[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5636 Introduced in House (IH)]

111th CONGRESS
  2d Session
                                H. R. 5636

   To establish Federally Qualified Behavioral Health Centers and to 
    require Medicaid coverage for services provided by such Centers.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             June 29, 2010

 Ms. Matsui (for herself and Mr. Engel) introduced the following bill; 
       which was referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
   To establish Federally Qualified Behavioral Health Centers and to 
    require Medicaid coverage for services provided by such Centers.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Community Mental Health and 
Addiction Safety Net Equity Act of 2010''.

SEC. 2. FEDERALLY QUALIFIED BEHAVIORAL HEALTH CENTERS.

    Section 1913 of the Public Health Service Act (42 U.S.C. 300x-3) is 
amended--
            (1) in subsection (a)(2)(A), by striking ``community mental 
        health services'' and inserting ``behavioral health services 
        (of the type offered by federally qualified behavioral health 
        centers consistent with subsection (c)(3))'';
            (2) in subsection (b)--
                    (A) by striking paragraph (1) and inserting the 
                following:
            ``(1) services under the plan will be provided only through 
        appropriate, qualified community programs (which may include 
        federally qualified behavioral health centers, child mental 
        health programs, psychosocial rehabilitation programs, mental 
        health peer-support programs, and mental health primary 
        consumer-directed programs); and''; and
                    (B) in paragraph (2), by striking ``community 
                mental health centers'' and inserting ``federally 
                qualified behavioral health centers''; and
            (3) by striking subsection (c) and inserting the following:
    ``(c) Criteria for Federally Qualified Behavioral Health Centers.--
            ``(1) In general.--The Administrator shall certify, and 
        recertify at least every 5 years, federally qualified 
        behavioral health centers as meeting the criteria specified in 
        this subsection.
            ``(2) Regulations.--Not later than 18 months after the date 
        of the enactment of the Community Mental Health and Addiction 
        Safety Net Equity Act of 2010, the Administrator shall issue 
        final regulations for certifying non-profit or local government 
        centers as centers under paragraph (1).
            ``(3) Criteria.--The criteria referred to in subsection 
        (b)(2) are that the center performs each of the following:
                    ``(A) Provide services in locations that ensure 
                services will be available and accessible promptly and 
                in a manner which preserves human dignity and assures 
                continuity of care.
                    ``(B) Provide services in a mode of service 
                delivery appropriate for the target population.
                    ``(C) Provide individuals with a choice of service 
                options where there is more than one efficacious 
                treatment.
                    ``(D) Employ a core staff of clinical staff that is 
                multidisciplinary and culturally and linguistically 
                competent.
                    ``(E) Provide services, within the limits of the 
                capacities of the center, to any individual residing or 
                employed in the service area of the center, regardless 
                of the ability of the individual to pay.
                    ``(F) Provide, directly or through contract, to the 
                extent covered for adults in the State Medicaid plan 
                under title XIX of the Social Security Act and for 
                children in accordance with section 1905(r) of such Act 
                regarding early and periodic screening, diagnosis, and 
                treatment, each of the following services:
                            ``(i) Screening, assessment, and diagnosis, 
                        including risk assessment.
                            ``(ii) Person-centered treatment planning 
                        or similar processes, including risk assessment 
                        and crisis planning.
                            ``(iii) Outpatient clinic mental health 
                        services, including screening, assessment, 
                        diagnosis, psychotherapy, substance abuse 
                        counseling, medication management, and 
                        integrated treatment for mental illness and 
                        substance abuse which shall be evidence-based 
                        (including cognitive behavioral therapy and 
                        other such therapies which are evidence-based).
                            ``(iv) Outpatient clinic primary care 
                        services, including screening and monitoring of 
                        key health indicators and health risk 
                        (including screening for diabetes, 
                        hypertension, and cardiovascular disease and 
                        monitoring of weight, height, body mass index 
                        (BMI), blood pressure, blood glucose or HbA1C, 
                        and lipid profile).
                            ``(v) Crisis mental health services, 
                        including 24-hour mobile crisis teams, 
                        emergency crisis intervention services, and 
                        crisis stabilization.
                            ``(vi) Targeted case management (services 
                        to assist individuals gaining access to needed 
                        medical, social, educational, and other 
                        services and applying for income security and 
                        other benefits to which they may be entitled).
                            ``(vii) Psychiatric rehabilitation services 
                        including skills training, assertive community 
                        treatment, family psychoeducation, disability 
                        self-management, supported employment, 
                        supported housing services, therapeutic foster 
                        care services, and such other evidence-based 
                        practices as the Secretary may require.
                            ``(viii) Peer support and counselor 
                        services and family supports.
                    ``(G) Maintain linkages, and where possible enter 
                into formal contracts with the following:
                            ``(i) Inpatient psychiatric facilities and 
                        substance abuse detoxification and residential 
                        programs.
                            ``(ii) Adult and youth peer support and 
                        counselor services.
                            ``(iii) Family support services for 
                        families of children with serious mental 
                        disorders.
                            ``(iv) Other community or regional 
                        services, supports, and providers, including 
                        schools, child welfare agencies, juvenile and 
                        criminal justice agencies and facilities, 
                        housing agencies and programs, employers, and 
                        other social services.
                            ``(v) Onsite or offsite access to primary 
                        care services.
                            ``(vi) Enabling services, including 
                        outreach, transportation, and translation.
                            ``(vii) Health and wellness services, 
                        including services for tobacco cessation.''.

SEC. 3. MEDICAID COVERAGE AND PAYMENT FOR FEDERALLY QUALIFIED 
              BEHAVIORAL HEALTH CENTER SERVICES.

    (a) Payment for Services Provided by Federally Qualified Behavioral 
Health Centers.--Section 1902(bb) of the Social Security Act (42 U.S.C. 
1396a(bb)) is amended--
            (1) in the heading, by striking ``and Rural Health 
        Clinics'' and inserting ``, Federally Qualified Behavioral 
        Health Centers, and Rural Health Clinics'';
            (2) in paragraph (1), by inserting ``(and beginning with 
        fiscal year 2011 with respect to services furnished on or after 
        January 1, 2011, and each succeeding fiscal year, for services 
        described in section 1905(a)(2)(D) furnished by a federally 
        qualified behavioral health center)'' after ``by a rural health 
        clinic'';
            (3) in paragraph (2)--
                    (A) by striking the heading and inserting ``Initial 
                fiscal year'';
                    (B) by inserting ``(or, in the case of services 
                described in section 1905(a)(2)(D) furnished by a 
                federally qualified behavioral health center, for 
                services furnished on and after January 1, 2011, during 
                fiscal year 2011)'' after ``January 1, 2001, during 
                fiscal year 2001'';
                    (C) by inserting ``(or, in the case of services 
                described in section 1905(a)(2)(D) furnished by a 
                federally qualified behavioral health center, during 
                fiscal years 2009 and 2010)'' after ``1999 and 2000''; 
                and
                    (D) by inserting ``(or, in the case of services 
                described in section 1905(a)(2)(D) furnished by a 
                federally qualified behavioral health center, during 
                fiscal year 2011)'' before the period;
            (4) in paragraph (3)--
                    (A) in the heading, by striking ``Fiscal year 2002 
                and succeeding'' and inserting ``Succeeding''; and
                    (B) by inserting ``(or, in the case of services 
                described in section 1905(a)(2)(D) furnished by a 
                federally qualified behavioral health center, for 
                services furnished during fiscal year 2012 or a 
                succeeding fiscal year)'' after ``2002 or a succeeding 
                fiscal year'';
            (5) in paragraph (4)--
                    (A) by inserting ``(or as a federally qualified 
                behavioral health center after fiscal year 2010)'' 
                after ``or rural health clinic after fiscal year 
                2000'';
                    (B) by striking ``furnished by the center or'' and 
                inserting ``furnished by the federally qualified health 
                center, services described in section 1905(a)(2)(D) 
                furnished by the federally qualified behavioral health 
                center, or'';
                    (C) in the second sentence, by striking ``or rural 
                health clinic'' and inserting ``, federally qualified 
                behavioral health center, or rural health clinic'';
            (6) in paragraph (5), in each of subparagraphs (A) and (B), 
        by striking ``or rural health clinic'' and inserting ``, 
        federally qualified behavioral health center, or rural health 
        clinic''; and
            (7) in paragraph (6), by striking ``or to a rural health 
        clinic'' and inserting ``, to a federally qualified behavioral 
        health center for services described in section 1905(a)(2)(D), 
        or to a rural health clinic''.
    (b) Inclusion of Federally Qualified Behavioral Health Center 
Services in the Term Medical Assistance.--Section 1905(a)(2) of the 
Social Security Act (42 U.S.C. 1396d(a)(2)) is amended--
            (1) by striking ``and'' before ``(C)''; and
            (2) by inserting before the semicolon at the end the 
        following: ``, and (D) federally qualified behavioral health 
        center services (as defined in subsection (l)(4))''.
    (c) Definition of Federally Qualified Behavioral Health Center 
Services.--Section 1905(l) of the Social Security Act (42 U.S.C. 
1396d(l)) is amended by adding at the end the following paragraph:
            ``(4)(A) The term `federally qualified behavioral health 
        center services' means services furnished to an individual at a 
        federally qualified behavioral health center (as defined by 
        subparagraph (B).
            ``(B) The term `federally qualified behavioral health 
        center' means an entity that is certified under section 1913(c) 
        of the Public Health Service Act as meeting the criteria 
        described in paragraph (3) of such section.''.

SEC. 4. MENTAL HEALTH AND ADDICTION SAFETY NET STUDIES.

    (a) Paperwork Reduction Study.--
            (1) In general.--Not later than 12 months after the date of 
        the enactment of this Act, the Institute of Medicine shall 
        submit to the appropriate committees of Congress a report that 
        evaluates the combined paperwork burden of federally qualified 
        behavioral health centers certified section 1913(c) of the 
        Public Health Service Act, as inserted by section 2.
            (2) Scope.--In preparing the report under paragraph (1), 
        the Institute of Medicine shall examine licensing, 
        certification, service definitions, claims payment, billing 
        codes, and financial auditing requirements utilized 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, State 
        Medicaid agencies, State departments of health, State 
        departments of education, and State and local juvenile justice 
        and social services agencies to--
                    (A) establish an estimate of the combined 
                nationwide cost of complying with the requirements 
                described in this paragraph, in terms of both 
                administrative funding and staff time;
                    (B) establish an estimate of the per capita cost to 
                each federally qualified behavioral health center 
                certified under section 1913(c) of the Public Health 
                Service Act to comply with the requirements described 
                in this paragraph, in terms of both administrative 
                funding and staff time; and
                    (C) make administrative and statutory 
                recommendations to Congress, which may include a 
                uniform methodology, to reduce the paperwork burden 
                experienced by such federally qualified behavioral 
                health centers.
            (3) Authorization of appropriations.--There are authorized 
        to be appropriated to carry out this subsection $550,000 for 
        each of the fiscal years 2012 and 2013.
    (b) Wage Study.--
            (1) In general.--Not later than 12 months after the date of 
        the enactment of this Act, the Institute of Medicine shall 
        conduct a nationwide analysis, and submit a report to the 
        appropriate committees of Congress, concerning the compensation 
        structure of professional and paraprofessional personnel 
        employed by federally qualified behavioral health centers 
        certified under section 1913(c) of the Public Health Service 
        Act, as inserted by section 2, as compared with the 
        compensation structure of comparable health safety net 
        providers and relevant private sector health care employers.
            (2) Scope.--In preparing the report under paragraph (1), 
        the Institute of Medicine shall examine compensation 
        disparities, if such disparities are determined to exist, by 
        type of personnel, type of provider or private sector employer, 
        and by geographic region.
            (3) Authorization of appropriations.--There are authorized 
        to be appropriated to carry out this subsection, $550,000 for 
        each of the fiscal years 2012 and 2013.
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