amended— (1) in paragraph (17), by striking and at the end; (2) in paragraph (18), by striking the period at the end and inserting a semicolon; and (3) by adding at the end the following: (19) evaluate, in consultation with the Assistant Secretary for Financial Resources, the information used for oversight of grants under programs related to mental and substance use disorders, including co-occurring disorders, administered by the Center for Mental Health Services; (20) periodically review Federal programs and activities relating to the diagnosis or prevention of, or treatment or rehabilitation for, mental illness and substance use disorders to identify any such programs or activities that have proven to be effective or efficient in improving outcomes or increasing access to evidence-based programs; (21) establish standards for the appointment of peer-review panels to evaluate grant applications and recommend standards for mental health grant programs; and . (d) Standards for grant programs Section 501(d) of the Public Health Service Act ( 42 U.S.C. 290aa(d) ), as amended by subsection (c), is further amended by adding at the end the following: (22) in consultation with the National Mental Health and Substance Use Policy Laboratory, and after providing an opportunity for public input, set standards for grant programs under this title for mental health and substance use services, which may address— (A) the capacity of the grantee to implement the award; (B) requirements for the description of the program implementation approach; (C) the extent to which the grant plan submitted by the grantee as part of its application must explain how the grantee will reach the population of focus and provide a statement of need, including to what extent the grantee will increase the number of clients served and the estimated percentage of clients receiving services who report positive functioning after 6 months or no past-month substance use, as applicable; (D) the extent to which the grantee must collect and report on required performance measures; and (E) the extent to which the grantee is proposing evidence-based practices and the extent to which— (i) those evidence-based practices must be used with respect to a population similar to the population for which the evidence-based practices were shown to be effective; or (ii) if no evidence-based practice exists for a population of focus, the way in which the grantee will implement adaptations of evidence-based practices, promising practices, or cultural practices. . (e) Member of Council on Graduate Medical Education Section 762 of the Public Health Service Act ( 42 U.S.C. 290o ) is amended— (1) in subsection (b)— (A) by redesignating paragraphs (4), (5), and (6) as paragraphs (5), (6), and (7), respectively; and (B) by inserting after paragraph (3) the following: (4) the Assistant Secretary for Mental Health and Substance Use; ; and (2) in subsection (c), by striking (4), (5), and (6) each place it appears and inserting (5), (6), and (7) . (f) Conforming amendments Title V of the Public Health Service Act ( 42 U.S.C. 290aa et seq. ), as amended by the previous provisions of this section, is further amended— (1) by striking Administrator of the Substance Abuse and Mental Health Services Administration each place it appears and inserting Assistant Secretary for Mental Health and Substance Use ; and (2) by striking Administrator each place it appears (including in any headings) and inserting Assistant Secretary , except where the term Administrator appears— (A) in each of subsections (e) and (f) of section 501 of such Act ( 42 U.S.C. 290aa ), including the headings of such subsections, within the term Associate Administrator ; (B) in section 507(b)(6) of such Act ( 42 U.S.C. 290bb(b)(6) ), within the term Administrator of the Health Resources and Services Administration ; (C) in section 507(b)(6) of such Act ( 42 U.S.C. 290bb(b)(6) ), within the term Administrator of the Centers for Medicare & Medicaid Services ; (D) in section 519B(c)(1)(B) of such Act (42 U.S.C. 290bb-25b(c)(1)(B)), within the term Administrator of the National Highway Traffic Safety Administration ; or (E) in each of sections 519B(c)(1)(B), 520C(a), and 520D(a) of such Act (42 U.S.C. 290bb-25b(c)(1)(B), 290bb-34(a), 290bb-35(a)), within the term Administrator of the Office of Juvenile Justice and Delinquency Prevention . (g) References After executing subsections (a), (b), and (f), any reference in statute, regulation, or guidance to the Administrator of the Substance Abuse and Mental Health Services Administration shall be construed to be a reference to the Assistant Secretary for Mental Health and Substance Use. 102. Improving oversight of mental health and substance use programs Title V of the Public Health Service Act is amended by inserting after section 501 of such Act ( 42 U.S.C. 290aa ) the following: 501A. Improving oversight of mental health and substance use programs (a) Activities For the purpose of ensuring efficient and effective planning and evaluation of mental and substance use disorder programs and related activities, the Assistant Secretary for Planning and Evaluation, in consultation with the Assistant Secretary for Mental Health and Substance Use, shall— (1) collect and organize relevant data on homelessness, involvement with the criminal justice system, hospitalizations, mortality outcomes, and other measures the Secretary deems appropriate from across Federal departments and agencies; (2) evaluate programs related to mental and substance use disorders, including co-occurring disorders, across Federal departments and agencies, as appropriate, including programs related to— (A) prevention, intervention, treatment, and recovery support services, including such services for individuals with a serious mental illness or serious emotional disturbance; (B) the reduction of homelessness and involvement with the criminal justice system among individuals with a mental or substance use disorder; and (C) public health and health services; and (3) consult, as appropriate, with the Assistant Secretary, the Behavioral Health Coordinating Council of the Department of Health and Human Services, other agencies within the Department of Health and Human Services, and other relevant Federal departments. (b) Recommendations The Assistant Secretary for Planning and Evaluation shall develop an evaluation strategy that identifies priority programs to be evaluated by the Assistant Secretary and priority programs to be evaluated by other relevant agencies within the Department of Health and Human Services. The Assistant Secretary for Planning and Evaluation shall provide recommendations on improving programs and activities based on the evaluation described in subsection (a)(2) as needing improvement. . 103. National Mental Health and Substance Use Policy Laboratory Title V of the Public Health Service Act ( 42 U.S.C. 290aa et seq. ) is amended by inserting after section 501A, as added by section 102 of this Act, the following: 501B. National Mental Health and Substance Use Policy Laboratory (a) In general There shall be established within the Administration a National Mental Health and Substance Use Policy Laboratory (referred to in this section as the Laboratory ). (b) Responsibilities The Laboratory shall— (1) continue to carry out the authorities and activities that were in effect for the Office of Policy, Planning, and Innovation as such Office existed prior to the date of enactment of the Helping Families in Mental Health Crisis Act of 2016 ; (2) identify, coordinate, and facilitate the implementation of policy changes likely to have a significant effect on mental health, mental illness, and the prevention and treatment of substance use disorder services; (3) collect, as appropriate, information from grantees under programs operated by the Administration in order to evaluate and disseminate information on evidence-based practices, including culturally and linguistically appropriate services, as appropriate, and service delivery models; (4) provide leadership in identifying and coordinating policies and programs, including evidence-based programs, related to mental and substance use disorders; (5) recommend ways in which payers may implement program and policy findings of the Administration and the Laboratory to improve outcomes and reduce per capita program costs; (6) in consultation with the Assistant Secretary for Planning and Evaluation, as appropriate, periodically review Federal programs and activities relating to the diagnosis or prevention of, or treatment or rehabilitation for, mental illness and substance use disorders, including by— (A) identifying any such programs or activities that are duplicative; (B) identifying any such programs or activities that are not evidence-based, effective, or efficient; and (C) formulating recommendations for coordinating, eliminating, or improving programs or activities identified under subparagraph (A) or (B) and merging such programs or activities into other successful programs or activities; and (7) carry out other activities as deemed necessary to continue to encourage innovation and disseminate evidence-based programs and practices, including programs and practices with scientific merit. (c) Evidence-Based practices and service delivery models (1) In general In selecting evidence-based best practices and service delivery models for evaluation and dissemination, the Laboratory— (A) shall give preference to models that improve— (i) the coordination between mental health and physical health providers; (ii) the coordination among such providers and the justice and corrections system; and (iii) the cost effectiveness, quality, effectiveness, and efficiency of health care services furnished to individuals with serious mental illness or serious emotional disturbance, in mental health crisis, or at risk to themselves, their families, and the general public; and (B) may include clinical protocols and practices used in the Recovery After Initial Schizophrenia Episode (RAISE) project and the North American Prodrome Longitudinal Study (NAPLS) of the National Institute of Mental Health. (2) Deadline for beginning implementation The Laboratory shall begin implementation of the duties described in this subsection not later than January 1, 2018. (3) Consultation In carrying out the duties under this subsection, the Laboratory shall consult with— (A) representatives of the National Institute of Mental Health, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism, on an ongoing basis; (B) other appropriate Federal agencies; (C) clinical and analytical experts with expertise in psychiatric medical care and clinical psychological care, health care management, education, corrections health care, and mental health court systems, as appropriate; and (D) other individuals and agencies as determined appropriate by the Assistant Secretary. . 104. Peer-support specialist programs (a) In general Not later than 2 years after the date of enactment of this Act, the Comptroller General of the United States shall conduct a study on peer-support specialist programs in up to 10 States (to be selected by the Comptroller General) that receive funding from the Substance Abuse and Mental Health Services Administration and submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives a report containing the results of such study. (b) Contents of study In conducting the study under subsection (a), the Comptroller General of the United States shall examine and identify best practices in the selected States related to training and credential requirements for peer-specialist programs, such as— (1) hours of formal work or volunteer experience related to mental and substance use disorders conducted through such programs; (2) types of peer support specialist exams required for such programs in the States; (3) codes of ethics used by such programs in the States; (4) required or recommended skill sets of such programs in the State; and (5) requirements for continuing education. 105. Prohibition against lobbying using Federal funds by systems accepting Federal funds to protect and advocate the rights of individuals with mental illness Section 105(a) of the Protection and Advocacy for Individuals with Mental Illness Act ( 42 U.S.C. 10805(a) ) is amended— (1) in paragraph (9), by striking and at the end; (2) in paragraph (10), by striking the period at the end and inserting ; and ; and (3) by adding at the end the following: (11) agree to refrain, during any period for which funding is provided to the system under this part, from using Federal funds to pay the salary or expenses of any grant or contract recipient, or agent acting for such recipient, related to any activity designed to influence the enactment of legislation, appropriations, regulation, administrative action, or Executive order proposed or pending before the Congress or any State government, State legislature or local legislature or legislative body, other than for normal and recognized executive-legislative relationships or participation by an agency or officer of a State, local, or tribal government in policymaking and administrative processes within the executive branch of that government. . 106. Reporting for protection and advocacy organizations (a) Public availability of reports Section 105(a)(7) of the Protection and Advocacy for Individuals with Mental Illness Act ( 42 U.S.C. 10805(a)(7) ) is amended by striking is located a report and inserting is located, and make publicly available, a report . (b) Detailed accounting Section 114(a) of the Protection and Advocacy for Individuals with Mental Illness Act ( 42 U.S.C. 10824(a) ) is amended— (1) in paragraph (3), by striking and at the end; (2) in paragraph (4), by striking the period at the end and inserting ; and ; and (3) by adding at the end the following: (5) using data from the existing required annual program progress reports submitted by each system funded under this title, a detailed accounting for each such system of how funds are spent, disaggregated according to whether the funds were received from the Federal Government, the State government, a local government, or a private entity. . 107. Grievance procedure Section 105 of the Protection and Advocacy for Individuals with Mental Illness Act ( 42 U.S.C. 10805 ), as amended, is further amended by adding at the end the following: (d) Grievance procedure The Secretary shall establish an independent grievance procedure for persons described in subsection (a)(9). . 108. Center for Behavioral Health Statistics and Quality Title V of the Public Health Service Act ( 42 U.S.C. 290aa et seq. ) is amended— (1) in section 501(b) ( 42 U.S.C. 290aa(b) ), by adding at the end the following: (4) The Center for Behavioral Health Statistics and Quality. ; (2) in section 502(a)(1) ( 42 U.S.C. 290aa–1(a)(1) )— (A) in subparagraph (C), by striking and at the end; (B) in subparagraph (D), by striking the period at the end and inserting ; and ; and (C) by inserting after subparagraph (D) the following: (E) the Center for Behavioral Health Statistics and Quality. ; and (3) in part B ( 42 U.S.C. 290bb et seq. ) by adding at the end the following new subpart: 4 Center for Behavioral Health Statistics and Quality 520L. Center for Behavioral Health Statistics and Quality (a) Establishment There is established in the Administration a Center for Behavioral Health Statistics and Quality (in this section referred to as the Center ). The Center shall be headed by a Director (in this section referred to as the Director ) appointed by the Secretary from among individuals with extensive experience and academic qualifications in research and analysis in behavioral health care or related fields. (b) Duties The Director of the Center shall— (1) coordinate the Administration’s integrated data strategy by coordinating— (A) surveillance and data collection (including that authorized by section 505); (B) evaluation; (C) statistical and analytic support; (D) service systems research; and (E) performance and quality information systems; (2) recommend a core set of measurement standards for grant programs administered by the Administration; and (3) coordinate evaluation efforts for the grant programs, contracts, and collaborative agreements of the Administration. (c) Biannual report to Congress Not later than 2 years after the date of enactment of this section, and every 2 years thereafter, the Director of the Center shall submit to Congress a report on the quality of services furnished through grant programs of the Administration, including applicable measures of outcomes for individuals and public outcomes such as— (1) the number of patients screened positive for unhealthy alcohol use who receive brief counseling as appropriate; the number of patients screened positive for tobacco use and receiving smoking cessation interventions; the number of patients with a new diagnosis of major depressive episode who are assessed for suicide risk; the number of patients screened positive for clinical depression with a documented followup plan; and the number of patients with a documented pain assessment that have a followup treatment plan when pain is present; and satisfaction with care; (2) the incidence and prevalence of substance use and mental disorders; the number of suicide attempts and suicide completions; overdoses seen in emergency rooms resulting from alcohol and drug use; emergency room boarding; overdose deaths; emergency psychiatric hospitalizations; new criminal justice involvement while in treatment; stable housing; and rates of involvement in employment, education, and training; and (3) such other measures for outcomes of services as the Director may determine. (d) Staffing Composition The staff of the Center may include individuals with advanced degrees and field expertise as well as clinical and research experience in mental and substance use disorders such as— (1) professionals with clinical and research expertise in the prevention and treatment of, and recovery from, substance use and mental disorders; (2) professionals with training and expertise in statistics or research and survey design and methodologies; and (3) other related fields in the social and behavioral sciences, as specified by relevant position descriptions. (e) Grants and contracts In carrying out the duties established in subsection (b), the Director may make grants to and enter into contracts and cooperative agreements with public and nonprofit private entities. (f) Definition In this section, the term emergency room boarding means the practice of admitting patients to an emergency department and holding such patients in the department until inpatient psychiatric beds become available. . 109. Strategic plan Section 501 of the Public Health Service Act ( 42 U.S.C. 290aa ) is amended— (1) by redesignating subsections (l) through (o) as subsections (m) through (p), respectively; and (2) by inserting after subsection (k) the following: (l) Strategic plan (1) In general Not later than December 1, 2017, and every 5 years thereafter, the Assistant Secretary shall develop and carry out a strategic plan in accordance with this subsection for the planning and operation of evidence-based programs and grants carried out by the Administration. (2) Coordination In developing and carrying out the strategic plan under this section, the Assistant Secretary shall take into consideration the report of the Interdepartmental Serious Mental Illness Coordinating Committee under section 301 of the Helping Families in Mental Health Crisis Act of 2016. (3) Publication of plan Not later than December 1, 2017, and every 5 years thereafter, the Assistant Secretary shall— (A) submit the strategic plan developed under paragraph (1) to the appropriate committees of Congress; and (B) post such plan on the Internet website of the Administration. (4) Contents The strategic plan developed under paragraph (1) shall— (A) identify strategic priorities, goals, and measurable objectives for mental and substance use disorder activities and programs operated and supported by the Administration, including priorities to prevent or eliminate the burden of mental illness and substance use disorders; (B) identify ways to improve services for individuals with a mental or substance use disorder, including services related to the prevention of, diagnosis of, intervention in, treatment of, and recovery from, mental or substance use disorders, including serious mental illness or serious emotional disturbance, and access to services and supports for individuals with a serious mental illness or serious emotional disturbance; (C) ensure that programs provide, as appropriate, access to effective and evidence-based prevention, diagnosis, intervention, treatment, and recovery services, including culturally and linguistically appropriate services, as appropriate, for individuals with a mental or substance use disorder; (D) identify opportunities to collaborate with the Health Resources and Services Administration to develop or improve— (i) initiatives to encourage individuals to pursue careers (especially in rural and underserved areas and populations) as psychiatrists, psychologists, psychiatric nurse practitioners, physician assistants, occupational therapists, clinical social workers, certified peer support specialists, licensed professional counselors, or other licensed or certified mental health professionals, including such professionals specializing in the diagnosis, evaluation, or treatment of individuals with a serious mental illness or serious emotional disturbance; and (ii) a strategy to improve the recruitment, training, and retention of a workforce for the treatment of individuals with mental or substance use disorders, or co-occurring disorders; (E) identify opportunities to improve collaboration with States, local governments, communities, and Indian tribes and tribal organizations (as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act ( 25 U.S.C. 450b )); and (F) specify a strategy to disseminate evidenced-based and promising best practices related to prevention, diagnosis, early intervention, treatment, and recovery services related to mental illness, particularly for individuals with a serious mental illness and children and adolescents with a serious emotional disturbance, and substance use disorders. . 110. Authorities of centers for mental health services and substance abuse treatment (a) Center for mental health services Section 520(b) of the Public Health Service Act ( 42 U.S.C. 290bb–31(b) ) is amended— (1) by redesignating paragraphs (3) through (15) as paragraphs (4) through (16), respectively; (2) by inserting after paragraph (2) the following: (3) collaborate with the Director of the National Institute of Mental Health to ensure that, as appropriate, programs related to the prevention and treatment of mental illness and the promotion of mental health are carried out in a manner that reflects the best available science and evidence-based practices, including culturally and linguistically appropriate services; ; (3) in paragraph (5), as so redesignated, by inserting through policies and programs that reduce risk and promote resiliency before the semicolon; (4) in paragraph (6), as so redesignated, by inserting in collaboration with the Director of the National Institute of Mental Health, before develop ; (5) in paragraph (8), as so redesignated, by inserting , increase meaningful participation of individuals with mental illness in programs and activities of the Administration, before and protect the legal ; (6) in paragraph (10), as so redesignated, by striking professional and paraprofessional personnel pursuant to section 303 and inserting paraprofessional personnel and health professionals ; (7) in paragraph (11), as so redesignated, by inserting and telemental health, after rural mental health, ; (8) in paragraph (12), as so redesignated, by striking establish a clearinghouse for mental health information to assure the widespread dissemination of such information and inserting disseminate mental health information, including evidenced-based practices, ; (9) in paragraph (15), as so redesignated, by striking and at the end; (10) in paragraph (16), as so redesignated, by striking the period and inserting ; and ; and (11) by adding at the end the following: (17) consult with other agencies and offices of the Department of Health and Human Services to ensure, with respect to each grant awarded by the Center for Mental Health Services, the consistent documentation of the application of criteria when awarding grants and the ongoing oversight of grantees after such grants are awarded. . (b) Director of the center for substance abuse treatment Section 507 of the Public Health Service Act ( 42 U.S.C. 290bb ) is amended— (1) in subsection (a)— (A) by striking treatment of substance abuse and inserting treatment of substance use disorders ; and (B) by striking abuse treatment systems and inserting use disorder treatment systems ; and (2) in subsection (b)— (A) in paragraph (3), by striking abuse and inserting use disorder ; (B) in paragraph (4), by striking individuals who abuse drugs and inserting individuals who use drugs ; (C) in paragraph (9), by striking carried out by the Director ; (D) by striking paragraph (10); (E) by redesignating paragraphs (11) through (14) as paragraphs (10) through (13), respectively; (F) in paragraph (12), as so redesignated, by striking ; and and inserting a semicolon; and (G) by striking paragraph (13), as so redesignated, and inserting the following: (13) ensure the consistent documentation of the application of criteria when awarding grants and the ongoing oversight of grantees after such grants are awarded; and (14) work with States, providers, and individuals in recovery, and their families, to promote the expansion of recovery support services and systems of care oriented towards recovery. . 111. Advisory councils Section 502(b) of the Public Health Service Act ( 42 U.S.C. 290aa–1(b) ) is amended— (1) in paragraph (2)— (A) in subparagraph (E), by striking and after the semicolon; (B) by redesignating subparagraph (F) as subparagraph (I); and (C) by inserting after subparagraph (E), the following: (F) for the advisory councils appointed under subsections (a)(1)(A) and (a)(1)(D), the Director of the National Institute of Mental Health; (G) for the advisory councils appointed under subsections (a)(1)(A), (a)(1)(B), and (a)(1)(C), the Director of the National Institute on Drug Abuse; (H) for the advisory councils appointed under subsections (a)(1)(A), (a)(1)(B), and (a)(1)(C), the Director of the National Institute on Alcohol Abuse and Alcoholism; and ; and (2) in paragraph (3), by adding at the end the following: (C) Not less than half of the members of the advisory council appointed under subsection (a)(1)(D)— (i) shall have— (I) a medical degree; (II) a doctoral degree in psychology; or (III) an advanced degree in nursing or social work from an accredited graduate school or be a certified physician assistant; and (ii) shall specialize in the mental health field. . 112. Peer review Section 504(b) of the Public Health Service Act ( 42 U.S.C. 290aa–3(b) ) is amended by adding at the end the following: In the case of any such peer review group that is reviewing a grant, cooperative agreement, or contract related to mental illness treatment, not less than half of the members of such peer review group shall be licensed and experienced professionals in the prevention, diagnosis, or treatment of, or recovery from, mental or substance use disorders and have a medical degree, a doctoral degree in psychology, or an advanced degree in nursing or social work from an accredited program. . II Medicaid Mental Health Coverage 201. Rule of construction related to Medicaid coverage of mental health services and primary care services furnished on the same day Nothing in title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ) shall be construed as prohibiting separate payment under the State plan under such title (or under a waiver of the plan) for the provision of a mental health service or primary care service under such plan, with respect to an individual, because such service is— (1) a primary care service furnished to the individual by a provider at a facility on the same day a mental health service is furnished to such individual by such provider (or another provider) at the facility; or (2) a mental health service furnished to the individual by a provider at a facility on the same day a primary care service is furnished to such individual by such provider (or another provider) at the facility. 202. Optional limited coverage of inpatient services furnished in institutions for mental diseases (a) In general Section 1903(m)(2) of the Social Security Act ( 42 U.S.C. 1396b(m)(2) ) is amended by adding at the end the following new subparagraph: (I) (i) Notwithstanding the limitation specified in the subdivision (B) following paragraph (29) of section 1905(a) and subject to clause (ii), a State may, under a risk contract entered into by the State under this title (or under section 1115) with a medicaid managed care organization or a prepaid inpatient health plan (as defined in section 438.2 of title 42, Code of Federal Regulations (or any successor regulation)), make a monthly capitation payment to such organization or plan for enrollees with the organization or plan who are over 21 years of age and under 65 years of age and are receiving inpatient treatment in an institution for mental diseases (as defined in section 1905(i)), so long as each of the following conditions is met: (I) The institution is a hospital providing inpatient psychiatric or substance use disorder services or a sub-acute facility providing psychiatric or substance use disorder crisis residential services. (II) The length of stay in such an institution for such treatment is for a short-term stay of no more than 15 days during the period of the monthly capitation payment. (III) The provision of such treatment meets the following criteria for consideration as services or settings that are in lieu of services or settings covered under the State plan: (aa) The State determines that the alternative service or setting is a medically appropriate and cost-effective substitute for the covered service or setting under the State plan. (bb) The enrollee is not required by the managed care organization or prepaid inpatient health plan to use the alternative service or setting. (cc) Such treatment is authorized and identified in such contract, and will be offered to such enrollees at the option of the managed care organization or prepaid inpatient health plan. (ii) For purposes of setting the amount of such a monthly capitation payment, a State may use the utilization of services provided to an individual under this subparagraph when developing the inpatient psychiatric or substance use disorder component of such payment, but the amount of such payment for such services may not exceed the cost of the same services furnished through providers included under the State plan. . (b) Effective date The amendment made by subsection (a) shall apply beginning on July 5, 2016, or the date of the enactment of this Act, whichever is later. 203. Study and report related to Medicaid managed care regulation (a) Study The Secretary of Health and Human Services, acting through the Administrator of the Centers for Medicare & Medicaid Services, shall conduct a study on coverage under the Medicaid program under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ) of services provided through a medicaid managed care organization (as defined in section 1903(m) of such Act ( 42 U.S.C. 1396b(m) ) or a prepaid inpatient health plan (as defined in section 438.2 of title 42, Code of Federal Regulations (or any successor regulation)) with respect to individuals over the age of 21 and under the age of 65 for the treatment of a mental health disorder in institutions for mental diseases (as defined in section 1905(i) of such Act ( 42 U.S.C. 1396d(i) )). Such study shall include information on the following: (1) The extent to which States, including the District of Columbia and each territory or possession of the United States, are providing capitated payments to such organizations or plans for enrollees who are receiving services in institutions for mental diseases. (2) The number of individuals receiving medical assistance under a State plan under such title XIX, or a waiver of such plan, who receive services in institutions for mental diseases through such organizations and plans. (3) The range of and average number of months, and the length of stay during such months, that such individuals are receiving such services in such institutions. (4) How such organizations or plans determine when to provide for the furnishing of such services through an institution for mental diseases in lieu of other benefits (including the full range of community-based services) under their contract with the State agency administering the State plan under such title XIX, or a waiver of such plan, to address psychiatric or substance use disorder treatment. (5) The extent to which the provision of services within such institutions has affected the capitated payments for such organizations or plans. (b) Report Not later than three years after the date of the enactment of this Act, the Secretary shall submit to Congress a report on the study conducted under subsection (a). 204. Guidance on opportunities for innovation Not later than one year after the date of the enactment of this Act, the Administrator of the Centers for Medicare & Medicaid Services shall issue a State Medicaid Director letter regarding opportunities to design innovative service delivery systems, including systems for providing community-based services, for individuals with serious mental illness or serious emotional disturbance who are receiving medical assistance under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ). The letter shall include opportunities for demonstration projects under section 1115 of such Act ( 42 U.S.C. 1315 ), to improve care for such individuals. 205. Study and report on Medicaid emergency psychiatric demonstration project (a) Collection of information The Secretary of Health and Human Services, acting through the Administrator of the Centers for Medicare & Medicaid Services, shall, with respect to each State that has participated in the demonstration project established under section 2707 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 1396a note), collect from each such State information on the following: (1) The number of institutions for mental diseases (as defined in section 1905(i) of the Social Security Act ( 42 U.S.C. 1396d(i) )) and beds in such institutions that received payment for the provision of services to individuals who receive medical assistance under a State plan under the Medicaid program under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ) (or under a waiver of such plan) through the demonstration project in each such State as compared to the total number of institutions for mental diseases and beds in the State. (2) The extent to which there is a reduction in expenditures under the Medicaid program under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ) or other spending on the full continuum of physical or mental health care for individuals who receive treatment in an institution for mental diseases under the demonstration project, including outpatient, inpatient, emergency, and ambulatory care, that is attributable to such individuals receiving treatment in institutions for mental diseases under the demonstration project. (3) The number of forensic psychiatric hospitals, the number of beds in such hospitals, and the number of forensic psychiatric beds in other hospitals in such State, based on the most recent data available, to the extent practical, as determined by such Administrator. (4) The amount of any disproportionate share hospital payments under section 1923 of the Social Security Act ( 42 U.S.C. 1396r–4 ) that institutions for mental diseases in the State received during the period beginning on July 1, 2012, and ending on June 30, 2015, and the extent to which the demonstration project reduced the amount of such payments. (5) The most recent data regarding all facilities or sites in the State in which any individuals with serious mental illness who are receiving medical assistance under a State plan under the Medicaid program under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ) (or under a waiver of such plan) are treated during the period referred to in paragraph (4), to the extent practical, as determined by the Administrator, including— (A) the types of such facilities or sites (such as an institution for mental diseases, a hospital emergency department, or other inpatient hospital); (B) the average length of stay in such a facility or site by such an individual, disaggregated by facility type; and (C) the payment rate under the State plan (or a waivers of such plan) for services furnished to such an individual for that treatment, disaggregated by facility type, during the period in which the demonstration project is in operation. (6) The extent to which the utilization of hospital emergency departments during the period in which the demonstration project was is in operation differed, with respect to individuals who are receiving medical assistance under a State plan under the Medicaid program under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ) (or under a waiver of such plan), between— (A) those individuals who received treatment in an institution for mental diseases under the demonstration project; (B) those individuals who met the eligibility requirements for the demonstration project but who did not receive treatment in an institution for mental diseases under the demonstration project; and (C) those individuals with serious mental illness who did not meet such eligibility requirements and did not receive treatment for such illness in an institution for mental diseases. (b) Report Not later than two years after the date of the enactment of this Act, the Secretary of Health and Human Services shall submit to Congress a report that summarizes and analyzes the information collected under subsection (a). Such report may be submitted as part of the report required under section 2707(f) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 1396a note) or separately. 206. Providing full-range of EPSDT services to children in IMDs Section 1905(a)(16) of the Social Security Act ( 42 U.S.C. 1396d(a)(16) ) is amended by inserting before the semicolon at the end the following: , and, effective January 1, 2019, the full-range of early and periodic screening, diagnostic, and treatment services (as defined in subsection (r)) for such individuals whether or not such screening, diagnostic, and treatment services are furnished by the provider of inpatient psychiatric hospital services for individuals under age 21 . 207. Electronic visit verification system required for personal care services and home health care services under Medicaid (a) In general Section 1903 of the Social Security Act ( 42 U.S.C. 1396b ) is amended by inserting after subsection (k) the following new subsection: (l) (1) Subject to paragraphs (3) and (4), with respect to any amount expended for personal care services or home health care services requiring an in-home visit by a provider that are provided under a State plan under this title (or under a waiver of the plan) and furnished in a calendar quarter beginning on or after January 1, 2019 (or, in the case of home health care services, on or after January 1, 2023), unless a State requires the use of an electronic visit verification system for such services furnished in such quarter under the plan or such waiver, the Federal medical assistance percentage shall be reduced— (A) in the case of personal care services— (i) for calendar quarters in 2019 and 2020, by .25 percentage points; (ii) for calendar quarters in 2021, by .5 percentage points; (iii) for calendar quarters in 2022, by .75 percentage points; and (iv) for calendar quarters in 2023 and each year thereafter, by 1 percentage point; and (B) in the case of home health care services— (i) for calendar quarters in 2023 and 2024, by .25 percentage points; (ii) for calendar quarters in 2025, by .5 percentage points; (iii) for calendar quarters in 2026, by .75 percentage points; and (iv) for calendar quarters in 2027 and each year thereafter, by 1 percentage point. (2) Subject to paragraphs (3) and (4), in implementing the requirement for the use of an electronic visit verification system under paragraph (1), a State shall— (A) consult with agencies and entities that provide personal care services, home health care services, or both under the State plan (or under a waiver of the plan) to ensure that such system— (i) is minimally burdensome; (ii) takes into account existing best practices and electronic visit verification systems in use in the State; and (iii) is conducted in accordance with the requirements of HIPAA privacy and security law (as defined in section 3009 of the Public Health Service Act); (B) take into account a stakeholder process that includes input from beneficiaries, family caregivers, personal care or home health care services workers, and other stakeholders, as determined by the State in accordance with guidance from the Secretary; and (C) ensure that individuals who furnish personal care services, home health care services, or both under the State plan (or under a waiver of the plan) are provided the opportunity for training on the use of such system. (3) Paragraphs (1) and (2) shall not apply in the case of a State that, as of the date of the enactment of this subsection, requires the use of any system for the electronic verification of visits conducted as part of both personal care services and home health care services. (4) (A) In the case of a State described in subparagraph (B), the reduction under paragraph (1) shall not apply— (i) in the case of personal care services, for calendar quarters in 2019; and (ii) in the case of home health care services, for calendar quarters in 2023. (B) For purposes of subparagraph (A), a State described in this subparagraph is a State that demonstrates to the Secretary that the State— (i) has made a good faith effort to comply with the requirements of paragraphs (1) and (2) (including by taking steps to adopt the technology used for an electronic visit verification system); or (ii) in implementing such a system, has encountered unavoidable system delays. (5) In this subsection: (A) The term electronic visit verification system means, with respect to personal care services or home health care services, a system under which visits conducted as part of such services are electronically verified with respect to— (i) the type of service performed; (ii) the individual receiving the service; (iii) the date of the service; (iv) the location of service delivery; (v) the individual providing the service; and (vi) the time the service begins and ends. (B) The term home health care services means services described in section 1905(a)(7) provided under a State plan under this title (or under a waiver of the plan). (C) The term personal care services means personal care services provided under a State plan under this title (or under a waiver of the plan), including services provided under section 1905(a)(24), 1915(c), 1915(i), 1915(j), or 1915(k) or under a wavier under section 1115. (6) (A) In the case in which a State requires personal care service and home health care service providers to utilize an electronic visit verification system operated by the State or a contractor on behalf of the State, the Secretary shall pay to the State, for each quarter, an amount equal to 90 per centum of so much of the sums expended during such quarter as are attributable to the design, development, or installation of such system, and 75 per centum of so much of the sums for the operation and maintenance of such system. (B) Subparagraph (A) shall not apply in the case in which a State requires personal care service and home health care service providers to utilize an electronic visit verification system that is not operated by the State or a contractor on behalf of the State. . (b) Collection and dissemination of best practices Not later than January 1, 2018, the Secretary of Health and Human Services shall, with respect to electronic visit verification systems (as defined in subsection (l)(5) of section 1903 of the Social Security Act ( 42 U.S.C. 1396b ), as inserted by subsection (a)), collect and disseminate best practices to State Medicaid Directors with respect to— (1) training individuals who furnish personal care services, home health care services, or both under the State plan under title XIX of such Act (or under a waiver of the plan) on such systems and the operation of such systems and the prevention of fraud with respect to the provision of personal care services or home health care services (as defined in such subsection (l)(5)); and (2) the provision of notice and educational materials to family caregivers and beneficiaries with respect to the use of such electronic visit verification systems and other means to prevent such fraud. (c) Rules of construction (1) No employer-employee relationship established Nothing in the amendment made by this section may be construed as establishing an employer-employee relationship between the agency or entity that provides for personal care services or home health care services and the individuals who, under a contract with such an agency or entity, furnish such services for purposes of part 552 of title 29, Code of Federal Regulations (or any successor regulations). (2) No particular or uniform electronic visit verification system required Nothing in the amendment made by this section shall be construed to require the use of a particular or uniform electronic visit verification system (as defined in subsection (l)(5) of section 1903 of the Social Security Act ( 42 U.S.C. 1396b ), as inserted by subsection (a)) by all agencies or entities that provide personal care services or home health care under a State plan under title XIX of the Social Security Act (or under a waiver of the plan) ( 42 U.S.C. 1396 et seq. ). (3) No limits on provision of care Nothing in the amendment made by this section may be construed to limit, with respect to personal care services or home health care services provided under a State plan under title XIX of the Social Security Act (or under a waiver of the plan) ( 42 U.S.C. 1396 et seq. ), provider selection, constrain beneficiaries’ selection of a caregiver, or impede the manner in which care is delivered. (4) No prohibition on State quality measures requirements Nothing in the amendment made by this section shall be construed as prohibiting a State, in implementing an electronic visit verification system (as defined in subsection (l)(5) of section 1903 of the Social Security Act ( 42 U.S.C. 1396b ), as inserted by subsection (a)), from establishing requirements related to quality measures for such system. III Interdepartmental Serious Mental Illness Coordinating Committee 301. Interdepartmental Serious Mental Illness Coordinating Committee (a) Establishment (1) In general Not later than 3 months after the date of enactment of this Act, the Secretary of Health and Human Services, or the designee of the Secretary, shall establish a committee to be known as the Interdepartmental Serious Mental Illness Coordinating Committee (in this section referred to as the Committee ). (2) Federal Advisory Committee Act Except as provided in this section, the provisions of the Federal Advisory Committee Act (5 U.S.C. App.) shall apply to the Committee. (b) Meetings The Committee shall meet not fewer than 2 times each year. (c) Responsibilities Not later than 1 year after the date of enactment of this Act, and 5 years after such date of enactment, the Committee shall submit to Congress a report including— (1) a summary of advances in serious mental illness and serious emotional disturbance research related to the prevention of, diagnosis of, intervention in, and treatment and recovery of, serious mental illnesses, serious emotional disturbances, and advances in access to services and support for individuals with a serious mental illness or serious emotional disturbance; (2) an evaluation of the effect on public health of Federal programs related to serious mental illness or serious emotional disturbance, including measurements of public health outcomes such as— (A) rates of suicide, suicide attempts, prevalence of serious mental illness, serious emotional disturbances, and substance use disorders, overdose, overdose deaths, emergency hospitalizations, emergency room boarding, preventable emergency room visits, involvement with the criminal justice system, crime, homelessness, and unemployment; (B) increased rates of employment and enrollment in educational and vocational programs; (C) quality of mental and substance use disorder treatment services; and (D) any other criteria as may be determined by the Secretary; (3) a plan to improve outcomes for individuals with serious mental illness or serious emotional disturbances, including reducing incarceration for such individuals, reducing homelessness, and increasing employment; and (4) specific recommendations for actions that agencies can take to better coordinate the administration of mental health services for people with serious mental illness or serious emotional disturbances. (d) Committee extension Upon the submission of the second report under subsection (c), the Secretary shall submit a recommendation to Congress on whether to extend the operation of the Committee. (e) Membership (1) Federal members The Committee shall be composed of the following Federal representatives, or their designees: (A) The Secretary of Health and Human Services, who shall serve as the Chair of the Committee. (B) The Director of the National Institutes of Health. (C) The Assistant Secretary for Health of the Department of Health and Human Services. (D) The Assistant Secretary for Mental Health and Substance Use. (E) The Attorney General of the United States. (F) The Secretary of Veterans Affairs. (G) The Secretary of Defense. (H) The Secretary of Housing and Urban Development. (I) The Secretary of Education. (J) The Secretary of Labor. (K) The Commissioner of Social Security. (L) The Administrator of the Centers for Medicare & Medicaid Services. (2) Non-Federal members The Committee shall also include not less than 14 non-Federal public members appointed by the Secretary of Health and Human Services, of which— (A) at least 2 members shall be individuals with lived experience with serious mental illness or serious emotional disturbance; (B) at least 1 member shall be a parent or legal guardian of an individual with a history of a serious mental illness or serious emotional disturbance; (C) at least 1 member shall be a representative of a leading research, advocacy, or service organization for individuals with serious mental illness or serious emotional disturbance; (D) at least 2 members shall be— (i) a licensed psychiatrist with experience treating serious mental illnesses or serious emotional disturbances; (ii) a licensed psychologist with experience treating serious mental illnesses or serious emotional disturbances; (iii) a licensed clinical social worker with experience treating serious mental illness or serious emotional disturbances; or (iv) a licensed psychiatric nurse, nurse practitioner, or physician assistant with experience treating serious mental illnesses or serious emotional disturbances; (E) at least 1 member shall be a licensed mental health professional with a specialty in treating children and adolescents with serious emotional disturbances; (F) at least 1 member shall be a mental health professional who has research or clinical mental health experience working with minorities; (G) at least 1 member shall be a mental health professional who has research or clinical mental health experience working with medically underserved populations; (H) at least 1 member shall be a State certified mental health peer specialist; (I) at least 1 member shall be a judge with experience adjudicating cases within a mental health court; (J) at least 1 member shall be a law enforcement officer or corrections officer with extensive experience in interfacing with individuals with a serious mental illness or serious emotional disturbance, or in a mental health crisis; and (K) at least 1 member shall be a homeless services provider with experience working with individuals with serious mental illness, with serious emotional disturbance, or having mental health crisis. (3) Terms A member of the Committee appointed under paragraph (2) shall serve for a term of 3 years, and may be reappointed for one or more additional 3-year terms. Any member appointed to fill a vacancy for an unexpired term shall be appointed for the remainder of such term. A member may serve after the expiration of the member’s term until a successor has been appointed. (f) Working groups In carrying out its functions, the Committee may establish working groups. Such working groups shall be composed of Committee members, or their designees, and may hold such meetings as are necessary. (g) Sunset The Committee shall terminate on the date that is 6 years after the date on which the Committee is established under subsection (a)(1). IV Compassionate Communication on HIPAA 401. Sense of Congress (a) Findings Congress finds the following: (1) The vast majority of individuals with mental illness are capable of understanding their illness and caring for themselves. (2) Persons with serious mental illness (in this section referred to as SMI ), including schizophrenia spectrum, bipolar disorders, and major depressive disorder, may be significantly impaired in their ability to understand or make sound decisions for their care and needs. By nature of their illness, cognitive impairments in reasoning and judgment, as well as the presence of hallucinations, delusions, and severe emotional distortions, they may lack the awareness they even have a mental illness (a condition known as anosognosia), and thus may be unable to make sound decisions regarding their care, nor follow through consistently and effectively on their care needs. (3) Persons with mental illness or SMI may require and benefit from mental health treatment in order to recover to the fullest extent of their ability; these beneficial interventions may include psychiatric care, psychological care, medication, peer support, educational support, employment support, and housing support. (4) Persons with SMI who are provided with professional and supportive services may still experience times when their symptoms may greatly impair their abilities to make sound decisions for their personal care or may discontinue their care as a result of this impaired decisionmaking resulting in a further deterioration of their condition. They may experience a temporary or prolonged impairment as a result of their diminished capacity to care for themselves. (5) Episodes of psychiatric crises among those with SMI can result in neurological harm to the individual’s brain. (6) Persons with SMI— (A) are at high risk for other chronic physical illnesses, with approximately 50 percent having two or more co-occurring chronic physical illnesses such as cardiac, pulmonary, cancer, and endocrine disorders; and (B) have three times the odds of having chronic bronchitis, five times the odds of having emphysema, and four times the odds of having COPD, are more than four times as likely to have fluid and electrolyte disorders, and are nearly three times as likely to be nicotine dependent. (7) Some psychotropic medications, such as second generation antipsychotics, significantly increase risk for chronic illnesses such as diabetes and cardiovascular disease. (8) When the individual fails to seek or maintain treatment for these physical conditions over a long term, it can result in the individual becoming gravely disabled, or developing life-threatening illnesses. Early and consistent treatment can ameliorate or reduce symptoms or cure the disease. (9) Persons with SMI die 7 to 24 years earlier than their age cohorts primarily because of complications from their chronic physical illness and failure to seek or maintain treatment resulting from emotional and cognitive impairments from their SMI. (10) It is beneficial to the person with SMI and chronic illness to seek and maintain continuity of medical care and treatment for their mental illness to prevent further deterioration and harm to their own safety. (11) When the individual with SMI is significantly diminished in their capacity to care for themselves long term or acutely, other supportive interventions to assist their care may be necessary to protect their health and safety. (12) Prognosis for the physical and psychiatric health of those with SMI may improve when responsible caregivers facilitate and participate in care. (13) When an individual with SMI is chronically incapacitated in their ability to care for themselves, caregivers can pursue legal guardianship to facilitate care in appropriate areas while being mindful to allow the individual to make decisions for themselves in areas where they are capable. (14) Individuals with SMI who have prolonged periods of being significantly functional can, during such periods, design and sign an advanced directive to predefine and choose medications, providers, treatment plans, and hospitals, and provide caregivers with guardianship the ability to help in those times when a patient’s psychiatric symptoms worsen to the point of making them incapacitated or leaving them with a severely diminished capacity to make informed decisions about their care which may result in harm to their physical and mental health. (15) All professional and support efforts should be made to help the individual with SMI and acute or chronic physical illnesses to understand and follow through on treatment. (16) When individuals with SMI, even after efforts to help them understand, have failed to care for themselves, there exists confusion in the health care community around what is currently permissible under HIPAA rules. This confusion may hinder communication with responsible caregivers who may be able to facilitate care for the patient with SMI in instances when the individual does not give permission for disclosure. (b) Sense of Congress It is the sense of the Congress that, for the sake of the health and safety of persons with serious mental illness, more clarity is needed surrounding the existing HIPAA privacy rule promulgated pursuant to section 264(c) of the Health Insurance Portability and Accountability Act ( 42 U.S.C. 1320d–2 note) to permit health care professionals to communicate, when necessary, with responsible known caregivers of such persons, the limited, appropriate protected health information of such persons in order to facilitate treatment, but not including psychotherapy notes. 402. Confidentiality of records Not later than one year after the date on which the Secretary of Health and Human Services first finalizes regulations updating part 2 of title 42, Code of Federal Regulations (relating to confidentiality of alcohol and drug abuse patient records) after the date of enactment of this Act, the Secretary shall convene relevant stakeholders to determine the effect of such regulations on patient care, health outcomes, and patient privacy. The Secretary shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate, and make publicly available, a report on the findings of such stakeholders. 403. Clarification of circumstances under which disclosure of protected health information is permitted (a) In general Not later than one year after the date of enactment of this section, the Secretary of Health and Human Services shall promulgate final regulations clarifying the circumstances under which, consistent with the provisions of subpart C of title XI of the Social Security Act ( 42 U.S.C. 1320d et seq. ) and regulations promulgated pursuant to section 264(c) of the Health Insurance Portability and Accountability Act of 1996 ( 42 U.S.C. 1320d–2 note), a health care provider or covered entity may disclose the protected health information of a patient with a mental illness, including for purposes of— (1) communicating (including with respect to treatment, side effects, risk factors, and the availability of community resources) with a family member of such patient, caregiver of such patient, or other individual to the extent that such family member, caregiver, or individual is involved in the care of the patient; (2) communicating with a family member of the patient, caregiver of such patient, or other individual involved in the care of the patient in the case that the patient is an adult; (3) communicating with the parent or caregiver of a patient in the case that the patient is a minor; (4) considering the patient’s capacity to agree or object to the sharing of the protected health information of the patient; (5) communicating and sharing information with the family or caregivers of the patient when— (A) the patient consents; (B) the patient does not consent, but the patient lacks the capacity to agree or object and the communication or sharing of information is in the patient’s best interest; (C) the patient does not consent and the patient is not incapacitated or in an emergency circumstance, but the ability of the patient to make rational health care decisions is significantly diminished by reason of the physical or mental health condition of the patient; and (D) the patient does not consent, but such communication and sharing of information is necessary to prevent impending and serious deterioration of the patient’s mental or physical health; (6) involving a patient’s family members, caregivers, or others involved in the patient’s care or care plan, including facilitating treatment and medication adherence, in dealing with patient failures to adhere to medication or other therapy; (7) listening to or receiving information with respect to the patient from the family or caregiver of such patient receiving mental illness treatment; (8) communicating with family members of the patient, caregivers of the patient, law enforcement, or others when the patient presents a serious and imminent threat of harm to self or others; and (9) communicating to law enforcement and family members of the patient or caregivers of the patient about the admission of the patient to receive care at a facility or the release of a patient who was admitted to a facility for an emergency psychiatric hold or involuntary treatment. (b) Coordination The Secretary of Health and Human Services shall carry out this section in coordination with the Director of the Office for Civil Rights within the Department of Health and Human Services. (c) Consistency with guidance The Secretary of Health and Human Services shall ensure that the regulations under this section are consistent with the guidance entitled HIPAA Privacy Rule and Sharing Information Related to Mental Health , issued by the Department of Health and Human Services on February 20, 2014. 404. Development and dissemination of model training programs (a) Initial programs and materials Not later than one year after the date of the enactment of this Act, the Secretary of Health and Human Services (in this section referred to as the Secretary ) shall develop and disseminate— (1) a model program and materials for training health care providers (including physicians, emergency medical personnel, psychologists, counselors, therapists, behavioral health facilities and clinics, care managers, and hospitals) regarding the circumstances under which, consistent with the standards governing the privacy and security of individually identifiable health information promulgated by the Secretary under subpart C of title XI of the Social Security Act ( 42 U.S.C. 1320d et seq. ) and regulations promulgated pursuant to section 264(c) of the Health Insurance Portability and Accountability Act of 1996 ( 42 U.S.C. 1320d–2 note), the protected health information of patients with a mental illness may be disclosed with and without patient consent; (2) a model program and materials for training lawyers and others in the legal profession on such circumstances; and (3) a model program and materials for training patients and their families regarding their rights to protect and obtain information under the standards specified in paragraph (1). (b) Periodic updates The Secretary shall— (1) periodically review and update the model programs and materials developed under subsection (a); and (2) disseminate the updated model programs and materials. (c) Contents The programs and materials developed under subsection (a) shall address the guidance entitled HIPAA Privacy Rule and Sharing Information Related to Mental Health , issued by the Department of Health and Human Services on February 20, 2014. (d) Coordination The Secretary shall carry out this section in coordination with the Director of the Office for Civil Rights within the Department of Health and Human Services, the Assistant Secretary for Mental Health and Substance Use, the Administrator of the Health Resources and Services Administration, and the heads of other relevant agencies within the Department of Health and Human Services. (e) Input of certain entities In developing the model programs and materials required by subsections (a) and (b), the Secretary shall solicit the input of relevant national, State, and local associations, medical societies, and licensing boards. (f) Funding There are authorized to be appropriated to carry out this section $4,000,000 for fiscal year 2018, $2,000,000 for each of fiscal years 2019 and 2020, and $1,000,000 for each of fiscal years 2021 and 2022. V Increasing Access to Treatment for Serious Mental Illness 501. Assertive community treatment grant program for individuals with serious mental illness Part B of title V of the Public Health Service Act ( 42 U.S.C. 290bb et seq. ) is amended by inserting after section 520L the following: 520M. Assertive community treatment grant program for individuals with serious mental illness (a) In general The Assistant Secretary shall award grants to eligible entities— (1) to establish assertive community treatment programs for individuals with serious mental illness; or (2) to maintain or expand such programs. (b) Eligible entities To be eligible to receive a grant under this section, an entity shall be a State, county, city, tribe, tribal organization, mental health system, health care facility, or any other entity the Assistant Secretary deems appropriate. (c) Special Consideration In selecting among applicants for a grant under this section, the Assistant Secretary may give special consideration to the potential of the applicant’s program to reduce hospitalization, homelessness, and involvement with the criminal justice system while improving the health and social outcomes of the patient. (d) Additional Activities The Assistant Secretary shall— (1) not later than the end of fiscal year 2021, submit a report to the appropriate congressional committees on the grant program under this section, including an evaluation of— (A) cost savings and public health outcomes such as mortality, suicide, substance abuse, hospitalization, and use of services; (B) rates of involvement with the criminal justice system of patients; (C) rates of homelessness among patients; and (D) patient and family satisfaction with program participation; and (2) provide appropriate information, training, and technical assistance to grant recipients under this section to help such recipients to establish, maintain, or expand their assertive community treatment programs. (e) Authorization of appropriations (1) In general To carry out this section, there is authorized to be appropriated $5,000,000 for the period of fiscal years 2018 through 2022. (2) Use of Certain Funds Of the funds appropriated to carry out this section in any fiscal year, no more than 5 percent shall be available to the Assistant Secretary for carrying out subsection (d). . 502. 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— (1) to State and local governments and Indian tribes and tribal organizations to enhance community-based crisis response systems; or (2) to States to develop, maintain, or enhance a database of beds at inpatient psychiatric facilities, crisis stabilization units, and residential community mental health and residential substance use disorder treatment facilities, for individuals with serious mental illness, serious emotional disturbance, or substance use disorders. (b) Application (1) In general To receive a grant or cooperative agreement 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)(1) shall include a plan for— (A) promoting integration and coordination between local public and private entities engaged in crisis response, including first responders, emergency health care providers, primary care providers, law enforcement, court systems, health care payers, social service providers, and behavioral health providers; (B) developing a plan for entering into memoranda of understanding with public and private entities to implement crisis response services; (C) expanding the continuum of community-based services to address crisis intervention and prevention; and (D) developing models for minimizing hospital readmissions, including through appropriate discharge planning. (3) Beds database plan An application for a grant under subsection (a)(2) shall include a plan for developing, maintaining, or enhancing a real-time Internet-based bed database to collect, aggregate, and display information about beds in 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 facilities for the temporary treatment of individuals in mental or substance use disorder crisis. (c) Database requirements A bed database described in this section is a database that— (1) includes information on inpatient psychiatric facilities, crisis stabilization units, and residential community mental health and residential substance use disorder facilities in the State involved, including contact information for the facility or unit; (2) provides real-time information about the number of beds available at each facility or unit and, for each available bed, the type of patient that may be admitted, the level of security provided, and any other information that may be necessary to allow for the proper identification of appropriate facilities for treatment of individuals in mental or substance use disorder crisis; and (3) enables searches of the database to identify available beds that are appropriate for the treatment of individuals in mental or substance use disorder crisis. (d) Evaluation An entity receiving a grant under subsection (a)(1) 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 of individuals receiving crisis planning and early intervention supports; (2) individuals reporting improved functional outcomes; and (3) individuals receiving regular followup care following a crisis. (e) Authorization of appropriations There is authorized to be appropriated to carry out this section, $5,000,000 for the period of fiscal years 2018 through 2022. . 503. Increased and extended funding for assisted outpatient grant program for individuals with serious mental illness Section 224(g) of the Protecting Access to Medicare Act of 2014 ( 42 U.S.C. 290aa note) is amended— (1) in paragraph (1), by striking 2018 and inserting 2022 ; and (2) in paragraph (2), by striking is authorized to be appropriated to carry out this section $15,000,000 for each of fiscal years 2015 through 2018 and inserting are authorized to be appropriated to carry out this section $15,000,000 for each of fiscal years 2015 through 2017, $20,000,000 for fiscal year 2018, $19,000,000 for each of fiscal years 2019 and 2020, and $18,000,000 for each of fiscal years 2021 and 2022 . 504. Liability protections for health professional volunteers at community health centers Section 224 of the Public Health Service Act ( 42 U.S.C. 233 ) is amended by adding at the end the following: (q) (1) For purposes of this section, a health professional volunteer at an entity described in subsection (g)(4) shall, in providing a health professional service eligible for funding under section 330 to an individual, be deemed to be an employee of the Public Health Service for a calendar year that begins during a fiscal year for which a transfer was made under paragraph (4)(C). The preceding sentence is subject to the provisions of this subsection. (2) In providing a health service to an individual, a health care practitioner shall for purposes of this subsection be considered to be a health professional volunteer at an entity described in subsection (g)(4) if the following conditions are met: (A) The service is provided to the individual at the facilities of an entity described in subsection (g)(4), or through offsite programs or events carried out by the entity. (B) The entity is sponsoring the health care practitioner pursuant to paragraph (3)(B). (C) The health care practitioner does not receive any compensation for the service from the individual or from any third-party payer (including reimbursement under any insurance policy or health plan, or under any Federal or State health benefits program), except that the health care practitioner may receive repayment from the entity described in subsection (g)(4) for reasonable expenses incurred by the health care practitioner in the provision of the service to the individual. (D) Before the service is provided, the health care practitioner or the entity described in subsection (g)(4) posts a clear and conspicuous notice at the site where the service is provided of the extent to which the legal liability of the health care practitioner is limited pursuant to this subsection. (E) At the time the service is provided, the health care practitioner is licensed or certified in accordance with applicable law regarding the provision of the service. (3) Subsection (g) (other than paragraphs (3) and (5)) and subsections (h), (i), and (l) apply to a health care practitioner for purposes of this subsection to the same extent and in the same manner as such subsections apply to an officer, governing board member, employee, or contractor of an entity described in subsection (g)(4), subject to paragraph (4) and subject to the following: (A) The first sentence of paragraph (1) applies in lieu of the first sentence of subsection (g)(1)(A). (B) With respect to an entity described in subsection (g)(4), a health care practitioner is not a health professional volunteer at such entity unless the entity sponsors the health care practitioner. For purposes of this subsection, the entity shall be considered to be sponsoring the health care practitioner if— (i) with respect to the health care practitioner, the entity submits to the Secretary an application meeting the requirements of subsection (g)(1)(D); and (ii) the Secretary, pursuant to subsection (g)(1)(E), determines that the health care practitioner is deemed to be an employee of the Public Health Service. (C) In the case of a health care practitioner who is determined by the Secretary pursuant to subsection (g)(1)(E) to be a health professional volunteer at such entity, this subsection applies to the health care practitioner (with respect to services performed on behalf of the entity sponsoring the health care practitioner pursuant to subparagraph (B)) for any cause of action arising from an act or omission of the health care practitioner occurring on or after the date on which the Secretary makes such determination. (D) Subsection (g)(1)(F) applies to a health care practitioner for purposes of this subsection only to the extent that, in providing health services to an individual, each of the conditions specified in paragraph (2) is met. (4) (A) Amounts in the fund established under subsection (k)(2) shall be available for transfer under subparagraph (C) for purposes of carrying out this subsection. (B) Not later May 1 of each fiscal year, the Attorney General, in consultation with the Secretary, shall submit to the Congress a report providing an estimate of the amount of claims (together with related fees and expenses of witnesses) that, by reason of the acts or omissions of health professional volunteers, will be paid pursuant to this section during the calendar year that begins in the following fiscal year. Subsection (k)(1)(B) applies to the estimate under the preceding sentence regarding health professional volunteers to the same extent and in the same manner as such subsection applies to the estimate under such subsection regarding officers, governing board members, employees, and contractors of entities described in subsection (g)(4). (C) Not later than December 31 of each fiscal year, the Secretary shall transfer from the fund under subsection (k)(2) to the appropriate accounts in the Treasury an amount equal to the estimate made under subparagraph (B) for the calendar year beginning in such fiscal year, subject to the extent of amounts in the fund. (5) (A) This subsection takes effect on October 1, 2017, except as provided in subparagraph (B). (B) Effective on the date of the enactment of this subsection— (i) the Secretary may issue regulations for carrying out this subsection, and the Secretary may accept and consider applications submitted pursuant to paragraph (3)(B); and (ii) reports under paragraph (4)(B) may be submitted to the Congress. . VI Supporting Innovative and Evidence-Based Programs A Encouraging the Advancement, Incorporation, and Development of Evidence-Based Practices 601. Encouraging innovation and evidence-based programs Section 501B of the Public Health Service Act, as inserted by section 103, is further amended, by inserting after subsection (c) the following new subsection: (d) Promoting innovation (1) In general The Assistant Secretary, in coordination with the Laboratory, may award grants to States, local governments, Indian tribes or tribal organizations (as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act), educational institutions, and nonprofit organizations to develop evidence-based interventions, including culturally and linguistically appropriate services, as appropriate, for— (A) evaluating a model that has been scientifically demonstrated to show promise, but would benefit from further applied development, for— (i) enhancing the prevention, diagnosis, intervention, treatment, and recovery of mental illness, serious emotional disturbance, substance use disorders, and co-occurring disorders; or (ii) integrating or coordinating physical health services and mental and substance use disorder services; and (B) expanding, replicating, or scaling evidence-based programs across a wider area to enhance effective screening, early diagnosis, intervention, and treatment with respect to mental illness, serious mental illness, and serious emotional disturbance, primarily by— (i) applying delivery of care, including training staff in effective evidence-based treatment; or (ii) integrating models of care across specialties and jurisdictions. (2) Consultation In awarding grants under this paragraph, the Assistant Secretary shall, as appropriate, consult with the advisory councils described in section 502, the National Institute of Mental Health, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism, as appropriate. (3) Authorization of appropriations There are authorized to be appropriated— (A) to carry out paragraph (1)(A), $7,000,000 for the period of fiscal years 2018 through 2020; and (B) to carry out paragraph (1)(B), $7,000,000 for the period of fiscal years 2018 through 2020. . 602. Promoting access to information on evidence-based programs and practices Part D of title V of the Public Health Service Act is amended by inserting after section 543 of such Act (42 U.S.C. 290dd–2 ) the following: 544. Promoting access to information on evidence-based programs and practices (a) In general The Assistant Secretary shall improve access to reliable and valid information on evidence-based programs and practices, including information on the strength of evidence associated with such programs and practices, related to mental and substance use disorders for States, local communities, nonprofit entities, and other stakeholders by posting on the website of the National Registry of Evidence-Based Programs and Practices evidence-based programs and practices that have been reviewed by the Assistant Secretary pursuant to the requirements of this section. (b) Notice (1) Periods In carrying out subsection (a), the Assistant Secretary may establish an initial period for the submission of applications for evidence-based programs and practices to be posted publicly in accordance with subsection (a) (and may establish subsequent such periods). The Assistant Secretary shall publish notice of such application periods in the Federal Register. (2) Addressing gaps Such notice may solicit applications for evidence-based practices and programs to address gaps in information identified by the Assistant Secretary, the Assistant Secretary for Planning and Evaluation, the Assistant Secretary for Financial Resources, or the National Mental Health and Substance Use Policy Laboratory, including pursuant to priorities identified in the strategic plan established under section 501(l). (c) Requirements The Assistant Secretary shall establish minimum requirements for applications referred to in this section, including applications related to the submission of research and evaluation. (d) Review and rating The Assistant Secretary shall review applications prior to public posting, and may prioritize the review of applications for evidence-based practices and programs that are related to topics included in the notice established under subsection (b). The Assistant Secretary shall utilize a rating and review system, which shall include information on the strength of evidence associated with such programs and practices and a rating of the methodological rigor of the research supporting the application. The Assistant Secretary shall make the metrics used to evaluate applications and the resulting ratings publicly available. . 603. Sense of Congress It is the sense of the Congress that the National Institute of Mental Health should conduct or support research on the determinants of self-directed and other violence connected to mental illness. B Supporting the State Response to Mental Health Needs 611. Community Mental Health Services Block Grant (a) Formula grants Section 1911(b) of the Public Health Service Act ( 42 U.S.C. 300x(b) ) is amended— (1) by redesignating paragraphs (1) through (3) as paragraphs (2) through (4), respectively; and (2) by inserting before paragraph (2) (as so redesignated), the following: (1) providing community mental health services for adults with a serious mental illness and children with a serious emotional disturbance as defined in accordance with section 1912(c); . (b) State plan Subsection (b) of section 1912 of the Public Health Service Act ( 42 U.S.C. 300x–1 ) is amended to read as follows: (b) Criteria for Plan In accordance with subsection (a), a State shall submit to the Secretary a plan that, at a minimum, satisfies the following criteria: (1) System of care The plan provides a description of the system of care of the State, including as follows: (A) Comprehensive community-based health systems The plan shall— (i) identify the single State agency to be responsible for the administration of the program under the grant, including any third party who administers mental health services and is responsible for complying with the requirements of this part with respect to the grant; (ii) provide for an organized community-based system of care for individuals with mental illness, and describe available services and resources in a comprehensive system of care, including services for individuals with mental health and behavioral health co-occurring disorders; (iii) include a description of the manner in which the State and local entities will coordinate services to maximize the efficiency, effectiveness, quality, and cost effectiveness of services and programs to produce the best possible outcomes (including health services, rehabilitation services, employment services, housing services, educational services, substance use disorder services, legal services, law enforcement services, social services, child welfare services, medical and dental care services, and other support services to be provided with Federal, State, and local public and private resources) with other agencies to enable individuals receiving services to function outside of inpatient or residential institutions, to the maximum extent of their capabilities, including services to be provided by local school systems under the Individuals with Disabilities Education Act; (iv) include a description of how the State— (I) promotes evidence-based practices, including those evidence-based programs that address the needs of individuals with early serious mental illness regardless of the age of the individual at onset; (II) provides comprehensive individualized treatment; or (III) integrates mental and physical health services; (v) include a description of case management services; (vi) include a description of activities that seek to engage individuals with serious mental illness or serious emotional disturbance and their caregivers where appropriate in making health care decisions, including activities that enhance communication between individuals, families, caregivers, and treatment providers; and (vii) as appropriate to and reflective of the uses the State proposes for the block grant monies— (I) a description of the activities intended to reduce hospitalizations and hospital stays using the block grant monies; (II) a description of the activities intended to reduce incidents of suicide using the block grant monies; and (III) a description of how the State integrates mental health and primary care using the block grant monies. (B) Mental health system data and epidemiology The plan shall contain an estimate of the incidence and prevalence in the State of serious mental illness among adults and serious emotional disturbance among children and presents quantitative targets and outcome measures for programs and services provided under this subpart. (C) Children’s services In the case of children with serious emotional disturbance (as defined in accordance with subsection (c)), the plan shall provide for a system of integrated social services, educational services, child welfare services, juvenile justice services, law enforcement services, and substance use disorder services that, together with health and mental health services, will be provided in order for such children to receive care appropriate for their multiple needs (such system to include services provided under the Individuals with Disabilities Education Act). (D) Targeted services to rural and homeless populations The plan shall describe the State’s outreach to and services for individuals who are homeless and how community-based services will be provided to individuals residing in rural areas. (E) Management services The plan shall— (i) describe the financial resources available, the existing mental health workforce, and the workforce trained in treating individuals with co-occurring mental and substance use disorders; (ii) provide for the training of providers of emergency health services regarding mental health; (iii) describe the manner in which the State intends to expend the grant under section 1911 for the fiscal year involved; and (iv) describe the manner in which the State intends to comply with each of the funding agreements in this subpart and subpart III. (2) Goals and objectives The plan establishes goals and objectives for the period of the plan, including targets and milestones that are intended to be met, and the activities that will be undertaken to achieve those targets. . (c) Best practices in clinical care models Section 1920 of the Public Health Service Act ( 42 U.S.C. 300x–9 ) is amended by adding at the end the following: (c) Best practices in clinical care models A State shall expend not less than 10 percent of the amount the State receives for carrying out this subpart in each fiscal year to support evidence-based programs that address the needs of individuals with early serious mental illness, including psychotic disorders, regardless of the age of the individual at onset. . (d) Additional provisions Section 1915(b) of the Public Health Service Act ( 42 U.S.C. 300x–4(b) ) is amended— (1) by amending paragraph (1) to read as follows: (1) In general A funding agreement for a grant under section 1911 is that the State involved will maintain State expenditures for community mental health services at a level that is not less than the average of the amounts prescribed by this paragraph (prior to any waiver under paragraph (3)) for such expenditures by such State for each of the two fiscal years immediately preceding the fiscal year for which the State is applying for the grant. ; (2) in paragraph (2)— (A) by striking subsection (a) and inserting paragraph (1) ; and (B) by striking principle and inserting principal ; (3) by amending paragraph (3) to read as follows: (3) Waiver (A) In general The Secretary may, upon the request of a State, waive the requirement established in paragraph (1) in whole or in part, if the Secretary determines that extraordinary economic conditions in the State in the fiscal year involved or in the previous fiscal year justify the waiver. (B) Date certain for action upon request The Secretary shall approve or deny a request for a waiver under this paragraph not later than 120 days after the date on which the request is made. (C) Applicability of waiver A waiver provided by the Secretary under this paragraph shall be applicable only to the fiscal year involved. ; and (4) in paragraph (4)— (A) by amending subparagraph (A) to read as follows: (A) In general (i) Determination and reduction The Secretary shall determine, in the case of each State, and for each fiscal year, whether the State maintained material compliance with the agreement made under paragraph (1). If the Secretary determines that a State has failed to maintain such compliance for a fiscal year, the Secretary shall reduce the amount of the allotment under section 1911 for the State, for the first fiscal year beginning after such determination is final, by an amount equal to the amount constituting such failure for the previous fiscal year about which the determination was made. (ii) Alternative sanction The Secretary may by regulation provide for an alternative method of imposing a sanction for a failure by a State to maintain material compliance with the agreement under paragraph (1) if the Secretary determines that such alternative method would be more equitable and would be a more effective incentive for States to maintain such material compliance. ; and (B) in subparagraph (B)— (i) by inserting after the subparagraph designation the following: Submission of information to the secretary.— ; and (ii) by striking subparagraph (A) and inserting subparagraph (A)(i) . (e) Application for grant Section 1917(a) of the Public Health Service Act ( 42 U.S.C. 300x–6(a) ) is amended— (1) in paragraph (1), by striking 1941 and inserting 1942(a) ; and (2) in paragraph (5), by striking 1915(b)(3)(B) and inserting 1915(b) . C Strengthening Mental Health Care for Children and Adolescents 621. Telehealth child psychiatry access grants Title III of the Public Health Service Act is amended by inserting after section 330L of such Act ( 42 U.S.C. 254c–18 ) the following new section: 330M. Telehealth child psychiatry access grants (a) In General The Secretary, acting through the Administrator of the Health Resources and Services Administration and in coordination with other relevant Federal agencies, shall award grants to States, political subdivisions of States, Indian tribes, and tribal organizations (for purposes of this section, as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act ( 25 U.S.C. 450b )) to promote behavioral health integration in pediatric primary care by— (1) supporting the development of statewide child psychiatry access programs; and (2) supporting the improvement of existing statewide child psychiatry access programs. (b) Program Requirements (1) In general A child psychiatry access program referred to in subsection (a), with respect to which a grant under such subsection may be used, shall— (A) be a statewide network of pediatric mental health teams that provide support to pediatric primary care sites as an integrated team; (B) support and further develop organized State networks of child and adolescent psychiatrists to provide consultative support to pediatric primary care sites; (C) conduct an assessment of critical behavioral consultation needs among pediatric providers and such providers’ preferred mechanisms for receiving consultation and training and technical assistance; (D) develop an online database and communication mechanisms, including telehealth, to facilitate consultation support to pediatric practices; (E) provide rapid statewide clinical telephone or telehealth consultations when requested between the pediatric mental health teams and pediatric primary care providers; (F) conduct training and provide technical assistance to pediatric primary care providers to support the early identification, diagnosis, treatment, and referral of children with behavioral health conditions or co-occurring intellectual and other developmental disabilities; (G) inform and assist pediatric providers in accessing child psychiatry consultations and in scheduling and conducting technical assistance; (H) assist with referrals to specialty care and community or behavioral health resources; and (I) establish mechanisms for measuring and monitoring increased access to child and adolescent psychiatric services by pediatric primary care providers and expanded capacity of pediatric primary care providers to identify, treat, and refer children with mental health problems. (2) Pediatric mental health teams In this subsection, the term pediatric mental health team means a team of case coordinators, child and adolescent psychiatrists, and licensed clinical mental health professionals, such as a psychologist, social worker, or mental health counselor. (c) Application A State, political subdivision of a State, Indian tribe, or tribal organization seeking a grant under this section shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require, including a plan for the rigorous evaluation of activities that are carried out with funds received under such grant. (d) Evaluation A State, political subdivision of a State, Indian tribe, or tribal organization that receives a grant under this section shall prepare and submit an evaluation of activities carried out with funds received under such grant to the Secretary at such time, in such manner, and containing such information as the Secretary may reasonably require, including a process and outcome evaluation. (e) Matching Requirement The Secretary may not award a grant under this section unless the State, political subdivision of a State, Indian tribe, or tribal organization involved agrees, with respect to the costs to be incurred by the State, political subdivision of a State, Indian tribe, or tribal organization in carrying out the purpose described in this section, to make available non-Federal contributions (in cash or in kind) toward such costs in an amount that is not less than 20 percent of Federal funds provided in the grant. (f) Authorization of appropriations To carry this section, there are authorized to be appropriated $9,000,000 for the period of fiscal years 2018 through 2020. . 622. Infant and early childhood mental health promotion, intervention, and treatment Part Q of title III of the Public Health Service Act ( 42 U.S.C. 290h et seq. ) is amended by adding at the end the following: 399Z–2. Infant and early childhood mental health promotion, intervention, and treatment (a) Grants The Secretary shall— (1) award grants to eligible entities, including human services agencies, to develop, maintain, or enhance infant and early childhood mental health promotion, intervention, and treatment programs, including— (A) programs for infants and children at significant risk of developing, showing early signs of, or having been diagnosed with mental disorders including serious emotional disturbance; and (B) multigenerational therapy and other services that support the caregiving relationship; and (2) ensure that programs funded through grants under this section are evidence-informed or evidence-based models, practices, and methods that are, as appropriate, culturally and linguistically appropriate, and can be replicated in other appropriate settings. (b) Eligible children and entities In this section: (1) Eligible child The term eligible child means a child from birth to not more than 5 years of age who— (A) is at risk for, shows early signs of, or has been diagnosed with a mental disorder, including serious emotional disturbance; and (B) may benefit from infant and early childhood intervention or treatment programs or specialized preschool or elementary school programs that are evidence-based or that have been scientifically demonstrated to show promise but would benefit from further applied development. (2) Eligible entity The term eligible entity means a nonprofit institution that— (A) is accredited or approved by a State mental health or education agency, as applicable, to provide for children from infancy to 5 years of age mental health promotion, intervention, or treatment services that are evidence-based or that have been scientifically demonstrated to show promise but would benefit from further applied development; and (B) provides programs described in subsection (a) that are evidence-based or that have been scientifically demonstrated to show promise but would benefit from further applied development. (c) Application An eligible entity seeking a grant under subsection (a) shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require. (d) Use of funds for early intervention and treatment programs An eligible entity may use amounts awarded under a grant under subsection (a)(1) to carry out the following: (1) Provide age-appropriate mental health promotion and early intervention services or mental disorder treatment services, which may include specialized programs, for eligible children at significant risk of developing, showing early signs of, or having been diagnosed with a mental disorder, including serious emotional disturbance. Such services may include social and behavioral services as well as multigenerational therapy and other services ‎that support the caregiving relationship. (2) Provide training for health care professionals with expertise in infant and early childhood mental health care with respect to appropriate and relevant integration with other disciplines such as primary care clinicians, early intervention specialists, child welfare staff, home visitors, early care and education providers, and others who work with young children and families. (3) Provide mental health consultation to personnel of early care and education programs (including licensed or regulated center-based and home-based child care, home visiting, preschool special education, and early intervention programs) who work with children and families. (4) Provide training for mental health clinicians in infant and early childhood promising and evidence-based practices and models for mental health treatment and early intervention, including with regard to practices for identifying and treating mental and behavioral disorders of infants and children resulting from exposure or repeated exposure to adverse childhood experiences or childhood trauma. (5) Provide age-appropriate assessment, diagnostic, and intervention services for eligible children, including early mental health promotion, intervention, and treatment services. (e) Matching funds The Secretary may not award a grant under this section to an eligible entity unless the eligible entity agrees, with respect to the costs to be incurred by the eligible entity in carrying out the activities described in subsection (d), to make available non-Federal contributions (in cash or in kind) toward such costs in an amount that is not less than 10 percent of the total amount of Federal funds provided in the grant. (f) Authorization of appropriations To carry this section, there are authorized to be appropriated $20,000,000 for the period of fiscal years 2018 through 2022. . 623. National Child Traumatic Stress Initiative Section 582 of the Public Health Service Act ( 42 U.S.C. 290hh–1 ; relating to grants to address the problems of persons who experience violence related stress) is amended— (1) in subsection (a), by striking developing programs and all that follows and inserting the following: developing and maintaining programs that provide for— (1) the continued operation of the National Child Traumatic Stress Initiative (referred to in this section as the NCTSI ), which includes a coordinating center that focuses on the mental, behavioral, and biological aspects of psychological trauma response; and (2) the development of knowledge with regard to evidence-based practices for identifying and treating mental disorders, behavioral disorders, and physical health conditions of children and youth resulting from witnessing or experiencing a traumatic event. ; (2) in subsection (b)— (A) by striking subsection (a) related and inserting subsection (a)(2) (related ; (B) by striking treating disorders associated with psychological trauma and inserting treating mental, behavioral, and biological disorders associated with psychological trauma) ; and (C) by striking mental health agencies and programs that have established clinical and basic research and inserting universities, hospitals, mental health agencies, and other programs that have established clinical expertise and research ; (3) by redesignating subsections (c) through (g) as subsections (g) through (k), respectively; (4) by inserting after subsection (b), the following: (c) Child outcome data The NCTSI coordinating center shall collect, analyze, report, and make publicly available NCTSI-wide child treatment process and outcome data regarding the early identification and delivery of evidence-based treatment and services for children and families served by the NCTSI grantees. (d) Training The NCTSI coordinating center shall facilitate the coordination of training initiatives in evidence-based and trauma-informed treatments, interventions, and practices offered to NCTSI grantees, providers, and partners. (e) Dissemination The NCTSI coordinating center shall, as appropriate, collaborate with the Secretary in the dissemination of evidence-based and trauma-informed interventions, treatments, products, and other resources to appropriate stakeholders. (f) Review The Secretary shall, consistent with the peer-review process, ensure that NCTSI applications are reviewed by appropriate experts in the field as part of a consensus review process. The Secretary shall include review criteria related to expertise and experience in child trauma and evidence-based practices. ; (5) in subsection (g) (as so redesignated), by striking with respect to centers of excellence are distributed equitably among the regions of the country and inserting are distributed equitably among the regions of the United States ; (6) in subsection (i) (as so redesignated), by striking recipient may not exceed 5 years and inserting recipient shall not be less than 4 years, but shall not exceed 5 years ; and (7) in subsection (j) (as so redesignated), by striking $50,000,000 and all that follows through 2006 and inserting $46,887,000 for each of fiscal years 2017 through 2021 . VII Grant programs and program reauthorization A Garrett Lee Smith Memorial Act reauthorization 701. Youth interagency research, training, and technical assistance centers Section 520C of the Public Health Service Act ( 42 U.S.C. 290bb–34 ) is amended— (1) by striking the section heading and inserting Suicide prevention technical assistance center. ; (2) in subsection (a), by striking and in consultation with and all that follows through the period at the end of paragraph (2) and inserting shall establish a research, training, and technical assistance resource center to provide appropriate information, training, and technical assistance to States, political subdivisions of States, federally recognized Indian tribes, tribal organizations, institutions of higher education, public organizations, or private nonprofit organizations regarding the prevention of suicide among all ages, particularly among groups that are at high risk for suicide. ; (3) by striking subsections (b) and (c); (4) by redesignating subsection (d) as subsection (b); (5) in subsection (b), as so redesignated— (A) by striking the subsection heading and inserting Responsibilities of the center.— ; (B) in the matter preceding paragraph (1), by striking The additional research and all that follows through nonprofit organizations for and inserting The center established under subsection (a) shall conduct activities for the purpose of ; (C) by striking youth suicide each place such term appears and inserting suicide ; (D) in paragraph (1)— (i) by striking the development or continuation of and inserting developing and continuing ; and (ii) by inserting for all ages, particularly among groups that are at high risk for suicide before the semicolon at the end; (E) in paragraph (2), by inserting for all ages, particularly among groups that are at high risk for suicide before the semicolon at the end; (F) in paragraph (3), by inserting and tribal after statewide ; (G) in paragraph (5), by inserting and prevention after intervention ; (H) in paragraph (8), by striking in youth ; (I) in paragraph (9), by striking and behavioral health and inserting health and substance use disorder ; and (J) in paragraph (10), by inserting conducting before other ; and (6) by striking subsection (e) and inserting the following: (c) Authorization of appropriations For the purpose of carrying out this section, there are authorized to be appropriated $5,988,000 for each of fiscal years 2017 through 2021. (d) Report Not later than 2 years after the date of enactment of the Helping Families in Mental Health Crisis Act of 2016 , the Secretary shall submit to Congress a report on the activities carried out by the center established under subsection (a) during the year involved, including the potential effects of such activities, and the States, organizations, and institutions that have worked with the center. . 702. Youth suicide early intervention and prevention strategies Section 520E of the Public Health Service Act ( 42 U.S.C. 290bb–36 ) is amended— (1) in paragraph (1) of subsection (a) and in subsection (c), by striking substance abuse each place such term appears and inserting substance use disorder ; (2) in subsection (b)(2)— (A) by striking each State is awarded only 1 grant or cooperative agreement under this section and inserting a State does not receive more than 1 grant or cooperative agreement under this section at any 1 time ; and (B) by striking been awarded and inserting received ; and (3) by striking subsection (m) and inserting the following: (m) Authorization of appropriations For the purpose of carrying out this section, there are authorized to be appropriated $35,427,000 for each of fiscal years 2017 through 2021. . 703. Mental health and substance use disorder services on campus Section 520E–2 of the Public Health Service Act ( 42 U.S.C. 290bb–36b ) is amended— (1) in the section heading, by striking and behavioral health and inserting health and substance use disorder ; (2) in subsection (a)— (A) by striking Services, and inserting Services and ; (B) by striking and behavioral health problems and inserting health or substance use disorders ; and (C) by striking substance abuse and inserting substance use disorders ; (3) in subsection (b)— (A) in the matter preceding paragraph (1), by striking for— and inserting for one or more of the following: ; and (B) by striking paragraphs (1) through (6) and inserting the following: (1) Educating students, families, faculty, and staff to increase awareness of mental health and substance use disorders. (2) The operation of hotlines. (3) Preparing informational material. (4) Providing outreach services to notify students about available mental health and substance use disorder services. (5) Administering voluntary mental health and substance use disorder screenings and assessments. (6) Supporting the training of students, faculty, and staff to respond effectively to students with mental health and substance use disorders. (7) Creating a network infrastructure to link colleges and universities with health care providers who treat mental health and substance use disorders. ; (4) in subsection (c)(5), by striking substance abuse and inserting substance use disorder ; (5) in subsection (d)— (A) in the matter preceding paragraph (1), by striking An institution of higher education desiring a grant under this section and inserting To be eligible to receive a grant under this section, an institution of higher education ; (B) in paragraph (1)— (i) by striking and behavioral health and inserting health and substance use disorder ; and (ii) by inserting , including veterans whenever possible and appropriate, after students ; and (C) in paragraph (2), by inserting , which may include, as appropriate and in accordance with subsection (b)(7), a plan to seek input from relevant stakeholders in the community, including appropriate public and private entities, in order to carry out the program under the grant before the period at the end; (6) in subsection (e)(1), by striking and behavioral health problems and inserting health and substance use disorders ; (7) in subsection (f)(2)— (A) by striking and behavioral health and inserting health and substance use disorder ; and (B) by striking suicide and substance abuse and inserting suicide and substance use disorders ; and (8) in subsection (h), by striking $5,000,000 for fiscal year 2005 and all that follows through the period at the end and inserting $6,488,000 for each of fiscal years 2017 through 2021. . B Other provisions 711. National Suicide Prevention Lifeline Program 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 inserting after section 520E–2 ( 42 U.S.C. 290bb–36b ) the following: 520E–3. National Suicide Prevention Lifeline Program (a) In general The Secretary, acting through the Assistant Secretary, shall maintain the National Suicide Prevention Lifeline Program (referred to in this section as the Program ), authorized under section 520A and in effect prior to the date of enactment of the Helping Families in Mental Health Crisis Act of 2016 . (b) Activities In maintaining the Program, the activities of the Secretary shall include— (1) coordinating a network of crisis centers across the United States for providing suicide prevention and crisis intervention services to individuals seeking help at any time, day or night; (2) maintaining a suicide prevention hotline to link callers to local emergency, mental health, and social services resources; and (3) consulting with the Secretary of Veterans Affairs to ensure that veterans calling the suicide prevention hotline have access to a specialized veterans’ suicide prevention hotline. (c) Authorization of appropriations To carry out this section, there are authorized to be appropriated $7,198,000 for each of fiscal years 2017 through 2021. . 712. Workforce development studies and reports (a) In general Not later than 2 years after the date of enactment of this Act, the Assistant Secretary for Mental Health and Substance Use, in consultation with the Administrator of the Health Resources and Services Administration, shall conduct a study, and publicly post on the appropriate Internet website of the Department of Health and Human Services a report, on the mental health and substance use disorder workforce in order to inform Federal, State, and local efforts related to workforce enhancement. (b) Contents The report under this section shall contain— (1) national and State-level projections of the supply and demand of mental health and substance use disorder health workers, including the number of individuals practicing in fields deemed relevant by the Secretary; (2) an assessment of the mental health and substance use disorder workforce capacity, strengths, and weaknesses as of the date of the report, including the capacity of primary care to prevent, screen, treat, or refer for mental health and substance use disorders; (3) information on trends within the mental health and substance use disorder provider workforce, including the number of individuals entering the mental health workforce over the next five years; (4) information on the gaps in workforce development for mental health providers and professionals, including those who serve pediatric, adult, and geriatric patients; and (5) any additional information determined by the Assistant Secretary for Mental Health and Substance Use, in consultation with the Administrator of the Health Resources and Services Administration, to be relevant to the mental health and substance use disorder provider workforce. 713. Minority Fellowship Program Title V of the Public Health Service Act ( 42 U.S.C. 290aa et seq. ) is amended by adding at the end the following: K Minority Fellowship Program 597. Fellowships (a) In general The Secretary shall maintain a program, to be known as the Minority Fellowship Program, under which the Secretary awards fellowships, which may include stipends, for the purposes of— (1) increasing behavioral health practitioners’ knowledge of issues related to prevention, treatment, and recovery support for mental and substance use disorders among racial and ethnic minority populations; (2) improving the quality of mental and substance use disorder prevention and treatment delivered to racial and ethnic minorities; and (3) increasing the number of culturally competent behavioral health professionals and school personnel who teach, administer, conduct services research, and provide direct mental health or substance use services to racial and ethnic minority populations. (b) Training covered The fellowships under subsection (a) shall be for postbaccalaureate training (including for master’s and doctoral degrees) for mental health professionals, including in the fields of psychiatry, nursing, social work, psychology, marriage and family therapy, mental health counseling, and substance use and addiction counseling. (c) Authorization of appropriations To carry out this section, there are authorized to be appropriated $12,669,000 for each of fiscal years 2017, 2018, and 2019 and $13,669,000 for each of fiscal years 2020 and 2021. . 714. Center and program repeals Part B of title V of the Public Health Service Act ( 42 U.S.C. 290bb et seq. ) is amended by striking the second section 514 ( 42 U.S.C. 290bb–9 ), relating to methamphetamine and amphetamine treatment initiatives, and sections 514A, 517, 519A, 519C, 519E, 520D, and 520H ( 42 U.S.C. 290bb–8 , 290bb–23, 290bb–25a, 290bb–25c, 290bb–25e, 290bb–35, and 290bb–39). 715. National violent death reporting system The Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control and Prevention, is encouraged to improve, particularly through the inclusion of additional States, the National Violent Death Reporting System as authorized by title III of the Public Health Service Act ( 42 U.S.C. 241 et seq. ). Participation in the system by the States shall be voluntary. 716. Sense of Congress on prioritizing Native American youth and suicide prevention programs (a) Findings The Congress finds as follows: (1) Suicide is the eighth leading cause of death among American Indians and Alaska Natives across all ages. (2) Among American Indians and Alaska Natives who are 10 to 34 years of age, suicide is the second leading cause of death. (3) The suicide rate among American Indian and Alaska Native adolescents and young adults ages 15 to 34 (19.5 per 100,000) is 1.5 times higher than the national average for that age group (12.9 per 100,000). (b) Sense of Congress It is the sense of Congress that the Secretary of Health and Human Services, in carrying out programs for Native American youth and suicide prevention programs for youth suicide intervention, should prioritize programs and activities for individuals who have a high risk or disproportional burden of suicide, such as Native Americans. 717. Peer professional workforce development grant program (a) In general For the purposes described in subsection (b), the Secretary of Health and Human Services shall award grants to develop and sustain behavioral health paraprofessional training and education programs, including through tuition support. (b) Purposes The purposes of grants under this section are— (1) to increase the number of behavioral health paraprofessionals, including trained peers, recovery coaches, mental health and addiction specialists, prevention specialists, and pre-masters-level addiction counselors; and (2) to help communities develop the infrastructure to train and certify peers as behavioral health paraprofessionals. (c) Eligible entities To be eligible to receive a grant under this section, an entity shall be a community college or other entity the Secretary deems appropriate. (d) Geographic distribution In awarding grants under this section, the Secretary shall seek to achieve an appropriate national balance in the geographic distribution of such awards. (e) Special consideration In awarding grants under this section, the Secretary may give special consideration to proposed and existing programs targeting peer professionals serving youth ages 16 to 25. (f) Authorization of appropriations To carry out this section, there is authorized to be appropriated $10,000,000 for the period of fiscal years 2018 through 2022. 718. National Health Service Corps (a) Definitions (1) Primary health services Section 331(a)(3)(D) of the Public Health Service Act ( 42 U.S.C. 254d(a)(3) ) is amended by inserting (including pediatric mental health subspecialty services) after pediatrics . (2) Behavioral and mental health professionals Clause (i) of section 331(a)(3)(E) of the Public Health Service Act ( 42 U.S.C. 254d(a)(3)(E) ) is amended by inserting (and pediatric subspecialists thereof) before the period at the end. (b) Eligibility To participate in loan repayment program Section 338B(b)(1)(B) of the Public Health Service Act ( 42 U.S.C. 254l–1(b)(1)(B) ) is amended by inserting , including any physician child and adolescent psychiatry residency or fellowship training program after be enrolled in an approved graduate training program in medicine, osteopathic medicine, dentistry, behavioral and mental health, or other health profession . 719. Adult suicide prevention (a) Grants (1) Authority The Assistant Secretary for Mental Health and Substance Use (referred to in this section as the Assistant Secretary ) may award grants to eligible entities in order to implement suicide prevention efforts amongst adults 25 and older. (2) Purpose The grant program under this section shall be designed to raise suicide awareness, establish referral processes, and improve clinical care practice standards for treating suicide ideation, plans, and attempts among adults. (3) Recipients To be eligible to receive a grant under this section, an entity shall be a community-based primary care or behavioral health care setting, an emergency department, a State mental health agency, an Indian tribe, a tribal organization, or any other entity the Assistant Secretary deems appropriate. (4) Nature of activities The grants awarded under paragraph (1) shall be used to implement programs that— (A) screen for suicide risk in adults and provide intervention and referral to treatment; (B) implement evidence-based practices to treat individuals who are at suicide risk, including appropriate followup services; and (C) raise awareness, reduce stigma, and foster open dialogue about suicide prevention. (b) Additional activities The Assistant Secretary shall— (1) evaluate the activities supported by grants awarded under subsection (a) in order to further the Nation’s understanding of effective interventions to prevent suicide in adults; (2) disseminate the findings from the evaluation as the Assistant Secretary considers appropriate; and (3) provide appropriate information, training, and technical assistance to eligible entities that receive a grant under this section, in order to help such entities to meet the requirements of this section, including assistance with— (A) selection and implementation of evidence-based interventions and frameworks to prevent suicide, such as the Zero Suicide framework; and (B) other activities as the Assistant Secretary determines appropriate. (c) Duration A grant under this section shall be for a period of not more than 5 years. (d) Authorization of appropriations (1) In general There is authorized to be appropriated to carry out this section $30,000,000 for the period of fiscal years 2018 through 2022. (2) Use of certain funds Of the funds appropriated to carry out this section in any fiscal year, the lesser of 5 percent of such funds or $500,000 shall be available to the Assistant Secretary for purposes of carrying out subsection (b). 720. Crisis intervention grants for police officers and first responders (a) In general The Assistant Secretary for Mental Health and Substance Use may award grants to entities such as law enforcement agencies and first responders— (1) to provide specialized training to law enforcement officers, corrections officers, paramedics, emergency medical services workers, and other first responders (including village public safety officers (as defined in section 247 of the Indian Arts and Crafts Amendments Act of 2010 ( 42 U.S.C. 3796dd note)))— (A) to recognize individuals who have mental illness and how to properly intervene with individuals with mental illness; and (B) to establish programs that enhance the ability of law enforcement agencies to address the mental health, behavioral, and substance use problems of individuals encountered in the line of duty; and (2) to establish collaborative law enforcement and mental health programs, including behavioral health response teams and mental health crisis intervention teams comprised of mental health professionals, law enforcement officers, and other first responders, as appropriate, to provide on-site, face-to-face, mental and behavioral health care services during a mental health crisis, and to connect the individual in crisis to appropriate community-based treatment services in lieu of unnecessary hospitalization or further involvement with the criminal justice system. (b) Authorization of appropriations There are authorized to be appropriated to carry out this section $9,000,000 for the period of fiscal years 2018 through 2020. 721. Demonstration grant program to train health service psychologists in community-based mental health (a) Establishment The Secretary of Health and Human Services shall establish a grant program under which the Assistant Secretary of Mental Health and Substance Use Disorders may award grants to eligible institutions to support the recruitment, education, and clinical training experiences of health services psychology students, interns, and postdoctoral residents for education and clinical experience in community mental health settings. (b) Eligible institutions For purposes of this section, the term eligible institutions includes American Psychological Association-accredited doctoral, internship, and postdoctoral residency schools or programs in health service psychology that— (1) are focused on the development and implementation of interdisciplinary training of psychology graduate students and postdoctoral fellows in providing mental and behavioral health services to address substance use disorders, serious emotional disturbance, and serious illness, as well as developing faculty and implementing curriculum to prepare psychologists to work with underserved populations; and (2) demonstrate an ability to train health service psychologists in psychiatric hospitals, forensic hospitals, community mental health centers, community health centers, federally qualified health centers, or adult and juvenile correctional facilities. (c) Priorities In selecting grant recipients under this section, the Secretary shall give priority to eligible institutions in which training focuses on the needs of individuals with serious mental illness, serious emotional disturbance, justice-involved youth, and individuals with or at high risk for substance use disorders. (d) Authorization of appropriations There is authorized to be appropriated to carry out this section $12,000,000 for the period of fiscal years 2018 through 2022. 722. Investment in tomorrow’s pediatric health care workforce Section 775(e) of the Public Health Service Act (42 U.S.C 295f(e)) is amended to read as follows: (e) Authorization of appropriations To carry out this section, there is authorized to be appropriated $12,000,000 for the period of fiscal years 2018 through 2022. . 723. CUTGO compliance Section 319D(f) of the Public Health Service Act ( 42 U.S.C. 247d–4(f) ) is amended by striking $138,300,000 for each of fiscal years 2014 through 2018 and inserting $138,300,000 for each of fiscal years 2014 through 2016 and $58,000,000 for each of fiscal years 2017 and 2018 . VIII Mental Health Parity 801. Enhanced compliance with mental health and substance use disorder coverage requirements (a) Compliance program guidance document Section 2726(a) of the Public Health Service Act ( 42 U.S.C. 300gg–26(a) ) is amended by adding at the end the following: (6) Compliance program guidance document (A) In general Not later than 6 months after the date of enactment of the Helping Families in Mental Health Crisis Act of 2016 , the Inspector General of the Department of Health and Human Services, in coordination with the Secretary, the Secretary of Labor, or the Secretary of the Treasury, shall issue a compliance program guidance document to help improve compliance with this section. (B) Examples illustrating compliance and noncompliance (i) In general The compliance program guidance document required under this paragraph shall provide illustrative, de-identified examples (that do not disclose any protected health information or individually identifiable information) of previous findings of compliance and noncompliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986 based on investigations of violations of such sections, including— (I) examples illustrating requirements for information disclosures and nonquantitative treatment limitations; and (II) descriptions of the violations uncovered during the course of such investigations. (ii) Nonquantitative treatment limitations To the extent that any example described in clause (i) involves a finding of compliance or noncompliance with regard to any requirement for nonquantitative treatment limitations, the example shall provide sufficient detail to fully explain such finding, including a full description of the criteria involved for medical and surgical benefits and the criteria involved for mental health and substance use disorder benefits. (iii) Access to additional information regarding compliance In developing and issuing the compliance program guidance document required under this paragraph, the Inspector General of the Department of Health and Human Services may— (I) enter into interagency agreements with the Inspector General of the Department of Labor and the Inspector General of the Department of the Treasury to share findings of compliance and noncompliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986; and (II) enter into an agreement with a State to share information on findings of compliance and noncompliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986. (C) Recommendations The compliance program guidance document shall include recommendations to avoid violations of this section and encourage the development and use of internal controls to monitor adherence to applicable statutes, regulations, and program requirements. Such internal controls may include a compliance checklist with illustrative examples of nonquantitative treatment limitations on mental health and substance use disorder benefits, which may fail to comply with this section in relation to nonquantitative treatment limitations on medical and surgical benefits. (D) Updating the compliance program guidance document The compliance program guidance document shall be updated every 2 years to include illustrative, de-identified examples (that do not disclose any protected health information or individually identifiable information) of previous findings of compliance and noncompliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986. . (b) Additional guidance Section 2726(a) of the Public Health Service Act ( 42 U.S.C. 300gg–26(a) ) is amended by adding at the end the following: (7) Additional guidance (A) In general Not later than 6 months after the date of enactment of the Helping Families in Mental Health Crisis Act of 2016 , the Secretary, in coordination with the Secretary of Labor and the Secretary of the Treasury, shall issue guidance to group health plans and health insurance issuers offering group or individual health insurance coverage to assist such plans and issuers in satisfying the requirements of this section. (B) Disclosure (i) Guidance for plans and issuers The guidance issued under this paragraph shall include clarifying information and illustrative examples of methods that group health plans and health insurance issuers offering group or individual health insurance coverage may use for disclosing information to ensure compliance with the requirements under this section (and any regulations promulgated pursuant to this section). (ii) Documents for participants, beneficiaries, contracting providers, or authorized representatives The guidance issued under this paragraph may include clarifying information and illustrative examples of methods that group health plans and health insurance issuers offering group or individual health insurance coverage may use to provide any participant, beneficiary, contracting provider, or authorized representative, as applicable, with documents containing information that the health plans or issuers are required to disclose to participants, beneficiaries, contracting providers, or authorized representatives to ensure compliance with this section, any regulation issued pursuant to this section, or any other applicable law or regulation, including information that is comparative in nature with respect to— (I) nonquantitative treatment limitations for both medical and surgical benefits and mental health and substance use disorder benefits; (II) the processes, strategies, evidentiary standards, and other factors used to apply the limitations described in subclause (I); and (III) the application of the limitations described in subclause (I) to ensure that such limitations are applied in parity with respect to both medical and surgical benefits and mental health and substance use disorder benefits. (C) Nonquantitative treatment limitations The guidance issued under this paragraph shall include clarifying information and illustrative examples of methods, processes, strategies, evidentiary standards, and other factors that group health plans and health insurance issuers offering group or individual health insurance coverage may use regarding the development and application of nonquantitative treatment limitations to ensure compliance with this section (and any regulations promulgated pursuant to this section), including— (i) examples of methods of determining appropriate types of nonquantitative treatment limitations with respect to both medical and surgical benefits and mental health and substance use disorder benefits, including nonquantitative treatment limitations pertaining to— (I) medical management standards based on medical necessity or appropriateness, or whether a treatment is experimental or investigative; (II) limitations with respect to prescription drug formulary design; and (III) use of fail-first or step therapy protocols; (ii) examples of methods of determining— (I) network admission standards (such as credentialing); and (II) factors used in provider reimbursement methodologies (such as service type, geographic market, demand for services, and provider supply, practice size, training, experience, and licensure) as such factors apply to network adequacy; (iii) examples of sources of information that may serve as evidentiary standards for the purposes of making determinations regarding the development and application of nonquantitative treatment limitations; (iv) examples of specific factors, and the evidentiary standards used to evaluate such factors, used by such plans or issuers in performing a nonquantitative treatment limitation analysis; (v) examples of how specific evidentiary standards may be used to determine whether treatments are considered experimental or investigative; (vi) examples of how specific evidentiary standards may be applied to each service category or classification of benefits; (vii) examples of methods of reaching appropriate coverage determinations for new mental health or substance use disorder treatments, such as evidence-based early intervention programs for individuals with a serious mental illness and types of medical management techniques; (viii) examples of methods of reaching appropriate coverage determinations for which there is an indirect relationship between the covered mental health or substance use disorder benefit and a traditional covered medical and surgical benefit, such as residential treatment or hospitalizations involving voluntary or involuntary commitment; and (ix) additional illustrative examples of methods, processes, strategies, evidentiary standards, and other factors for which the Secretary determines that additional guidance is necessary to improve compliance with this section. (D) Public comment Prior to issuing any final guidance under this paragraph, the Secretary shall provide a public comment period of not less than 60 days during which any member of the public may provide comments on a draft of the guidance. . (c) Improving compliance (1) In general In the case that the Secretary of Health and Human Services, the Secretary of Labor, or the Secretary of the Treasury determines that a group health plan or health insurance issuer offering group or individual health insurance coverage has violated, at least 5 times, section 2726 of the Public Health Service Act ( 42 U.S.C. 300gg–26 ), section 712 of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1185a ), or section 9812 of the Internal Revenue Code, the appropriate Secretary shall audit plan documents for such health plan or issuer in the plan year following the Secretary’s determination in order to help improve compliance with such section. (2) Rule of construction Nothing in this subsection shall be construed to limit the authority, as in effect on the day before the date of enactment of this Act, of the Secretary of Health and Human Services, the Secretary of Labor, or the Secretary of the Treasury to audit documents of health plans or health insurance issuers. 802. Action plan for enhanced enforcement of mental health and substance use disorder coverage (a) Public meeting (1) In general Not later than 6 months after the date of enactment of this Act, the Secretary of Health and Human Services shall convene a public meeting of stakeholders described in paragraph (2) to produce an action plan for improved Federal and State coordination related to the enforcement of mental health parity and addiction equity requirements. (2) Stakeholders The stakeholders described in this paragraph shall include each of the following: (A) The Federal Government, including representatives from— (i) the Department of Health and Human Services; (ii) the Department of the Treasury; (iii) the Department of Labor; and (iv) the Department of Justice. (B) State governments, including— (i) State health insurance commissioners; (ii) appropriate State agencies, including agencies on public health or mental health; and (iii) State attorneys general or other representatives of State entities involved in the enforcement of mental health parity laws. (C) Representatives from key stakeholder groups, including— (i) the National Association of Insurance Commissioners; (ii) health insurance providers; (iii) providers of mental health and substance use disorder treatment; (iv) employers; and (v) patients or their advocates. (b) Action plan Not later than 6 months after the public meeting under subsection (a), the Secretary of Health and Human Services shall finalize the action plan described in such subsection and make it plainly available on the Internet website of the Department of Health and Human Services. (c) Content The action plan under this section shall— (1) reflect the input of the stakeholders invited to the public meeting under subsection (a); (2) identify specific strategic objectives regarding how the various Federal and State agencies charged with enforcement of mental health parity and addiction equity requirements will collaborate to improve enforcement of such requirements; (3) provide a timeline for implementing the action plan; and (4) provide specific examples of how such objectives may be met, which may include— (A) providing common educational information and documents to patients about their rights under Federal or State mental health parity and addiction equity requirements; (B) facilitating the centralized collection of, monitoring of, and response to patient complaints or inquiries relating to Federal or State mental health parity and addiction equity requirements, which may be through the development and administration of a single, toll-free telephone number and an Internet website portal; (C) Federal and State law enforcement agencies entering into memoranda of understanding to better coordinate enforcement responsibilities and information sharing, including whether such agencies should make the results of enforcement actions related to mental health parity and addiction equity requirements publicly available; and (D) recommendations to the Secretary and Congress regarding the need for additional legal authority to improve enforcement of mental health parity and addiction equity requirements, including the need for additional legal authority to ensure that nonquantitative treatment limitations are applied, and the extent and frequency of the applications of such limitations, both to medical and surgical benefits and to mental health and substance use disorder benefits in a comparable manner. 803. Report on investigations regarding parity in mental health and substance use disorder benefits (a) In general Not later than 1 year after the date of enactment of this Act, and annually thereafter for the subsequent 5 years, the Administrator of the Centers for Medicare & Medicaid Services, in collaboration with the Assistant Secretary of Labor of the Employee Benefits Security Administration and the Secretary of the Treasury, shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate a report summarizing the results of all closed Federal investigations completed during the preceding 12-month period with findings of any serious violation regarding compliance with mental health and substance use disorder coverage requirements under section 2726 of the Public Health Service Act ( 42 U.S.C. 300gg–26 ), section 712 of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1185a ), and section 9812 of the Internal Revenue Code of 1986. (b) Contents Subject to subsection (c), a report under subsection (a) shall, with respect to investigations described in such subsection, include each of the following: (1) The number of open or closed Federal investigations conducted during the covered reporting period. (2) Each benefit classification examined by any such investigation conducted during the covered reporting period. (3) Each subject matter, including compliance with requirements for quantitative and nonquantitative treatment limitations, of any such investigation conducted during the covered reporting period. (4) A summary of the basis of the final decision rendered for each closed investigation conducted during the covered reporting period that resulted in a finding of a serious violation. (c) Limitation Any individually identifiable information shall be excluded from reports under subsection (a) consistent with protections under the health privacy and security rules promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996 ( 42 U.S.C. 1320d–2 note). 804. GAO study on parity in mental health and substance use disorder benefits Not later than 3 years after the date of enactment of this Act, the Comptroller General of the United States, in consultation with the Secretary of Health and Human Services, the Secretary of Labor, and the Secretary of the Treasury, shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate a report detailing the extent to which group health plans or health insurance issuers offering group or individual health insurance coverage that provides both medical and surgical benefits and mental health or substance use disorder benefits, medicaid managed care organizations with a contract under section 1903(m) of the Social Security Act ( 42 U.S.C. 1396b(m) ), and health plans provided under the State Children’s Health Insurance Program under title XXI of the Social Security Act ( 42 U.S.C. 1397aa et seq. ) comply with section 2726 of the Public Health Service Act ( 42 U.S.C. 300gg–26 ), section 712 of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1185a ), and section 9812 of the Internal Revenue Code of 1986, including— (1) how nonquantitative treatment limitations, including medical necessity criteria, of such plans or issuers comply with such sections; (2) how the responsible Federal departments and agencies ensure that such plans or issuers comply with such sections, including an assessment of how the Secretary of Health and Human Services has used its authority to conduct audits of such plans to ensure compliance; (3) a review of how the various Federal and State agencies responsible for enforcing mental health parity requirements have improved enforcement of such requirements in accordance with the objectives and timeline described in the action plan under section 802; and (4) recommendations for how additional enforcement, education, and coordination activities by responsible Federal and State departments and agencies could better ensure compliance with such sections, including recommendations regarding the need for additional legal authority. 805. Information and awareness on eating disorders (a) Information The Secretary of Health and Human Services (in this section referred to as the Secretary ) may— (1) update information, related fact sheets, and resource lists related to eating disorders that are available on the public Internet website of the National Women's Health Information Center sponsored by the Office on Women's Health, to include— (A) updated findings and current research related to eating disorders, as appropriate; and (B) information about eating disorders, including information related to males and females; (2) incorporate, as appropriate, and in coordination with the Secretary of Education, information from publicly available resources into appropriate obesity prevention programs developed by the Office on Women's Health; and (3) make publicly available (through a public Internet website or other method) information, related fact sheets and resource lists, as updated under paragraph (1), and the information incorporated into appropriate obesity prevention programs, as updated under paragraph (2). (b) Awareness The Secretary may advance public awareness on— (1) the types of eating disorders; (2) the seriousness of eating disorders, including prevalence, comorbidities, and physical and mental health consequences; (3) methods to identify, intervene, refer for treatment, and prevent behaviors that may lead to the development of eating disorders; (4) discrimination and bullying based on body size; (5) the effects of media on self-esteem and body image; and (6) the signs and symptoms of eating disorders. 806. Education and training on eating disorders The Secretary of Health and Human Services may facilitate the identification of programs to educate and train health professionals and school personnel in effective strategies to— (1) identify individuals with eating disorders; (2) provide early intervention services for individuals with eating disorders; (3) refer patients with eating disorders for appropriate treatment; (4) prevent the development of eating disorders; or (5) provide appropriate treatment services for individuals with eating disorders. 807. GAO study on preventing discriminatory coverage limitations for individuals with serious mental illness and substance use disorders Not later than 2 years after the date of the enactment of this Act, the Comptroller General of the United States shall submit to Congress and make publicly available a report detailing Federal oversight of group health plans and health insurance coverage offered in connection with such plans (as such terms are defined in section 2791 of the Public Health Service Act ( 42 U.S.C. 300gg–91 ), including Medicaid managed care plans under section 1903 of the Social Security Act ( 42 U.S.C. 1396b ), to ensure compliance of such plans and coverage with sections 2726 of the Public Health Service Act ( 42 U.S.C. 300gg–26 ), 712 of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1185a ), and 9812 of the Internal Revenue Code of 1986 (in this section collectively referred to as the parity law ), including— (1) a description of how Federal regulations and guidance consider nonquantitative treatment limitations, including medical necessity criteria and application of such criteria to medical, surgical, and primary care, of such plans and coverage in ensuring compliance by such plans and coverage with the parity law; (2) a description of actions that Federal departments and agencies are taking to ensure that such plans and coverage comply with the parity law; and (3) the identification of enforcement, education, and coordination activities within Federal departments and agencies, including educational activities directed to State insurance commissioners, and a description of how such proper activities can be used to ensure full compliance with the parity law. 808. Clarification of existing parity rules If a group health plan or a health insurance issuer offering group or individual health insurance coverage provides coverage for eating disorder benefits, including residential treatment, such group health plan or health insurance issuer shall provide such benefits consistent with the requirements of section 2726 of the Public Health Service Act ( 42 U.S.C. 300gg–26 ), section 712 of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1185a ), and section 9812 of the Internal Revenue Code of 1986.

July 6, 2016 Reported from the Committee on Energy and Commerce with an amendment July 6, 2016 The Committees on Ways and Means and Education and the Workforce discharged; committed to the Committee of the Whole House on the State of the Union and ordered to be printed

tv_txt: IIB 114th CONGRESS 2d Session H. R. 2646 IN THE SENATE OF THE UNITED STATES July 7, 2016 Received July 14, 2016 Read twice and referred to the Committee on Health, Education, Labor, and Pensions AN ACT To make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis, and for other purposes.

1. Short title; table of contents (a) Short title This Act may be cited as the Helping Families in Mental Health Crisis Act of 2016 . (b) Table of contents The table of contents for this Act is as follows: Sec. 1. Short title; table of contents. Title I—Assistant Secretary for Mental Health and Substance Use Sec. 101. Assistant Secretary for Mental Health and Substance Use. Sec. 102. Improving oversight of mental health and substance use programs. Sec. 103. National Mental Health and Substance Use Policy Laboratory. Sec. 104. Peer-support specialist programs. Sec. 105. Prohibition against lobbying using Federal funds by systems accepting Federal funds to protect and advocate the rights of individuals with mental illness. Sec. 106. Reporting for protection and advocacy organizations. Sec. 107. Grievance procedure. Sec. 108. Center for Behavioral Health Statistics and Quality. Sec. 109. Strategic plan. Sec. 110. Authorities of centers for mental health services and substance abuse treatment. Sec. 111. Advisory councils. Sec. 112. Peer review. Title II—Medicaid Mental Health Coverage Sec. 201. Rule of construction related to Medicaid coverage of mental health services and primary care services furnished on the same day. Sec. 202. Optional limited coverage of inpatient services furnished in institutions for mental diseases. Sec. 203. Study and report related to Medicaid managed care regulation. Sec. 204. Guidance on opportunities for innovation. Sec. 205. Study and report on Medicaid emergency psychiatric demonstration project. Sec. 206. Providing EPSDT services to children in IMDs. Sec. 207. Electronic visit verification system required for personal care services and home health care services under Medicaid. Title III—Interdepartmental Serious Mental Illness Coordinating Committee Sec. 301. Interdepartmental Serious Mental Illness Coordinating Committee. Title IV—Compassionate Communication on HIPAA Sec. 401. Sense of Congress. Sec. 402. Confidentiality of records. Sec. 403. Clarification of circumstances under which disclosure of protected health information is permitted. Sec. 404. Development and dissemination of model training programs. Title V—Increasing Access to Treatment for Serious Mental Illness Sec. 501. Assertive community treatment grant program for individuals with serious mental illness. Sec. 502. Strengthening community crisis response systems. Sec. 503. Increased and extended funding for assisted outpatient grant program for individuals with serious mental illness. Sec. 504. Liability protections for health professional volunteers at community health centers. Title VI—Supporting Innovative and Evidence-Based Programs Subtitle A—Encouraging the Advancement, Incorporation, and Development of Evidence-Based Practices Sec. 601. Encouraging innovation and evidence-based programs. Sec. 602. Promoting access to information on evidence-based programs and practices. Sec. 603. Sense of Congress. Subtitle B—Supporting the State Response to Mental Health Needs Sec. 611. Community Mental Health Services Block Grant. Subtitle C—Strengthening Mental Health Care for Children and Adolescents Sec. 621. Tele-mental health care access grants. Sec. 622. Infant and early childhood mental health promotion, intervention, and treatment. Sec. 623. National Child Traumatic Stress Initiative. Title VII—Grant programs and program reauthorization Subtitle A—Garrett Lee Smith Memorial Act reauthorization Sec. 701. Youth interagency research, training, and technical assistance centers. Sec. 702. Youth suicide early intervention and prevention strategies. Sec. 703. Mental health and substance use disorder services on campus. Subtitle B—Other provisions Sec. 711. National Suicide Prevention Lifeline Program. Sec. 712. Workforce development studies and reports. Sec. 713. Minority Fellowship Program. Sec. 714. Center and program repeals. Sec. 715. National violent death reporting system. Sec. 716. Sense of Congress on prioritizing Native American youth and suicide prevention programs. Sec. 717. Peer professional workforce development grant program. Sec. 718. National Health Service Corps. Sec. 719. Adult suicide prevention. Sec. 720. Crisis intervention grants for police officers and first responders. Sec. 721. Demonstration grant program to train health service psychologists in community-based mental health. Sec. 722. Investment in tomorrow’s pediatric health care workforce. Sec. 723. CUTGO compliance. Title VIII—Mental Health Parity Sec. 801. Enhanced compliance with mental health and substance use disorder coverage requirements. Sec. 802. Action plan for enhanced enforcement of mental health and substance use disorder coverage. Sec. 803. Report on investigations regarding parity in mental health and substance use disorder benefits. Sec. 804. GAO study on parity in mental health and substance use disorder benefits. Sec. 805. Information and awareness on eating disorders. Sec. 806. Education and training on eating disorders. Sec. 807. GAO study on preventing discriminatory coverage limitations for individuals with serious mental illness and substance use disorders. Sec. 808. Clarification of existing parity rules. I Assistant Secretary for Mental Health and Substance Use 101. Assistant Secretary for Mental Health and Substance Use (a) Assistant Secretary Section 501(c) of the Public Health Service Act ( 42 U.S.C. 290aa ) is amended to read as follows: (c) Assistant Secretary and Deputy Assistant Secretary (1) Assistant Secretary (A) Appointment The Administration shall be headed by an official to be known as the Assistant Secretary for Mental Health and Substance Use (hereinafter in this title referred to as the Assistant Secretary ) who shall be appointed by the President, by and with the advice and consent of the Senate. (B) Qualifications In selecting the Assistant Secretary, the President shall give preference to individuals who have— (i) a doctoral degree in medicine, osteopathic medicine, or psychology; (ii) clinical and research experience regarding mental health and substance use disorders; and (iii) an understanding of biological, psychosocial, and pharmaceutical treatments of mental illness and substance use disorders. (2) Deputy Assistant Secretary The Assistant Secretary, with the approval of the Secretary, may appoint a Deputy Assistant Secretary and may employ and prescribe the functions of such officers and employees, including attorneys, as are necessary to administer the activities to be carried out through the Administration. . (b) Transfer of authorities The Secretary of Health and Human Services shall delegate to the Assistant Secretary for Mental Health and Substance Use all duties and authorities that— (1) as of the day before the date of enactment of this Act, were vested in the Administrator of the Substance Abuse and Mental Health Services Administration; and (2) are not terminated by this Act. (c) Evaluation Section 501(d) of the Public Health Service Act ( 42 U.S.C. 290aa(d) ) is amended— (1) in paragraph (17), by striking and at the end; (2) in paragraph (18), by striking the period at the end and inserting a semicolon; and (3) by adding at the end the following: (19) evaluate, in consultation with the Assistant Secretary for Financial Resources, the information used for oversight of grants under programs related to mental illness and substance use disorders, including co-occurring illness or disorders, administered by the Center for Mental Health Services; (20) periodically review Federal programs and activities relating to the diagnosis or prevention of, or treatment or rehabilitation for, mental illness and substance use disorders to identify any such programs or activities that have proven to be effective or efficient in improving outcomes or increasing access to evidence-based programs; (21) establish standards for the appointment of peer-review panels to evaluate grant applications and recommend standards for mental health grant programs; and . (d) Standards for grant programs Section 501(d) of the Public Health Service Act ( 42 U.S.C. 290aa(d) ), as amended by subsection (c), is further amended by adding at the end the following: (22) in consultation with the National Mental Health and Substance Use Policy Laboratory, and after providing an opportunity for public input, set standards for grant programs under this title for mental health and substance use services, which may address— (A) the capacity of the grantee to implement the award; (B) requirements for the description of the program implementation approach; (C) the extent to which the grant plan submitted by the grantee as part of its application must explain how the grantee will reach the population of focus and provide a statement of need, including to what extent the grantee will increase the number of clients served and the estimated percentage of clients receiving services who report positive functioning after 6 months or no past-month substance use, as applicable; (D) the extent to which the grantee must collect and report on required performance measures; and (E) the extent to which the grantee is proposing evidence-based practices and the extent to which— (i) those evidence-based practices must be used with respect to a population similar to the population for which the evidence-based practices were shown to be effective; or (ii) if no evidence-based practice exists for a population of focus, the way in which the grantee will implement adaptations of evidence-based practices, promising practices, or cultural practices. . (e) Emergency response Section 501(m) of the Public Health Service Act ( 42 U.S.C. 290aa(m) ) is amended by adding at the end the following: (4) Availability of funds through following fiscal year Amounts made available for carrying out this subsection shall remain available through the end of the fiscal year following the fiscal year for which such amounts are appropriated. . (f) Member of Council on Graduate Medical Education Section 762 of the Public Health Service Act ( 42 U.S.C. 290o ) is amended— (1) in subsection (b)— (A) by redesignating paragraphs (4), (5), and (6) as paragraphs (5), (6), and (7), respectively; and (B) by inserting after paragraph (3) the following: (4) the Assistant Secretary for Mental Health and Substance Use; ; and (2) in subsection (c), by striking (4), (5), and (6) each place it appears and inserting (5), (6), and (7) . (g) Conforming amendments Title V of the Public Health Service Act ( 42 U.S.C. 290aa et seq. ), as amended by the previous provisions of this section, is further amended— (1) by striking Administrator of the Substance Abuse and Mental Health Services Administration each place it appears and inserting Assistant Secretary for Mental Health and Substance Use ; and (2) by striking Administrator each place it appears (including in any headings) and inserting Assistant Secretary , except where the term Administrator appears— (A) in each of subsections (e) and (f) of section 501 of such Act ( 42 U.S.C. 290aa ), including the headings of such subsections, within the term Associate Administrator ; (B) in section 507(b)(6) of such Act ( 42 U.S.C. 290bb(b)(6) ), within the term Administrator of the Health Resources and Services Administration ; (C) in section 507(b)(6) of such Act ( 42 U.S.C. 290bb(b)(6) ), within the term Administrator of the Centers for Medicare & Medicaid Services ; (D) in section 519B(c)(1)(B) of such Act (42 U.S.C. 290bb–25b(c)(1)(B)), within the term Administrator of the National Highway Traffic Safety Administration ; or (E) in each of sections 519B(c)(1)(B), 520C(a), and 520D(a) of such Act (42 U.S.C. 290bb–25b(c)(1)(B), 290bb–34(a), 290bb–35(a)), within the term Administrator of the Office of Juvenile Justice and Delinquency Prevention . (h) References After executing subsections (a), (b), and (f), any reference in statute, regulation, or guidance to the Administrator of the Substance Abuse and Mental Health Services Administration shall be construed to be a reference to the Assistant Secretary for Mental Health and Substance Use. 102. Improving oversight of mental health and substance use programs Title V of the Public Health Service Act is amended by inserting after section 501 of such Act ( 42 U.S.C. 290aa ) the following: 501A. Improving oversight of mental health and substance use programs (a) Activities For the purpose of ensuring efficient and effective planning and evaluation of mental illness and substance use disorder programs and related activities, the Assistant Secretary for Planning and Evaluation, in consultation with the Assistant Secretary for Mental Health and Substance Use, shall— (1) collect and organize relevant data on homelessness, involvement with the criminal justice system, hospitalizations, mortality outcomes, and other measures the Secretary deems appropriate from across Federal departments and agencies; (2) evaluate programs related to mental illness and substance use disorders, including co-occurring illness or disorders, across Federal departments and agencies, as appropriate, including programs related to— (A) prevention, intervention, treatment, and recovery support services, including such services for individuals with a serious mental illness or serious emotional disturbance; (B) the reduction of homelessness and involvement with the criminal justice system among individuals with a mental illness or substance use disorder; and (C) public health and health services; and (3) consult, as appropriate, with the Assistant Secretary, the Behavioral Health Coordinating Council of the Department of Health and Human Services, other agencies within the Department of Health and Human Services, and other relevant Federal departments. (b) Recommendations The Assistant Secretary for Planning and Evaluation shall develop an evaluation strategy that identifies priority programs to be evaluated by the Assistant Secretary and priority programs to be evaluated by other relevant agencies within the Department of Health and Human Services. The Assistant Secretary for Planning and Evaluation shall provide recommendations on improving programs and activities based on the evaluation described in subsection (a)(2) as needing improvement. . 103. National Mental Health and Substance Use Policy Laboratory Title V of the Public Health Service Act ( 42 U.S.C. 290aa et seq. ) is amended by inserting after section 501A, as added by section 102 of this Act, the following: 501B. National Mental Health and Substance Use Policy Laboratory (a) In general There shall be established within the Administration a National Mental Health and Substance Use Policy Laboratory (referred to in this section as the Laboratory ). (b) Responsibilities The Laboratory shall— (1) continue to carry out the authorities and activities that were in effect for the Office of Policy, Planning, and Innovation as such Office existed prior to the date of enactment of the Helping Families in Mental Health Crisis Act of 2016 ; (2) identify, coordinate, and facilitate the implementation of policy changes likely to have a significant effect on mental health, mental illness, and the prevention and treatment of substance use disorder services; (3) collect, as appropriate, information from grantees under programs operated by the Administration in order to evaluate and disseminate information on evidence-based practices, including culturally and linguistically appropriate services, as appropriate, and service delivery models; (4) provide leadership in identifying and coordinating policies and programs, including evidence-based programs, related to mental illness and substance use disorders; (5) recommend ways in which payers may implement program and policy findings of the Administration and the Laboratory to improve outcomes and reduce per capita program costs; (6) in consultation with the Assistant Secretary for Planning and Evaluation, as appropriate, periodically review Federal programs and activities relating to the diagnosis or prevention of, or treatment or rehabilitation for, mental illness and substance use disorders, including by— (A) identifying any such programs or activities that are duplicative; (B) identifying any such programs or activities that are not evidence-based, effective, or efficient; and (C) formulating recommendations for coordinating, eliminating, or improving programs or activities identified under subparagraph (A) or (B) and merging such programs or activities into other successful programs or activities; and (7) carry out other activities as deemed necessary to continue to encourage innovation and disseminate evidence-based programs and practices, including programs and practices with scientific merit. (c) Evidence-Based practices and service delivery models (1) In general In selecting evidence-based best practices and service delivery models for evaluation and dissemination, the Laboratory— (A) shall give preference to models that improve— (i) the coordination between mental health and physical health providers; (ii) the coordination among such providers and the justice and corrections system; and (iii) the cost effectiveness, quality, effectiveness, and efficiency of health care services furnished to individuals with serious mental illness or serious emotional disturbance, in mental health crisis, or at risk to themselves, their families, and the general public; and (B) may include clinical protocols and practices used in the Recovery After Initial Schizophrenia Episode (RAISE) project and the North American Prodrome Longitudinal Study (NAPLS) of the National Institute of Mental Health. (2) Deadline for beginning implementation The Laboratory shall begin implementation of the duties described in this section not later than January 1, 2018. (3) Consultation In carrying out the duties under this section, the Laboratory shall consult with— (A) representatives of the National Institute of Mental Health, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism, on an ongoing basis; (B) other appropriate Federal agencies; (C) clinical and analytical experts with expertise in psychiatric medical care and clinical psychological care, health care management, education, corrections health care, and mental health court systems, as appropriate; and (D) other individuals and agencies as determined appropriate by the Assistant Secretary. . 104. Peer-support specialist programs (a) In general Not later than 2 years after the date of enactment of this Act, the Comptroller General of the United States shall conduct a study on peer-support specialist programs in up to 10 States (to be selected by the Comptroller General) that receive funding from the Substance Abuse and Mental Health Services Administration and submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives a report containing the results of such study. (b) Contents of study In conducting the study under subsection (a), the Comptroller General of the United States shall examine and identify best practices in the selected States related to training and credential requirements for peer-support specialist programs, such as— (1) hours of formal work or volunteer experience related to mental illness and substance use disorders conducted through such programs; (2) types of peer-support specialist exams required for such programs in the States; (3) codes of ethics used by such programs in the States; (4) required or recommended skill sets of such programs in the State; and (5) requirements for continuing education. 105. Prohibition against lobbying using Federal funds by systems accepting Federal funds to protect and advocate the rights of individuals with mental illness Section 105(a) of the Protection and Advocacy for Individuals with Mental Illness Act ( 42 U.S.C. 10805(a) ) is amended— (1) in paragraph (9), by striking and at the end; (2) in paragraph (10), by striking the period at the end and inserting ; and ; and (3) by adding at the end the following: (11) agree to refrain, during any period for which funding is provided to the system under this part, from using Federal funds to pay the salary or expenses of any grant or contract recipient, or agent acting for such recipient, related to any activity designed to influence the enactment of legislation, appropriations, regulation, administrative action, or Executive order proposed or pending before the Congress or any State or local government, including any legislative body, other than for normal and recognized executive-legislative relationships or participation by an agency or officer of a State, local, or tribal government in policymaking and administrative processes within the executive branch of that government. . 106. Reporting for protection and advocacy organizations (a) Public availability of reports Section 105(a)(7) of the Protection and Advocacy for Individuals with Mental Illness Act ( 42 U.S.C. 10805(a)(7) ) is amended by striking is located a report and inserting is located, and make publicly available, a report . (b) Detailed accounting Section 114(a) of the Protection and Advocacy for Individuals with Mental Illness Act ( 42 U.S.C. 10824(a) ) is amended— (1) in paragraph (3), by striking and at the end; (2) in paragraph (4), by striking the period at the end and inserting ; and ; and (3) by adding at the end the following: (5) using data from the existing required annual program progress reports submitted by each system funded under this title, a detailed accounting for each such system of how funds are spent, disaggregated according to whether the funds were received from the Federal Government, the State government, a local government, or a private entity. . 107. Grievance procedure Section 105 of the Protection and Advocacy for Individuals with Mental Illness Act ( 42 U.S.C. 10805 ), as amended, is further amended by adding at the end the following: (d) Grievance procedure The Secretary shall establish an independent grievance procedure for persons described in subsection (a)(9). . 108. Center for Behavioral Health Statistics and Quality Title V of the Public Health Service Act ( 42 U.S.C. 290aa et seq. ) is amended— (1) in section 501(b) ( 42 U.S.C. 290aa(b) ), by adding at the end the following: (4) The Center for Behavioral Health Statistics and Quality. ; (2) in section 502(a)(1) ( 42 U.S.C. 290aa–1(a)(1) )— (A) in subparagraph (C), by striking and at the end; (B) in subparagraph (D), by striking the period at the end and inserting ; and ; and (C) by inserting after subparagraph (D) the following: (E) the Center for Behavioral Health Statistics and Quality. ; and (3) in part B ( 42 U.S.C. 290bb et seq. ) by adding at the end the following new subpart: 4 Center for Behavioral Health Statistics and Quality 520L. Center for Behavioral Health Statistics and Quality (a) Establishment There is established in the Administration a Center for Behavioral Health Statistics and Quality (in this section referred to as the Center ). The Center shall be headed by a Director (in this section referred to as the Director ) appointed by the Secretary from among individuals with extensive experience and academic qualifications in research and analysis in behavioral health care or related fields. (b) Duties The Director of the Center shall— (1) coordinate the Administration’s integrated data strategy by coordinating— (A) surveillance and data collection (including that authorized by section 505); (B) evaluation; (C) statistical and analytic support; (D) service systems research; and (E) performance and quality information systems; (2) recommend a core set of measurement standards for grant programs administered by the Administration; and (3) coordinate evaluation efforts for the grant programs, contracts, and collaborative agreements of the Administration. (c) Biannual report to Congress Not later than 2 years after the date of enactment of this section, and every 2 years thereafter, the Director of the Center shall submit to Congress a report on the quality of services furnished through grant programs of the Administration, including applicable measures of outcomes for individuals and public outcomes such as— (1) the number of patients screened positive for unhealthy alcohol use who receive brief counseling as appropriate; the number of patients screened positive for tobacco use and receiving smoking cessation interventions; the number of patients with a new diagnosis of major depressive episode who are assessed for suicide risk; the number of patients screened positive for clinical depression with a documented followup plan; and the number of patients with a documented pain assessment that have a followup treatment plan when pain is present; and satisfaction with care; (2) the incidence and prevalence of mental illness and substance use disorders; the number of suicide attempts and suicide completions; overdoses seen in emergency rooms resulting from alcohol and drug use; emergency room boarding; overdose deaths; emergency psychiatric hospitalizations; new criminal justice involvement while in treatment; stable housing; and rates of involvement in employment, education, and training; and (3) such other measures for outcomes of services as the Director may determine. (d) Staffing Composition The staff of the Center may include individuals with advanced degrees and field expertise as well as clinical and research experience in mental illness and substance use disorders such as— (1) professionals with clinical and research expertise in the prevention and treatment of, and recovery from, mental illness and substance use disorders; (2) professionals with training and expertise in statistics or research and survey design and methodologies; and (3) other related fields in the social and behavioral sciences, as specified by relevant position descriptions. (e) Grants and contracts In carrying out the duties established in subsection (b), the Director may make grants to, and enter into contracts and cooperative agreements with, public and nonprofit private entities. (f) Definition In this section, the term emergency room boarding means the practice of admitting patients to an emergency department and holding such patients in the department until inpatient psychiatric beds become available. . 109. Strategic plan Section 501 of the Public Health Service Act ( 42 U.S.C. 290aa ) is further amended— (1) by redesignating subsections (l) through (o) as subsections (m) through (p), respectively; and (2) by inserting after subsection (k) the following: (l) Strategic plan (1) In general Not later than December 1, 2017, and every 5 years thereafter, the Assistant Secretary shall develop and carry out a strategic plan in accordance with this subsection for the planning and operation of evidence-based programs and grants carried out by the Administration. (2) Coordination In developing and carrying out the strategic plan under this section, the Assistant Secretary shall take into consideration the report of the Interdepartmental Serious Mental Illness Coordinating Committee under section 301 of the Helping Families in Mental Health Crisis Act of 2016. (3) Publication of plan Not later than December 1, 2017, and every 5 years thereafter, the Assistant Secretary shall— (A) submit the strategic plan developed under paragraph (1) to the appropriate committees of Congress; and (B) post such plan on the Internet website of the Administration. (4) Contents The strategic plan developed under paragraph (1) shall— (A) identify strategic priorities, goals, and measurable objectives for mental illness and substance use disorder activities and programs operated and supported by the Administration, including priorities to prevent or eliminate the burden of mental illness and substance use disorders; (B) identify ways to improve services for individuals with a mental illness or substance use disorder, including services related to the prevention of, diagnosis of, intervention in, treatment of, and recovery from, mental illness or substance use disorders, including serious mental illness or serious emotional disturbance, and access to services and supports for individuals with a serious mental illness or serious emotional disturbance; (C) ensure that programs provide, as appropriate, access to effective and evidence-based prevention, diagnosis, intervention, treatment, and recovery services, including culturally and linguistically appropriate services, as appropriate, for individuals with a mental illness or substance use disorder; (D) identify opportunities to collaborate with the Health Resources and Services Administration to develop or improve— (i) initiatives to encourage individuals to pursue careers (especially in rural and underserved areas and populations) as psychiatrists, psychologists, psychiatric nurse practitioners, physician assistants, occupational therapists, clinical social workers, certified peer-support specialists, licensed professional counselors, or other licensed or certified mental health professionals, including such professionals specializing in the diagnosis, evaluation, or treatment of individuals with a serious mental illness or serious emotional disturbance; and (ii) a strategy to improve the recruitment, training, and retention of a workforce for the treatment of individuals with mental illness or substance use disorders, or co-occurring illness or disorders; (E) identify opportunities to improve collaboration with States, local governments, communities, and Indian tribes and tribal organizations (as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act ( 25 U.S.C. 450b )); and (F) specify a strategy to disseminate evidenced-based and promising best practices related to prevention, diagnosis, early intervention, treatment, and recovery services related to mental illness, particularly for individuals with a serious mental illness and children and adolescents with a serious emotional disturbance, and substance use disorders. . 110. Authorities of centers for mental health services and substance abuse treatment (a) Center for mental health services Section 520(b) of the Public Health Service Act ( 42 U.S.C. 290bb–31(b) ) is amended— (1) by redesignating paragraphs (3) through (15) as paragraphs (4) through (16), respectively; (2) by inserting after paragraph (2) the following: (3) collaborate with the Director of the National Institute of Mental Health to ensure that, as appropriate, programs related to the prevention and treatment of mental illness and the promotion of mental health are carried out in a manner that reflects the best available science and evidence-based practices, including culturally and linguistically appropriate services; ; (3) in paragraph (5), as so redesignated, by inserting through policies and programs that reduce risk and promote resiliency before the semicolon; (4) in paragraph (6), as so redesignated, by inserting in collaboration with the Director of the National Institute of Mental Health, before develop ; (5) in paragraph (8), as so redesignated, by inserting , increase meaningful participation of individuals with mental illness in programs and activities of the Administration, before and protect the legal ; (6) in paragraph (10), as so redesignated, by striking professional and paraprofessional personnel pursuant to section 303 and inserting paraprofessional personnel and health professionals ; (7) in paragraph (11), as so redesignated, by inserting and telemental health, after rural mental health, ; (8) in paragraph (12), as so redesignated, by striking establish a clearinghouse for mental health information to assure the widespread dissemination of such information and inserting disseminate mental health information, including evidenced-based practices, ; (9) in paragraph (15), as so redesignated, by striking and at the end; (10) in paragraph (16), as so redesignated, by striking the period and inserting ; and ; and (11) by adding at the end the following: (17) consult with other agencies and offices of the Department of Health and Human Services to ensure, with respect to each grant awarded by the Center for Mental Health Services, the consistent documentation of the application of criteria when awarding grants and the ongoing oversight of grantees after such grants are awarded. . (b) Director of the center for substance abuse treatment Section 507 of the Public Health Service Act ( 42 U.S.C. 290bb ) is amended— (1) in subsection (a)— (A) by striking treatment of substance abuse and inserting treatment of substance use disorders ; and (B) by striking abuse treatment systems and inserting use disorder treatment systems ; and (2) in subsection (b)— (A) in paragraph (3), by striking abuse and inserting use disorder ; (B) in paragraph (4), by striking individuals who abuse drugs and inserting individuals who use drugs ; (C) in paragraph (9), by striking carried out by the Director ; (D) by striking paragraph (10); (E) by redesignating paragraphs (11) through (14) as paragraphs (10) through (13), respectively; (F) in paragraph (12), as so redesignated, by striking ; and and inserting a semicolon; and (G) by striking paragraph (13), as so redesignated, and inserting the following: (13) ensure the consistent documentation of the application of criteria when awarding grants and the ongoing oversight of grantees after such grants are awarded; and (14) work with States, providers, and individuals in recovery, and their families, to promote the expansion of recovery support services and systems of care oriented towards recovery. . 111. Advisory councils Section 502(b) of the Public Health Service Act ( 42 U.S.C. 290aa–1(b) ) is amended— (1) in paragraph (2)— (A) in subparagraph (E), by striking and after the semicolon; (B) by redesignating subparagraph (F) as subparagraph (I); and (C) by inserting after subparagraph (E), the following: (F) for the advisory councils appointed under subsections (a)(1)(A) and (a)(1)(D), the Director of the National Institute of Mental Health; (G) for the advisory councils appointed under subsections (a)(1)(A), (a)(1)(B), and (a)(1)(C), the Director of the National Institute on Drug Abuse; (H) for the advisory councils appointed under subsections (a)(1)(A), (a)(1)(B), and (a)(1)(C), the Director of the National Institute on Alcohol Abuse and Alcoholism; and ; and (2) in paragraph (3), by adding at the end the following: (C) Not less than half of the members of the advisory council appointed under subsection (a)(1)(D)— (i) shall have— (I) a medical degree; (II) a doctoral degree in psychology; or (III) an advanced degree in nursing or social work from an accredited graduate school or be a certified physician assistant; and (ii) shall specialize in the mental health field. . 112. Peer review Section 504(b) of the Public Health Service Act ( 42 U.S.C. 290aa–3(b) ) is amended by adding at the end the following: In the case of any such peer review group that is reviewing a grant, cooperative agreement, or contract related to mental illness treatment, not less than half of the members of such peer review group shall be licensed and experienced professionals in the prevention, diagnosis, or treatment of, or recovery from, mental illness or substance use disorders and have a medical degree, a doctoral degree in psychology, or an advanced degree in nursing or social work from an accredited program. . II Medicaid Mental Health Coverage 201. Rule of construction related to Medicaid coverage of mental health services and primary care services furnished on the same day Nothing in title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ) shall be construed as prohibiting separate payment under the State plan under such title (or under a waiver of the plan) for the provision of a mental health service or primary care service under such plan, with respect to an individual, because such service is— (1) a primary care service furnished to the individual by a provider at a facility on the same day a mental health service is furnished to such individual by such provider (or another provider) at the facility; or (2) a mental health service furnished to the individual by a provider at a facility on the same day a primary care service is furnished to such individual by such provider (or another provider) at the facility. 202. Optional limited coverage of inpatient services furnished in institutions for mental diseases (a) In general Section 1903(m)(2) of the Social Security Act ( 42 U.S.C. 1396b(m)(2) ) is amended by adding at the end the following new subparagraph: (I) (i) Notwithstanding the limitation specified in the subdivision (B) following paragraph (29) of section 1905(a) and subject to clause (ii), a State may, under a risk contract entered into by the State under this title (or under section 1115) with a medicaid managed care organization or a prepaid inpatient health plan (as defined in section 438.2 of title 42, Code of Federal Regulations (or any successor regulation)), make a monthly capitation payment to such organization or plan for enrollees with the organization or plan who are over 21 years of age and under 65 years of age and are receiving inpatient treatment in an institution for mental diseases (as defined in section 1905(i)), so long as each of the following conditions is met: (I) The institution is a hospital providing inpatient psychiatric or substance use disorder services or a sub-acute facility providing psychiatric or substance use disorder crisis residential services. (II) The length of stay in such an institution for such treatment is for a short-term stay of no more than 15 days during the period of the monthly capitation payment. (III) The provision of such treatment meets the following criteria for consideration as services or settings that are provided in lieu of services or settings covered under the State plan: (aa) The State determines that the alternative service or setting is a medically appropriate and cost-effective substitute for the service or setting covered under the State plan. (bb) The enrollee is not required by the managed care organization or prepaid inpatient health plan to use the alternative service or setting. (cc) Such treatment is authorized and identified in such contract, and will be offered to such enrollees at the option of the managed care organization or prepaid inpatient health plan. (ii) For purposes of setting the amount of such a monthly capitation payment, a State may use the utilization of services provided to an individual under this subparagraph when developing the inpatient psychiatric or substance use disorder component of such payment, but the amount of such payment for such services may not exceed the cost of the same services furnished through providers included under the State plan. . (b) Effective date The amendment made by subsection (a) shall apply beginning on July 5, 2016, or the date of the enactment of this Act, whichever is later. 203. Study and report related to Medicaid managed care regulation (a) Study The Secretary of Health and Human Services, acting through the Administrator of the Centers for Medicare & Medicaid Services, shall conduct a study on coverage under the Medicaid program under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ) of services provided through a medicaid managed care organization (as defined in section 1903(m) of such Act ( 42 U.S.C. 1396b(m) ) or a prepaid inpatient health plan (as defined in section 438.2 of title 42, Code of Federal Regulations (or any successor regulation)) with respect to individuals over the age of 21 and under the age of 65 for the treatment of a mental health disorder in institutions for mental diseases (as defined in section 1905(i) of such Act ( 42 U.S.C. 1396d(i) )). Such study shall include information on the following: (1) The extent to which States, including the District of Columbia and each territory or possession of the United States, are providing capitated payments to such organizations or plans for enrollees who are receiving services in institutions for mental diseases. (2) The number of individuals receiving medical assistance under a State plan under such title XIX, or a waiver of such plan, who receive services in institutions for mental diseases through such organizations and plans. (3) The range of and average number of months, and the length of stay during such months, that such individuals are receiving such services in such institutions. (4) How such organizations or plans determine when to provide for the furnishing of such services through an institution for mental diseases in lieu of other benefits (including the full range of community-based services) under their contract with the State agency administering the State plan under such title XIX, or a waiver of such plan, to address psychiatric or substance use disorder treatment. (5) The extent to which the provision of services within such institutions has affected the capitated payments for such organizations or plans. (b) Report Not later than 3 years after the date of the enactment of this Act, the Secretary shall submit to Congress a report on the study conducted under subsection (a). 204. Guidance on opportunities for innovation Not later than 1 year after the date of the enactment of this Act, the Administrator of the Centers for Medicare & Medicaid Services shall issue a State Medicaid Director letter regarding opportunities to design innovative service delivery systems, including systems for providing community-based services, for individuals with serious mental illness or serious emotional disturbance who are receiving medical assistance under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ). The letter shall include opportunities for demonstration projects under section 1115 of such Act ( 42 U.S.C. 1315 ), to improve care for such individuals. 205. Study and report on Medicaid emergency psychiatric demonstration project (a) Collection of information The Secretary of Health and Human Services, acting through the Administrator of the Centers for Medicare & Medicaid Services, shall, with respect to each State that has participated in the demonstration project established under section 2707 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 1396a note), collect from each such State information on the following: (1) The number of institutions for mental diseases (as defined in section 1905(i) of the Social Security Act ( 42 U.S.C. 1396d(i) )) and beds in such institutions that received payment for the provision of services to individuals who receive medical assistance under a State plan under the Medicaid program under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ) (or under a waiver of such plan) through the demonstration project in each such State as compared to the total number of institutions for mental diseases and beds in the State. (2) The extent to which there is a reduction in expenditures under the Medicaid program under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ) or other spending on the full continuum of physical or mental health care for individuals who receive treatment in an institution for mental diseases under the demonstration project, including outpatient, inpatient, emergency, and ambulatory care, that is attributable to such individuals receiving treatment in institutions for mental diseases under the demonstration project. (3) The number of forensic psychiatric hospitals, the number of beds in such hospitals, and the number of forensic psychiatric beds in other hospitals in such State, based on the most recent data available, to the extent practical, as determined by such Administrator. (4) The amount of any disproportionate share hospital payments under section 1923 of the Social Security Act ( 42 U.S.C. 1396r–4 ) that institutions for mental diseases in the State received during the period beginning on July 1, 2012, and ending on June 30, 2015, and the extent to which the demonstration project reduced the amount of such payments. (5) The most recent data regarding all facilities or sites in the State in which any individuals with serious mental illness who are receiving medical assistance under a State plan under the Medicaid program under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ) (or under a waiver of such plan) are treated during the period referred to in paragraph (4), to the extent practical, as determined by the Administrator, including— (A) the types of such facilities or sites (such as an institution for mental diseases, a hospital emergency department, or other inpatient hospital); (B) the average length of stay in such a facility or site by such an individual, disaggregated by facility type; and (C) the payment rate under the State plan (or a waivers of such plan) for services furnished to such an individual for that treatment, disaggregated by facility type, during the period in which the demonstration project is in operation. (6) The extent to which the utilization of hospital emergency departments during the period in which the demonstration project was is in operation differed, with respect to individuals who are receiving medical assistance under a State plan under the Medicaid program under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ) (or under a waiver of such plan), between— (A) those individuals who received treatment in an institution for mental diseases under the demonstration project; (B) those individuals who met the eligibility requirements for the demonstration project but who did not receive treatment in an institution for mental diseases under the demonstration project; and (C) those individuals with serious mental illness who did not meet such eligibility requirements and did not receive treatment for such illness in an institution for mental diseases. (b) Report Not later than 2 years after the date of the enactment of this Act, the Secretary of Health and Human Services shall submit to Congress a report that summarizes and analyzes the information collected under subsection (a). Such report may be submitted as part of the report required under section 2707(f) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 1396a note) or separately. 206. Providing EPSDT services to children in IMDs (a) In general Section 1905(a)(16) of the Social Security Act ( 42 U.S.C. 1396d(a)(16) ) is amended— (1) by striking effective January 1, 1973 and inserting (A) effective January 1, 1973 ; and (2) by inserting before the semicolon at the end the following: , and, (B) for individuals receiving services described in subparagraph (A), early and periodic screening, diagnostic, and treatment services (as defined in subsection (r)), whether or not such screening, diagnostic, and treatment services are furnished by the provider of the services described in such subparagraph . (b) Effective date The amendment made by subsection (a) shall apply with respect to items and services furnished in calendar quarters beginning on or after January 1, 2019. 207. Electronic visit verification system required for personal care services and home health care services under Medicaid (a) In general Section 1903 of the Social Security Act ( 42 U.S.C. 1396b ) is amended by inserting after subsection (k) the following new subsection: (l) (1) Subject to paragraphs (3) and (4), with respect to any amount expended for personal care services or home health care services requiring an in-home visit by a provider that are provided under a State plan under this title (or under a waiver of the plan) and furnished in a calendar quarter beginning on or after January 1, 2019 (or, in the case of home health care services, on or after January 1, 2023), unless a State requires the use of an electronic visit verification system for such services furnished in such quarter under the plan or such waiver, the Federal medical assistance percentage shall be reduced— (A) in the case of personal care services— (i) for calendar quarters in 2019 and 2020, by .25 percentage points; (ii) for calendar quarters in 2021, by .5 percentage points; (iii) for calendar quarters in 2022, by .75 percentage points; and (iv) for calendar quarters in 2023 and each year thereafter, by 1 percentage point; and (B) in the case of home health care services— (i) for calendar quarters in 2023 and 2024, by .25 percentage points; (ii) for calendar quarters in 2025, by .5 percentage points; (iii) for calendar quarters in 2026, by .75 percentage points; and (iv) for calendar quarters in 2027 and each year thereafter, by 1 percentage point. (2) Subject to paragraphs (3) and (4), in implementing the requirement for the use of an electronic visit verification system under paragraph (1), a State shall— (A) consult with agencies and entities that provide personal care services, home health care services, or both under the State plan (or under a waiver of the plan) to ensure that such system— (i) is minimally burdensome; (ii) takes into account existing best practices and electronic visit verification systems in use in the State; and (iii) is conducted in accordance with the requirements of HIPAA privacy and security law (as defined in section 3009 of the Public Health Service Act); (B) take into account a stakeholder process that includes input from beneficiaries, family caregivers, individuals who furnish personal care services or home health care services, and other stakeholders, as determined by the State in accordance with guidance from the Secretary; and (C) ensure that individuals who furnish personal care services, home health care services, or both under the State plan (or under a waiver of the plan) are provided the opportunity for training on the use of such system. (3) Paragraphs (1) and (2) shall not apply in the case of a State that, as of the date of the enactment of this subsection, requires the use of any system for the electronic verification of visits conducted as part of both personal care services and home health care services, so long as the State continues to require the use of such system with respect to the electronic verification of such visits. (4) (A) In the case of a State described in subparagraph (B), the reduction under paragraph (1) shall not apply— (i) in the case of personal care services, for calendar quarters in 2019; and (ii) in the case of home health care services, for calendar quarters in 2023. (B) For purposes of subparagraph (A), a State described in this subparagraph is a State that demonstrates to the Secretary that the State— (i) has made a good faith effort to comply with the requirements of paragraphs (1) and (2) (including by taking steps to adopt the technology used for an electronic visit verification system); or (ii) in implementing such a system, has encountered unavoidable system delays. (5) In this subsection: (A) The term electronic visit verification system means, with respect to personal care services or home health care services, a system under which visits conducted as part of such services are electronically verified with respect to— (i) the type of service performed; (ii) the individual receiving the service; (iii) the date of the service; (iv) the location of service delivery; (v) the individual providing the service; and (vi) the time the service begins and ends. (B) The term home health care services means services described in section 1905(a)(7) provided under a State plan under this title (or under a waiver of the plan). (C) The term personal care services means personal care services provided under a State plan under this title (or under a waiver of the plan), including services provided under section 1905(a)(24), 1915(c), 1915(i), 1915(j), or 1915(k) or under a wavier under section 1115. (6) (A) In the case in which a State requires personal care service and home health care service providers to utilize an electronic visit verification system operated by the State or a contractor on behalf of the State, the Secretary shall pay to the State, for each quarter, an amount equal to 90 per centum of so much of the sums expended during such quarter as are attributable to the design, development, or installation of such system, and 75 per centum of so much of the sums for the operation and maintenance of such system. (B) Subparagraph (A) shall not apply in the case in which a State requires personal care service and home health care service providers to utilize an electronic visit verification system that is not operated by the State or a contractor on behalf of the State. . (b) Collection and dissemination of best practices Not later than January 1, 2018, the Secretary of Health and Human Services shall, with respect to electronic visit verification systems (as defined in subsection (l)(5) of section 1903 of the Social Security Act ( 42 U.S.C. 1396b ), as inserted by subsection (a)), collect and disseminate best practices to State Medicaid Directors with respect to— (1) training individuals who furnish personal care services, home health care services, or both under the State plan under title XIX of such Act (or under a waiver of the plan) on such systems and the operation of such systems and the prevention of fraud with respect to the provision of personal care services or home health care services (as defined in such subsection (l)(5)); and (2) the provision of notice and educational materials to family caregivers and beneficiaries with respect to the use of such electronic visit verification systems and other means to prevent such fraud. (c) Rules of construction (1) No employer-employee relationship established Nothing in the amendment made by this section may be construed as establishing an employer-employee relationship between the agency or entity that provides for personal care services or home health care services and the individuals who, under a contract with such an agency or entity, furnish such services for purposes of part 552 of title 29, Code of Federal Regulations (or any successor regulations). (2) No particular or uniform electronic visit verification system required Nothing in the amendment made by this section shall be construed to require the use of a particular or uniform electronic visit verification system (as defined in subsection (l)(5) of section 1903 of the Social Security Act ( 42 U.S.C. 1396b ), as inserted by subsection (a)) by all agencies or entities that provide personal care services or home health care under a State plan under title XIX of the Social Security Act (or under a waiver of the plan) ( 42 U.S.C. 1396 et seq. ). (3) No limits on provision of care Nothing in the amendment made by this section may be construed to limit, with respect to personal care services or home health care services provided under a State plan under title XIX of the Social Security Act (or under a waiver of the plan) ( 42 U.S.C. 1396 et seq. ), provider selection, constrain beneficiaries’ selection of a caregiver, or impede the manner in which care is delivered. (4) No prohibition on State quality measures requirements Nothing in the amendment made by this section shall be construed as prohibiting a State, in implementing an electronic visit verification system (as defined in subsection (l)(5) of section 1903 of the Social Security Act ( 42 U.S.C. 1396b ), as inserted by subsection (a)), from establishing requirements related to quality measures for such system. III Interdepartmental Serious Mental Illness Coordinating Committee 301. Interdepartmental Serious Mental Illness Coordinating Committee (a) Establishment (1) In general Not later than 3 months after the date of enactment of this Act, the Secretary of Health and Human Services, or the designee of the Secretary, shall establish a committee to be known as the Interdepartmental Serious Mental Illness Coordinating Committee (in this section referred to as the Committee ). (2) Federal Advisory Committee Act Except as provided in this section, the provisions of the Federal Advisory Committee Act (5 U.S.C. App.) shall apply to the Committee. (b) Meetings The Committee shall meet not fewer than two times each year. (c) Responsibilities Not later than 1 year after the date of enactment of this Act, and 5 years after such date of enactment, the Committee shall submit to Congress a report including— (1) a summary of advances in serious mental illness and serious emotional disturbance research related to the prevention of, diagnosis of, intervention in, and treatment and recovery of, serious mental illnesses, serious emotional disturbances, and advances in access to services and support for individuals with a serious mental illness or serious emotional disturbance; (2) an evaluation of the effect on public health of Federal programs related to serious mental illness or serious emotional disturbance, including measurements of public health outcomes such as— (A) rates of suicide, suicide attempts, prevalence of serious mental illness, serious emotional disturbances, and substance use disorders, overdose, overdose deaths, emergency hospitalizations, emergency room boarding, preventable emergency room visits, involvement with the criminal justice system, crime, homelessness, and unemployment; (B) increased rates of employment and enrollment in educational and vocational programs; (C) quality of mental illness and substance use disorder treatment services; and (D) any other criteria as may be determined by the Secretary; (3) a plan to improve outcomes for individuals with serious mental illness or serious emotional disturbances, including reducing incarceration for such individuals, reducing homelessness, and increasing employment; and (4) specific recommendations for actions that agencies can take to better coordinate the administration of mental health services for people with serious mental illness or serious emotional disturbances. (d) Committee extension Upon the submission of the second report under subsection (c), the Secretary shall submit a recommendation to Congress on whether to extend the operation of the Committee. (e) Membership (1) Federal members The Committee shall be composed of the following Federal representatives, or their designees: (A) The Secretary of Health and Human Services, who shall serve as the Chair of the Committee. (B) The Director of the National Institutes of Health. (C) The Assistant Secretary for Health of the Department of Health and Human Services. (D) The Assistant Secretary for Mental Health and Substance Use. (E) The Attorney General of the United States. (F) The Secretary of Veterans Affairs. (G) The Secretary of Defense. (H) The Secretary of Housing and Urban Development. (I) The Secretary of Education. (J) The Secretary of Labor. (K) The Commissioner of Social Security. (L) The Administrator of the Centers for Medicare & Medicaid Services. (2) Non-Federal members The Committee shall also include not less than 14 non-Federal public members appointed by the Secretary of Health and Human Services, of which— (A) at least two members shall be individuals with lived experience with serious mental illness or serious emotional disturbance; (B) at least one member shall be a parent or legal guardian of an individual with a history of a serious mental illness or serious emotional disturbance; (C) at least one member shall be a representative of a leading research, advocacy, or service organization for individuals with serious mental illness or serious emotional disturbance; (D) at least two members shall be— (i) a licensed psychiatrist with experience treating serious mental illnesses or serious emotional disturbances; (ii) a licensed psychologist with experience treating serious mental illnesses or serious emotional disturbances; (iii) a licensed clinical social worker with experience treating serious mental illness or serious emotional disturbances; or (iv) a licensed psychiatric nurse, nurse practitioner, or physician assistant with experience treating serious mental illnesses or serious emotional disturbances; (E) at least one member shall be a licensed mental health professional with a specialty in treating children and adolescents with serious emotional disturbances; (F) at least one member shall be a mental health professional who has research or clinical mental health experience working with minorities; (G) at least one member shall be a mental health professional who has research or clinical mental health experience working with medically underserved populations; (H) at least one member shall be a State certified mental health peer-support specialist; (I) at least one member shall be a judge with experience adjudicating cases within a mental health court; (J) at least one member shall be a law enforcement officer or corrections officer with extensive experience in interfacing with individuals with a serious mental illness or serious emotional disturbance, or in a mental health crisis; and (K) at least one member shall be a homeless services provider with experience working with individuals with serious mental illness, with serious emotional disturbance, or having mental health crisis. (3) Terms A member of the Committee appointed under paragraph (2) shall serve for a term of 3 years, and may be reappointed for one or more additional 3-year terms. Any member appointed to fill a vacancy for an unexpired term shall be appointed for the remainder of such term. A member may serve after the expiration of the member’s term until a successor has been appointed. (f) Working groups In carrying out its functions, the Committee may establish working groups. Such working groups shall be composed of Committee members, or their designees, and may hold such meetings as are necessary. (g) Sunset The Committee shall terminate on the date that is 6 years after the date on which the Committee is established under subsection (a)(1). IV Compassionate Communication on HIPAA 401. Sense of Congress (a) Findings Congress finds the following: (1) The vast majority of individuals with mental illness are capable of understanding their illness and caring for themselves. (2) Persons with serious mental illness (in this section referred to as SMI ), including schizophrenia spectrum, bipolar disorders, and major depressive disorder, may be significantly impaired in their ability to understand or make sound decisions for their care and needs. By nature of their illness, cognitive impairments in reasoning and judgment, as well as the presence of hallucinations, delusions, and severe emotional distortions, they may lack the awareness they even have a mental illness (a condition known as anosognosia), and thus may be unable to make sound decisions regarding their care, nor follow through consistently and effectively on their care needs. (3) Persons with mental illness or SMI may require and benefit from mental health treatment in order to recover to the fullest extent of their ability; these beneficial interventions may include psychiatric care, psychological care, medication, peer support, educational support, employment support, and housing support. (4) Persons with SMI who are provided with professional and supportive services may still experience times when their symptoms may greatly impair their abilities to make sound decisions for their personal care or may discontinue their care as a result of this impaired decisionmaking resulting in a further deterioration of their condition. They may experience a temporary or prolonged impairment as a result of their diminished capacity to care for themselves. (5) Episodes of psychiatric crises among those with SMI can result in neurological harm to the individual’s brain. (6) Persons with SMI— (A) are at high risk for other chronic physical illnesses, with approximately 50 percent having two or more co-occurring chronic physical illnesses such as cardiac, pulmonary, cancer, and endocrine disorders; and (B) have three times the odds of having chronic bronchitis, five times the odds of having emphysema, and four times the odds of having COPD, are more than four times as likely to have fluid and electrolyte disorders, and are nearly three times as likely to be nicotine dependent. (7) Some psychotropic medications, such as second generation antipsychotics, significantly increase risk for chronic illnesses such as diabetes and cardiovascular disease. (8) When the individual fails to seek or maintain treatment for these physical conditions over a long term, it can result in the individual becoming gravely disabled, or developing life-threatening illnesses. Early and consistent treatment can ameliorate or reduce symptoms or cure the disease. (9) Persons with SMI die 7 to 24 years earlier than their age cohorts primarily because of complications from their chronic physical illness and failure to seek or maintain treatment resulting from emotional and cognitive impairments from their SMI. (10) It is beneficial to the person with SMI and chronic illness to seek and maintain continuity of medical care and treatment for their mental illness to prevent further deterioration and harm to their own safety. (11) When the individual with SMI is significantly diminished in their capacity to care for themselves long term or acutely, other supportive interventions to assist their care may be necessary to protect their health and safety. (12) Prognosis for the physical and psychiatric health of those with SMI may improve when responsible caregivers facilitate and participate in care. (13) When an individual with SMI is chronically incapacitated in their ability to care for themselves, caregivers can pursue legal guardianship to facilitate care in appropriate areas while being mindful to allow the individual to make decisions for themselves in areas where they are capable. (14) Individuals with SMI who have prolonged periods of being significantly functional can, during such periods, design and sign an advanced directive to predefine and choose medications, providers, treatment plans, and hospitals, and provide caregivers with guardianship the ability to help in those times when a patient’s psychiatric symptoms worsen to the point of making them incapacitated or leaving them with a severely diminished capacity to make informed decisions about their care which may result in harm to their physical and mental health. (15) All professional and support efforts should be made to help the individual with SMI and acute or chronic physical illnesses to understand and follow through on treatment. (16) When individuals with SMI, even after efforts to help them understand, have failed to care for themselves, there exists confusion in the health care community around what is currently permissible under HIPAA rules. This confusion may hinder communication with responsible caregivers who may be able to facilitate care for the patient with SMI in instances when the individual does not give permission for disclosure. (b) Sense of Congress It is the sense of the Congress that, for the sake of the health and safety of persons with serious mental illness, more clarity is needed surrounding the existing HIPAA privacy rule promulgated pursuant to section 264(c) of the Health Insurance Portability and Accountability Act ( 42 U.S.C. 1320d–2 note) to permit health care professionals to communicate, when necessary, with responsible known caregivers of such persons, the limited, appropriate protected health information of such persons in order to facilitate treatment, but not including psychotherapy notes. 402. Confidentiality of records Not later than 1 year after the date on which the Secretary of Health and Human Services first finalizes regulations updating part 2 of title 42, Code of Federal Regulations (relating to confidentiality of alcohol and drug abuse patient records) after the date of enactment of this Act, the Secretary shall convene relevant stakeholders to determine the effect of such regulations on patient care, health outcomes, and patient privacy. The Secretary shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate, and make publicly available, a report on the findings of such stakeholders. 403. Clarification of circumstances under which disclosure of protected health information is permitted (a) In general Not later than 1 year after the date of enactment of this section, the Secretary of Health and Human Services shall promulgate final regulations clarifying the circumstances under which, consistent with the provisions of subpart C of title XI of the Social Security Act ( 42 U.S.C. 1320d et seq. ) and regulations promulgated pursuant to section 264(c) of the Health Insurance Portability and Accountability Act of 1996 ( 42 U.S.C. 1320d–2 note), a health care provider or covered entity may disclose the protected health information of a patient with a mental illness, including for purposes of— (1) communicating (including with respect to treatment, side effects, risk factors, and the availability of community resources) with a family member of such patient, caregiver of such patient, or other individual to the extent that such family member, caregiver, or individual is involved in the care of the patient; (2) communicating with a family member of the patient, caregiver of such patient, or other individual involved in the care of the patient in the case that the patient is an adult; (3) communicating with the parent or caregiver of a patient in the case that the patient is a minor; (4) considering the patient’s capacity to agree or object to the sharing of the protected health information of the patient; (5) communicating and sharing information with the family or caregivers of the patient when— (A) the patient consents; (B) the patient does not consent, but the patient lacks the capacity to agree or object and the communication or sharing of information is in the patient’s best interest; (C) the patient does not consent and the patient is not incapacitated or in an emergency circumstance, but the ability of the patient to make rational health care decisions is significantly diminished by reason of the physical or mental health condition of the patient; and (D) the patient does not consent, but such communication and sharing of information is necessary to prevent impending and serious deterioration of the patient’s mental or physical health; (6) involving a patient’s family members, caregivers, or others involved in the patient’s care or care plan, including facilitating treatment and medication adherence, in dealing with patient failures to adhere to medication or other therapy; (7) listening to or receiving information with respect to the patient from the family or caregiver of such patient receiving mental illness treatment; (8) communicating with family members of the patient, caregivers of the patient, law enforcement, or others when the patient presents a serious and imminent threat of harm to self or others; and (9) communicating to law enforcement and family members of the patient or caregivers of the patient about the admission of the patient to receive care at a facility or the release of a patient who was admitted to a facility for an emergency psychiatric hold or involuntary treatment. (b) Coordination The Secretary of Health and Human Services shall carry out this section in coordination with the Director of the Office for Civil Rights within the Department of Health and Human Services. (c) Consistency with guidance The Secretary of Health and Human Services shall ensure that the regulations under this section are consistent with the guidance entitled HIPAA Privacy Rule and Sharing Information Related to Mental Health , issued by the Department of Health and Human Services on February 20, 2014. 404. Development and dissemination of model training programs (a) Initial programs and materials Not later than 1 year after the date of the enactment of this Act, the Secretary of Health and Human Services (in this section referred to as the Secretary ) shall develop and disseminate— (1) a model program and materials for training health care providers (including physicians, emergency medical personnel, psychologists, counselors, therapists, behavioral health facilities and clinics, care managers, and hospitals) regarding the circumstances under which, consistent with the standards governing the privacy and security of individually identifiable health information promulgated by the Secretary under subpart C of title XI of the Social Security Act ( 42 U.S.C. 1320d et seq. ) and regulations promulgated pursuant to section 264(c) of the Health Insurance Portability and Accountability Act of 1996 ( 42 U.S.C. 1320d–2 note), the protected health information of patients with a mental illness may be disclosed with and without patient consent; (2) a model program and materials for training lawyers and others in the legal profession on such circumstances; and (3) a model program and materials for training patients and their families regarding their rights to protect and obtain information under the standards specified in paragraph (1). (b) Periodic updates The Secretary shall— (1) periodically review and update the model programs and materials developed under subsection (a); and (2) disseminate the updated model programs and materials. (c) Contents The programs and materials developed under subsection (a) shall address the guidance entitled HIPAA Privacy Rule and Sharing Information Related to Mental Health , issued by the Department of Health and Human Services on February 20, 2014. (d) Coordination The Secretary shall carry out this section in coordination with the Director of the Office for Civil Rights within the Department of Health and Human Services, the Assistant Secretary for Mental Health and Substance Use, the Administrator of the Health Resources and Services Administration, and the heads of other relevant agencies within the Department of Health and Human Services. (e) Input of certain entities In developing the model programs and materials required by subsections (a) and (b), the Secretary shall solicit the input of relevant national, State, and local associations, medical societies, and licensing boards. (f) Funding There are authorized to be appropriated to carry out this section $4,000,000 for fiscal year 2018, $2,000,000 for each of fiscal years 2019 and 2020, and $1,000,000 for each of fiscal years 2021 and 2022. V Increasing Access to Treatment for Serious Mental Illness 501. Assertive community treatment grant program for individuals with serious mental illness Part B of title V of the Public Health Service Act ( 42 U.S.C. 290bb et seq. ) is amended by inserting after section 520L the following: 520M. Assertive community treatment grant program for individuals with serious mental illness (a) In general The Assistant Secretary shall award grants to eligible entities— (1) to establish assertive community treatment programs for individuals with serious mental illness; or (2) to maintain or expand such programs. (b) Eligible entities To be eligible to receive a grant under this section, an entity shall be a State, county, city, tribe, tribal organization, mental health system, health care facility, or any other entity the Assistant Secretary deems appropriate. (c) Special Consideration In selecting among applicants for a grant under this section, the Assistant Secretary may give special consideration to the potential of the applicant’s program to reduce hospitalization, homelessness, and involvement with the criminal justice system while improving the health and social outcomes of the patient. (d) Additional Activities The Assistant Secretary shall— (1) not later than the end of fiscal year 2021, submit a report to the appropriate congressional committees on the grant program under this section, including an evaluation of— (A) cost savings and public health outcomes such as mortality, suicide, substance abuse, hospitalization, and use of services; (B) rates of involvement with the criminal justice system of patients; (C) rates of homelessness among patients; and (D) patient and family satisfaction with program participation; and (2) provide appropriate information, training, and technical assistance to grant recipients under this section to help such recipients to establish, maintain, or expand their assertive community treatment programs. (e) Authorization of appropriations (1) In general To carry out this section, there is authorized to be appropriated $5,000,000 for the period of fiscal years 2018 through 2022. (2) Use of Certain Funds Of the funds appropriated to carry out this section in any fiscal year, no more than 5 percent shall be available to the Assistant Secretary for carrying out subsection (d). . 502. 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— (1) to State and local governments and Indian tribes and tribal organizations to enhance community-based crisis response systems; or (2) to States to develop, maintain, or enhance a database of beds at inpatient psychiatric facilities, crisis stabilization units, and residential community mental health and residential substance use disorder treatment facilities, for individuals with serious mental illness, serious emotional disturbance, or substance use disorders. (b) Application (1) In general To receive a grant or cooperative agreement 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)(1) shall include a plan for— (A) promoting integration and coordination between local public and private entities engaged in crisis response, including first responders, emergency health care providers, primary care providers, law enforcement, court systems, health care payers, social service providers, and behavioral health providers; (B) developing a plan for entering into memoranda of understanding with public and private entities to implement crisis response services; (C) expanding the continuum of community-based services to address crisis intervention and prevention; and (D) developing models for minimizing hospital readmissions, including through appropriate discharge planning. (3) Beds database plan An application for a grant under subsection (a)(2) shall include a plan for developing, maintaining, or enhancing a real-time Internet-based bed database to collect, aggregate, and display information about beds in 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 facilities for the temporary treatment of individuals in mental or substance use disorder crisis. (c) Database requirements A bed database described in this section is a database that— (1) includes information on inpatient psychiatric facilities, crisis stabilization units, and residential community mental health and residential substance use disorder facilities in the State involved, including contact information for the facility or unit; (2) provides real-time information about the number of beds available at each facility or unit and, for each available bed, the type of patient that may be admitted, the level of security provided, and any other information that may be necessary to allow for the proper identification of appropriate facilities for treatment of individuals in mental or substance use disorder crisis; and (3) enables searches of the database to identify available beds that are appropriate for the treatment of individuals in mental or substance use disorder crisis. (d) Evaluation An entity receiving a grant under subsection (a)(1) 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 of individuals receiving crisis planning and early intervention supports; (2) individuals reporting improved functional outcomes; and (3) individuals receiving regular followup care following a crisis. (e) Authorization of appropriations There is authorized to be appropriated to carry out this section, $5,000,000 for the period of fiscal years 2018 through 2022. . 503. Increased and extended funding for assisted outpatient grant program for individuals with serious mental illness Section 224(g) of the Protecting Access to Medicare Act of 2014 ( 42 U.S.C. 290aa note) is amended— (1) in paragraph (1), by striking 2018 and inserting 2022 ; and (2) in paragraph (2), by striking is authorized to be appropriated to carry out this section $15,000,000 for each of fiscal years 2015 through 2018 and inserting are authorized to be appropriated to carry out this section $15,000,000 for each of fiscal years 2015 through 2017, $20,000,000 for fiscal year 2018, $19,000,000 for each of fiscal years 2019 and 2020, and $18,000,000 for each of fiscal years 2021 and 2022 . 504. Liability protections for health professional volunteers at community health centers Section 224 of the Public Health Service Act ( 42 U.S.C. 233 ) is amended by adding at the end the following: (q) (1) For purposes of this section, a health professional volunteer at an entity described in subsection (g)(4) shall, in providing a health professional service eligible for funding under section 330 to an individual, be deemed to be an employee of the Public Health Service for a calendar year that begins during a fiscal year for which a transfer was made under paragraph (4)(C). The preceding sentence is subject to the provisions of this subsection. (2) In providing a health service to an individual, a health care practitioner shall for purposes of this subsection be considered to be a health professional volunteer at an entity described in subsection (g)(4) if the following conditions are met: (A) The service is provided to the individual at the facilities of an entity described in subsection (g)(4), or through offsite programs or events carried out by the entity. (B) The entity is sponsoring the health care practitioner pursuant to paragraph (3)(B). (C) The health care practitioner does not receive any compensation for the service from the individual or from any third-party payer (including reimbursement under any insurance policy or health plan, or under any Federal or State health benefits program), except that the health care practitioner may receive repayment from the entity described in subsection (g)(4) for reasonable expenses incurred by the health care practitioner in the provision of the service to the individual. (D) Before the service is provided, the health care practitioner or the entity described in subsection (g)(4) posts a clear and conspicuous notice at the site where the service is provided of the extent to which the legal liability of the health care practitioner is limited pursuant to this subsection. (E) At the time the service is provided, the health care practitioner is licensed or certified in accordance with applicable law regarding the provision of the service. (3) Subsection (g) (other than paragraphs (3) and (5)) and subsections (h), (i), and (l) apply to a health care practitioner for purposes of this subsection to the same extent and in the same manner as such subsections apply to an officer, governing board member, employee, or contractor of an entity described in subsection (g)(4), subject to paragraph (4) and subject to the following: (A) The first sentence of paragraph (1) applies in lieu of the first sentence of subsection (g)(1)(A). (B) With respect to an entity described in subsection (g)(4), a health care practitioner is not a health professional volunteer at such entity unless the entity sponsors the health care practitioner. For purposes of this subsection, the entity shall be considered to be sponsoring the health care practitioner if— (i) with respect to the health care practitioner, the entity submits to the Secretary an application meeting the requirements of subsection (g)(1)(D); and (ii) the Secretary, pursuant to subsection (g)(1)(E), determines that the health care practitioner is deemed to be an employee of the Public Health Service. (C) In the case of a health care practitioner who is determined by the Secretary pursuant to subsection (g)(1)(E) to be a health professional volunteer at such entity, this subsection applies to the health care practitioner (with respect to services performed on behalf of the entity sponsoring the health care practitioner pursuant to subparagraph (B)) for any cause of action arising from an act or omission of the health care practitioner occurring on or after the date on which the Secretary makes such determination. (D) Subsection (g)(1)(F) applies to a health care practitioner for purposes of this subsection only to the extent that, in providing health services to an individual, each of the conditions specified in paragraph (2) is met. (4) (A) Amounts in the fund established under subsection (k)(2) shall be available for transfer under subparagraph (C) for purposes of carrying out this subsection. (B) Not later May 1 of each fiscal year, the Attorney General, in consultation with the Secretary, shall submit to the Congress a report providing an estimate of the amount of claims (together with related fees and expenses of witnesses) that, by reason of the acts or omissions of health professional volunteers, will be paid pursuant to this section during the calendar year that begins in the following fiscal year. Subsection (k)(1)(B) applies to the estimate under the preceding sentence regarding health professional volunteers to the same extent and in the same manner as such subsection applies to the estimate under such subsection regarding officers, governing board members, employees, and contractors of entities described in subsection (g)(4). (C) Not later than December 31 of each fiscal year, the Secretary shall transfer from the fund under subsection (k)(2) to the appropriate accounts in the Treasury an amount equal to the estimate made under subparagraph (B) for the calendar year beginning in such fiscal year, subject to the extent of amounts in the fund. (5) (A) This subsection takes effect on October 1, 2017, except as provided in subparagraph (B). (B) Effective on the date of the enactment of this subsection— (i) the Secretary may issue regulations for carrying out this subsection, and the Secretary may accept and consider applications submitted pursuant to paragraph (3)(B); and (ii) reports under paragraph (4)(B) may be submitted to the Congress. . VI Supporting Innovative and Evidence-Based Programs A Encouraging the Advancement, Incorporation, and Development of Evidence-Based Practices 601. Encouraging innovation and evidence-based programs Section 501B of the Public Health Service Act, as inserted by section 103, is further amended, by inserting after subsection (c) the following new subsection: (d) Promoting innovation (1) In general The Assistant Secretary, in coordination with the Laboratory, may award grants to States, local governments, Indian tribes or tribal organizations (as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act), educational institutions, and nonprofit organizations to develop evidence-based interventions, including culturally and linguistically appropriate services, as appropriate, for— (A) evaluating a model that has been scientifically demonstrated to show promise, but would benefit from further applied development, for— (i) enhancing the prevention, diagnosis, intervention, treatment, and recovery of mental illness, serious emotional disturbance, substance use disorders, and co-occurring illness or disorders; or (ii) integrating or coordinating physical health services and mental illness and substance use disorder services; and (B) expanding, replicating, or scaling evidence-based programs across a wider area to enhance effective screening, early diagnosis, intervention, and treatment with respect to mental illness, serious mental illness, and serious emotional disturbance, primarily by— (i) applying delivery of care, including training staff in effective evidence-based treatment; or (ii) integrating models of care across specialties and jurisdictions. (2) Consultation In awarding grants under this paragraph, the Assistant Secretary shall, as appropriate, consult with the advisory councils described in section 502, the National Institute of Mental Health, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism, as appropriate. (3) Authorization of appropriations There are authorized to be appropriated— (A) to carry out paragraph (1)(A), $7,000,000 for the period of fiscal years 2018 through 2020; and (B) to carry out paragraph (1)(B), $7,000,000 for the period of fiscal years 2018 through 2020. . 602. Promoting access to information on evidence-based programs and practices Part D of title V of the Public Health Service Act is amended by inserting after section 543 of such Act (42 U.S.C. 290dd–2 ) the following: 544. Promoting access to information on evidence-based programs and practices (a) In general The Assistant Secretary shall improve access to reliable and valid information on evidence-based programs and practices, including information on the strength of evidence associated with such programs and practices, related to mental illness and substance use disorders for States, local communities, nonprofit entities, and other stakeholders by posting on the website of the National Registry of Evidence-Based Programs and Practices evidence-based programs and practices that have been reviewed by the Assistant Secretary pursuant to the requirements of this section. (b) Notice (1) Periods In carrying out subsection (a), the Assistant Secretary may establish an initial period for the submission of applications for evidence-based programs and practices to be posted publicly in accordance with subsection (a) (and may establish subsequent such periods). The Assistant Secretary shall publish notice of such application periods in the Federal Register. (2) Addressing gaps Such notice may solicit applications for evidence-based practices and programs to address gaps in information identified by the Assistant Secretary, the Assistant Secretary for Planning and Evaluation, the Assistant Secretary for Financial Resources, or the National Mental Health and Substance Use Policy Laboratory, including pursuant to priorities identified in the strategic plan established under section 501(l). (c) Requirements The Assistant Secretary shall establish minimum requirements for applications referred to in this section, including applications related to the submission of research and evaluation. (d) Review and rating The Assistant Secretary shall review applications prior to public posting, and may prioritize the review of applications for evidence-based practices and programs that are related to topics included in the notice established under subsection (b). The Assistant Secretary shall utilize a rating and review system, which shall include information on the strength of evidence associated with such programs and practices and a rating of the methodological rigor of the research supporting the application. The Assistant Secretary shall make the metrics used to evaluate applications and the resulting ratings publicly available. . 603. Sense of Congress It is the sense of the Congress that the National Institute of Mental Health should conduct or support research on the determinants of self-directed and other violence connected to mental illness. B Supporting the State Response to Mental Health Needs 611. Community Mental Health Services Block Grant (a) Formula grants Section 1911(b) of the Public Health Service Act ( 42 U.S.C. 300x(b) ) is amended— (1) by redesignating paragraphs (1) through (3) as paragraphs (2) through (4), respectively; and (2) by inserting before paragraph (2) (as so redesignated), the following: (1) providing community mental health services for adults with a serious mental illness and children with a serious emotional disturbance as defined in accordance with section 1912(c); . (b) State plan Subsection (b) of section 1912 of the Public Health Service Act ( 42 U.S.C. 300x–1 ) is amended to read as follows: (b) Criteria for Plan The criteria specified in this subsection are as follows: (1) System of care The plan provides a description of the system of care of the State, including as follows: (A) Comprehensive community-based health systems The plan shall— (i) identify the single State agency to be responsible for the administration of the program under the grant and any third party with whom the agency will contract (subject to such third party complying with the requirements of this part) for administering mental health services through such program; (ii) provide for an organized community-based system of care for individuals with mental illness, and describe available services and resources in a comprehensive system of care, including services for individuals with mental health and behavioral health co-occurring illness or disorders; (iii) include a description of the manner in which the State and local entities will coordinate services to maximize the efficiency, effectiveness, quality, and cost effectiveness of services and programs to produce the best possible outcomes (including health services, rehabilitation services, employment services, housing services, educational services, substance use disorder services, legal services, law enforcement services, social services, child welfare services, medical and dental care services, and other support services to be provided with Federal, State, and local public and private resources) with other agencies to enable individuals receiving services to function outside of inpatient or residential institutions, to the maximum extent of their capabilities, including services to be provided by local school systems under the Individuals with Disabilities Education Act; (iv) include a description of how the State— (I) promotes evidence-based practices, including those evidence-based programs that address the needs of individuals with early serious mental illness regardless of the age of the individual at onset; (II) provides comprehensive individualized treatment; or (III) integrates mental and physical health services; (v) include a description of case management services in the State; (vi) include a description of activities that seek to engage individuals with serious mental illness or serious emotional disturbance and their caregivers where appropriate in making health care decisions, including activities that enhance communication between individuals, families, caregivers, and treatment providers; and (vii) as appropriate to and reflective of the uses the State proposes for the block grant monies— (I) a description of the activities intended to reduce hospitalizations and hospital stays using the block grant monies; (II) a description of the activities intended to reduce incidents of suicide using the block grant monies; and (III) a description of how the State integrates mental health and primary care using the block grant monies. (B) Mental health system data and epidemiology The plan shall contain an estimate of the incidence and prevalence in the State of serious mental illness among adults and serious emotional disturbance among children and presents quantitative targets and outcome measures for programs and services provided under this subpart. (C) Children’s services In the case of children with serious emotional disturbance (as defined in accordance with subsection (c)), the plan shall provide for a system of integrated social services, educational services, child welfare services, juvenile justice services, law enforcement services, and substance use disorder services that, together with health and mental health services, will be provided in order for such children to receive care appropriate for their multiple needs (such system to include services provided under the Individuals with Disabilities Education Act). (D) Targeted services to rural and homeless populations The plan shall describe the State’s outreach to and services for individuals who are homeless and how community-based services will be provided to individuals residing in rural areas. (E) Management services The plan shall— (i) describe the financial resources available, the existing mental health workforce, and the workforce trained in treating individuals with co-occurring mental illness and substance use disorders; (ii) provide for the training of providers of emergency health services regarding mental health; (iii) describe the manner in which the State intends to expend the grant under section 1911 for the fiscal year involved; and (iv) describe the manner in which the State intends to comply with each of the funding agreements in this subpart and subpart III. (2) Goals and objectives The plan establishes goals and objectives for the period of the plan, including targets and milestones that are intended to be met, and the activities that will be undertaken to achieve those goals and objectives. . (c) Best practices in clinical care models Section 1920 of the Public Health Service Act ( 42 U.S.C. 300x–9 ) is amended by adding at the end the following: (c) Best practices in clinical care models A State shall expend not less than 10 percent of the amount the State receives for carrying out this subpart in each fiscal year to support evidence-based programs that address the needs of individuals with early serious mental illness, including psychotic disorders, regardless of the age of the individual at the onset of such illness. . (d) Additional provisions Section 1915(b) of the Public Health Service Act ( 42 U.S.C. 300x–4(b) ) is amended— (1) by amending paragraph (1) to read as follows: (1) In general A funding agreement for a grant under section 1911 is that the State involved will maintain State expenditures for community mental health services at a level that is not less than the average of the amounts prescribed by this paragraph (prior to any waiver under paragraph (3)) for such expenditures by such State for each of the 2 fiscal years immediately preceding the fiscal year for which the State is applying for the grant. ; (2) in paragraph (2)— (A) by striking under subsection (a) and inserting specified in paragraph (1) ; and (B) by striking principle and inserting principal ; (3) by amending paragraph (3) to read as follows: (3) Waiver (A) In general The Secretary may, upon the request of a State, waive the requirement established in paragraph (1) in whole or in part, if the Secretary determines that extraordinary economic conditions in the State in the fiscal year involved or in the previous fiscal year justify the waiver. (B) Date certain for action upon request The Secretary shall approve or deny a request for a waiver under this paragraph not later than 120 days after the date on which the request is made. (C) Applicability of waiver A waiver provided by the Secretary under this paragraph shall be applicable only to the fiscal year involved. ; and (4) in paragraph (4)— (A) by amending subparagraph (A) to read as follows: (A) In general (i) Determination and reduction The Secretary shall determine, in the case of each State, and for each fiscal year, whether the State maintained material compliance with the agreement made under paragraph (1). If the Secretary determines that a State has failed to maintain such compliance for a fiscal year, the Secretary shall reduce the amount of the allotment under section 1911 for the State, for the first fiscal year beginning after such determination is final, by an amount equal to the amount constituting such failure for the previous fiscal year about which the determination was made. (ii) Alternative sanction The Secretary may by regulation provide for an alternative method of imposing a sanction for a failure by a State to maintain material compliance with the agreement under paragraph (1) if the Secretary determines that such alternative method would be more equitable and would be a more effective incentive for States to maintain such material compliance. ; and (B) in subparagraph (B)— (i) by inserting after the subparagraph designation the following: Submission of information to the secretary.— ; and (ii) by striking subparagraph (A) and inserting subparagraph (A)(i) . (e) Application for grant Section 1917(a) of the Public Health Service Act ( 42 U.S.C. 300x–6(a) ) is amended— (1) in paragraph (1), by striking 1941 and inserting 1942(a) ; and (2) in paragraph (5), by striking 1915(b)(3)(B) and inserting 1915(b) . C Strengthening Mental Health Care for Children and Adolescents 621. Tele-mental health care access grants Title III of the Public Health Service Act is amended by inserting after section 330L of such Act ( 42 U.S.C. 254c–18 ) the following new section: 330M. Tele-mental health care access grants (a) In General The Secretary, acting through the Administrator of the Health Resources and Services Administration and in coordination with other relevant Federal agencies, shall award grants to States, political subdivisions of States, Indian tribes, and tribal organizations (for purposes of this section, as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act ( 25 U.S.C. 450b )) to promote behavioral health integration in pediatric primary care by— (1) supporting the development of statewide child mental health care access programs; and (2) supporting the improvement of existing statewide child mental health care access programs. (b) Program Requirements (1) In general A child mental health care access program referred to in subsection (a), with respect to which a grant under such subsection may be used, shall— (A) be a statewide network of pediatric mental health teams that provide support to pediatric primary care sites as an integrated team; (B) support and further develop organized State networks of child and adolescent psychiatrists and psychologists to provide consultative support to pediatric primary care sites; (C) conduct an assessment of critical behavioral consultation needs among pediatric providers and such providers’ preferred mechanisms for receiving consultation and training and technical assistance; (D) develop an online database and communication mechanisms, including telehealth, to facilitate consultation support to pediatric practices; (E) provide rapid statewide clinical telephone or telehealth consultations when requested between the pediatric mental health teams and pediatric primary care providers; (F) conduct training and provide technical assistance to pediatric primary care providers to support the early identification, diagnosis, treatment, and referral of children with behavioral health conditions or co-occurring intellectual and other developmental disabilities; (G) provide information to pediatric providers about, and assist pediatric providers in accessing, child psychiatry and psychology consultations and in scheduling and conducting technical assistance; (H) assist with referrals to specialty care and community or behavioral health resources; and (I) establish mechanisms for measuring and monitoring increased access to child and adolescent psychiatric and psychology services by pediatric primary care providers and expanded capacity of pediatric primary care providers to identify, treat, and refer children with mental health problems. (2) Pediatric mental health teams In this subsection, the term pediatric mental health team means a team of case coordinators, child and adolescent psychiatrists, and licensed clinical mental health professionals, such as a psychologist, social worker, or mental health counselor. (c) Application A State, political subdivision of a State, Indian tribe, or tribal organization seeking a grant under this section shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require, including a plan for the rigorous evaluation of activities that are carried out with funds received under such grant. (d) Evaluation A State, political subdivision of a State, Indian tribe, or tribal organization that receives a grant under this section shall prepare and submit an evaluation of activities carried out with funds received under such grant to the Secretary at such time, in such manner, and containing such information as the Secretary may reasonably require, including a process and outcome evaluation. (e) Matching Requirement The Secretary may not award a grant under this section unless the State, political subdivision of a State, Indian tribe, or tribal organization involved agrees, with respect to the costs to be incurred by the State, political subdivision of a State, Indian tribe, or tribal organization in carrying out the purpose described in this section, to make available non-Federal contributions (in cash or in kind) toward such costs in an amount that is not less than 20 percent of Federal funds provided in the grant. (f) Authorization of appropriations To carry this section, there are authorized to be appropriated $9,000,000 for the period of fiscal years 2018 through 2020. . 622. Infant and early childhood mental health promotion, intervention, and treatment Part Q of title III of the Public Health Service Act ( 42 U.S.C. 290h et seq. ) is amended by adding at the end the following: 399Z–2. Infant and early childhood mental health promotion, intervention, and treatment (a) Grants The Secretary shall— (1) award grants to eligible entities, including human services agencies, to develop, maintain, or enhance infant and early childhood mental health promotion, intervention, and treatment programs, including— (A) programs for infants and children at significant risk of developing, showing early signs of, or having been diagnosed with mental illness including serious emotional disturbance; and (B) multigenerational therapy and other services that support the caregiving relationship; and (2) ensure that programs funded through grants under this section are evidence-informed or evidence-based models, practices, and methods that are, as appropriate, culturally and linguistically appropriate, and can be replicated in other appropriate settings. (b) Eligible children and entities In this section: (1) Eligible child The term eligible child means a child from birth to not more than 5 years of age who— (A) is at risk for, shows early signs of, or has been diagnosed with a mental illness, including serious emotional disturbance; and (B) may benefit from infant and early childhood intervention or treatment programs or specialized preschool or elementary school programs that are evidence-based or that have been scientifically demonstrated to show promise but would benefit from further applied development. (2) Eligible entity The term eligible entity means a nonprofit institution that— (A) is accredited or approved by a State mental health or education agency, as applicable, to provide for children from infancy to 5 years of age mental health promotion, intervention, or treatment services that are evidence-based or that have been scientifically demonstrated to show promise but would benefit from further applied development; and (B) provides programs described in subsection (a) that are evidence-based or that have been scientifically demonstrated to show promise but would benefit from further applied development. (c) Application An eligible entity seeking a grant under subsection (a) shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require. (d) Use of funds for early intervention and treatment programs An eligible entity may use amounts awarded under a grant under subsection (a)(1) to carry out the following: (1) Provide age-appropriate mental health promotion and early intervention services or mental illness treatment services, which may include specialized programs, for eligible children at significant risk of developing, showing early signs of, or having been diagnosed with a mental illness, including serious emotional disturbance. Such services may include social and behavioral services as well as multigenerational therapy and other services ‎that support the caregiving relationship. (2) Provide training for health care professionals with expertise in infant and early childhood mental health care with respect to appropriate and relevant integration with other disciplines such as primary care clinicians, early intervention specialists, child welfare staff, home visitors, early care and education providers, and others who work with young children and families. (3) Provide mental health consultation to personnel of early care and education programs (including licensed or regulated center-based and home-based child care, home visiting, preschool special education, and early intervention programs) who work with children and families. (4) Provide training for mental health clinicians in infant and early childhood in promising and evidence-based practices and models for infant and early childhood mental health treatment and early intervention, including with regard to practices for identifying and treating mental illness and behavioral disorders of infants and children resulting from exposure or repeated exposure to adverse childhood experiences or childhood trauma. (5) Provide age-appropriate assessment, diagnostic, and intervention services for eligible children, including early mental health promotion, intervention, and treatment services. (e) Matching funds The Secretary may not award a grant under this section to an eligible entity unless the eligible entity agrees, with respect to the costs to be incurred by the eligible entity in carrying out the activities described in subsection (d), to make available non-Federal contributions (in cash or in kind) toward such costs in an amount that is not less than 10 percent of the total amount of Federal funds provided in the grant. (f) Authorization of appropriations To carry this section, there are authorized to be appropriated $20,000,000 for the period of fiscal years 2018 through 2022. . 623. National Child Traumatic Stress Initiative Section 582 of the Public Health Service Act ( 42 U.S.C. 290hh–1 ; relating to grants to address the problems of persons who experience violence related stress) is amended— (1) in subsection (a), by striking developing programs and all that follows and inserting the following: developing and maintaining programs that provide for— (1) the continued operation of the National Child Traumatic Stress Initiative (referred to in this section as the NCTSI ), which includes a coordinating center that focuses on the mental, behavioral, and biological aspects of psychological trauma response; and (2) the development of knowledge with regard to evidence-based practices for identifying and treating mental illness, behavioral disorders, and physical health conditions of children and youth resulting from witnessing or experiencing a traumatic event. ; (2) in subsection (b)— (A) by striking subsection (a) related and inserting subsection (a)(2) (related ; (B) by striking treating disorders associated with psychological trauma and inserting treating mental illness and behavioral and biological disorders associated with psychological trauma) ; and (C) by striking mental health agencies and programs that have established clinical and basic research and inserting universities, hospitals, mental health agencies, and other programs that have established clinical expertise and research ; (3) by redesignating subsections (c) through (g) as subsections (g) through (k), respectively; (4) by inserting after subsection (b), the following: (c) Child outcome data The NCTSI coordinating center shall collect, analyze, report, and make publicly available NCTSI-wide child treatment process and outcome data regarding the early identification and delivery of evidence-based treatment and services for children and families served by the NCTSI grantees. (d) Training The NCTSI coordinating center shall facilitate the coordination of training initiatives in evidence-based and trauma-informed treatments, interventions, and practices offered to NCTSI grantees, providers, and partners. (e) Dissemination The NCTSI coordinating center shall, as appropriate, collaborate with the Secretary in the dissemination of evidence-based and trauma-informed interventions, treatments, products, and other resources to appropriate stakeholders. (f) Review The Secretary shall, consistent with the peer-review process, ensure that NCTSI applications are reviewed by appropriate experts in the field as part of a consensus review process. The Secretary shall include review criteria related to expertise and experience in child trauma and evidence-based practices. ; (5) in subsection (g) (as so redesignated), by striking with respect to centers of excellence are distributed equitably among the regions of the country and inserting are distributed equitably among the regions of the United States ; (6) in subsection (i) (as so redesignated), by striking recipient may not exceed 5 years and inserting recipient shall not be less than 4 years, but shall not exceed 5 years ; and (7) in subsection (j) (as so redesignated), by striking $50,000,000 and all that follows through 2006 and inserting $46,887,000 for each of fiscal years 2017 through 2021 . VII Grant programs and program reauthorization A Garrett Lee Smith Memorial Act reauthorization 701. Youth interagency research, training, and technical assistance centers Section 520C of the Public Health Service Act ( 42 U.S.C. 290bb–34 ) is amended— (1) by striking the section heading and inserting Suicide prevention technical assistance center. ; (2) in subsection (a), by striking and in consultation with and all that follows through the period at the end of paragraph (2) and inserting shall establish a research, training, and technical assistance resource center to provide appropriate information, training, and technical assistance to States, political subdivisions of States, federally recognized Indian tribes, tribal organizations, institutions of higher education, public organizations, or private nonprofit organizations regarding the prevention of suicide among all ages, particularly among groups that are at high risk for suicide. ; (3) by striking subsections (b) and (c); (4) by redesignating subsection (d) as subsection (b); (5) in subsection (b), as so redesignated— (A) by striking the subsection heading and inserting Responsibilities of the center.— ; (B) in the matter preceding paragraph (1), by striking The additional research and all that follows through nonprofit organizations for and inserting The center established under subsection (a) shall conduct activities for the purpose of ; (C) by striking youth suicide each place such term appears and inserting suicide ; (D) in paragraph (1)— (i) by striking the development or continuation of and inserting developing and continuing ; and (ii) by inserting for all ages, particularly among groups that are at high risk for suicide before the semicolon at the end; (E) in paragraph (2), by inserting for all ages, particularly among groups that are at high risk for suicide before the semicolon at the end; (F) in paragraph (3), by inserting and tribal after statewide ; (G) in paragraph (5), by inserting and prevention after intervention ; (H) in paragraph (8), by striking in youth ; (I) in paragraph (9), by striking and behavioral health and inserting health and substance use disorder ; and (J) in paragraph (10), by inserting conducting before other ; and (6) by striking subsection (e) and inserting the following: (c) Authorization of appropriations For the purpose of carrying out this section, there are authorized to be appropriated $5,988,000 for each of fiscal years 2017 through 2021. (d) Report Not later than 2 years after the date of enactment of the Helping Families in Mental Health Crisis Act of 2016 , the Secretary shall submit to Congress a report on the activities carried out by the center established under subsection (a) during the year involved, including the potential effects of such activities, and the States, organizations, and institutions that have worked with the center. . 702. Youth suicide early intervention and prevention strategies Section 520E of the Public Health Service Act ( 42 U.S.C. 290bb–36 ) is amended— (1) in paragraph (1) of subsection (a) and in subsection (c), by striking substance abuse each place such term appears and inserting substance use disorder ; (2) in subsection (b)(2)— (A) by striking each State is awarded only 1 grant or cooperative agreement under this section and inserting a State does not receive more than one grant or cooperative agreement under this section at any one time ; and (B) by striking been awarded and inserting received ; and (3) by striking subsection (m) and inserting the following: (m) Authorization of appropriations For the purpose of carrying out this section, there are authorized to be appropriated $35,427,000 for each of fiscal years 2017 through 2021. . 703. Mental health and substance use disorder services on campus Section 520E–2 of the Public Health Service Act ( 42 U.S.C. 290bb–36b ) is amended— (1) in the section heading, by striking and behavioral health and inserting health and substance use disorder ; (2) in subsection (a)— (A) by striking Services, and inserting Services and ; (B) by striking and behavioral health problems and inserting health or substance use disorders ; and (C) by striking substance abuse and inserting substance use disorders ; (3) in subsection (b)— (A) in the matter preceding paragraph (1), by striking for— and inserting for one or more of the following: ; and (B) by striking paragraphs (1) through (6) and inserting the following: (1) Educating students, families, faculty, and staff to increase awareness of mental health and substance use disorders. (2) The operation of hotlines. (3) Preparing informational material. (4) Providing outreach services to notify students about available mental health and substance use disorder services. (5) Administering voluntary mental health and substance use disorder screenings and assessments. (6) Supporting the training of students, faculty, and staff to respond effectively to students with mental health and substance use disorders. (7) Creating a network infrastructure to link colleges and universities with health care providers who treat mental health and substance use disorders. ; (4) in subsection (c)(5), by striking substance abuse and inserting substance use disorder ; (5) in subsection (d)— (A) in the matter preceding paragraph (1), by striking An institution of higher education desiring a grant under this section and inserting To be eligible to receive a grant under this section, an institution of higher education ; (B) in paragraph (1)— (i) by striking and behavioral health and inserting health and substance use disorder ; and (ii) by inserting , including veterans whenever possible and appropriate, after students ; and (C) in paragraph (2), by inserting , which may include, as appropriate and in accordance with subsection (b)(7), a plan to seek input from relevant stakeholders in the community, including appropriate public and private entities, in order to carry out the program under the grant before the period at the end; (6) in subsection (e)(1), by striking and behavioral health problems and inserting health and substance use disorders ; (7) in subsection (f)(2)— (A) by striking and behavioral health and inserting health and substance use disorder ; and (B) by striking suicide and substance abuse and inserting suicide and substance use disorders ; and (8) in subsection (h), by striking $5,000,000 for fiscal year 2005 and all that follows through the period at the end and inserting $6,488,000 for each of fiscal years 2017 through 2021. . B Other provisions 711. National Suicide Prevention Lifeline Program 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 inserting after section 520E–2 ( 42 U.S.C. 290bb–36b ) the following: 520E–3. National Suicide Prevention Lifeline Program (a) In general The Secretary, acting through the Assistant Secretary, shall maintain the National Suicide Prevention Lifeline Program (referred to in this section as the Program ), authorized under section 520A and in effect prior to the date of enactment of the Helping Families in Mental Health Crisis Act of 2016 . (b) Activities In maintaining the Program, the activities of the Secretary shall include— (1) coordinating a network of crisis centers across the United States for providing suicide prevention and crisis intervention services to individuals seeking help at any time, day or night; (2) maintaining a suicide prevention hotline to link callers to local emergency, mental health, and social services resources; and (3) consulting with the Secretary of Veterans Affairs to ensure that veterans calling the suicide prevention hotline have access to a specialized veterans’ suicide prevention hotline. (c) Authorization of appropriations To carry out this section, there are authorized to be appropriated $7,198,000 for each of fiscal years 2017 through 2021. . 712. Workforce development studies and reports (a) In general Not later than 2 years after the date of enactment of this Act, the Assistant Secretary for Mental Health and Substance Use, in consultation with the Administrator of the Health Resources and Services Administration, shall conduct a study, and publicly post on the appropriate Internet website of the Department of Health and Human Services a report, on the mental health and substance use disorder workforce in order to inform Federal, State, and local efforts related to workforce enhancement. (b) Contents The report under this section shall contain— (1) national and State-level projections of the supply and demand of mental health and substance use disorder health workers, including the number of individuals practicing in fields deemed relevant by the Secretary; (2) an assessment of the mental health and substance use disorder workforce capacity, strengths, and weaknesses as of the date of the report, including the capacity of primary care to prevent, screen, treat, or refer for mental health and substance use disorders; (3) information on trends within the mental health and substance use disorder provider workforce, including the number of individuals entering the mental health workforce over the next 5 years; (4) information on the gaps in workforce development for mental health providers and professionals, including those who serve pediatric, adult, and geriatric patients; and (5) any additional information determined by the Assistant Secretary for Mental Health and Substance Use, in consultation with the Administrator of the Health Resources and Services Administration, to be relevant to the mental health and substance use disorder provider workforce. 713. Minority Fellowship Program Title V of the Public Health Service Act ( 42 U.S.C. 290aa et seq. ) is amended by adding at the end the following: K Minority Fellowship Program 597. Fellowships (a) In general The Secretary shall maintain a program, to be known as the Minority Fellowship Program, under which the Secretary awards fellowships, which may include stipends, for the purposes of— (1) increasing behavioral health practitioners’ knowledge of issues related to prevention, treatment, and recovery support for mental illness and substance use disorders among racial and ethnic minority populations; (2) improving the quality of mental illness and substance use disorder prevention and treatment delivered to racial and ethnic minorities; and (3) increasing the number of culturally competent behavioral health professionals and school personnel who teach, administer, conduct services research, and provide direct mental health or substance use services to racial and ethnic minority populations. (b) Training covered The fellowships under subsection (a) shall be for postbaccalaureate training (including for master’s and doctoral degrees) for mental health professionals, including in the fields of psychiatry, nursing, social work, psychology, marriage and family therapy, mental health counseling, and substance use and addiction counseling. (c) Authorization of appropriations To carry out this section, there are authorized to be appropriated $12,669,000 for each of fiscal years 2017, 2018, and 2019 and $13,669,000 for each of fiscal years 2020 and 2021. . 714. Center and program repeals Part B of title V of the Public Health Service Act ( 42 U.S.C. 290bb et seq. ) is amended by striking the second section 514 ( 42 U.S.C. 290bb–9 ), relating to methamphetamine and amphetamine treatment initiatives, and sections 514A, 517, 519A, 519C, 519E, 520D, and 520H ( 42 U.S.C. 290bb–8 , 290bb–23, 290bb–25a, 290bb–25c, 290bb–25e, 290bb–35, and 290bb–39). 715. National violent death reporting system The Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control and Prevention, is encouraged to improve, particularly through the inclusion of additional States, the National Violent Death Reporting System as authorized by title III of the Public Health Service Act ( 42 U.S.C. 241 et seq. ). Participation in the system by the States shall be voluntary. 716. Sense of Congress on prioritizing Native American youth and suicide prevention programs (a) Findings The Congress finds as follows: (1) Suicide is the eighth leading cause of death among American Indians and Alaska Natives across all ages. (2) Among American Indians and Alaska Natives who are 10 to 34 years of age, suicide is the second leading cause of death. (3) The suicide rate among American Indian and Alaska Native adolescents and young adults ages 15 to 34 (19.5 per 100,000) is 1.5 times higher than the national average for that age group (12.9 per 100,000). (b) Sense of Congress It is the sense of Congress that the Secretary of Health and Human Services, in carrying out programs for Native American youth and suicide prevention programs for youth suicide intervention, should prioritize programs and activities for individuals who have a high risk or disproportional burden of suicide, such as Native Americans. 717. Peer professional workforce development grant program (a) In general For the purposes described in subsection (b), the Secretary of Health and Human Services shall award grants to develop and sustain behavioral health paraprofessional training and education programs, including through tuition support. (b) Purposes The purposes of grants under this section are— (1) to increase the number of behavioral health paraprofessionals, including trained peers, recovery coaches, mental health and addiction specialists, prevention specialists, and pre-masters-level addiction counselors; and (2) to help communities develop the infrastructure to train and certify peers as behavioral health paraprofessionals. (c) Eligible entities To be eligible to receive a grant under this section, an entity shall be a community college or other entity the Secretary deems appropriate. (d) Geographic distribution In awarding grants under this section, the Secretary shall seek to achieve an appropriate national balance in the geographic distribution of such awards. (e) Special consideration In awarding grants under this section, the Secretary may give special consideration to proposed and existing programs targeting peer professionals serving youth ages 16 to 25. (f) Authorization of appropriations To carry out this section, there is authorized to be appropriated $10,000,000 for the period of fiscal years 2018 through 2022. 718. National Health Service Corps (a) Definitions (1) Primary health services Section 331(a)(3)(D) of the Public Health Service Act ( 42 U.S.C. 254d(a)(3) ) is amended by inserting (including pediatric mental health subspecialty services) after pediatrics . (2) Behavioral and mental health professionals Clause (i) of section 331(a)(3)(E) of the Public Health Service Act ( 42 U.S.C. 254d(a)(3)(E) ) is amended by inserting (and pediatric subspecialists thereof) before the period at the end. (b) Eligibility To participate in loan repayment program Section 338B(b)(1)(B) of the Public Health Service Act ( 42 U.S.C. 254l–1(b)(1)(B) ) is amended by inserting , including any physician child and adolescent psychiatry residency or fellowship training program after be enrolled in an approved graduate training program in medicine, osteopathic medicine, dentistry, behavioral and mental health, or other health profession . 719. Adult suicide prevention (a) Grants (1) Authority The Assistant Secretary for Mental Health and Substance Use (referred to in this section as the Assistant Secretary ) may award grants to eligible entities in order to implement suicide prevention efforts amongst adults 25 and older. (2) Purpose The grant program under this section shall be designed to raise suicide awareness, establish referral processes, and improve clinical care practice standards for treating suicide ideation, plans, and attempts among adults. (3) Recipients To be eligible to receive a grant under this section, an entity shall be a community-based primary care or behavioral health care setting, an emergency department, a State mental health agency, an Indian tribe, a tribal organization, or any other entity the Assistant Secretary deems appropriate. (4) Nature of activities The grants awarded under paragraph (1) shall be used to implement programs that— (A) screen for suicide risk in adults and provide intervention and referral to treatment; (B) implement evidence-based practices to treat individuals who are at suicide risk, including appropriate followup services; and (C) raise awareness, reduce stigma, and foster open dialogue about suicide prevention. (b) Additional activities The Assistant Secretary shall— (1) evaluate the activities supported by grants awarded under subsection (a) in order to further the Nation’s understanding of effective interventions to prevent suicide in adults; (2) disseminate the findings from the evaluation as the Assistant Secretary considers appropriate; and (3) provide appropriate information, training, and technical assistance to eligible entities that receive a grant under this section, in order to help such entities to meet the requirements of this section, including assistance with— (A) selection and implementation of evidence-based interventions and frameworks to prevent suicide, such as the Zero Suicide framework; and (B) other activities as the Assistant Secretary determines appropriate. (c) Duration A grant under this section shall be for a period of not more than 5 years. (d) Authorization of appropriations (1) In general There is authorized to be appropriated to carry out this section $30,000,000 for the period of fiscal years 2018 through 2022. (2) Use of certain funds Of the funds appropriated to carry out this section in any fiscal year, the lesser of 5 percent of such funds or $500,000 shall be available to the Assistant Secretary for purposes of carrying out subsection (b). 720. Crisis intervention grants for police officers and first responders (a) In general The Assistant Secretary for Mental Health and Substance Use may award grants to entities such as law enforcement agencies and first responders— (1) to provide specialized training to law enforcement officers, corrections officers, paramedics, emergency medical services workers, and other first responders (including village public safety officers (as defined in section 247 of the Indian Arts and Crafts Amendments Act of 2010 ( 42 U.S.C. 3796dd note)))— (A) to recognize individuals who have mental illness and how to properly intervene with individuals with mental illness; and (B) to establish programs that enhance the ability of law enforcement agencies to address the mental health, behavioral, and substance use problems of individuals encountered in the line of duty; and (2) to establish collaborative law enforcement and mental health programs, including behavioral health response teams and mental health crisis intervention teams comprised of mental health professionals, law enforcement officers, and other first responders, as appropriate, to provide on-site, face-to-face, mental and behavioral health care services during a mental health crisis, and to connect the individual in crisis to appropriate community-based treatment services in lieu of unnecessary hospitalization or further involvement with the criminal justice system. (b) Authorization of appropriations There are authorized to be appropriated to carry out this section $9,000,000 for the period of fiscal years 2018 through 2020. 721. Demonstration grant program to train health service psychologists in community-based mental health (a) Establishment The Secretary of Health and Human Services shall establish a grant program under which the Assistant Secretary of Mental Health and Substance Use Disorders may award grants to eligible institutions to support the recruitment, education, and clinical training experiences of health services psychology students, interns, and postdoctoral residents for education and clinical experience in community mental health settings. (b) Eligible institutions For purposes of this section, the term eligible institutions includes American Psychological Association-accredited doctoral, internship, and postdoctoral residency schools or programs in health service psychology that— (1) are focused on the development and implementation of interdisciplinary training of psychology graduate students and postdoctoral fellows in providing mental and behavioral health services to address substance use disorders, serious emotional disturbance, and serious illness, as well as developing faculty and implementing curriculum to prepare psychologists to work with underserved populations; and (2) demonstrate an ability to train health service psychologists in psychiatric hospitals, forensic hospitals, community mental health centers, community health centers, federally qualified health centers, or adult and juvenile correctional facilities. (c) Priorities In selecting grant recipients under this section, the Secretary shall give priority to eligible institutions in which training focuses on the needs of individuals with serious mental illness, serious emotional disturbance, justice-involved youth, and individuals with or at high risk for substance use disorders. (d) Authorization of appropriations There is authorized to be appropriated to carry out this section $12,000,000 for the period of fiscal years 2018 through 2022. 722. Investment in tomorrow’s pediatric health care workforce Section 775(e) of the Public Health Service Act ( 42 U.S.C. 295f(e) ) is amended to read as follows: (e) Authorization of appropriations To carry out this section, there is authorized to be appropriated $12,000,000 for the period of fiscal years 2018 through 2022. . 723. CUTGO compliance Section 319D(f) of the Public Health Service Act ( 42 U.S.C. 247d–4(f) ) is amended by striking $138,300,000 for each of fiscal years 2014 through 2018 and inserting $138,300,000 for each of fiscal years 2014 through 2016 and $58,000,000 for each of fiscal years 2017 and 2018 . VIII Mental Health Parity 801. Enhanced compliance with mental health and substance use disorder coverage requirements (a) Compliance program guidance document Section 2726(a) of the Public Health Service Act ( 42 U.S.C. 300gg–26(a) ) is amended by adding at the end the following: (6) Compliance program guidance document (A) In general Not later than 12 months after the date of enactment of the Helping Families in Mental Health Crisis Act of 2016 , the Secretary, the Secretary of Labor, and the Secretary of the Treasury, in consultation with the Inspector General of the Department of Health and Human Services, shall issue a compliance program guidance document to help improve compliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, and section 9812 of the Internal Revenue Code of 1986, as applicable. (B) Examples illustrating compliance and noncompliance (i) In general The compliance program guidance document required under this paragraph shall provide illustrative, de-identified examples (that do not disclose any protected health information or individually identifiable information) of previous findings of compliance and noncompliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable, based on investigations of violations of such sections, including— (I) examples illustrating requirements for information disclosures and nonquantitative treatment limitations; and (II) descriptions of the violations uncovered during the course of such investigations. (ii) Nonquantitative treatment limitations To the extent that any example described in clause (i) involves a finding of compliance or noncompliance with regard to any requirement for nonquantitative treatment limitations, the example shall provide sufficient detail to fully explain such finding, including a full description of the criteria involved for medical and surgical benefits and the criteria involved for mental health and substance use disorder benefits. (iii) Access to additional information regarding compliance In developing and issuing the compliance program guidance document required under this paragraph, the Secretaries specified in subparagraph (A)— (I) shall enter into interagency agreements with the Inspector General of the Department of Health and Human Services, the Inspector General of the Department of Labor, and the Inspector General of the Department of the Treasury to share findings of compliance and noncompliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable; and (II) shall seek to enter into an agreement with a State to share information on findings of compliance and noncompliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable. (C) Recommendations The compliance program guidance document shall include recommendations to comply with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable, and encourage the development and use of internal controls to monitor adherence to applicable statutes, regulations, and program requirements. Such internal controls may include a compliance checklist with illustrative examples of nonquantitative treatment limitations on mental health and substance use disorder benefits, which may fail to comply with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable, in relation to nonquantitative treatment limitations on medical and surgical benefits. (D) Updating the compliance program guidance document The compliance program guidance document shall be updated every 2 years to include illustrative, de-identified examples (that do not disclose any protected health information or individually identifiable information) of previous findings of compliance and noncompliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable. . (b) Additional guidance Section 2726(a) of the Public Health Service Act ( 42 U.S.C. 300gg–26(a) ), as amended by subsection (a), is further amended by adding at the end the following: (7) Additional guidance (A) In general Not later than 1 year after the date of enactment of the Helping Families in Mental Health Crisis Act of 2016 , the Secretary, in coordination with the Secretary of Labor and the Secretary of the Treasury, shall issue guidance to group health plans and health insurance issuers offering group or individual health insurance coverage to assist such plans and issuers in satisfying the requirements of this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable,. (B) Disclosure (i) Guidance for plans and issuers The guidance issued under this paragraph shall include clarifying information and illustrative examples of methods that group health plans and health insurance issuers offering group or individual health insurance coverage may use for disclosing information to ensure compliance with the requirements under this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable, (and any regulations promulgated pursuant to such sections, as applicable). (ii) Documents for participants, beneficiaries, contracting providers, or authorized representatives The guidance issued under this paragraph shall include clarifying information and illustrative examples of methods that group health plans and health insurance issuers offering group or individual health insurance coverage may use to provide any participant, beneficiary, contracting provider, or authorized representative, as applicable, with documents containing information that the health plans or issuers are required to disclose to participants, beneficiaries, contracting providers, or authorized representatives to ensure compliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable; any regulation issued pursuant to such respective section, or any other applicable law or regulation, including information that is comparative in nature with respect to— (I) nonquantitative treatment limitations for both medical and surgical benefits and mental health and substance use disorder benefits; (II) the processes, strategies, evidentiary standards, and other factors used to apply the limitations described in subclause (I); and (III) the application of the limitations described in subclause (I) to ensure that such limitations are applied in parity with respect to both medical and surgical benefits and mental health and substance use disorder benefits. (C) Nonquantitative treatment limitations The guidance issued under this paragraph shall include clarifying information and illustrative examples of methods, processes, strategies, evidentiary standards, and other factors that group health plans and health insurance issuers offering group or individual health insurance coverage may use regarding the development and application of nonquantitative treatment limitations to ensure compliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable, (and any regulations promulgated pursuant to such respective section), including— (i) examples of methods of determining appropriate types of nonquantitative treatment limitations with respect to both medical and surgical benefits and mental health and substance use disorder benefits, including nonquantitative treatment limitations pertaining to— (I) medical management standards based on medical necessity or appropriateness, or whether a treatment is experimental or investigative; (II) limitations with respect to prescription drug formulary design; and (III) use of fail-first or step therapy protocols; (ii) examples of methods of determining— (I) network admission standards (such as credentialing); and (II) factors used in provider reimbursement methodologies (such as service type, geographic market, demand for services, and provider supply, practice size, training, experience, and licensure) as such factors apply to network adequacy; (iii) examples of sources of information that may serve as evidentiary standards for the purposes of making determinations regarding the development and application of nonquantitative treatment limitations; (iv) examples of specific factors, and the evidentiary standards used to evaluate such factors, used by such plans or issuers in performing a nonquantitative treatment limitation analysis; (v) examples of how specific evidentiary standards may be used to determine whether treatments are considered experimental or investigative; (vi) examples of how specific evidentiary standards may be applied to each service category or classification of benefits; (vii) examples of methods of reaching appropriate coverage determinations for new mental health or substance use disorder treatments, such as evidence-based early intervention programs for individuals with a serious mental illness and types of medical management techniques; (viii) examples of methods of reaching appropriate coverage determinations for which there is an indirect relationship between the covered mental health or substance use disorder benefit and a traditional covered medical and surgical benefit, such as residential treatment or hospitalizations involving voluntary or involuntary commitment; and (ix) additional illustrative examples of methods, processes, strategies, evidentiary standards, and other factors for which the Secretary determines that additional guidance is necessary to improve compliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable. (D) Public comment Prior to issuing any final guidance under this paragraph, the Secretary shall provide a public comment period of not less than 60 days during which any member of the public may provide comments on a draft of the guidance. . (c) Availability of plan information (1) PHSA amendment Paragraph (4) of section 2726(a) of the Public Health Service Act ( 42 U.S.C. 300gg–26(a) ) is amended to read as follows: (4) Availability of plan information The criteria for medical necessity determinations made under the plan or health insurance coverage with respect to mental health or substance use disorder benefits or medical or surgical benefits, the reason for denial of any such benefits, and any other information appropriate to demonstrate compliance under this section (including any such medical and surgical information) shall be made available by the plan administrator (or the health insurance issuer offering such coverage) in accordance with applicable regulations to the current or potential participant, beneficiary, or contracting provider involved upon request. The Secretary may promulgate any such regulations, including interim final regulations or temporary regulations, as may be appropriate to carry out this paragraph. . (2) ERISA amendment Paragraph (4) of section 712(a) of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1185a(a) ) is amended to read as follows: (4) Availability of plan information The criteria for medical necessity determinations made under the plan with respect to mental health or substance use disorder benefits or medical or surgical benefits (or the health insurance coverage offered in connection with the plan with respect to such benefits), the reason for denial of any such benefits, and any other information appropriate to demonstrate compliance under this section (including any such medical and surgical information) shall be made available by the plan administrator (or the health insurance issuer offering such coverage) in accordance with applicable regulations to the current or potential participant, beneficiary, or contracting provider involved upon request. The Secretary may promulgate any such regulations, including interim final regulations or temporary regulations, as may be appropriate to carry out this paragraph. . (3) IRC amendment Paragraph (4) of section 9812(a) of the Internal Revenue Code of 1986 is amended to read as follows: (4) Availability of plan information The criteria for medical necessity determinations made under the plan with respect to mental health or substance use disorder benefits or medical or surgical benefits, the reason for denial of any such benefits, and any other information appropriate to demonstrate compliance under this section (including any such medical and surgical information) shall be made available by the plan administrator in accordance with applicable regulations to the current or potential participant, beneficiary, or contracting provider involved upon request. The Secretary may promulgate any such regulations, including interim final regulations or temporary regulations, as may be appropriate to carry out this paragraph. . (d) Improving compliance (1) In general In the case that the Secretary of Health and Human Services, the Secretary of Labor, or the Secretary of the Treasury determines that a group health plan or health insurance issuer offering group or individual health insurance coverage has violated, at least five times, section 2726 of the Public Health Service Act ( 42 U.S.C. 300gg–26 ), section 712 of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1185a ), or section 9812 of the Internal Revenue Code of 1986, respectively, the appropriate Secretary shall audit plan documents for such health plan or issuer in the plan year following the Secretary’s determination in order to help improve compliance with such section. (2) Rule of construction Nothing in this subsection shall be construed to limit the authority, as in effect on the day before the date of enactment of this Act, of the Secretary of Health and Human Services, the Secretary of Labor, or the Secretary of the Treasury to audit documents of health plans or health insurance issuers. 802. Action plan for enhanced enforcement of mental health and substance use disorder coverage (a) Public meeting (1) In general Not later than 6 months after the date of enactment of this Act, the Secretary of Health and Human Services shall convene a public meeting of stakeholders described in paragraph (2) to produce an action plan for improved Federal and State coordination related to the enforcement of section 2726 of the Public Health Service Act ( 42 U.S.C. 300gg–26 ), section 712 of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1185a ), and section 9812 of the Internal Revenue Code of 1986, and any comparable provisions of State law (in this section collectively referred to as mental health parity and addiction equity requirements ). (2) Stakeholders The stakeholders described in this paragraph shall include each of the following: (A) The Federal Government, including representatives from— (i) the Department of Health and Human Services; (ii) the Department of the Treasury; (iii) the Department of Labor; and (iv) the Department of Justice. (B) State governments, including— (i) State health insurance commissioners; (ii) appropriate State agencies, including agencies on public health or mental health; and (iii) State attorneys general or other representatives of State entities involved in the enforcement of mental health parity and addiction equity requirements. (C) Representatives from key stakeholder groups, including— (i) the National Association of Insurance Commissioners; (ii) health insurance providers; (iii) providers of mental health and substance use disorder treatment; (iv) employers; and (v) patients or their advocates. (b) Action plan Not later than 6 months after the conclusion of the public meeting under subsection (a), the Secretary of Health and Human Services shall finalize the action plan described in such subsection and make it plainly available on the Internet website of the Department of Health and Human Services. (c) Content The action plan under this section shall— (1) reflect the input of the stakeholders participating in the public meeting under subsection (a); (2) identify specific strategic objectives regarding how the various Federal and State agencies charged with enforcement of mental health parity and addiction equity requirements will collaborate to improve enforcement of such requirements; (3) provide a timeline for implementing the action plan; and (4) provide specific examples of how such objectives may be met, which may include— (A) providing common educational information and documents to patients about their rights under mental health parity and addiction equity requirements; (B) facilitating the centralized collection of, monitoring of, and response to patient complaints or inquiries relating to mental health parity and addiction equity requirements, which may be through the development and administration of a single, toll-free telephone number and an Internet website portal; (C) Federal and State law enforcement agencies entering into memoranda of understanding to better coordinate enforcement responsibilities and information sharing, including whether such agencies should make the results of enforcement actions related to mental health parity and addiction equity requirements publicly available; and (D) recommendations to the Congress regarding the need for additional legal authority to improve enforcement of mental health parity and addiction equity requirements, including the need for additional legal authority to ensure that nonquantitative treatment limitations are applied, and the extent and frequency of the applications of such limitations, both to medical and surgical benefits and to mental health and substance use disorder benefits in a comparable manner. 803. Report on investigations regarding parity in mental health and substance use disorder benefits (a) In general Not later than 1 year after the date of enactment of this Act, and annually thereafter for the subsequent 5 years, the Administrator of the Centers for Medicare & Medicaid Services, in collaboration with the Assistant Secretary of Labor of the Employee Benefits Security Administration and the Secretary of the Treasury, shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate a report summarizing the results of all closed Federal investigations completed during the preceding 12-month period with findings of any serious violation regarding compliance with mental health and substance use disorder coverage requirements under section 2726 of the Public Health Service Act ( 42 U.S.C. 300gg–26 ), section 712 of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1185a ), and section 9812 of the Internal Revenue Code of 1986. (b) Contents Subject to subsection (c), a report under subsection (a) shall, with respect to investigations described in such subsection, include each of the following: (1) The number of closed Federal investigations conducted during the covered reporting period. (2) Each benefit classification examined by any such investigation conducted during the covered reporting period. (3) Each subject matter, including compliance with requirements for quantitative and nonquantitative treatment limitations, of any such investigation conducted during the covered reporting period. (4) A summary of the basis of the final decision rendered for each closed investigation conducted during the covered reporting period that resulted in a finding of a serious violation. (c) Limitation Any individually identifiable information shall be excluded from reports under subsection (a) consistent with protections under the health privacy and security rules promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996 ( 42 U.S.C. 1320d–2 note). 804. GAO study on parity in mental health and substance use disorder benefits Not later than 3 years after the date of enactment of this Act, the Comptroller General of the United States, in consultation with the Secretary of Health and Human Services, the Secretary of Labor, and the Secretary of the Treasury, shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate a report detailing the extent to which group health plans or health insurance issuers offering group or individual health insurance coverage that provides both medical and surgical benefits and mental health or substance use disorder benefits, medicaid managed care organizations with a contract under section 1903(m) of the Social Security Act ( 42 U.S.C. 1396b(m) ), and health plans provided under the State Children’s Health Insurance Program under title XXI of the Social Security Act ( 42 U.S.C. 1397aa et seq. ) comply with section 2726 of the Public Health Service Act ( 42 U.S.C. 300gg–26 ), section 712 of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1185a ), and section 9812 of the Internal Revenue Code of 1986, including— (1) how nonquantitative treatment limitations, including medical necessity criteria, of such plans or issuers comply with such sections; (2) how the responsible Federal departments and agencies ensure that such plans or issuers comply with such sections, including an assessment of how the Secretary of Health and Human Services has used its authority to conduct audits of such plans to ensure compliance; (3) a review of how the various Federal and State agencies responsible for enforcing mental health parity requirements have improved enforcement of such requirements in accordance with the objectives and timeline described in the action plan under section 802; and (4) recommendations for how additional enforcement, education, and coordination activities by responsible Federal and State departments and agencies could better ensure compliance with such sections, including recommendations regarding the need for additional legal authority. 805. Information and awareness on eating disorders (a) Information The Secretary of Health and Human Services (in this section referred to as the Secretary ) may— (1) update information, related fact sheets, and resource lists related to eating disorders that are available on the public Internet website of the National Women's Health Information Center sponsored by the Office on Women's Health, to include— (A) updated findings and current research related to eating disorders, as appropriate; and (B) information about eating disorders, including information related to males and females; (2) incorporate, as appropriate, and in coordination with the Secretary of Education, information from publicly available resources into appropriate obesity prevention programs developed by the Office on Women's Health; and (3) make publicly available (through a public Internet website or other method) information, related fact sheets and resource lists, as updated under paragraph (1), and the information incorporated into appropriate obesity prevention programs, as updated under paragraph (2). (b) Awareness The Secretary may advance public awareness on— (1) the types of eating disorders; (2) the seriousness of eating disorders, including prevalence, comorbidities, and physical and mental health consequences; (3) methods to identify, intervene, refer for treatment, and prevent behaviors that may lead to the development of eating disorders; (4) discrimination and bullying based on body size; (5) the effects of media on self-esteem and body image; and (6) the signs and symptoms of eating disorders. 806. Education and training on eating disorders The Secretary of Health and Human Services may facilitate the identification of programs to educate and train health professionals and school personnel in effective strategies to— (1) identify individuals with eating disorders; (2) provide early intervention services for individuals with eating disorders; (3) refer patients with eating disorders for appropriate treatment; (4) prevent the development of eating disorders; or (5) provide appropriate treatment services for individuals with eating disorders. 807. GAO study on preventing discriminatory coverage limitations for individuals with serious mental illness and substance use disorders Not later than 2 years after the date of the enactment of this Act, the Comptroller General of the United States shall submit to Congress and make publicly available a report detailing Federal oversight of group health plans and health insurance coverage offered in the individual or group market (as such terms are defined in section 2791 of the Public Health Service Act ( 42 U.S.C. 300gg–91 )), including Medicaid managed care plans under section 1903 of the Social Security Act ( 42 U.S.C. 1396b ), to ensure compliance of such plans and coverage with sections 2726 of the Public Health Service Act ( 42 U.S.C. 300gg–26 ), 712 of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1185a ), and 9812 of the Internal Revenue Code of 1986 (in this section collectively referred to as the parity law ), including— (1) a description of how Federal regulations and guidance consider nonquantitative treatment limitations, including medical necessity criteria and application of such criteria to medical, surgical, and primary care, of such plans and coverage in ensuring compliance by such plans and coverage with the parity law; (2) a description of actions that Federal departments and agencies are taking to ensure that such plans and coverage comply with the parity law; and (3) the identification of enforcement, education, and coordination activities within Federal departments and agencies, including educational activities directed to State insurance commissioners, and a description of how such proper activities can be used to ensure full compliance with the parity law. 808. Clarification of existing parity rules If a group health plan or a health insurance issuer offering group or individual health insurance coverage provides coverage for eating disorder benefits, including residential treatment, such group health plan or health insurance issuer shall provide such benefits consistent with the requirements of section 2726 of the Public Health Service Act ( 42 U.S.C. 300gg–26 ), section 712 of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1185a ), and section 9812 of the Internal Revenue Code of 1986.

Passed the House of Representatives July 6, 2016. Karen L. Haas, Clerk