114 HR 2646 : Helping Families in Mental Health Crisis Act of 2016
U.S. House of Representatives
2016-07-14
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.
1.Short title; table of contents
(a)This Act may be cited as the Helping Families in Mental Health Crisis Act of 2016
. (b)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.
<enum>I</enum><header>Assistant Secretary for Mental Health and Substance Use</header>
<section id="H3D36B6E863EE4334AA744BC434B55A46"><enum>101.</enum><header>Assistant Secretary for Mental Health and Substance Use</header>
<subsection id="H0FCD5D8C98B948F9A663777213F8A0B6"><enum>(a)</enum><header>Assistant Secretary</header><text>Section 501(c) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290aa">42 U.S.C. 290aa</external-xref>) is amended to read as follows:</text> <quoted-block display-inline="no-display-inline" id="H2B09A79623384BE1956F8DA82E793696" style="OLC"> <subsection id="HC9D84D4D52B7481C920F8D880417AFF6"><enum>(c)</enum><header>Assistant Secretary and Deputy Assistant Secretary</header> <paragraph id="HB69CD4455FF84BC2B5111FB93016F9BC"><enum>(1)</enum><header>Assistant Secretary</header> <subparagraph id="H0398A94037E349E9B1F1398913253FA3"><enum>(A)</enum><header>Appointment</header><text>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 <quote>Assistant Secretary</quote>) who shall be appointed by the President, by and with the advice and consent of the Senate.</text>
</subparagraph><subparagraph commented="no" id="H84FA7CD0BCAD4FEEBC39CA1D81EFFE21"><enum>(B)</enum><header>Qualifications</header><text display-inline="yes-display-inline">In selecting the Assistant Secretary, the President shall give preference to individuals who have—</text> <clause id="HF8D8A1BA463F43BBA61A166EF835D0BD"><enum>(i)</enum><text display-inline="yes-display-inline">a doctoral degree in medicine, osteopathic medicine, or psychology;</text>
</clause><clause id="H8002E12D135847BB8B3D7D901F31B05A"><enum>(ii)</enum><text display-inline="yes-display-inline">clinical and research experience regarding mental health and substance use disorders; and</text> </clause><clause id="H186FF25D69FE43C5A0935E02DD02244F"><enum>(iii)</enum><text>an understanding of biological, psychosocial, and pharmaceutical treatments of mental illness and substance use disorders.</text>
</clause></subparagraph></paragraph><paragraph id="H7946BD3A54B046598D2D06FDAC537652"><enum>(2)</enum><header>Deputy Assistant Secretary</header><text>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.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H8D248C3E7DCE4D1E8FA5EFA78D020F77"><enum>(b)</enum><header>Transfer of authorities</header><text>The Secretary of Health and Human Services shall delegate to the Assistant Secretary for Mental Health and Substance Use all duties and authorities that—</text>
<paragraph id="HC913C42803534CB6B86DBB1240505F3F"><enum>(1)</enum><text>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</text>
</paragraph><paragraph id="H0A0D05C335244D87AFA92F7409807469"><enum>(2)</enum><text>are not terminated by this Act.</text> </paragraph></subsection><subsection id="HCD78FAFD65ED46CAB90CCEA49869E973"><enum>(c)</enum><header>Evaluation</header><text display-inline="yes-display-inline">Section 501(d) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290aa">42 U.S.C. 290aa(d)</external-xref>) is amended—</text>
<paragraph id="HAB9813BAC1D049F6A0CD0FB8BFCD8153"><enum>(1)</enum><text>in paragraph (17), by striking <quote>and</quote> at the end;</text> </paragraph><paragraph id="H3358CD53C6D0455E875E8725F48EB221"><enum>(2)</enum><text>in paragraph (18), by striking the period at the end and inserting a semicolon; and</text>
</paragraph><paragraph id="HF325AE9DC7C34281925F9E1CB2A148E8"><enum>(3)</enum><text>by adding at the end the following:</text> <quoted-block display-inline="no-display-inline" id="H73BBD2458C8D477EA5D9047AAAB0C6B9" style="OLC"> <paragraph id="HA8AEBC2319544BACBB1DB799459F2E80"><enum>(19)</enum><text display-inline="yes-display-inline">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;</text>
</paragraph><paragraph id="H81DD4C4E3B90404DA06E5CFAE877CAF1"><enum>(20)</enum><text>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;</text>
</paragraph><paragraph id="H0A70FB321364436F9B5445DA0A0A2221"><enum>(21)</enum><text display-inline="yes-display-inline">establish standards for the appointment of peer-review panels to evaluate grant applications and recommend standards for mental health grant programs; and</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection commented="no" id="HDC2DA71185C3499998B79843D9A69EA3"><enum>(d)</enum><header>Standards for grant programs</header><text display-inline="yes-display-inline">Section 501(d) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290aa">42 U.S.C. 290aa(d)</external-xref>), as amended by subsection (c), is further amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H14D0F32845BC40A983210416A1E185F6" style="OLC">
<paragraph commented="no" id="H420DF612699C430B82876F45CB85B479"><enum>(22)</enum><text display-inline="yes-display-inline">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—</text>
<subparagraph commented="no" id="H96177FC771124CD7A0783D1D6F4ECED4"><enum>(A)</enum><text>the capacity of the grantee to implement the award;</text> </subparagraph><subparagraph commented="no" id="HBE85BCC6FED5452B9FD6B93A39472951"><enum>(B)</enum><text>requirements for the description of the program implementation approach;</text>
</subparagraph><subparagraph commented="no" id="HC14A28133253436F807543C5F108500A"><enum>(C)</enum><text>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;</text>
</subparagraph><subparagraph commented="no" id="H2C8CD64B9E654368B4C134F061BEAF87"><enum>(D)</enum><text>the extent to which the grantee must collect and report on required performance measures; and</text> </subparagraph><subparagraph commented="no" id="HB18F4019EBD74E788C54115110C93D24"><enum>(E)</enum><text>the extent to which the grantee is proposing evidence-based practices and the extent to which—</text>
<clause commented="no" id="HE3141B57128E44AB8701B0F86FCC9784"><enum>(i)</enum><text>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</text>
</clause><clause commented="no" id="HE2BA59079DA94688A2EE414ECEB440E8"><enum>(ii)</enum><text>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.</text></clause></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H3A961E9FD4A4478C9A506344A3F02871"><enum>(e)</enum><header>Emergency response</header><text display-inline="yes-display-inline">Section 501(m) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290aa">42 U.S.C. 290aa(m)</external-xref>) is amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="HD81B0E5B1D674BFC9A0E07AAD02BF505" style="OLC">
<paragraph id="H6D3CAC1A2D804CA7B2645A58B8A86B75"><enum>(4)</enum><header>Availability of funds through following fiscal year</header><text display-inline="yes-display-inline">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.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H586F5DA263BC425E97D6A4C44E0E4827"><enum>(f)</enum><header>Member of Council on Graduate Medical Education</header><text>Section 762 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290o">42 U.S.C. 290o</external-xref>) is amended—</text> <paragraph id="H8D715B1221654C95AE020D43055FE1C1"><enum>(1)</enum><text>in subsection (b)—</text>
<subparagraph id="H61BE8536483E4328B2AED87826B3EC41"><enum>(A)</enum><text>by redesignating paragraphs (4), (5), and (6) as paragraphs (5), (6), and (7), respectively; and</text> </subparagraph><subparagraph id="HBF938D5086E74D7ABCC24C1193D58D9B"><enum>(B)</enum><text>by inserting after paragraph (3) the following:</text>
<quoted-block display-inline="no-display-inline" id="HA3BAAAC8080742369DF7A1904210C572" style="OLC">
<paragraph id="HC054DFF363A0459884F21E9C5489CE02"><enum>(4)</enum><text display-inline="yes-display-inline">the Assistant Secretary for Mental Health and Substance Use;</text></paragraph><after-quoted-block>; and</after-quoted-block></quoted-block> </subparagraph></paragraph><paragraph id="HA95AC8F4FBB04B118CFB5F48F1540287"><enum>(2)</enum><text>in subsection (c), by striking <quote>(4), (5), and (6)</quote> each place it appears and inserting <quote>(5), (6), and (7)</quote>.</text>
</paragraph></subsection><subsection id="H2EC38212657546EB854C12B4EC989B6F"><enum>(g)</enum><header>Conforming amendments</header><text display-inline="yes-display-inline">Title V of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290aa">42 U.S.C. 290aa et seq.</external-xref>), as amended by the previous provisions of this section, is further amended—</text>
<paragraph id="H35B574CB4F8641FA957E814DB49B413E"><enum>(1)</enum><text>by striking <quote>Administrator of the Substance Abuse and Mental Health Services Administration</quote> each place it appears and inserting <quote>Assistant Secretary for Mental Health and Substance Use</quote>; and</text> </paragraph><paragraph id="H2AF08892765C4FE29A69973EC9EF1AC1"><enum>(2)</enum><text>by striking <quote>Administrator</quote> each place it appears (including in any headings) and inserting <quote>Assistant Secretary</quote>, except where the term <quote>Administrator</quote> appears—</text>
<subparagraph id="HD0E9D53DD6B8464C9B0CC57AEF223857"><enum>(A)</enum><text display-inline="yes-display-inline">in each of subsections (e) and (f) of section 501 of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290aa">42 U.S.C. 290aa</external-xref>), including the headings of such subsections, within the term <quote>Associate Administrator</quote>;</text>
</subparagraph><subparagraph id="HE9062395CBD94CAF85254D2F0E34AFB1"><enum>(B)</enum><text display-inline="yes-display-inline">in section 507(b)(6) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290bb">42 U.S.C. 290bb(b)(6)</external-xref>), within the term <quote>Administrator of the Health Resources and Services Administration</quote>;</text> </subparagraph><subparagraph id="H942FDEF4C3BE41C78759DE0BDF6F0693"><enum>(C)</enum><text display-inline="yes-display-inline">in section 507(b)(6) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290bb">42 U.S.C. 290bb(b)(6)</external-xref>), within the term <quote>Administrator of the Centers for Medicare & Medicaid Services</quote>;</text>
</subparagraph><subparagraph id="H0D759A6FE7BD44E1AF364C9A01C38DDF"><enum>(D)</enum><text display-inline="yes-display-inline">in section 519B(c)(1)(B) of such Act (42 U.S.C. 290bb–25b(c)(1)(B)), within the term <quote>Administrator of the National Highway Traffic Safety Administration</quote>; or</text> </subparagraph><subparagraph id="HD29ABD8F47E3485D83C3DCEF75B6D31A"><enum>(E)</enum><text display-inline="yes-display-inline">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 <quote>Administrator of the Office of Juvenile Justice and Delinquency Prevention</quote>.</text>
</subparagraph></paragraph></subsection><subsection id="H73BD1BF010204B26A1BD9846543C4F46"><enum>(h)</enum><header>References</header><text>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.</text>
</subsection></section><section id="H07F5720AAC954BCEA241B1E0F9B2E594"><enum>102.</enum><header>Improving oversight of mental health and substance use programs</header><text display-inline="no-display-inline">Title V of the Public Health Service Act is amended by inserting after section 501 of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290aa">42 U.S.C. 290aa</external-xref>) the following:</text>
<quoted-block display-inline="no-display-inline" id="HB96D985A14B34C2FA9FACCC8EA3B8DBB" style="OLC">
<section commented="no" id="H85BB463CABA040158AAC1DF39D34674A"><enum>501A.</enum><header>Improving oversight of mental health and substance use programs</header>
<subsection commented="no" id="H57971826F6CB4DA9809082E66AF822E1"><enum>(a)</enum><header>Activities</header><text display-inline="yes-display-inline">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—</text>
<paragraph commented="no" id="H24257134CF5A4690A3CAB7B357BAC7BF"><enum>(1)</enum><text display-inline="yes-display-inline">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;</text>
</paragraph><paragraph commented="no" id="H4EC3D3C46E5E47B3B3E7826AE76BED5C"><enum>(2)</enum><text>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—</text>
<subparagraph commented="no" id="H65C50A996E7540E0B52EA0C098E6AFEF"><enum>(A)</enum><text>prevention, intervention, treatment, and recovery support services, including such services for individuals with a serious mental illness or serious emotional disturbance;</text>
</subparagraph><subparagraph commented="no" id="H68A3F864508641EF9DFE1AA5AB24DA5C"><enum>(B)</enum><text>the reduction of homelessness and involvement with the criminal justice system among individuals with a mental illness or substance use disorder; and</text>
</subparagraph><subparagraph commented="no" id="H1E97C4309C944B3DA1AB3FCEFA50F907"><enum>(C)</enum><text>public health and health services; and</text> </subparagraph></paragraph><paragraph commented="no" id="H08122D914FA348B887F5EE9292D165AE"><enum>(3)</enum><text>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.</text>
</paragraph></subsection><subsection commented="no" id="HBBD0FD7BCE954E759FB000300544D19F"><enum>(b)</enum><header>Recommendations</header><text display-inline="yes-display-inline">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.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="HCA158D9B340346BBA4F8EE539113B25B"><enum>103.</enum><header>National Mental Health and Substance Use Policy Laboratory</header><text display-inline="no-display-inline">Title V of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290aa">42 U.S.C. 290aa et seq.</external-xref>) is amended by inserting after section 501A, as added by section 102 of this Act, the following:</text>
<quoted-block display-inline="no-display-inline" id="HF7F11EBAEC4B457E9FDB77A655FE5903" style="OLC">
<section id="H4E4B3C2654C04D94ABECDB76F6A9D6FC"><enum>501B.</enum><header>National Mental Health and Substance Use Policy Laboratory</header>
<subsection id="HC5804487EBC94558A6C5D57F4C4221F0"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">There shall be established within the Administration a National Mental Health and Substance Use Policy Laboratory (referred to in this section as the <quote>Laboratory</quote>).</text>
</subsection><subsection id="HBD400BC0787D43D3A0D11D74B210A111"><enum>(b)</enum><header>Responsibilities</header><text>The Laboratory shall—</text> <paragraph id="H0B428D4E8A8D43D8B04FFE5963AD46DA"><enum>(1)</enum><text>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 <short-title>Helping Families in Mental Health Crisis Act of 2016</short-title>;</text>
</paragraph><paragraph id="HF18557EEEA79496CAE1AC95336B1DDF4"><enum>(2)</enum><text>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;</text>
</paragraph><paragraph id="HBA8F3E9F51884955B1FA2298ACB08996"><enum>(3)</enum><text>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;</text>
</paragraph><paragraph id="H88796D28C06E4DC2869CBA98A111B139"><enum>(4)</enum><text>provide leadership in identifying and coordinating policies and programs, including evidence-based programs, related to mental illness and substance use disorders;</text>
</paragraph><paragraph id="H26DD27B2F89146658F1376A854445DE8"><enum>(5)</enum><text display-inline="yes-display-inline">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;</text>
</paragraph><paragraph id="H71EB9E74E7D74AA4AE0670DF42604D04"><enum>(6)</enum><text>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—</text>
<subparagraph id="H93993E0EB5BF495CB5D93D2F90B08091"><enum>(A)</enum><text>identifying any such programs or activities that are duplicative;</text> </subparagraph><subparagraph id="HA40F063680F74735866D6B9BE80BCCCD"><enum>(B)</enum><text>identifying any such programs or activities that are not evidence-based, effective, or efficient; and</text>
</subparagraph><subparagraph id="H926A8DAD93834FA9AA1003703A27FACF"><enum>(C)</enum><text>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</text>
</subparagraph></paragraph><paragraph commented="no" id="H2FCF4ACBA4F14820BA03BBD6BCF91323"><enum>(7)</enum><text>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.</text>
</paragraph></subsection><subsection commented="no" id="H0341FBD63D5D40FDBB39D8D0F1D9D31A"><enum>(c)</enum><header>Evidence-Based practices and service delivery models</header><text display-inline="yes-display-inline"></text> <paragraph commented="no" id="HCA4986EF311D4925AB774D2D527AD63D"><enum>(1)</enum><header>In general</header><text>In selecting evidence-based best practices and service delivery models for evaluation and dissemination, the Laboratory—</text>
<subparagraph commented="no" id="H9F7A314785A54776AEEE52565C28BD81"><enum>(A)</enum><text display-inline="yes-display-inline">shall give preference to models that improve—</text> <clause commented="no" id="H3BDA7EF3BBE448C89A5D021994F94A2C"><enum>(i)</enum><text>the coordination between mental health and physical health providers;</text>
</clause><clause commented="no" id="HEEB7C7CA88BF45E6AF7201E19AE3C0BB"><enum>(ii)</enum><text>the coordination among such providers and the justice and corrections system; and</text> </clause><clause commented="no" id="HD921443BAD2C4519B5B7EB4519D26660"><enum>(iii)</enum><text>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</text>
</clause></subparagraph><subparagraph commented="no" id="H53974CA2B5AF46B1898FA801D570A46C"><enum>(B)</enum><text>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.</text>
</subparagraph></paragraph><paragraph commented="no" id="HB2B76783A5054618863E7A59FE80D980"><enum>(2)</enum><header>Deadline for beginning implementation</header><text>The Laboratory shall begin implementation of the duties described in this section not later than January 1, 2018.</text>
</paragraph><paragraph commented="no" id="H2495F5CBE70B45C7BDA50CE529558EF4"><enum>(3)</enum><header>Consultation</header><text>In carrying out the duties under this section, the Laboratory shall consult with—</text> <subparagraph commented="no" id="H51A59EC3EEFE42C696CD544001C7A8C3"><enum>(A)</enum><text>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;</text>
</subparagraph><subparagraph commented="no" id="H6D00D84E259C4586843B17AB13B9D9C7"><enum>(B)</enum><text>other appropriate Federal agencies;</text> </subparagraph><subparagraph commented="no" id="H9004858F143949A69F3CE144AAF3A5F3"><enum>(C)</enum><text display-inline="yes-display-inline">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</text>
</subparagraph><subparagraph commented="no" id="H558337306B6F41C39E47ECD8C0855BA1"><enum>(D)</enum><text>other individuals and agencies as determined appropriate by the Assistant Secretary.</text></subparagraph></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block> </section><section commented="no" id="H62B8B6EB7B20440E9827F6DBE8E1F72C"><enum>104.</enum><header>Peer-support specialist programs</header> <subsection commented="no" id="HE95DF3DBFA2D4CA79D0D58C5E5A94164"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">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.</text>
</subsection><subsection commented="no" id="H2D508D3B0DEB4C20B9B7B4E78F64698F"><enum>(b)</enum><header>Contents of study</header><text>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—</text>
<paragraph commented="no" id="H26EAD26B63854C95A3A29CCA0EC3B8DF"><enum>(1)</enum><text>hours of formal work or volunteer experience related to mental illness and substance use disorders conducted through such programs;</text>
</paragraph><paragraph commented="no" id="H73FE890CA0144F71A8B7FA904F7C0064"><enum>(2)</enum><text>types of peer-support specialist exams required for such programs in the States;</text> </paragraph><paragraph commented="no" id="H3C77C15AF37744A6B53D44CA2BDEEB63"><enum>(3)</enum><text>codes of ethics used by such programs in the States;</text>
</paragraph><paragraph commented="no" id="H0360474767B84B9D9E6B64E1AC11ADFD"><enum>(4)</enum><text>required or recommended skill sets of such programs in the State; and</text> </paragraph><paragraph commented="no" id="HDAB184F2FDD2417BA09D1B40285D615A"><enum>(5)</enum><text>requirements for continuing education.</text>
</paragraph></subsection></section><section commented="no" id="H0E7BC6E748C74DB4AA4CE973A8F02774"><enum>105.</enum><header>Prohibition against lobbying using Federal funds by systems accepting Federal funds to protect and
advocate the rights of individuals with mental illness</header><text display-inline="no-display-inline">Section 105(a) of the Protection and Advocacy for Individuals with Mental Illness Act (<external-xref legal-doc="usc" parsable-cite="usc/42/10805">42 U.S.C. 10805(a)</external-xref>) is amended—</text>
<paragraph commented="no" id="H01BACF5F0536476F81255F7079A69D90"><enum>(1)</enum><text>in paragraph (9), by striking <quote>and</quote> at the end;</text> </paragraph><paragraph commented="no" id="HAE5FA8AA469F48608286833359849A45"><enum>(2)</enum><text>in paragraph (10), by striking the period at the end and inserting <quote>; and</quote>; and</text>
</paragraph><paragraph commented="no" id="HF0C3106E38BF4BC293F6125B684F26E6"><enum>(3)</enum><text>by adding at the end the following:</text> <quoted-block display-inline="no-display-inline" id="H5F42FCD232CC43E9947C133F9AD9EB76" style="OLC"> <paragraph commented="no" id="H4C1B470ADA99405AA34D052C4F72CC9D"><enum>(11)</enum><text display-inline="yes-display-inline">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.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section><section id="HC79BF2AE36B6408AA23D979530A900BC"><enum>106.</enum><header>Reporting for protection and advocacy organizations</header>
<subsection id="HE49E990265534D259329581677A0CC92"><enum>(a)</enum><header>Public availability of reports</header><text display-inline="yes-display-inline">Section 105(a)(7) of the Protection and Advocacy for Individuals with Mental Illness Act (<external-xref legal-doc="usc" parsable-cite="usc/42/10805">42 U.S.C. 10805(a)(7)</external-xref>) is amended by striking <quote>is located a report</quote> and inserting <quote>is located, and make publicly available, a report</quote>.</text>
</subsection><subsection id="H9696FA18ADB6424EB2A377BC16F81452"><enum>(b)</enum><header>Detailed accounting</header><text display-inline="yes-display-inline">Section 114(a) of the Protection and Advocacy for Individuals with Mental Illness Act (<external-xref legal-doc="usc" parsable-cite="usc/42/10824">42 U.S.C. 10824(a)</external-xref>) is amended—</text>
<paragraph id="H59133319C08B4A658E0670BEBA5B3EBD"><enum>(1)</enum><text>in paragraph (3), by striking <quote>and</quote> at the end;</text> </paragraph><paragraph id="H89CA8EA57CD64F8FB6CAB339B90C18C0"><enum>(2)</enum><text>in paragraph (4), by striking the period at the end and inserting <quote>; and</quote>; and</text>
</paragraph><paragraph id="HE93FA23C08E3474D920DA82B4F38451D"><enum>(3)</enum><text>by adding at the end the following:</text> <quoted-block display-inline="no-display-inline" id="HADF4E36467014D43AD12700D89576B9B" style="OLC"> <paragraph id="HF8B8816E7EA3498CB53150899E42465E"><enum>(5)</enum><text display-inline="yes-display-inline">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.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection></section><section id="H9D03FCF128AE41D4871F241D2810E93D"><enum>107.</enum><header>Grievance procedure</header><text display-inline="no-display-inline">Section 105 of the Protection and Advocacy for Individuals with Mental Illness Act (<external-xref legal-doc="usc" parsable-cite="usc/42/10805">42 U.S.C. 10805</external-xref>), as amended, is further amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H0CEE33CF0FAF419CAAEDF3A7A25463A4" style="OLC">
<subsection commented="no" id="H92EE5FB49F314BD4BA75A087C2EF0A6A"><enum>(d)</enum><header>Grievance procedure</header><text display-inline="yes-display-inline">The Secretary shall establish an independent grievance procedure for persons described in subsection (a)(9).</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="HB9BB7CCEA3D94A1BA37E89FDF197D81F"><enum>108.</enum><header>Center for Behavioral Health Statistics and Quality</header><text display-inline="no-display-inline">Title V of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290aa">42 U.S.C. 290aa et seq.</external-xref>) is amended—</text> <paragraph id="H9A2666E3ED274951ABD1C8E9EC0D85F1"><enum>(1)</enum><text display-inline="yes-display-inline">in section 501(b) (<external-xref legal-doc="usc" parsable-cite="usc/42/290aa">42 U.S.C. 290aa(b)</external-xref>), by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H00CBE649B67B4451B44FBA0DC221BE62" style="OLC">
<paragraph id="H86775B1997CF4A69AB601BA958BE4289"><enum>(4)</enum><text display-inline="yes-display-inline">The Center for Behavioral Health Statistics and Quality.</text></paragraph><after-quoted-block>;</after-quoted-block></quoted-block> </paragraph><paragraph id="HB80246FCC6A9471093F55EADFE4B0496"><enum>(2)</enum><text>in section 502(a)(1) (<external-xref legal-doc="usc" parsable-cite="usc/42/290aa-1">42 U.S.C. 290aa–1(a)(1)</external-xref>)—</text>
<subparagraph id="HED69F8B60411489FBDAE837656C0D2B3"><enum>(A)</enum><text>in subparagraph (C), by striking <quote>and</quote> at the end;</text> </subparagraph><subparagraph id="HCC30ACDAFD63406EA8DFA531B6786EDE"><enum>(B)</enum><text>in subparagraph (D), by striking the period at the end and inserting <quote>; and</quote>; and</text>
</subparagraph><subparagraph id="H1493845A50074E06914CF1F821FEAD50"><enum>(C)</enum><text>by inserting after subparagraph (D) the following:</text> <quoted-block display-inline="no-display-inline" id="HD8DBDEC08FF54D3CB672921159717AD9" style="OLC"> <subparagraph id="HFE2EC73136EA432284E1AFB3D338A4D2"><enum>(E)</enum><text display-inline="yes-display-inline">the Center for Behavioral Health Statistics and Quality.</text></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="HBBAF4E1C21524F93A2228FF8613C65DB"><enum>(3)</enum><text>in part B (<external-xref legal-doc="usc" parsable-cite="usc/42/290bb">42 U.S.C. 290bb et seq.</external-xref>) by adding at the end the following new subpart:</text> <quoted-block display-inline="no-display-inline" id="H8611FC903E2248959087857AA1354B82" style="OLC"> <subpart id="H1C540CBC66844E1392B2A90A6112B11E"><enum>4</enum><header>Center for Behavioral Health Statistics and Quality</header> <section id="HB2D411A9B158408B8B0A9E37F724AB22"><enum>520L.</enum><header>Center for Behavioral Health Statistics and Quality</header> <subsection id="H6B97D1638F1B4CC3A09C64FD31199054"><enum>(a)</enum><header>Establishment</header><text display-inline="yes-display-inline">There is established in the Administration a Center for Behavioral Health Statistics and Quality (in this section referred to as the <quote>Center</quote>). The Center shall be headed by a Director (in this section referred to as the <quote>Director</quote>) appointed by the Secretary from among individuals with extensive experience and academic qualifications in research and analysis in behavioral health care or related fields.</text>
</subsection><subsection id="H659948F106054EACBE56AE583F3A75AD"><enum>(b)</enum><header>Duties</header><text>The Director of the Center shall—</text> <paragraph id="H8F8DD9EF42C5430DBEE94B9602CA4C9F"><enum>(1)</enum><text>coordinate the Administration’s integrated data strategy by coordinating—</text>
<subparagraph id="H8886ADB545634655A6EF709D4140B5A0"><enum>(A)</enum><text>surveillance and data collection (including that authorized by section 505);</text> </subparagraph><subparagraph id="H24BCFAEEC7094833AC64A9E3A2277F65"><enum>(B)</enum><text>evaluation;</text>
</subparagraph><subparagraph id="H35D145F309B1495A8CB546755DC9D507"><enum>(C)</enum><text>statistical and analytic support;</text> </subparagraph><subparagraph id="H3EBD6BE3190542D4854D30F1C8E5417C"><enum>(D)</enum><text>service systems research; and</text>
</subparagraph><subparagraph id="HCF83691BAA3D46418783DFBD1F323A91"><enum>(E)</enum><text>performance and quality information systems;</text> </subparagraph></paragraph><paragraph id="H2EA30E37C61B4B248AEE5A61B3BE96AD"><enum>(2)</enum><text>recommend a core set of measurement standards for grant programs administered by the Administration; and</text>
</paragraph><paragraph id="H9D842B3989DC44F88A0F3DD7EDC30947"><enum>(3)</enum><text>coordinate evaluation efforts for the grant programs, contracts, and collaborative agreements of the Administration.</text>
</paragraph></subsection><subsection id="H948C1765D0F64F7B8F307E0AAAEA9337"><enum>(c)</enum><header>Biannual report to Congress</header><text>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—</text>
<paragraph id="H4CBD77CB6E0E4B1287935EF56C66FDC9"><enum>(1)</enum><text>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;</text>
</paragraph><paragraph id="HA8828A821A564DA581AB2D1AC76C3EFF"><enum>(2)</enum><text>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</text>
</paragraph><paragraph id="H988C8E6ECCED419B8951B01BCA29EECC"><enum>(3)</enum><text>such other measures for outcomes of services as the Director may determine.</text> </paragraph></subsection><subsection id="HF9AD3E7A68B246ABAB8F7E7C1C90DBA1"><enum>(d)</enum><header>Staffing Composition</header><text>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—</text>
<paragraph id="H67FC298DF4B2485FA816164D9FF2CC93"><enum>(1)</enum><text>professionals with clinical and research expertise in the prevention and treatment of, and recovery from, mental illness and substance use disorders;</text>
</paragraph><paragraph id="HF13720E610C64F188FD9D6D4722F22BF"><enum>(2)</enum><text>professionals with training and expertise in statistics or research and survey design and methodologies; and</text>
</paragraph><paragraph id="H23695F29CC00415AB7016C524AC2CD22"><enum>(3)</enum><text>other related fields in the social and behavioral sciences, as specified by relevant position descriptions.</text>
</paragraph></subsection><subsection id="H9F799827965F4548881BA13377715C5C"><enum>(e)</enum><header>Grants and contracts</header><text>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.</text>
</subsection><subsection id="HE01B7A97D0834E2CB894B9AD61CCBEB7"><enum>(f)</enum><header>Definition</header><text>In this section, the term <term>emergency room boarding</term> means the practice of admitting patients to an emergency department and holding such patients in the department until inpatient psychiatric beds become available.</text></subsection></section></subpart><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section><section id="H370618CD7CD84F129045BACD6AAC4A07"><enum>109.</enum><header>Strategic plan</header><text display-inline="no-display-inline">Section 501 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290aa">42 U.S.C. 290aa</external-xref>) is further amended—</text> <paragraph id="H638005DFB9104DFC95FC6841D6E39453"><enum>(1)</enum><text>by redesignating subsections (l) through (o) as subsections (m) through (p), respectively; and</text>
</paragraph><paragraph id="HE6A429B03BFF42A7AB00EAAF7A1D1ADA"><enum>(2)</enum><text>by inserting after subsection (k) the following:</text> <quoted-block display-inline="no-display-inline" id="H185BEB2EF0594FD28F6C4CFF03C466D5" style="OLC"> <subsection id="HA1DE7629976C4FD1AE55CC5676CE4AC8"><enum>(l)</enum><header>Strategic plan</header> <paragraph id="H93818FC6364F4C619015B6F5E5310B32"><enum>(1)</enum><header>In general</header><text>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.</text>
</paragraph><paragraph id="H97CAC90DF6EB42D08797D4263CAE2413"><enum>(2)</enum><header>Coordination</header><text display-inline="yes-display-inline">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.</text>
</paragraph><paragraph id="H1F69D5FCF916466698A0968967FA5C93"><enum>(3)</enum><header>Publication of plan</header><text>Not later than December 1, 2017, and every 5 years thereafter, the Assistant Secretary shall—</text> <subparagraph id="H9E65FE372CED45ECB42EBAF29CC4FECA"><enum>(A)</enum><text>submit the strategic plan developed under paragraph (1) to the appropriate committees of Congress; and</text>
</subparagraph><subparagraph id="H08A5D5C2656A4CEDB005153B196AE455"><enum>(B)</enum><text>post such plan on the Internet website of the Administration.</text> </subparagraph></paragraph><paragraph id="H7DE6528534214A429A214765000458B4"><enum>(4)</enum><header>Contents</header><text>The strategic plan developed under paragraph (1) shall—</text>
<subparagraph id="H7CE6F264594E45A493DF0F3BD8AD5E33"><enum>(A)</enum><text>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;</text>
</subparagraph><subparagraph id="H91E323AB6EDD4790AA7F8DF06EF6A94A"><enum>(B)</enum><text>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;</text>
</subparagraph><subparagraph id="H837D107640F84736ADECC024A5B68884"><enum>(C)</enum><text>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;</text>
</subparagraph><subparagraph id="HE913F31C6E0A4C138DECA938B46FD538"><enum>(D)</enum><text>identify opportunities to collaborate with the Health Resources and Services Administration to develop or improve—</text>
<clause id="H842545172D174A4F941D8DFE166789B5"><enum>(i)</enum><text>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</text>
</clause><clause id="H05604DD5EA014DEBA0C008F30F3C4D07"><enum>(ii)</enum><text>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;</text>
</clause></subparagraph><subparagraph id="HC4C8BF9C9FFA41A48141AE4AB91DC461"><enum>(E)</enum><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/25/450b">25 U.S.C. 450b</external-xref>)); and</text>
</subparagraph><subparagraph id="H3BB0BF3544BD406DAEFD0D7430C698E2"><enum>(F)</enum><text>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.</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section><section id="H311D5E669F08483DA296148297809369"><enum>110.</enum><header>Authorities of centers for mental health services and substance abuse treatment</header>
<subsection id="HB8DA92820BCC489FB8AB98AD6230C424"><enum>(a)</enum><header>Center for mental health services</header><text>Section 520(b) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290bb-31">42 U.S.C. 290bb–31(b)</external-xref>) is amended—</text> <paragraph id="H56DF77A18528419BBB3B00E5FF864606"><enum>(1)</enum><text>by redesignating paragraphs (3) through (15) as paragraphs (4) through (16), respectively;</text>
</paragraph><paragraph id="HD34776619CEE4FB69D93DC84CCED504D"><enum>(2)</enum><text>by inserting after paragraph (2) the following:</text> <quoted-block display-inline="no-display-inline" id="HA6CFBA9C2E9D4898ACB4C0688E285AD7" style="OLC"> <paragraph id="HC5FA1E3DEAD945EFBC03174F77A43ECB"><enum>(3)</enum><text>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;</text></paragraph><after-quoted-block>;</after-quoted-block></quoted-block>
</paragraph><paragraph id="HD5B8DC40F152467B80687CD22EDF86B4"><enum>(3)</enum><text>in paragraph (5), as so redesignated, by inserting <quote>through policies and programs that reduce risk and promote resiliency</quote> before the semicolon;</text> </paragraph><paragraph id="HDD8DE41B649C45F8B9A522E6F0593960"><enum>(4)</enum><text>in paragraph (6), as so redesignated, by inserting <quote>in collaboration with the Director of the National Institute of Mental Health,</quote> before <quote>develop</quote>;</text>
</paragraph><paragraph id="H6677D5472F9B4C7289F45CBE9AC15E2B"><enum>(5)</enum><text>in paragraph (8), as so redesignated, by inserting <quote>, increase meaningful participation of individuals with mental illness in programs and activities of the Administration,</quote> before <quote>and protect the legal</quote>;</text>
</paragraph><paragraph id="H83159B35CDB647DFA00768D850AB60BB"><enum>(6)</enum><text>in paragraph (10), as so redesignated, by striking <quote>professional and paraprofessional personnel pursuant to section 303</quote> and inserting <quote>paraprofessional personnel and health professionals</quote>;</text> </paragraph><paragraph id="H4770623DD06042CC9B8B1574001734C3"><enum>(7)</enum><text>in paragraph (11), as so redesignated, by inserting <quote>and telemental health,</quote> after <quote>rural mental health,</quote>;</text>
</paragraph><paragraph commented="no" id="H2A6EBD71EB8542FA83A76B6D5C278848"><enum>(8)</enum><text>in paragraph (12), as so redesignated, by striking <quote>establish a clearinghouse for mental health information to assure the widespread dissemination of such information</quote> and inserting <quote>disseminate mental health information, including evidenced-based practices,</quote>;</text>
</paragraph><paragraph id="H5AF10132B22744CDBDDBEF67E6E9B752"><enum>(9)</enum><text>in paragraph (15), as so redesignated, by striking <quote>and</quote> at the end;</text> </paragraph><paragraph id="H646809A7623547D0BA22B7422D0EA049"><enum>(10)</enum><text>in paragraph (16), as so redesignated, by striking the period and inserting <quote>; and</quote>; and</text>
</paragraph><paragraph id="HE0148DD6C743465581E7F149BE8D0533"><enum>(11)</enum><text>by adding at the end the following:</text> <quoted-block display-inline="no-display-inline" id="H985589BEC0CA4623845B1B072D4928A4" style="OLC"> <paragraph id="H7D07F7513CE14E56B5388B5F085E55EE"><enum>(17)</enum><text display-inline="yes-display-inline">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.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="HE68686536BDF416F83114568AFDE4522"><enum>(b)</enum><header>Director of the center for substance abuse treatment</header><text>Section 507 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290bb">42 U.S.C. 290bb</external-xref>) is amended—</text> <paragraph id="HF79C86543A8040329E96BC25F1431D79"><enum>(1)</enum><text>in subsection (a)—</text>
<subparagraph id="H3CF972FCCFDB4D0086B45192BF508F56"><enum>(A)</enum><text>by striking <quote>treatment of substance abuse</quote> and inserting <quote>treatment of substance use disorders</quote>; and</text> </subparagraph><subparagraph id="HE9759BBCC80E434A9CF3F6FAF5CAAAC3"><enum>(B)</enum><text>by striking <quote>abuse treatment systems</quote> and inserting <quote>use disorder treatment systems</quote>; and</text>
</subparagraph></paragraph><paragraph id="HFF10B74690A54F5A8FD8C96C38A78D89"><enum>(2)</enum><text>in subsection (b)—</text> <subparagraph id="H9F6B91B3E5AA4CF4BEAD02A40E7DB9C5"><enum>(A)</enum><text>in paragraph (3), by striking <quote>abuse</quote> and inserting <quote>use disorder</quote>;</text>
</subparagraph><subparagraph id="H929ADFD46DB245AC817142766729C074"><enum>(B)</enum><text>in paragraph (4), by striking <quote>individuals who abuse drugs</quote> and inserting <quote>individuals who use drugs</quote>;</text> </subparagraph><subparagraph id="HE95BE82146054EA7A7DFB50DF7F7D913"><enum>(C)</enum><text>in paragraph (9), by striking <quote>carried out by the Director</quote>;</text>
</subparagraph><subparagraph id="H03B577372E014E5F98719B8F9AEA6AE6"><enum>(D)</enum><text>by striking paragraph (10);</text> </subparagraph><subparagraph id="H0F72BAE727D042C0BBEE582592DE499E"><enum>(E)</enum><text>by redesignating paragraphs (11) through (14) as paragraphs (10) through (13), respectively;</text>
</subparagraph><subparagraph id="HC08C60B0EF9D4DA3A18A3C88796EB53D"><enum>(F)</enum><text>in paragraph (12), as so redesignated, by striking <quote>; and</quote> and inserting a semicolon; and</text> </subparagraph><subparagraph id="H1DCB16FDEAB64AF5A389FC6A70BBC4C2"><enum>(G)</enum><text>by striking paragraph (13), as so redesignated, and inserting the following:</text>
<quoted-block display-inline="no-display-inline" id="H3AC363546AAE48EDA7B5B1BC1ABF2EF0" style="OLC">
<paragraph id="H4B770C24D22C43BA9910221E7C1BCE54"><enum>(13)</enum><text>ensure the consistent documentation of the application of criteria when awarding grants and the ongoing oversight of grantees after such grants are awarded; and</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H3379CE4604974C59ABD5DC2FF6C4C0D2"><enum>(14)</enum><text>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.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph></subsection></section><section id="H382748E9499A43A79BF4DC3146AD6E8D"><enum>111.</enum><header>Advisory councils</header><text display-inline="no-display-inline">Section 502(b) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290aa-1">42 U.S.C. 290aa–1(b)</external-xref>) is amended—</text> <paragraph id="HB0F702A677904DB69635A71DF2FA9D42"><enum>(1)</enum><text>in paragraph (2)—</text>
<subparagraph id="HF50338BE15644801AEC421E6296E1390"><enum>(A)</enum><text>in subparagraph (E), by striking <quote>and</quote> after the semicolon;</text> </subparagraph><subparagraph id="HEF09905146C14B3AA08EBAD108B968A8"><enum>(B)</enum><text>by redesignating subparagraph (F) as subparagraph (I); and</text>
</subparagraph><subparagraph id="H358E6EA54166419CBF5762A36807C863"><enum>(C)</enum><text>by inserting after subparagraph (E), the following:</text> <quoted-block display-inline="no-display-inline" id="HF2A3581957854C9A809322FA38B6F029" style="OLC"> <subparagraph id="H0EDC34BAD97B470B8AC57597043B3BB0"><enum>(F)</enum><text display-inline="yes-display-inline">for the advisory councils appointed under subsections (a)(1)(A) and (a)(1)(D), the Director of the National Institute of Mental Health;</text>
</subparagraph><subparagraph id="H8D475A0E134E48CFAAE5BAD5A7220B18"><enum>(G)</enum><text display-inline="yes-display-inline">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;</text>
</subparagraph><subparagraph id="H2FE4172B79C24557B740CB10878A0193"><enum>(H)</enum><text display-inline="yes-display-inline">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</text></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H50FFB3543ACD4F17A9DD9F16EA638AD3"><enum>(2)</enum><text>in paragraph (3), by adding at the end the following:</text> <quoted-block display-inline="no-display-inline" id="HE3E66842BCC342D8ADBF492CF6D844B2" style="OLC"> <subparagraph id="H2B552029E5FE455692C8C7EE9AFCF376"><enum>(C)</enum><text>Not less than half of the members of the advisory council appointed under subsection (a)(1)(D)—</text>
<clause id="H92712999563D400E9A1AA164C0B2EDF9"><enum>(i)</enum><text>shall have—</text> <subclause id="H08E2DAB90CFE4EC99A72D56D8A9F5AC7"><enum>(I)</enum><text>a medical degree;</text>
</subclause><subclause id="H44931DD4B98941F7B3D8F33189369545"><enum>(II)</enum><text>a doctoral degree in psychology; or</text> </subclause><subclause id="H8845B6939A7E48E48CF6B4B833AECFF4"><enum>(III)</enum><text>an advanced degree in nursing or social work from an accredited graduate school or be a certified physician assistant; and</text>
</subclause></clause><clause id="H7C8884AA3AAA44DEBB921C61BBB6C022"><enum>(ii)</enum><text>shall specialize in the mental health field.</text></clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block> </paragraph></section><section id="H114C1D1AE78342B3A5B53A731521FAB1"><enum>112.</enum><header>Peer review</header><text display-inline="no-display-inline">Section 504(b) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290aa-3">42 U.S.C. 290aa–3(b)</external-xref>) is amended by adding at the end the following: <quote>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.</quote>.</text>
</section><enum>II</enum><header>Medicaid Mental Health Coverage</header>
<section id="HE020AEE28FB742DCBC9B08A239F7E5B0"><enum>201.</enum><header>Rule of construction related to Medicaid coverage of mental health services and primary care
services furnished on the same day</header><text display-inline="no-display-inline">Nothing in title XIX of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396 et seq.</external-xref>) 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—</text>
<paragraph id="H09064306A424436798E8A51C9323B1FC"><enum>(1)</enum><text>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</text>
</paragraph><paragraph id="HE1D83536C6E94687920F82C8687F269B"><enum>(2)</enum><text display-inline="yes-display-inline">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.</text>
</paragraph></section><section id="HF2D064641BEA4FA982A975B19DDEF0F4"><enum>202.</enum><header>Optional limited coverage of inpatient services furnished in institutions for mental diseases</header>
<subsection id="H54CDE939965B4BFE81AE83798E0E5541"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 1903(m)(2) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396b">42 U.S.C. 1396b(m)(2)</external-xref>) is amended by adding at the end the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="HD99AC3B1553B49AD8A8FFA1FE1728C96" style="traditional">
<subparagraph id="HBCD7921E2B044AAF93053D587392668E" indent="up2"><enum>(I)</enum>
<clause commented="no" display-inline="yes-display-inline" id="HDD165AB703CB45258D4A7B43C0DD191E"><enum>(i)</enum><text display-inline="yes-display-inline">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:</text>
<subclause id="H354808514BC94032A7C91C024B819BD2" indent="up1"><enum>(I)</enum><text>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.</text>
</subclause><subclause id="H062EEF3A188C4847B5F7FFE833947448" indent="up1"><enum>(II)</enum><text>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.</text>
</subclause><subclause id="H87833AE275BA4A8E8206EC319146E75D" indent="up1"><enum>(III)</enum><text display-inline="yes-display-inline">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:</text>
<item id="H9AD9EA3068C74569BA8DA0B5D3E30EDC"><enum>(aa)</enum><text display-inline="yes-display-inline">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.</text>
</item><item id="HF8B3B528841A4A61B82855A22EDC28E8"><enum>(bb)</enum><text display-inline="yes-display-inline">The enrollee is not required by the managed care organization or prepaid inpatient health plan to use the alternative service or setting.</text>
</item><item id="H437696E091E44881A11980AB2193B058"><enum>(cc)</enum><text display-inline="yes-display-inline">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.</text>
</item></subclause></clause><clause id="HE95EDE6BC3DF435789AE9976B59A8E12" indent="up1"><enum>(ii)</enum><text display-inline="yes-display-inline">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.</text></clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H34F72378F4B94B58A94E05BEE2F4C935"><enum>(b)</enum><header>Effective date</header><text>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.</text>
</subsection></section><section id="H0FFCE5C85CA24903A402463F18EA5FE2"><enum>203.</enum><header>Study and report related to Medicaid managed care regulation</header>
<subsection id="HC9FA3C713AA54732B4703D4D972EDCE2"><enum>(a)</enum><header>Study</header><text display-inline="yes-display-inline">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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396 et seq.</external-xref>) of services provided through a medicaid managed care organization (as defined in section 1903(m) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396b">42 U.S.C. 1396b(m)</external-xref>) 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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1396d">42 U.S.C. 1396d(i)</external-xref>)). Such study shall include information on the following:</text>
<paragraph id="HCD1B272B2A614017A6CED1ABFDA85A26"><enum>(1)</enum><text>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.</text>
</paragraph><paragraph id="H2A965D6D2A5946F6AC1AAD918E60640E"><enum>(2)</enum><text>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.</text>
</paragraph><paragraph id="H42188E0ADA57405CBB16381DAF69C15A"><enum>(3)</enum><text>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.</text>
</paragraph><paragraph id="HA4154A0871284B6598BF164782A9B61C"><enum>(4)</enum><text display-inline="yes-display-inline">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.</text>
</paragraph><paragraph id="HB338CB4469CB48C08C59B0524386AA7F"><enum>(5)</enum><text>The extent to which the provision of services within such institutions has affected the capitated payments for such organizations or plans.</text>
</paragraph></subsection><subsection id="HE057EA36857248A2A55B43A82042B205"><enum>(b)</enum><header>Report</header><text>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).</text>
</subsection></section><section id="H6F4C6CDF488747528F81072BBB8CD7AD"><enum>204.</enum><header>Guidance on opportunities for innovation</header><text display-inline="no-display-inline">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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396 et seq.</external-xref>). The letter shall include opportunities for demonstration projects under section 1115 of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1315">42 U.S.C. 1315</external-xref>), to improve care for such individuals.</text>
</section><section id="HDBC67AC444AB465A85A7421BFCCD12B3"><enum>205.</enum><header>Study and report on Medicaid emergency psychiatric demonstration project</header>
<subsection id="H423A1AECAAE0486E9BD5F4F0C4DFECB5"><enum>(a)</enum><header>Collection of information</header><text display-inline="yes-display-inline">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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a</external-xref> note), collect from each such State information on the following:</text>
<paragraph id="HAEDCA80322B34F33B4B88882F807EC6D"><enum>(1)</enum><text display-inline="yes-display-inline">The number of institutions for mental diseases (as defined in section 1905(i) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396d">42 U.S.C. 1396d(i)</external-xref>)) 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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396 et seq.</external-xref>) (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.</text>
</paragraph><paragraph id="H7DB17954CBF94F10BA0A5D33EB7025CA"><enum>(2)</enum><text display-inline="yes-display-inline">The extent to which there is a reduction in expenditures under the Medicaid program under title XIX of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396 et seq.</external-xref>) 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.</text>
</paragraph><paragraph id="H6DF7E78583094C99B2FE2FEAF8F0E588"><enum>(3)</enum><text display-inline="yes-display-inline">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.</text>
</paragraph><paragraph id="H4532D686D3D04952A258A8C236078D41"><enum>(4)</enum><text display-inline="yes-display-inline">The amount of any disproportionate share hospital payments under section 1923 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396r-4">42 U.S.C. 1396r–4</external-xref>) 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.</text>
</paragraph><paragraph id="H6C0F8FBEB973458CB10038F16D2F10EE"><enum>(5)</enum><text display-inline="yes-display-inline">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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396 et seq.</external-xref>) (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—</text>
<subparagraph id="H007C25DF264849DD80DB55F69F90D6DE"><enum>(A)</enum><text display-inline="yes-display-inline">the types of such facilities or sites (such as an institution for mental diseases, a hospital emergency department, or other inpatient hospital);</text>
</subparagraph><subparagraph id="H6C609F67B3CF49128F86850C6019B20F"><enum>(B)</enum><text display-inline="yes-display-inline">the average length of stay in such a facility or site by such an individual, disaggregated by facility type; and</text>
</subparagraph><subparagraph id="H4A0F39234B394FB99B906562417A2A68"><enum>(C)</enum><text>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.</text>
</subparagraph></paragraph><paragraph id="H62F5FBCFA4BA42289E56F6DB2F1A3154"><enum>(6)</enum><text display-inline="yes-display-inline">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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396 et seq.</external-xref>) (or under a waiver of such plan), between—</text>
<subparagraph id="H4C30715F41024F449BBAAF009B058C3A"><enum>(A)</enum><text display-inline="yes-display-inline">those individuals who received treatment in an institution for mental diseases under the demonstration project;</text>
</subparagraph><subparagraph id="H173B5C4AE2D84090B6CD177EF6BB4D75"><enum>(B)</enum><text display-inline="yes-display-inline">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</text>
</subparagraph><subparagraph id="HF2820571B6344190A6FD272D8590A188"><enum>(C)</enum><text display-inline="yes-display-inline">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.</text>
</subparagraph></paragraph></subsection><subsection id="HFFC4D3ABF7BA41F4A45EA9688C75FAE6"><enum>(b)</enum><header>Report</header><text display-inline="yes-display-inline">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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a</external-xref> note) or separately.</text>
</subsection></section><section id="H1E7E42D59E2A49A09BD470BB83C2D5ED"><enum>206.</enum><header>Providing EPSDT services to children in IMDs</header>
<subsection id="HC723FC954C94417C94470283B519FB64"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 1905(a)(16) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396d">42 U.S.C. 1396d(a)(16)</external-xref>) is amended—</text> <paragraph id="H8424EBC9071E4C16992BF39C91709981"><enum>(1)</enum><text>by striking <quote>effective January 1, 1973</quote> and inserting <quote>(A) effective January 1, 1973</quote>; and</text>
</paragraph><paragraph id="H926B0BF093DB44679C6DF10E75C7679B"><enum>(2)</enum><text>by inserting before the semicolon at the end the following: <quote>, 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</quote>.</text>
</paragraph></subsection><subsection id="HDC3845ED9B0C4777A1EDC5A2FA44953F"><enum>(b)</enum><header>Effective date</header><text>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.</text>
</subsection></section><section id="H9BB51FBD2DDC4CD8B71CD033CCA536F9"><enum>207.</enum><header>Electronic visit verification system required for personal care services and home health care
services under Medicaid</header>
<subsection id="H260D1169165A42C5AF1C890FA41E7A4E"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 1903 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396b">42 U.S.C. 1396b</external-xref>) is amended by inserting after subsection (k) the following new subsection:</text>
<quoted-block display-inline="no-display-inline" id="H7E818848057C4D7DB3B4EF6E1A9FD266" style="traditional">
<subsection id="H3C8855AF671346BF9447FB3B75036C30"><enum>(l)</enum>
<paragraph commented="no" display-inline="yes-display-inline" id="HF8FF08461B1948F88B31F0937E4F6D0A"><enum>(1)</enum><text display-inline="yes-display-inline">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—</text>
<subparagraph id="H5B8E0FDCABA049018846B9ED324E2023" indent="up1"><enum>(A)</enum><text display-inline="yes-display-inline">in the case of personal care services—</text> <clause id="H0F542D16F945461BA012648B515A3EFD"><enum>(i)</enum><text>for calendar quarters in 2019 and 2020, by .25 percentage points;</text>
</clause><clause id="HDA291CC2EDD34EAE99171FBEA07C08D9"><enum>(ii)</enum><text>for calendar quarters in 2021, by .5 percentage points;</text> </clause><clause id="HE56DE0C984714E2B9D07A46C664E1FF1"><enum>(iii)</enum><text display-inline="yes-display-inline">for calendar quarters in 2022, by .75 percentage points; and</text>
</clause><clause id="H6D142AE5530D4EFB89EAB294CA709008"><enum>(iv)</enum><text>for calendar quarters in 2023 and each year thereafter, by 1 percentage point; and</text> </clause></subparagraph><subparagraph id="H02E15003D42A4237A0E5D151EACC0A19" indent="up1"><enum>(B)</enum><text display-inline="yes-display-inline">in the case of home health care services—</text>
<clause id="HBFE33A4AF4ED4513A017DD25EB3FF1E7"><enum>(i)</enum><text>for calendar quarters in 2023 and 2024, by .25 percentage points;</text> </clause><clause id="HEF735D111C8043D0A0E5482B6341AD76"><enum>(ii)</enum><text>for calendar quarters in 2025, by .5 percentage points;</text>
</clause><clause id="H3EAC6818AB4642AA929D81A386E9AABF"><enum>(iii)</enum><text>for calendar quarters in 2026, by .75 percentage points; and</text> </clause><clause id="H52B3C19DCAA449B581763C4912A1746E"><enum>(iv)</enum><text display-inline="yes-display-inline">for calendar quarters in 2027 and each year thereafter, by 1 percentage point.</text>
</clause></subparagraph></paragraph><paragraph id="H4250512EC07943008ABA6F6EBA1F8F15" indent="up1"><enum>(2)</enum><text display-inline="yes-display-inline">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—</text>
<subparagraph id="H7D7E4E11A6F5467FAB44F3D182854B38"><enum>(A)</enum><text>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—</text>
<clause id="HDA88D17FB0244D0BADD77DE97179D103"><enum>(i)</enum><text display-inline="yes-display-inline">is minimally burdensome;</text> </clause><clause id="H2D7D70AC9A4B4E149BAF93915AC5AEC8"><enum>(ii)</enum><text display-inline="yes-display-inline">takes into account existing best practices and electronic visit verification systems in use in the State; and</text>
</clause><clause id="H9E7EB4F8E90A49D4B452C845AAF72FE6"><enum>(iii)</enum><text display-inline="yes-display-inline">is conducted in accordance with the requirements of HIPAA privacy and security law (as defined in section 3009 of the Public Health Service Act);</text>
</clause></subparagraph><subparagraph id="HEA2EE477CCDE4DAD828C460E5FF15CB1"><enum>(B)</enum><text display-inline="yes-display-inline">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</text>
</subparagraph><subparagraph id="H21A931013796409983E3214A0150047D"><enum>(C)</enum><text display-inline="yes-display-inline">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.</text>
</subparagraph></paragraph><paragraph id="H6A61FF41812C420F8F65F245795FEECA" indent="up1"><enum>(3)</enum><text display-inline="yes-display-inline">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.</text>
</paragraph><paragraph id="H0CBB36A0B6C6418BB85A9B84B891A05B" indent="up1"><enum>(4)</enum>
<subparagraph commented="no" display-inline="yes-display-inline" id="H73254C222F6549DC8D47DDBED7226A37"><enum>(A)</enum><text display-inline="yes-display-inline">In the case of a State described in subparagraph (B), the reduction under paragraph (1) shall not apply—</text>
<clause id="HB5A4E9161C4D4232A1F6192F8907D675" indent="up1"><enum>(i)</enum><text display-inline="yes-display-inline">in the case of personal care services, for calendar quarters in 2019; and</text> </clause><clause id="HF62B2CB1BBA14D17810C143DC3F0DAD0" indent="up1"><enum>(ii)</enum><text display-inline="yes-display-inline">in the case of home health care services, for calendar quarters in 2023.</text>
</clause></subparagraph><subparagraph id="HBE2E86FB66534CDD960A339A5C2EC617" indent="up1"><enum>(B)</enum><text display-inline="yes-display-inline">For purposes of subparagraph (A), a State described in this subparagraph is a State that demonstrates to the Secretary that the State—</text>
<clause id="HA4EEC192183B415296A0CE5511D3D6E6"><enum>(i)</enum><text>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</text>
</clause><clause id="H285D9CCC1A06405A83994FD1F5D7BE04"><enum>(ii)</enum><text>in implementing such a system, has encountered unavoidable system delays.</text> </clause></subparagraph></paragraph><paragraph id="H81949370A25742739E5F194596F71756" indent="up1"><enum>(5)</enum><text display-inline="yes-display-inline">In this subsection:</text>
<subparagraph id="HE1430D8788324CEDBC926A9D7B78492E"><enum>(A)</enum><text display-inline="yes-display-inline">The term <quote>electronic visit verification system</quote> 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—</text>
<clause id="H060B231923B84B81BF5855FD3861EF6C"><enum>(i)</enum><text>the type of service performed;</text> </clause><clause id="H3BB295859C8F4AEF8B1698BC910BE8BD"><enum>(ii)</enum><text>the individual receiving the service;</text>
</clause><clause id="H6D1C46EEFA284BDC9BF2A4CE4A146B53"><enum>(iii)</enum><text>the date of the service;</text> </clause><clause id="HEFAB3507116B4409984F53862802B789"><enum>(iv)</enum><text>the location of service delivery;</text>
</clause><clause id="H1C6C8236636E45E384C8413FAB1C97D3"><enum>(v)</enum><text>the individual providing the service; and</text> </clause><clause id="H151349AFCB384F09A825DE25B29372C0"><enum>(vi)</enum><text>the time the service begins and ends.</text>
</clause></subparagraph><subparagraph id="H20DA8619605D4C0A93B2904F70B55D19"><enum>(B)</enum><text display-inline="yes-display-inline">The term <quote>home health care services</quote> means services described in section 1905(a)(7) provided under a State plan under this title (or under a waiver of the plan).</text>
</subparagraph><subparagraph id="H86E562441C204955BDB7E839A19CA4B8"><enum>(C)</enum><text>The term <quote>personal care services</quote> 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.</text>
</subparagraph></paragraph><paragraph id="H6BFD9D9E158448C7AE61F23AE758204F" indent="up1"><enum>(6)</enum>
<subparagraph commented="no" display-inline="yes-display-inline" id="HA9AA8AA68AC345D5AC45DC579C69F2C3"><enum>(A)</enum><text display-inline="yes-display-inline">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.</text>
</subparagraph><subparagraph id="H1CF92571A9E649508099323EBE92AE03" indent="up1"><enum>(B)</enum><text display-inline="yes-display-inline">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.</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H2A99A3BED49C464B9EBFF53DB4827372"><enum>(b)</enum><header>Collection and dissemination of best practices</header><text display-inline="yes-display-inline">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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1396b">42 U.S.C. 1396b</external-xref>), as inserted by subsection (a)), collect and disseminate best practices to State Medicaid Directors with respect to—</text>
<paragraph id="H234E578261A24BA883A713E17CA45AB0"><enum>(1)</enum><text display-inline="yes-display-inline">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</text>
</paragraph><paragraph id="H7163C3D585004DC99C860807BF432115"><enum>(2)</enum><text display-inline="yes-display-inline">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.</text>
</paragraph></subsection><subsection id="H1901556D695A4736940561AD5516AFF9"><enum>(c)</enum><header>Rules of construction</header>
<paragraph id="HB9ED915DF11343D69EEA4682F98C86F4"><enum>(1)</enum><header>No employer-employee relationship established</header><text>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).<italic></italic></text>
</paragraph><paragraph id="H0ADB2C217F194C269C51CD0823F7A073"><enum>(2)</enum><header>No particular or uniform electronic visit verification system required</header><text display-inline="yes-display-inline">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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1396b">42 U.S.C. 1396b</external-xref>), 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) (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396 et seq.</external-xref>).</text>
</paragraph><paragraph id="HF87AF291DD3C459FBA9CF9851E60AECE"><enum>(3)</enum><header>No limits on provision of care</header><text display-inline="yes-display-inline">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) (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396 et seq.</external-xref>), provider selection, constrain beneficiaries’ selection of a caregiver, or impede the manner in which care is delivered.</text>
</paragraph><paragraph id="HE53D3717B65B440D921C1619ABA1D4CF"><enum>(4)</enum><header>No prohibition on State quality measures requirements</header><text display-inline="yes-display-inline">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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1396b">42 U.S.C. 1396b</external-xref>), as inserted by subsection (a)), from establishing requirements related to quality measures for such system.</text>
</paragraph></subsection></section><enum>III</enum><header>Interdepartmental Serious Mental Illness Coordinating Committee</header>
<section id="HBF546EFB8DED4183B94869814A5DE2E2"><enum>301.</enum><header>Interdepartmental Serious Mental Illness Coordinating Committee</header>
<subsection id="H345F286AB1FE4084912CA5AB446B7E93"><enum>(a)</enum><header>Establishment</header>
<paragraph id="H37F51D738D28466B8BA80AD14F1A1EB2"><enum>(1)</enum><header>In general</header><text>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 <quote>Interdepartmental Serious Mental Illness Coordinating Committee</quote> (in this section referred to as the <quote>Committee</quote>).</text>
</paragraph><paragraph id="HE9BD4947F5014F7DB8B4C06DBC189B70"><enum>(2)</enum><header>Federal Advisory Committee Act</header><text>Except as provided in this section, the provisions of the Federal Advisory Committee Act (5 U.S.C. App.) shall apply to the Committee.</text>
</paragraph></subsection><subsection id="H1125A6A1030D4878AEEEB160830BCF5B"><enum>(b)</enum><header>Meetings</header><text>The Committee shall meet not fewer than two times each year.</text> </subsection><subsection id="HE50F5D4551084EC5B7E58D544911ACFE"><enum>(c)</enum><header>Responsibilities</header><text>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—</text>
<paragraph id="H3AC8F50CFAB54ECC9887A0CEE55D5B32"><enum>(1)</enum><text>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;</text>
</paragraph><paragraph id="H5F2E9A5D416F4874B3721F9D49ECF6E2"><enum>(2)</enum><text>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—</text>
<subparagraph id="HF9DB978864E14A029710B4E8778C3BE5"><enum>(A)</enum><text>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;</text>
</subparagraph><subparagraph id="HD1B9E122C36F427F88A2BE906CF588AE"><enum>(B)</enum><text>increased rates of employment and enrollment in educational and vocational programs;</text> </subparagraph><subparagraph id="HD5B0FEC6E28446DCAB89349E1CE92D0B"><enum>(C)</enum><text>quality of mental illness and substance use disorder treatment services; and</text>
</subparagraph><subparagraph id="H4D517387D00647CD801770402F22BA36"><enum>(D)</enum><text>any other criteria as may be determined by the Secretary;</text> </subparagraph></paragraph><paragraph id="H8029641237324CD5BC375BF079D29E1F"><enum>(3)</enum><text display-inline="yes-display-inline">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</text>
</paragraph><paragraph id="H46CC4F7B780143759B478D8305DBA03B"><enum>(4)</enum><text>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.</text>
</paragraph></subsection><subsection id="H56BE20F7F460443D8A37FB803E6B202D"><enum>(d)</enum><header>Committee extension</header><text>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.</text>
</subsection><subsection id="H482683C279B64B108DB370C395251231"><enum>(e)</enum><header>Membership</header>
<paragraph id="H46E66ED9F2C64E1BB08B1F50808CAA1A"><enum>(1)</enum><header>Federal members</header><text>The Committee shall be composed of the following Federal representatives, or their designees:</text> <subparagraph id="H9C9A2D536177427B9F327D6C56DA97A8"><enum>(A)</enum><text>The Secretary of Health and Human Services, who shall serve as the Chair of the Committee.</text>
</subparagraph><subparagraph id="HDCECCAA7B69147CAB86F53711925B633"><enum>(B)</enum><text display-inline="yes-display-inline">The Director of the National Institutes of Health.</text> </subparagraph><subparagraph id="H3BB93299C9A1412B93FC04E3A0AAA808"><enum>(C)</enum><text>The Assistant Secretary for Health of the Department of Health and Human Services.</text>
</subparagraph><subparagraph id="HFB6BCFF567F84BF78F80FB0421448D69"><enum>(D)</enum><text>The Assistant Secretary for Mental Health and Substance Use.</text> </subparagraph><subparagraph id="HBD03EEFC8DD04692B66226095E4D0CDD"><enum>(E)</enum><text>The Attorney General of the United States.</text>
</subparagraph><subparagraph id="H186F46D9DDFD435485899336FA626EB9"><enum>(F)</enum><text>The Secretary of Veterans Affairs.</text> </subparagraph><subparagraph id="HC58D6E65C2A34D948B7A6DDFC71E8768"><enum>(G)</enum><text>The Secretary of Defense.</text>
</subparagraph><subparagraph id="HDA6C04FD1286415C84C5C4747D5DB1AC"><enum>(H)</enum><text>The Secretary of Housing and Urban Development.</text> </subparagraph><subparagraph id="H4479EA7EF45E43F4A13316B4FE058A3E"><enum>(I)</enum><text>The Secretary of Education.</text>
</subparagraph><subparagraph id="HBDE4D8E6C4B449D2A5231A515D5F0FF6"><enum>(J)</enum><text>The Secretary of Labor.</text> </subparagraph><subparagraph id="H9FE974983DCF49AD99E0FAF8BAF8FEA3"><enum>(K)</enum><text>The Commissioner of Social Security.</text>
</subparagraph><subparagraph id="HD59D2D255F3B4C3A94BC33A04CD3B893"><enum>(L)</enum><text>The Administrator of the Centers for Medicare & Medicaid Services.</text> </subparagraph></paragraph><paragraph id="H4EE36C4FE33A49CBB56483723F4EF2FB"><enum>(2)</enum><header>Non-Federal members</header><text>The Committee shall also include not less than 14 non-Federal public members appointed by the Secretary of Health and Human Services, of which—</text>
<subparagraph id="HAFDC8444E4D44883AAB68345D2D5137E"><enum>(A)</enum><text display-inline="yes-display-inline">at least two members shall be individuals with lived experience with serious mental illness or serious emotional disturbance;</text>
</subparagraph><subparagraph id="HB4926577993E49DBA2D6F86A4B9EA8EA"><enum>(B)</enum><text>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;</text>
</subparagraph><subparagraph id="HB34E5050BB9B4A7AB915FE64EC884E0E"><enum>(C)</enum><text>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;</text>
</subparagraph><subparagraph id="H0B7C213C76BE492EA46B74FF984025EF"><enum>(D)</enum><text>at least two members shall be—</text> <clause id="H71B2F1EBAAFD4D34903476AB1F1FC5F8"><enum>(i)</enum><text>a licensed psychiatrist with experience treating serious mental illnesses or serious emotional disturbances;</text>
</clause><clause id="H94E207B46D3B479986E1354FBA4A84A0"><enum>(ii)</enum><text>a licensed psychologist with experience treating serious mental illnesses or serious emotional disturbances;</text>
</clause><clause id="HFBE2E889788D403F8905772836A2FAEF"><enum>(iii)</enum><text>a licensed clinical social worker with experience treating serious mental illness or serious emotional disturbances; or</text>
</clause><clause id="H157047BAC8C44377AC7AC112B277A659"><enum>(iv)</enum><text>a licensed psychiatric nurse, nurse practitioner, or physician assistant with experience treating serious mental illnesses or serious emotional disturbances;</text>
</clause></subparagraph><subparagraph id="H86D9076FC6B24523B3D2D1029AA0C3E9"><enum>(E)</enum><text>at least one member shall be a licensed mental health professional with a specialty in treating children and adolescents with serious emotional disturbances;</text>
</subparagraph><subparagraph id="H344BB0D608EA42C5B0D5F69FBCC425B7"><enum>(F)</enum><text>at least one member shall be a mental health professional who has research or clinical mental health experience working with minorities;</text>
</subparagraph><subparagraph id="H88FCD2F0CF99488985AC787E4A54251F"><enum>(G)</enum><text>at least one member shall be a mental health professional who has research or clinical mental health experience working with medically underserved populations;</text>
</subparagraph><subparagraph id="H8504B6982D1B421D8284A4B1B6AEDD00"><enum>(H)</enum><text>at least one member shall be a State certified mental health peer-support specialist;</text> </subparagraph><subparagraph id="HA563D95164F140EFA6DCA72EB069318B"><enum>(I)</enum><text display-inline="yes-display-inline">at least one member shall be a judge with experience adjudicating cases within a mental health court;</text>
</subparagraph><subparagraph id="H540A2E13F33A490D9854E0AE3D17D3AC"><enum>(J)</enum><text>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</text>
</subparagraph><subparagraph id="H5E799AB94DA64B3DA08CC8989E129B95"><enum>(K)</enum><text>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.</text>
</subparagraph></paragraph><paragraph id="HB5A353527DF14A7C8B06E11E31758A1C"><enum>(3)</enum><header>Terms</header><text>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.</text>
</paragraph></subsection><subsection id="HBBFEAF05D0C548058E1B842B142E466A"><enum>(f)</enum><header>Working groups</header><text>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.</text>
</subsection><subsection id="H843787BBB2E64A89B74566152C983439"><enum>(g)</enum><header>Sunset</header><text>The Committee shall terminate on the date that is 6 years after the date on which the Committee is established under subsection (a)(1).</text>
</subsection></section><enum>IV</enum><header>Compassionate Communication on HIPAA</header>
<section id="HE0C96DD14C494CEEB36B46C0A43B205A"><enum>401.</enum><header>Sense of Congress</header>
<subsection id="H2A7085113B8445E2B73C0921291DDE1F"><enum>(a)</enum><header>Findings</header><text>Congress finds the following:</text> <paragraph id="HE1CC157AF2CB47B6983A254362FC1261"><enum>(1)</enum><text>The vast majority of individuals with mental illness are capable of understanding their illness and caring for themselves.</text>
</paragraph><paragraph id="HAC3C8A3C37B642D3AC22166CE466436E"><enum>(2)</enum><text>Persons with serious mental illness (in this section referred to as <quote>SMI</quote>), 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.</text>
</paragraph><paragraph id="H2FD5DB3A748D4F6498FFB56A9137A7E8"><enum>(3)</enum><text>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.</text>
</paragraph><paragraph id="H5901E0B0D2D64781AA156B4B0227F62B"><enum>(4)</enum><text>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.</text>
</paragraph><paragraph id="H0A9E74AB1A5C4702A3F9CFB909CFF09D"><enum>(5)</enum><text>Episodes of psychiatric crises among those with SMI can result in neurological harm to the individual’s brain.</text>
</paragraph><paragraph id="H6554AC92142844E9B7A267122BB8A06D"><enum>(6)</enum><text>Persons with SMI—</text> <subparagraph id="HA4394F7199B747E09C263B547DDB8CF4"><enum>(A)</enum><text>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</text>
</subparagraph><subparagraph id="H6E62E9BD88AA4B39A08E19A8988B2DEC"><enum>(B)</enum><text>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.</text>
</subparagraph></paragraph><paragraph id="HC1345D1D51DF4E36ACF2A210219DBD1E"><enum>(7)</enum><text>Some psychotropic medications, such as second generation antipsychotics, significantly increase risk for chronic illnesses such as diabetes and cardiovascular disease.</text>
</paragraph><paragraph id="HB6896ADC7A054F95B00A4F0710E8E926"><enum>(8)</enum><text>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.</text>
</paragraph><paragraph id="H5D24D79452D5453E9E8048CA2E470261"><enum>(9)</enum><text>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.</text>
</paragraph><paragraph id="H4BDA2CF297C54C7584ED352CF30B5543"><enum>(10)</enum><text>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.</text>
</paragraph><paragraph id="H1A63898EEFEA42A88FC1400FC5E228B8"><enum>(11)</enum><text>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.</text>
</paragraph><paragraph id="H2FEFB212FF0B473FBD5AA681AD086E5B"><enum>(12)</enum><text>Prognosis for the physical and psychiatric health of those with SMI may improve when responsible caregivers facilitate and participate in care.</text>
</paragraph><paragraph id="H2BEE210113424043A097B9CF39C9D578"><enum>(13)</enum><text>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.</text>
</paragraph><paragraph id="H8E50DF8F91E34348A1334C1B4836A708"><enum>(14)</enum><text>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.</text>
</paragraph><paragraph id="HCD28F8DECCF241C1B65B293D931CC58C"><enum>(15)</enum><text>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.</text>
</paragraph><paragraph id="HBF54B862E66643369F3DAF5C9F27769A"><enum>(16)</enum><text>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.</text>
</paragraph></subsection><subsection id="H6CAC977714074841988616891DD107EC"><enum>(b)</enum><header>Sense of Congress</header><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1320d-2">42 U.S.C. 1320d–2</external-xref> 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.</text>
</subsection></section><section id="H8B5B710A675E4D3A9C820D9E9AF8C752"><enum>402.</enum><header>Confidentiality of records</header><text display-inline="no-display-inline">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.</text>
</section><section id="HDA3C30816BE94D2AA3C050552AE7B57B"><enum>403.</enum><header>Clarification of circumstances under which disclosure of protected health information is permitted</header>
<subsection id="HC618795EE3004530AEDE6AE8E0317E58"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1320d">42 U.S.C. 1320d et seq.</external-xref>) and regulations promulgated pursuant to section 264(c) of the Health Insurance Portability and Accountability Act of 1996 (<external-xref legal-doc="usc" parsable-cite="usc/42/1320d-2">42 U.S.C. 1320d–2</external-xref> 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—</text>
<paragraph id="H2BD376B1E6DB4EC3B3E3EB75A860530B"><enum>(1)</enum><text>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;</text>
</paragraph><paragraph id="H9E0013A2B9DE498383CAF6B2CA13EF09"><enum>(2)</enum><text display-inline="yes-display-inline">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;</text>
</paragraph><paragraph id="H9AE9B70165154EF5BCC87A6BE2E60F82"><enum>(3)</enum><text>communicating with the parent or caregiver of a patient in the case that the patient is a minor;</text> </paragraph><paragraph id="H7532B5408C144EEBA3609D8A3BB03D2C"><enum>(4)</enum><text>considering the patient’s capacity to agree or object to the sharing of the protected health information of the patient;</text>
</paragraph><paragraph id="H801948C129E84A8FBFD298AC41BBB9A1"><enum>(5)</enum><text>communicating and sharing information with the family or caregivers of the patient when—</text> <subparagraph id="H14D5A1EE1BBE41F994FF9C7B5C6CC98A"><enum>(A)</enum><text>the patient consents;</text>
</subparagraph><subparagraph id="H5A3A2DE3506A4B1181CB00A62103FDAC"><enum>(B)</enum><text>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;</text>
</subparagraph><subparagraph id="H976473B6635441BCB974CCBF7F0961FD"><enum>(C)</enum><text>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</text>
</subparagraph><subparagraph id="H9E372F1498704620B5E74BECCB6F5C3B"><enum>(D)</enum><text display-inline="yes-display-inline">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;</text>
</subparagraph></paragraph><paragraph id="HE243055ED60A4552A3AC012477F34AF9"><enum>(6)</enum><text>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;</text>
</paragraph><paragraph id="HEFFC492A4B2F410C80DB3F5B04410BA2"><enum>(7)</enum><text>listening to or receiving information with respect to the patient from the family or caregiver of such patient receiving mental illness treatment;</text>
</paragraph><paragraph id="HA20BD7F9946B4DEAA65B6622E6FE046D"><enum>(8)</enum><text>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</text>
</paragraph><paragraph id="H67A01BD3BD6F4CDB8B47260372A7702A"><enum>(9)</enum><text>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.</text>
</paragraph></subsection><subsection id="HBBC3551509FF46C9A1F1AF618B37A4EF"><enum>(b)</enum><header>Coordination</header><text>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.</text>
</subsection><subsection id="H9A507CFD81934FC5B314D4C3548FBB49"><enum>(c)</enum><header>Consistency with guidance</header><text>The Secretary of Health and Human Services shall ensure that the regulations under this section are consistent with the guidance entitled <quote>HIPAA Privacy Rule and Sharing Information Related to Mental Health</quote>, issued by the Department of Health and Human Services on February 20, 2014.</text>
</subsection></section><section id="H9D31145DC6164C06B6F88854BFFFE314"><enum>404.</enum><header>Development and dissemination of model training programs</header>
<subsection id="HBEED106E6D78421699D718B82377FA3B"><enum>(a)</enum><header>Initial programs and materials</header><text display-inline="yes-display-inline">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 <quote>Secretary</quote>) shall develop and disseminate—</text>
<paragraph id="H33EE1BEA7B144E4986A3C16B926F9A41"><enum>(1)</enum><text display-inline="yes-display-inline">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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1320d">42 U.S.C. 1320d et seq.</external-xref>) and regulations promulgated pursuant to section 264(c) of the Health Insurance Portability and Accountability Act of 1996 (<external-xref legal-doc="usc" parsable-cite="usc/42/1320d-2">42 U.S.C. 1320d–2</external-xref> note), the protected health information of patients with a mental illness may be disclosed with and without patient consent;</text>
</paragraph><paragraph id="H01CF1ACAC56B4FDA91BCA92226FCA38F"><enum>(2)</enum><text>a model program and materials for training lawyers and others in the legal profession on such circumstances; and</text>
</paragraph><paragraph id="HD65307240FEC4F6B8348AB3648648270"><enum>(3)</enum><text display-inline="yes-display-inline">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).</text>
</paragraph></subsection><subsection id="H7253E76006D8456CAFC33F20FE20AA6F"><enum>(b)</enum><header>Periodic updates</header><text>The Secretary shall—</text> <paragraph id="HFA2381E15C22450298548E15413ACFA4"><enum>(1)</enum><text>periodically review and update the model programs and materials developed under subsection (a); and</text>
</paragraph><paragraph id="H588725BA101D44A0B1189E8BD5BC7265"><enum>(2)</enum><text>disseminate the updated model programs and materials.</text> </paragraph></subsection><subsection id="H28A19232A1F94E90851D328A96475923"><enum>(c)</enum><header>Contents</header><text display-inline="yes-display-inline">The programs and materials developed under subsection (a) shall address the guidance entitled <quote>HIPAA Privacy Rule and Sharing Information Related to Mental Health</quote>, issued by the Department of Health and Human Services on February 20, 2014.</text>
</subsection><subsection id="H634418775EA14453A0A51E772F6BBB33"><enum>(d)</enum><header>Coordination</header><text display-inline="yes-display-inline">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.</text>
</subsection><subsection id="H8F6F65D2575542F3A13EBA7FD301DA0D"><enum>(e)</enum><header>Input of certain entities</header><text>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.</text>
</subsection><subsection commented="no" id="H93377EC3BC8440349666DB46135E235D"><enum>(f)</enum><header>Funding</header><text display-inline="yes-display-inline">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.</text>
</subsection></section><enum>V</enum><header>Increasing Access to Treatment for Serious Mental Illness</header>
<section commented="no" id="HE3398887A9A6420290065FF822D352F6" section-type="subsequent-section"><enum>501.</enum><header>Assertive community treatment grant program for individuals with serious mental illness</header><text display-inline="no-display-inline">Part B of title V of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290bb">42 U.S.C. 290bb et seq.</external-xref>) is amended by inserting after section 520L the following:</text>
<quoted-block display-inline="no-display-inline" id="H291547A7FE454A8BA2A4BB5A65F95478" style="OLC">
<section id="H8B22D2A49C154B2E89D5006E6EB2B2D6"><enum>520M.</enum><header>Assertive community treatment grant program for individuals with serious mental illness</header>
<subsection commented="no" id="H679847593F3A45F5AF86A05ADB860F43"><enum>(a)</enum><header>In general</header><text>The Assistant Secretary shall award grants to eligible entities—</text> <paragraph commented="no" id="H5894442BD7BD43179F76DA302B168833"><enum>(1)</enum><text>to establish assertive community treatment programs for individuals with serious mental illness; or</text>
</paragraph><paragraph commented="no" id="H954D3A2F891A4E719CAEFA4AA188E977"><enum>(2)</enum><text>to maintain or expand such programs.</text> </paragraph></subsection><subsection commented="no" id="HA0414A4E59134723AB7E2084A0001798"><enum>(b)</enum><header>Eligible entities</header><text display-inline="yes-display-inline">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.</text>
</subsection><subsection commented="no" id="HCA906B52C80F4ADF9A19F9E7311DDAC3"><enum>(c)</enum><header>Special Consideration</header><text>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.</text>
</subsection><subsection commented="no" id="H8A7EC3AB7BE14B1F850AFBAE5ED96396"><enum>(d)</enum><header>Additional Activities</header><text>The Assistant Secretary shall—</text> <paragraph commented="no" id="H35F1C56524774841A93DD34C4D5F4FE0"><enum>(1)</enum><text>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—</text>
<subparagraph commented="no" id="H784E9EA05C0949728E16E2DB28476EA1"><enum>(A)</enum><text>cost savings and public health outcomes such as mortality, suicide, substance abuse, hospitalization, and use of services;</text>
</subparagraph><subparagraph commented="no" id="H391F5471CD0044BC81ABCE93CF6F7834"><enum>(B)</enum><text>rates of involvement with the criminal justice system of patients;</text> </subparagraph><subparagraph commented="no" id="H4D708DC6DD00483BB90B4B8030A8AB97"><enum>(C)</enum><text>rates of homelessness among patients; and</text>
</subparagraph><subparagraph commented="no" id="HEC737CBF306140BEA7E0876EE4A230E4"><enum>(D)</enum><text>patient and family satisfaction with program participation; and</text> </subparagraph></paragraph><paragraph commented="no" id="H9B2970942BB641FA9600A86A3E7F1F45"><enum>(2)</enum><text>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.</text>
</paragraph></subsection><subsection commented="no" id="H5750840B44CB439FBE5129A5242F6E64"><enum>(e)</enum><header>Authorization of appropriations</header>
<paragraph commented="no" id="HC231E6E838B340FAAB8BC9DAEEE018D1"><enum>(1)</enum><header>In general</header><text>To carry out this section, there is authorized to be appropriated $5,000,000 for the period of fiscal years 2018 through 2022.</text>
</paragraph><paragraph commented="no" id="H68D9AF2F31AA4282BC72D61B0BB7BD6A"><enum>(2)</enum><header>Use of Certain Funds</header><text>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).</text></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="H600C2A4D4DE74F70A063367406A81E11"><enum>502.</enum><header>Strengthening community crisis response systems</header><text display-inline="no-display-inline">Section 520F of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290bb-37">42 U.S.C. 290bb–37</external-xref>) is amended to read as follows:</text> <quoted-block display-inline="no-display-inline" id="HF48D471714B44F0094BFF92D797AB8AB" style="OLC"> <section id="H8684CCC3432D4A2C87404D3B2D4CB0E0"><enum>520F.</enum><header>Strengthening community crisis response systems</header> <subsection id="H252B2900770D42F896AA1BD0DF34D410"><enum>(a)</enum><header>In general</header><text>The Secretary shall award competitive grants—</text>
<paragraph id="H179B002E962E4D6BBA19C02C8363F29B"><enum>(1)</enum><text>to State and local governments and Indian tribes and tribal organizations to enhance community-based crisis response systems; or</text>
</paragraph><paragraph id="HCA9D9DDF60054F668B943CC36D30CB2D"><enum>(2)</enum><text>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.</text>
</paragraph></subsection><subsection id="H3A14C5A71B3E4E29ADFECC8E0660C383"><enum>(b)</enum><header>Application</header>
<paragraph id="H78408FD6E59E49EA8424005BF2B63153"><enum>(1)</enum><header>In general</header><text>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.</text>
</paragraph><paragraph id="HA0A999C33593450CB7B9368679933A73"><enum>(2)</enum><header>Community-based crisis response plan</header><text>An application for a grant under subsection (a)(1) shall include a plan for—</text> <subparagraph id="H12873E6CBE724238A7B4F19A0FAE67B6"><enum>(A)</enum><text>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;</text>
</subparagraph><subparagraph id="H90A925A2AA454645B1AFA8F231F192F3"><enum>(B)</enum><text>developing a plan for entering into memoranda of understanding with public and private entities to implement crisis response services;</text>
</subparagraph><subparagraph id="H3C2106C1796D437683ADAF9310D43592"><enum>(C)</enum><text display-inline="yes-display-inline">expanding the continuum of community-based services to address crisis intervention and prevention; and</text>
</subparagraph><subparagraph id="HC301F5A2FF564FDEBE042885C7DFBF28"><enum>(D)</enum><text>developing models for minimizing hospital readmissions, including through appropriate discharge planning.</text>
</subparagraph></paragraph><paragraph id="H0D54F7B447434EDA923AF7928672A588"><enum>(3)</enum><header>Beds database plan</header><text>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.</text>
</paragraph></subsection><subsection id="H298760E93CC242CC8F1ED426A5A889A4"><enum>(c)</enum><header>Database requirements</header><text>A bed database described in this section is a database that—</text> <paragraph id="H2A6C8F54E6D34E8EA1F44E61F7F54FEC"><enum>(1)</enum><text>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;</text>
</paragraph><paragraph id="H95414D66F2484475A9E71FFB7FFBDA4C"><enum>(2)</enum><text>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</text>
</paragraph><paragraph id="H9A3588EB84194A70AB1B2EC536BB0B07"><enum>(3)</enum><text>enables searches of the database to identify available beds that are appropriate for the treatment of individuals in mental or substance use disorder crisis.</text>
</paragraph></subsection><subsection id="H82686A8E1F95497E858F0EC5ACCBCC4C"><enum>(d)</enum><header>Evaluation</header><text>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—</text>
<paragraph id="H92C3795541C84A629354488B4A162B86"><enum>(1)</enum><text>local crisis response services and measures of individuals receiving crisis planning and early intervention supports;</text>
</paragraph><paragraph id="H956356CCB83B4720A5303702D31DA3D3"><enum>(2)</enum><text>individuals reporting improved functional outcomes; and</text> </paragraph><paragraph id="HA2FD632C0D12489FB77CE2C5B04F3B38"><enum>(3)</enum><text>individuals receiving regular followup care following a crisis.</text>
</paragraph></subsection><subsection commented="no" id="H038BBDB496DD4A4EB7ACACF678D63825"><enum>(e)</enum><header>Authorization of appropriations</header><text display-inline="yes-display-inline">There is authorized to be appropriated to carry out this section, $5,000,000 for the period of fiscal years 2018 through 2022.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="HC3DFCD5AA2D14F14B0404C05C60CF630"><enum>503.</enum><header>Increased and extended funding for assisted outpatient grant program for individuals with serious
mental illness</header><text display-inline="no-display-inline">Section 224(g) of the Protecting Access to Medicare Act of 2014 (<external-xref legal-doc="usc" parsable-cite="usc/42/290aa">42 U.S.C. 290aa</external-xref> note) is amended—</text> <paragraph id="H03B11F7A932F42CFB118F6940CCA0373"><enum>(1)</enum><text>in paragraph (1), by striking <quote>2018</quote> and inserting <quote>2022</quote>; and</text>
</paragraph><paragraph commented="no" id="HA3D7619F04724AB6917D603D9CC937E7"><enum>(2)</enum><text>in paragraph (2), by striking <quote>is authorized to be appropriated to carry out this section $15,000,000 for each of fiscal years 2015 through 2018</quote> and inserting <quote>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</quote>.</text>
</paragraph></section><section id="H56CAF50180884797A9E207A69A0FDBB2" section-type="subsequent-section"><enum>504.</enum><header>Liability protections for health professional volunteers at community health centers</header><text display-inline="no-display-inline">Section 224 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/233">42 U.S.C. 233</external-xref>) is amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H725373133BE9498F8874834319F2761A" style="OLC">
<subsection id="HA15CFA955AE14AC5A66A6E5287DB2B4C"><enum>(q)</enum>
<paragraph commented="no" display-inline="yes-display-inline" id="HEE6FF233309D469F85F682634CAF7992"><enum>(1)</enum><text>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.</text>
</paragraph><paragraph id="HD6FBB5CD634D4909A0424D27ED3DFD8E" indent="up1"><enum>(2)</enum><text>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:</text>
<subparagraph id="HE2EFC3C5283A48C8AB6B8F48D02AC5C7"><enum>(A)</enum><text>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.</text>
</subparagraph><subparagraph id="H67CD951A435A4364B73C0DE9662D0D06"><enum>(B)</enum><text>The entity is sponsoring the health care practitioner pursuant to paragraph (3)(B).</text> </subparagraph><subparagraph id="HE6090B9450234BA5AA0465C3BCF953B1"><enum>(C)</enum><text display-inline="yes-display-inline">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.</text>
</subparagraph><subparagraph commented="no" id="H29CFCDE3433647B99920EE95B3702D68"><enum>(D)</enum><text display-inline="yes-display-inline">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.</text>
</subparagraph><subparagraph id="H177CB51A130642CA8F01B23823A62740"><enum>(E)</enum><text>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.</text>
</subparagraph></paragraph><paragraph id="H26468F5E55A24D5CB15D94D8F92D1A32" indent="up1"><enum>(3)</enum><text>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:</text>
<subparagraph id="H78220C5D3D5C4E598F50986C1697BB86"><enum>(A)</enum><text>The first sentence of paragraph (1) applies in lieu of the first sentence of subsection (g)(1)(A).</text> </subparagraph><subparagraph id="H67426B97381C4D5FAF6CECE6D48DB0F8"><enum>(B)</enum><text display-inline="yes-display-inline">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—</text>
<clause id="HAD486097499642F181B4629A24723C99"><enum>(i)</enum><text>with respect to the health care practitioner, the entity submits to the Secretary an application meeting the requirements of subsection (g)(1)(D); and</text>
</clause><clause id="H1387C5F4A1004069AFCC806975FE31CB"><enum>(ii)</enum><text>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.</text>
</clause></subparagraph><subparagraph id="H8036F1D67ADF4E6B9B5AEA2B4386D31A"><enum>(C)</enum><text display-inline="yes-display-inline">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.</text>
</subparagraph><subparagraph id="H1E23CFC6636A4FDE9635270EDA3DDC14"><enum>(D)</enum><text display-inline="yes-display-inline">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.</text>
</subparagraph></paragraph><paragraph id="HD0A922A3A8424730BD5BD3CC7B4D95B9" indent="up1"><enum>(4)</enum>
<subparagraph commented="no" display-inline="yes-display-inline" id="HAD08F466EC834EED81942BC538CB7A9E"><enum>(A)</enum><text>Amounts in the fund established under subsection (k)(2) shall be available for transfer under subparagraph (C) for purposes of carrying out this subsection.</text>
</subparagraph><subparagraph commented="no" id="H7EE0525885604E579DCB64D575EC641A" indent="up1"><enum>(B)</enum><text>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).</text>
</subparagraph><subparagraph commented="no" id="H00618EE69852420993AAFDC3EF78B1D1" indent="up1"><enum>(C)</enum><text>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.</text>
</subparagraph></paragraph><paragraph id="H0D486A4B5AAA482382ADEB582C6DD77E" indent="up1"><enum>(5)</enum>
<subparagraph commented="no" display-inline="yes-display-inline" id="H5594DC0C99C5480683E5A85865EAFF84"><enum>(A)</enum><text>This subsection takes effect on October 1, 2017, except as provided in subparagraph (B).</text> </subparagraph><subparagraph id="H53D1304BA5BA4690BEF5BFE13A0A4401" indent="up1"><enum>(B)</enum><text display-inline="yes-display-inline">Effective on the date of the enactment of this subsection—</text>
<clause id="HFFA6A3FB6EE34C7F9A09BC0542771F28"><enum>(i)</enum><text display-inline="yes-display-inline">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</text>
</clause><clause id="H274F55176F3648A39178B493DC1F44B5"><enum>(ii)</enum><text display-inline="yes-display-inline">reports under paragraph (4)(B) may be submitted to the Congress.</text></clause></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block> </section><enum>VI</enum><header>Supporting Innovative and Evidence-Based Programs</header> <subtitle id="H2D7B7AB36EED405A9FA0AC160E246192" style="OLC"><enum>A</enum><header>Encouraging the Advancement, Incorporation, and Development of Evidence-Based Practices</header> <section id="H513CDAA211B64CC2B4F6E16ABBB386BE"><enum>601.</enum><header>Encouraging innovation and evidence-based programs</header><text display-inline="no-display-inline">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:</text>
<quoted-block display-inline="no-display-inline" id="H983A215284FD4D68B42D38D644CDA828" style="OLC">
<subsection id="HB231024B0FDA4326A3A27A7DB89D3983"><enum>(d)</enum><header>Promoting innovation</header>
<paragraph id="H2C3858C857A646F5A9B7546AA7893BAF"><enum>(1)</enum><header>In general</header><text>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—</text>
<subparagraph id="H44ACC68CDF0B4F87B45B6CE34A4E90B5"><enum>(A)</enum><text>evaluating a model that has been scientifically demonstrated to show promise, but would benefit from further applied development, for—</text>
<clause id="HE05B4AC120E44F62B341A4B714B0E4C3"><enum>(i)</enum><text>enhancing the prevention, diagnosis, intervention, treatment, and recovery of mental illness, serious emotional disturbance, substance use disorders, and co-occurring illness or disorders; or</text>
</clause><clause id="H9AD3CC175FE04A4EB8B6311000FB1967"><enum>(ii)</enum><text>integrating or coordinating physical health services and mental illness and substance use disorder services; and</text>
</clause></subparagraph><subparagraph id="H349F287D521945AFBD92D5464CFCEB27"><enum>(B)</enum><text>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—</text>
<clause id="H7E922B3C152743D2A0212E55BC1DB133"><enum>(i)</enum><text>applying delivery of care, including training staff in effective evidence-based treatment; or</text> </clause><clause id="H880FE4A4FD084B14898187D66D1FBD8F"><enum>(ii)</enum><text>integrating models of care across specialties and jurisdictions.</text>
</clause></subparagraph></paragraph><paragraph id="H4E41AF3F3D0241D9AB896A87AA740771"><enum>(2)</enum><header>Consultation</header><text>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.</text>
</paragraph><paragraph id="HD2BF2D78836C4B1FA8785112977F23B2"><enum>(3)</enum><header>Authorization of appropriations</header><text display-inline="yes-display-inline">There are authorized to be appropriated—</text> <subparagraph id="H8957666A553649F28EBCD62531BB9E97"><enum>(A)</enum><text>to carry out paragraph (1)(A), $7,000,000 for the period of fiscal years 2018 through 2020; and</text>
</subparagraph><subparagraph id="H971C52ED174E4D06BF15B3F04E58D640"><enum>(B)</enum><text>to carry out paragraph (1)(B), $7,000,000 for the period of fiscal years 2018 through 2020.</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block> </section><section id="H67407E86831C40D99675B746E740720B"><enum>602.</enum><header>Promoting access to information on evidence-based programs and practices</header><text display-inline="no-display-inline">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:</text>
<quoted-block display-inline="no-display-inline" id="H129A394ED3F24919B51455D8837D222E" style="OLC">
<section id="H79FCE34CCA554EA2BEAFC7CCFACE7AF4"><enum>544.</enum><header>Promoting access to information on evidence-based programs and practices</header>
<subsection id="HBE2BE1677FFA4669A75500E892311238"><enum>(a)</enum><header>In general</header><text>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.</text>
</subsection><subsection id="H2608463487114A4CA81664BC2202E6E0"><enum>(b)</enum><header>Notice</header>
<paragraph id="HB0C7082D439A46099D7B3B651EAD220D"><enum>(1)</enum><header>Periods</header><text>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.</text>
</paragraph><paragraph id="HCF64BA38AE924484946E1A922CEBB957"><enum>(2)</enum><header>Addressing gaps</header><text>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).</text>
</paragraph></subsection><subsection id="HEA080CA9531C42599181E12AF0DFAABE"><enum>(c)</enum><header>Requirements</header><text>The Assistant Secretary shall establish minimum requirements for applications referred to in this section, including applications related to the submission of research and evaluation.</text>
</subsection><subsection id="HC50180303DE14E0DA1B8C1E3E390E456"><enum>(d)</enum><header>Review and rating</header><text>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.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="HF0203904101443838820E03585A383AD"><enum>603.</enum><header>Sense of Congress</header><text display-inline="no-display-inline">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.</text>
</section></subtitle><subtitle commented="no" id="HF533286630FD493396C0553AC9F6CA25" style="OLC"><enum>B</enum><header>Supporting the State Response to Mental Health Needs</header>
<section commented="no" id="H505A0A12069A43AAB9188E14042AEBE3"><enum>611.</enum><header>Community Mental Health Services Block Grant</header>
<subsection id="HEDBB856F4DA84131BA1F22BB4763CAFB"><enum>(a)</enum><header>Formula grants</header><text>Section 1911(b) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300x">42 U.S.C. 300x(b)</external-xref>) is amended—</text> <paragraph id="H86F5D2D8F11043F5830AE376BB4C14DB"><enum>(1)</enum><text>by redesignating paragraphs (1) through (3) as paragraphs (2) through (4), respectively; and</text>
</paragraph><paragraph id="H2E1986400F6B49ABB30CF7CA9765A258"><enum>(2)</enum><text>by inserting before paragraph (2) (as so redesignated), the following:</text> <quoted-block display-inline="no-display-inline" id="H4B33D074D4A541D0A0A73F6A0E9859AD" style="OLC"> <paragraph id="HBE73F257096042AD8EB54E6AFACAB5DF"><enum>(1)</enum><text>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);</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection commented="no" id="HED5B662B1AD94360A5729B0F3188EFC0"><enum>(b)</enum><header>State plan</header><text>Subsection (b) of section 1912 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300x-1">42 U.S.C. 300x–1</external-xref>) is amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H58AF78853E794EB1974844A3A2C2FBEE" style="OLC">
<subsection commented="no" id="H1B0D034A019141A8A1650EDE3E99BB90"><enum>(b)</enum><header>Criteria for Plan</header><text display-inline="yes-display-inline">The criteria specified in this subsection are as follows:</text> <paragraph commented="no" id="H83121AE8740D4CC78300AA3B33586B10"><enum>(1)</enum><header>System of care</header><text>The plan provides a description of the system of care of the State, including as follows:</text>
<subparagraph commented="no" id="H74B468885D1A48B6B651AC3665DCB2FB"><enum>(A)</enum><header>Comprehensive community-based health systems</header><text>The plan shall—</text> <clause commented="no" id="H6FC2F84C47BE4B3D8DDF415E145C7C55"><enum>(i)</enum><text display-inline="yes-display-inline">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;</text>
</clause><clause commented="no" id="HA202F112685D454895479FD1A0499F96"><enum>(ii)</enum><text display-inline="yes-display-inline">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;</text>
</clause><clause commented="no" id="H102F2E1F11C14EA880BDCA524E50969D"><enum>(iii)</enum><text>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;</text>
</clause><clause commented="no" id="H928D746F775A40589B284E3C5342FA31"><enum>(iv)</enum><text>include a description of how the State—</text> <subclause id="H7A99B467C3CD4A7E816E53AAB3784F8E"><enum>(I)</enum><text>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;</text>
</subclause><subclause id="H739035A3BA4845039A0E6D4A8A9ECC81"><enum>(II)</enum><text>provides comprehensive individualized treatment; or</text> </subclause><subclause id="HD767B6C139F240E89049843E120468E1"><enum>(III)</enum><text>integrates mental and physical health services;</text>
</subclause></clause><clause commented="no" id="H31F250BB35F2400190A5E86DFD581EB8"><enum>(v)</enum><text>include a description of case management services in the State;</text> </clause><clause commented="no" id="HC330ED5EBEB3459F8E9199BD32861304"><enum>(vi)</enum><text display-inline="yes-display-inline">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</text>
</clause><clause commented="no" id="H08FB23F6D75B430F8FA4E4197075C360"><enum>(vii)</enum><text>as appropriate to and reflective of the uses the State proposes for the block grant monies—</text> <subclause commented="no" id="H32A8FA1743504B38BE030B990CAB70F2"><enum>(I)</enum><text>a description of the activities intended to reduce hospitalizations and hospital stays using the block grant monies;</text>
</subclause><subclause commented="no" id="H00E659932C6045BB964723417FE1D2C1"><enum>(II)</enum><text>a description of the activities intended to reduce incidents of suicide using the block grant monies; and</text>
</subclause><subclause commented="no" id="H5CF64B38D7224188800793AD8FF03793"><enum>(III)</enum><text>a description of how the State integrates mental health and primary care using the block grant monies.</text>
</subclause></clause></subparagraph><subparagraph commented="no" id="HA80FB25F21E74A14B9877A6B4F316457"><enum>(B)</enum><header>Mental health system data and epidemiology</header><text>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.</text>
</subparagraph><subparagraph commented="no" id="H08B449C6B6964965BDECF44882702367"><enum>(C)</enum><header>Children’s services</header><text display-inline="yes-display-inline">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).</text>
</subparagraph><subparagraph commented="no" id="HC4BD31442B63404AB340817045F6B599"><enum>(D)</enum><header>Targeted services to rural and homeless populations</header><text>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.</text>
</subparagraph><subparagraph commented="no" id="H72E27B0174744F62B1413632721A466F"><enum>(E)</enum><header>Management services</header><text display-inline="yes-display-inline">The plan shall—</text> <clause id="H3D1A8370BA3F4021B3B2EDDCDD286A06"><enum>(i)</enum><text>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;</text>
</clause><clause id="H217D362818D44D9682A7A23CF9DD386F"><enum>(ii)</enum><text>provide for the training of providers of emergency health services regarding mental health;</text> </clause><clause id="H045365ABD2824C52BF14B6BAA198BF93"><enum>(iii)</enum><text>describe the manner in which the State intends to expend the grant under section 1911 for the fiscal year involved; and</text>
</clause><clause id="H01BAC122BCB8445DA5C9D7BA75EA8040"><enum>(iv)</enum><text>describe the manner in which the State intends to comply with each of the funding agreements in this subpart and subpart III.</text>
</clause></subparagraph></paragraph><paragraph commented="no" id="HCD47D7A98E704BEE95C87BE37860ADE3"><enum>(2)</enum><header>Goals and objectives</header><text>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.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="HEF791950DC7F453DBEF282AC103B4E26"><enum>(c)</enum><header>Best practices in clinical care models</header><text>Section 1920 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300x-9">42 U.S.C. 300x–9</external-xref>) is amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H7962F09C250B423682962FD3FA78891C" style="OLC">
<subsection id="HDF4DC09B52AA4D6CB17131E319007369"><enum>(c)</enum><header>Best practices in clinical care models</header><text display-inline="yes-display-inline">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.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="HEBCA0150BF15486F925065CB4F8DAE90"><enum>(d)</enum><header>Additional provisions</header><text display-inline="yes-display-inline">Section 1915(b) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300x-4">42 U.S.C. 300x–4(b)</external-xref>) is amended—</text> <paragraph id="H533F460A6BB843AEA514457E49285001"><enum>(1)</enum><text>by amending paragraph (1) to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H673F924F07824344B4F4A418F267FB68" style="OLC">
<paragraph id="H0A0D27981F424259B492E4664A5274DA"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">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.</text></paragraph><after-quoted-block>;</after-quoted-block></quoted-block>
</paragraph><paragraph id="H23C1E2E345414FECA6C48D84950A38A6"><enum>(2)</enum><text>in paragraph (2)—</text> <subparagraph id="H5D023D752988499AA41BB1341C155E54"><enum>(A)</enum><text>by striking <quote>under subsection (a)</quote> and inserting <quote>specified in paragraph (1)</quote>; and</text>
</subparagraph><subparagraph id="H3EE089AEAA0D4F76B4FCA6ACF829B40C"><enum>(B)</enum><text>by striking <quote>principle</quote> and inserting <quote>principal</quote>;</text> </subparagraph></paragraph><paragraph id="HA1F275BA1060481EB210890AEF82403D"><enum>(3)</enum><text>by amending paragraph (3) to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="HD1B5CD5CE4F34C3C8F5280703721BFDA" style="OLC">
<paragraph id="H8070A3EA8B574B30AECBC4A9FD6A9208"><enum>(3)</enum><header>Waiver</header>
<subparagraph id="HFAA8A366ECF8455883AE688771C6B897"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">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.</text>
</subparagraph><subparagraph id="HDE3130E2D2494606B609CEC51974A455"><enum>(B)</enum><header>Date certain for action upon request</header><text>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.</text>
</subparagraph><subparagraph id="H9B406CF9D86D44A2B88B12D60561C7FC"><enum>(C)</enum><header>Applicability of waiver</header><text>A waiver provided by the Secretary under this paragraph shall be applicable only to the fiscal year involved.</text></subparagraph></paragraph><after-quoted-block>; and</after-quoted-block></quoted-block>
</paragraph><paragraph id="HBA9FD0DB357C46A39FA85295796221DA"><enum>(4)</enum><text>in paragraph (4)—</text> <subparagraph id="H07957EC33C8F4177B2681F31863C4E07"><enum>(A)</enum><text>by amending subparagraph (A) to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H4EB2B942EBE14BCB9B71511D2BAE203A" style="OLC">
<subparagraph id="H740ED8932F3540BDB0DB2A30784AAE47"><enum>(A)</enum><header>In general</header>
<clause id="H3AD5D09BA8B744209EB5169695AF6608"><enum>(i)</enum><header>Determination and reduction</header><text display-inline="yes-display-inline">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.</text>
</clause><clause id="H5E13921C24924CDD9D7522160B8AC14A"><enum>(ii)</enum><header>Alternative sanction</header><text>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.</text></clause></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block>
</subparagraph><subparagraph id="H3B5D3ED97A0D4B57A32782847E6EF9EF"><enum>(B)</enum><text>in subparagraph (B)—</text> <clause id="HB87EDB1ECF6549DE86CED988717B5BDF"><enum>(i)</enum><text>by inserting after the subparagraph designation the following: <quote><header-in-text level="subparagraph" style="OLC">Submission of information to the secretary.—</header-in-text></quote>; and</text>
</clause><clause id="H623F89D67F914A5D91020DD3DDA5127F"><enum>(ii)</enum><text>by striking <quote>subparagraph (A)</quote> and inserting <quote>subparagraph (A)(i)</quote>.</text> </clause></subparagraph></paragraph></subsection><subsection id="HDF7BB6B7CC064F3E95ACF3CC1F9F0F3C"><enum>(e)</enum><header>Application for grant</header><text>Section 1917(a) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300x-6">42 U.S.C. 300x–6(a)</external-xref>) is amended—</text>
<paragraph id="HB436CFA96E834A5EA40CF69B465B8F38"><enum>(1)</enum><text>in paragraph (1), by striking <quote>1941</quote> and inserting <quote>1942(a)</quote>; and</text> </paragraph><paragraph id="H6CCDAAFEAF0E407BAFEBD17C19199669"><enum>(2)</enum><text>in paragraph (5), by striking <quote>1915(b)(3)(B)</quote> and inserting <quote>1915(b)</quote>.</text>
</paragraph></subsection></section></subtitle><subtitle id="H4F5054DE098F4702A8F75D2F1C9D8760" style="OLC"><enum>C</enum><header>Strengthening Mental Health Care for Children and Adolescents</header>
<section id="H44B3B6908D8246E0B3DDF35DF94C1A41"><enum>621.</enum><header>Tele-mental health care access grants</header><text display-inline="no-display-inline">Title III of the Public Health Service Act is amended by inserting after section 330L of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/254c-18">42 U.S.C. 254c–18</external-xref>) the following new section:</text>
<quoted-block display-inline="no-display-inline" id="HA3E4B528F9784D8B9145D63696A6FF92" style="OLC">
<section id="HC3E622698535498DAB67041462BE6432"><enum>330M.</enum><header>Tele-mental health care access grants</header>
<subsection id="HEA6E5781198C4EB1A8169397ADCE7EBF"><enum>(a)</enum><header>In General</header><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/25/450b">25 U.S.C. 450b</external-xref>)) to promote behavioral health integration in pediatric primary care by—</text>
<paragraph id="H96B01958B88E462898FED6A69853CA34"><enum>(1)</enum><text>supporting the development of statewide child mental health care access programs; and</text> </paragraph><paragraph id="H6D2490B63B7B44109AFD1CC1C1AD3BAB"><enum>(2)</enum><text>supporting the improvement of existing statewide child mental health care access programs.</text>
</paragraph></subsection><subsection id="H783121E304454B05A1F2122BEF8DB35D"><enum>(b)</enum><header>Program Requirements</header>
<paragraph id="HFBF4C61EBF1345F898B6F74D011CA3C9"><enum>(1)</enum><header>In general</header><text>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—</text>
<subparagraph id="H88C9E7D954D74D72883696FD72F9C552"><enum>(A)</enum><text>be a statewide network of pediatric mental health teams that provide support to pediatric primary care sites as an integrated team;</text>
</subparagraph><subparagraph id="H40F34DEE38CF4E2897DBE557FE4B790A"><enum>(B)</enum><text>support and further develop organized State networks of child and adolescent psychiatrists and psychologists to provide consultative support to pediatric primary care sites;</text>
</subparagraph><subparagraph id="H42A61744504947AAAC6986322DA7FE02"><enum>(C)</enum><text>conduct an assessment of critical behavioral consultation needs among pediatric providers and such providers’ preferred mechanisms for receiving consultation and training and technical assistance;</text>
</subparagraph><subparagraph id="HC3EE2F637C98459C936826173361AA64"><enum>(D)</enum><text>develop an online database and communication mechanisms, including telehealth, to facilitate consultation support to pediatric practices;</text>
</subparagraph><subparagraph id="H67659DA0F4C14A028DBFB024D4D4B804"><enum>(E)</enum><text>provide rapid statewide clinical telephone or telehealth consultations when requested between the pediatric mental health teams and pediatric primary care providers;</text>
</subparagraph><subparagraph id="H8448E405143843DD8D92C96194670E96"><enum>(F)</enum><text>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;</text>
</subparagraph><subparagraph id="HB75D22EFEC94457A9A3AFC70DA8D2098"><enum>(G)</enum><text>provide information to pediatric providers about, and assist pediatric providers in accessing, child psychiatry and psychology consultations and in scheduling and conducting technical assistance;</text>
</subparagraph><subparagraph id="HB32C34BF209942CA9D03CD1330A94543"><enum>(H)</enum><text>assist with referrals to specialty care and community or behavioral health resources; and</text> </subparagraph><subparagraph id="H57279C60B50142CCAAD53B817C09093E"><enum>(I)</enum><text>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.</text>
</subparagraph></paragraph><paragraph id="HF0EDCCFBA4244EA38AFCB256FF7DE54A"><enum>(2)</enum><header>Pediatric mental health teams</header><text>In this subsection, the term <term>pediatric mental health team</term> 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.</text>
</paragraph></subsection><subsection id="H0EDFADAFEBC24722B3BBF2BA85E7CA6D"><enum>(c)</enum><header>Application</header><text>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.</text>
</subsection><subsection id="H17DDFB20E54E464D890841B15981F840"><enum>(d)</enum><header>Evaluation</header><text display-inline="yes-display-inline">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.</text>
</subsection><subsection id="HD9217765266E42CCB3AAAB5641D799AF"><enum>(e)</enum><header>Matching Requirement</header><text>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.</text>
</subsection><subsection commented="no" id="HE992051F19EA45829B9388BDF2CB222F"><enum>(f)</enum><header>Authorization of appropriations</header><text>To carry this section, there are authorized to be appropriated $9,000,000 for the period of fiscal years 2018 through 2020.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="HABF6EBC09D964829AA6D361D8A2382FF"><enum>622.</enum><header>Infant and early childhood mental health promotion, intervention, and treatment</header><text display-inline="no-display-inline">Part Q of title III of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290h">42 U.S.C. 290h et seq.</external-xref>) is amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="HDDDE8472D6B14CF29E376BFE73B90563" style="OLC">
<section id="H0F80EE8A91A845E9B9BA80ABEF01E5C0"><enum>399Z–2.</enum><header>Infant and early childhood mental health promotion, intervention, and treatment</header>
<subsection id="H647FC3DF1F9B45C3ABAF7BFDA31F473D"><enum>(a)</enum><header>Grants</header><text>The Secretary shall—</text> <paragraph id="H566FCDEDA7CC42149BEE919210C82E0E"><enum>(1)</enum><text display-inline="yes-display-inline">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—</text>
<subparagraph id="H7439AF2A3B5A4EDEB1D181DE61A0E472"><enum>(A)</enum><text>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</text>
</subparagraph><subparagraph id="HB6F92B00348343BDA1DDBFBAAB38CE85"><enum>(B)</enum><text>multigenerational therapy and other services that support the caregiving relationship; and</text> </subparagraph></paragraph><paragraph id="H3C46CE673D10465AA4DE84C73C1C1E3E"><enum>(2)</enum><text>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.</text>
</paragraph></subsection><subsection id="H30159EA699B34426B040559721ABBC07"><enum>(b)</enum><header>Eligible children and entities</header><text>In this section:</text> <paragraph id="H23E09E4C17A147F88FD8E4AB4010E5AF"><enum>(1)</enum><header>Eligible child</header><text>The term <term>eligible child</term> means a child from birth to not more than 5 years of age who—</text>
<subparagraph id="H4EF3830DF9DB440BAEE91702FCDBAB22"><enum>(A)</enum><text>is at risk for, shows early signs of, or has been diagnosed with a mental illness, including serious emotional disturbance; and</text>
</subparagraph><subparagraph commented="no" id="H8E6286987595437C8757CD4D2B81E021"><enum>(B)</enum><text display-inline="yes-display-inline">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.</text>
</subparagraph></paragraph><paragraph id="HCF206A8814FA494EB15532FB21AA05B8"><enum>(2)</enum><header>Eligible entity</header><text>The term <term>eligible entity</term> means a nonprofit institution that—</text> <subparagraph id="HA30BC551B75F46ADBD5F1AB1AE3860F7"><enum>(A)</enum><text display-inline="yes-display-inline">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</text>
</subparagraph><subparagraph id="HF7F101526EC346F3B28F07AB95FC7311"><enum>(B)</enum><text display-inline="yes-display-inline">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.</text>
</subparagraph></paragraph></subsection><subsection id="H66CFE3BC531146ED8D4F217D004251D4"><enum>(c)</enum><header>Application</header><text>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.</text>
</subsection><subsection id="HDDF567BCF6684E4CADCF00E61500D7A1"><enum>(d)</enum><header>Use of funds for early intervention and treatment programs</header><text>An eligible entity may use amounts awarded under a grant under subsection (a)(1) to carry out the following:</text>
<paragraph id="H3E31BF59A3CB4B969B42B4F3873AA27F"><enum>(1)</enum><text display-inline="yes-display-inline">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.</text>
</paragraph><paragraph id="H99A2FE356B824F9F9FE1C750364506DC"><enum>(2)</enum><text>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.</text>
</paragraph><paragraph id="H3A6E0C6952F1419F934F6DEED4D03624"><enum>(3)</enum><text>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.</text>
</paragraph><paragraph id="H045DDAC1DEE0421F9BD883EE095081CB"><enum>(4)</enum><text display-inline="yes-display-inline">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.</text>
</paragraph><paragraph id="HDD0D639765F54725BC7A6975FFB4B15C"><enum>(5)</enum><text>Provide age-appropriate assessment, diagnostic, and intervention services for eligible children, including early mental health promotion, intervention, and treatment services.</text>
</paragraph></subsection><subsection id="HE48804A0F47548949A6E1FCE0C2C4BB8"><enum>(e)</enum><header>Matching funds</header><text>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.</text>
</subsection><subsection commented="no" id="H5B80786FA7CD49E8B5003BC9103060B9"><enum>(f)</enum><header>Authorization of appropriations</header><text>To carry this section, there are authorized to be appropriated $20,000,000 for the period of fiscal years 2018 through 2022.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="HE7DFF7AFE0514EFABF2636BA7CFCCB9A"><enum>623.</enum><header>National Child Traumatic Stress Initiative</header><text display-inline="no-display-inline">Section 582 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290hh-1">42 U.S.C. 290hh–1</external-xref>; relating to grants to address the problems of persons who experience violence related stress) is amended—</text>
<paragraph id="HEF6250E357FF4C9CB5C4989BB90563E2"><enum>(1)</enum><text>in subsection (a), by striking <quote>developing programs</quote> and all that follows and inserting the following:</text> <quoted-block display-inline="yes-display-inline" id="H107915919F6643E18051B0E4EB913590" style="OLC"> <text>developing and maintaining programs that provide for—</text><paragraph id="H6091B7ED6D6E442DB52992E9AF199CD6"><enum>(1)</enum><text>the continued operation of the National Child Traumatic Stress Initiative (referred to in this section as the <quote>NCTSI</quote>), which includes a coordinating center that focuses on the mental, behavioral, and biological aspects of psychological trauma response; and</text>
</paragraph><paragraph id="HE4BD7950DBF6409E873D8E5988EB7DAD"><enum>(2)</enum><text>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.</text></paragraph><after-quoted-block>;</after-quoted-block></quoted-block>
</paragraph><paragraph id="HB5C05FF3837A40FCB0F36BC7F5DC5BA2"><enum>(2)</enum><text>in subsection (b)—</text> <subparagraph id="H17514389E42040E7BEF5F4986C4F8E80"><enum>(A)</enum><text>by striking <quote>subsection (a) related</quote> and inserting <quote>subsection (a)(2) (related</quote>;</text>
</subparagraph><subparagraph id="HE7C02736A44B4A72BF1FD0EAD47521C7"><enum>(B)</enum><text>by striking <quote>treating disorders associated with psychological trauma</quote> and inserting <quote>treating mental illness and behavioral and biological disorders associated with psychological trauma)</quote>; and</text>
</subparagraph><subparagraph id="H59FD68FEE92E441585A5D57A3BF34ADA"><enum>(C)</enum><text>by striking <quote>mental health agencies and programs that have established clinical and basic research</quote> and inserting <quote>universities, hospitals, mental health agencies, and other programs that have established clinical expertise and research</quote>;</text>
</subparagraph></paragraph><paragraph id="H30F19E06594C4D94B4F5798D6B4A9ED0"><enum>(3)</enum><text>by redesignating subsections (c) through (g) as subsections (g) through (k), respectively;</text> </paragraph><paragraph id="HA9F23A824BA54EB0A881950A18A0BE98"><enum>(4)</enum><text>by inserting after subsection (b), the following:</text>
<quoted-block id="HC745BAA2F8E643CBBAF94951032DEAFA" style="OLC">
<subsection id="H29F96079E2784FCB8FD6768AC07BE5D4"><enum>(c)</enum><header>Child outcome data</header><text>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.</text>
</subsection><subsection id="H15BEDE75E1804776A3DDA870DE6D7115"><enum>(d)</enum><header>Training</header><text>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.</text>
</subsection><subsection id="HBFDAD8077CFE4740A1C02EF0895218AE"><enum>(e)</enum><header>Dissemination</header><text>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.</text>
</subsection><subsection id="H14F2D2161DDA4FC18B6B7C2ADE25F05A"><enum>(f)</enum><header>Review</header><text>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.</text></subsection><after-quoted-block>;</after-quoted-block></quoted-block>
</paragraph><paragraph id="HE8F2912C0EB84D1CB4D7625D2C8A6CBA"><enum>(5)</enum><text>in subsection (g) (as so redesignated), by striking <quote>with respect to centers of excellence are distributed equitably among the regions of the country</quote> and inserting <quote>are distributed equitably among the regions of the United States</quote>;</text> </paragraph><paragraph id="H787D44A40D3F4E55BFB45D34912CD755"><enum>(6)</enum><text>in subsection (i) (as so redesignated), by striking <quote>recipient may not exceed 5 years</quote> and inserting <quote>recipient shall not be less than 4 years, but shall not exceed 5 years</quote>; and</text>
</paragraph><paragraph commented="no" id="H10F7C1A712764EE0ABE67F643EE3691B"><enum>(7)</enum><text>in subsection (j) (as so redesignated), by striking <quote>$50,000,000</quote> and all that follows through <quote>2006</quote> and inserting <quote>$46,887,000 for each of fiscal years 2017 through 2021</quote>.</text> </paragraph></section></subtitle><enum> VII</enum><header>Grant programs and program reauthorization </header> <subtitle id="H572FBB2314B147C680D4CDF4E7D027DF"><enum>A</enum><header>Garrett Lee Smith Memorial Act reauthorization</header> <section commented="no" display-inline="no-display-inline" id="HFB29C130FFE74AC6A7AF77D41D4E783E"><enum>701.</enum><header display-inline="yes-display-inline">Youth interagency research, training, and technical assistance centers</header><text display-inline="no-display-inline">Section 520C of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290bb-34">42 U.S.C. 290bb–34</external-xref>) is amended—</text>
<paragraph commented="no" display-inline="no-display-inline" id="H8C338A4B9AB0445480A013A97CAA87AF"><enum>(1)</enum><text display-inline="yes-display-inline">by striking the section heading and inserting <quote><header-in-text level="section" style="OLC">Suicide prevention technical assistance center.</header-in-text></quote>;</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="H5B6B4753D175424CBD2ECA9442699078"><enum>(2)</enum><text display-inline="yes-display-inline">in subsection (a), by striking <quote>and in consultation with</quote> and all that follows through the period at the end of paragraph (2) and inserting <quote>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.</quote>;</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H7A8C178F5C12422988F9CD6762CC9EC6"><enum>(3)</enum><text display-inline="yes-display-inline">by striking subsections (b) and (c);</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="H035C7286542C479996B1A3C3EA537AE7"><enum>(4)</enum><text display-inline="yes-display-inline">by redesignating subsection (d) as subsection (b);</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HE12954F088624570A8CE76DA641894BE"><enum>(5)</enum><text display-inline="yes-display-inline">in subsection (b), as so redesignated—</text> <subparagraph commented="no" display-inline="no-display-inline" id="H52860A184A2B4520B02E818F85B1DEF3"><enum>(A)</enum><text display-inline="yes-display-inline">by striking the subsection heading and inserting <quote><header-in-text level="subsection" style="OLC">Responsibilities of the center.—</header-in-text></quote>;</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H5D9C973D96134DF69C089DD7B35AE71B"><enum>(B)</enum><text display-inline="yes-display-inline">in the matter preceding paragraph (1), by striking <quote>The additional research</quote> and all that follows through <quote>nonprofit organizations for</quote> and inserting <quote>The center established under subsection (a) shall conduct activities for the purpose of</quote>;</text> </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H0C2727ABBB224D3F8142CEB310BF1306"><enum>(C)</enum><text display-inline="yes-display-inline">by striking <quote>youth suicide</quote> each place such term appears and inserting <quote>suicide</quote>;</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HD5D9BC1AFC494232B84C01D58E18FFDD"><enum>(D)</enum><text display-inline="yes-display-inline">in paragraph (1)—</text> <clause commented="no" display-inline="no-display-inline" id="HD5C2AD74CD92434683016B753AF22AA4"><enum>(i)</enum><text display-inline="yes-display-inline">by striking <quote>the development or continuation of</quote> and inserting <quote>developing and continuing</quote>; and</text>
</clause><clause commented="no" display-inline="no-display-inline" id="H3E8A404F31074423BBFE71442B1D87E5"><enum>(ii)</enum><text display-inline="yes-display-inline">by inserting <quote>for all ages, particularly among groups that are at high risk for suicide</quote> before the semicolon at the end;</text> </clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HB95386B337D34C5294B7B56FB95F3521"><enum>(E)</enum><text display-inline="yes-display-inline">in paragraph (2), by inserting <quote>for all ages, particularly among groups that are at high risk for suicide</quote> before the semicolon at the end;</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HEB674D30944B47A78F0DA6133D9DB2C9"><enum>(F)</enum><text display-inline="yes-display-inline">in paragraph (3), by inserting <quote>and tribal</quote> after <quote>statewide</quote>;</text> </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H0D50535A374546549921572E95174061"><enum>(G)</enum><text display-inline="yes-display-inline">in paragraph (5), by inserting <quote>and prevention</quote> after <quote>intervention</quote>;</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H75B7F2175E0D41BDA224FB9CD73EF49C"><enum>(H)</enum><text display-inline="yes-display-inline">in paragraph (8), by striking <quote>in youth</quote>;</text> </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HDD9341A18F3E40F9B6B10E4D94483C7E"><enum>(I)</enum><text display-inline="yes-display-inline">in paragraph (9), by striking <quote>and behavioral health</quote> and inserting <quote>health and substance use disorder</quote>; and</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H09CF99EEF1504AA29EF2A5CF3AD107F4"><enum>(J)</enum><text display-inline="yes-display-inline">in paragraph (10), by inserting <quote>conducting</quote> before <quote>other</quote>; and</text> </subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HE12798A80FD74EB8B21DA40CC485352F"><enum>(6)</enum><text display-inline="yes-display-inline">by striking subsection (e) and inserting the following:</text>
<quoted-block display-inline="no-display-inline" id="HA715DF1E9B934FED96EABEFE7600F357" style="OLC">
<subsection commented="no" display-inline="no-display-inline" id="H6938091A6A7D497DBD3257B224D4946B"><enum>(c)</enum><header display-inline="yes-display-inline">Authorization of appropriations</header><text display-inline="yes-display-inline">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.</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="H5CDAA9CF543446679248FC0C733FB0FD"><enum>(d)</enum><header>Report</header><text display-inline="yes-display-inline">Not later than 2 years after the date of enactment of the <short-title>Helping Families in Mental Health Crisis Act of 2016</short-title>, 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.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section><section commented="no" display-inline="no-display-inline" id="HB5966BFD46DF4911A8B43F063B2256C0"><enum>702.</enum><header display-inline="yes-display-inline">Youth suicide early intervention and prevention strategies</header><text display-inline="no-display-inline">Section 520E of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290bb-36">42 U.S.C. 290bb–36</external-xref>) is amended—</text> <paragraph commented="no" display-inline="no-display-inline" id="H1BD6605BBDE7401FBFE6C849A66132FE"><enum>(1)</enum><text display-inline="yes-display-inline">in paragraph (1) of subsection (a) and in subsection (c), by striking <quote>substance abuse</quote> each place such term appears and inserting <quote>substance use disorder</quote>;</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H61256B81A12F4B26B9C262538D938DE3"><enum>(2)</enum><text display-inline="yes-display-inline">in subsection (b)(2)—</text> <subparagraph commented="no" display-inline="no-display-inline" id="HC555C798BC25496D9C1AA846A1D9EDE0"><enum>(A)</enum><text display-inline="yes-display-inline">by striking <quote>each State is awarded only 1 grant or cooperative agreement under this section</quote> and inserting <quote>a State does not receive more than one grant or cooperative agreement under this section at any one time</quote>; and</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H56F0EA3E8E8C4C44B03BDC372E97FC6D"><enum>(B)</enum><text display-inline="yes-display-inline">by striking <quote>been awarded</quote> and inserting <quote>received</quote>; and</text> </subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H811B422023164DEB9B08E3018B9AF6B4"><enum>(3)</enum><text display-inline="yes-display-inline">by striking subsection (m) and inserting the following:</text>
<quoted-block display-inline="no-display-inline" id="H7C27109F691045E9A9EC3C59373BA51D" style="OLC">
<subsection commented="no" display-inline="no-display-inline" id="H707A79B1987B49C29CA8807C750EA05F"><enum>(m)</enum><header display-inline="yes-display-inline">Authorization of appropriations</header><text display-inline="yes-display-inline">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.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section><section commented="no" display-inline="no-display-inline" id="H8EB569CB3C1F4483A3D90FFD50D88993"><enum>703.</enum><header display-inline="yes-display-inline">Mental health and substance use disorder services on campus</header><text display-inline="no-display-inline">Section 520E–2 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290bb-36b">42 U.S.C. 290bb–36b</external-xref>) is amended—</text> <paragraph commented="no" display-inline="no-display-inline" id="H3EBF4344FA6C47CF80EFB61E377EBF2B"><enum>(1)</enum><text display-inline="yes-display-inline">in the section heading, by striking <quote><header-in-text level="section" style="OLC">and behavioral health</header-in-text></quote> and inserting <quote><header-in-text level="section" style="OLC">health and substance use disorder</header-in-text></quote>;</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HBFFC35848E07415B83FA0015DC010ECF"><enum>(2)</enum><text display-inline="yes-display-inline">in subsection (a)—</text> <subparagraph commented="no" display-inline="no-display-inline" id="HC3449EA321914F889D7ADAC679469E42"><enum>(A)</enum><text display-inline="yes-display-inline">by striking <quote>Services,</quote> and inserting <quote>Services and</quote>;</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H5007538DFEAC4E39BCB7C240D8318FCC"><enum>(B)</enum><text display-inline="yes-display-inline">by striking <quote>and behavioral health problems</quote> and inserting <quote>health or substance use disorders</quote>; and</text> </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H2E6020B381CC494EAF03066E4C6B8CA3"><enum>(C)</enum><text display-inline="yes-display-inline">by striking <quote>substance abuse</quote> and inserting <quote>substance use disorders</quote>;</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H415C87176B294F86890627CB35AFF2E7"><enum>(3)</enum><text display-inline="yes-display-inline">in subsection (b)—</text> <subparagraph commented="no" display-inline="no-display-inline" id="H41B29CB66D4941ABB76737FCF31C5FF8"><enum>(A)</enum><text display-inline="yes-display-inline">in the matter preceding paragraph (1), by striking <quote>for—</quote> and inserting <quote>for one or more of the following:</quote>; and</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H150D0F041FB843E5AA5E11A345A4E632"><enum>(B)</enum><text display-inline="yes-display-inline">by striking paragraphs (1) through (6) and inserting the following:</text> <quoted-block display-inline="no-display-inline" id="HFBD6F00E107845B3A36574D5787A158F" style="OLC"> <paragraph commented="no" display-inline="no-display-inline" id="HE1068CEAA48945B9A538F83D7E77B1B1"><enum>(1)</enum><text display-inline="yes-display-inline">Educating students, families, faculty, and staff to increase awareness of mental health and substance use disorders.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HDFC2DE6EA3F3442F9C5B38B9AAC221CB"><enum>(2)</enum><text display-inline="yes-display-inline">The operation of hotlines.</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="HA0B913249EF74D8E808BAA4DCCA871F9"><enum>(3)</enum><text display-inline="yes-display-inline">Preparing informational material.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H20343473D1C04C1491ED3AB183E30807"><enum>(4)</enum><text display-inline="yes-display-inline">Providing outreach services to notify students about available mental health and substance use disorder services.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HC1F8F9CF95B042AEA771888AF07F3135"><enum>(5)</enum><text display-inline="yes-display-inline">Administering voluntary mental health and substance use disorder screenings and assessments.</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="H2285888A274F48EA900002C147D44E79"><enum>(6)</enum><text display-inline="yes-display-inline">Supporting the training of students, faculty, and staff to respond effectively to students with mental health and substance use disorders.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H249DB8461D1E4AEE922421E6ABD495FE"><enum>(7)</enum><text display-inline="yes-display-inline">Creating a network infrastructure to link colleges and universities with health care providers who treat mental health and substance use disorders.</text></paragraph><after-quoted-block>;</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HC91549F17AF048C8BA895B156FC479AD"><enum>(4)</enum><text display-inline="yes-display-inline">in subsection (c)(5), by striking <quote>substance abuse</quote> and inserting <quote>substance use disorder</quote>;</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="HC97C10A7C7F9495D92955FBF8A351B9D"><enum>(5)</enum><text display-inline="yes-display-inline">in subsection (d)—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="H304FE7CEC2624E61B600F56AE678A16F"><enum>(A)</enum><text display-inline="yes-display-inline">in the matter preceding paragraph (1), by striking <quote>An institution of higher education desiring a grant under this section</quote> and inserting <quote>To be eligible to receive a grant under this section, an institution of higher education</quote>;</text> </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H271F49E9584B472F96C9607FB274EB57"><enum>(B)</enum><text display-inline="yes-display-inline">in paragraph (1)—</text>
<clause commented="no" display-inline="no-display-inline" id="HA4DEAEDFF607499980D93AED2EBF9578"><enum>(i)</enum><text display-inline="yes-display-inline">by striking <quote>and behavioral health</quote> and inserting <quote>health and substance use disorder</quote>; and</text> </clause><clause commented="no" display-inline="no-display-inline" id="HBB2EDAF79C2C4D6F9F2056E404803CD8"><enum>(ii)</enum><text display-inline="yes-display-inline">by inserting <quote>, including veterans whenever possible and appropriate,</quote> after <quote>students</quote>; and</text>
</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H58D3B6ED2CA1478F82481AAEC8D6C6C1"><enum>(C)</enum><text display-inline="yes-display-inline">in paragraph (2), by inserting <quote>, 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</quote> before the period at the end;</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H054C665329FE4ABD9EE62255CD062155"><enum>(6)</enum><text display-inline="yes-display-inline">in subsection (e)(1), by striking <quote>and behavioral health problems</quote> and inserting <quote>health and substance use disorders</quote>;</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="HD45BC5DB5BC44D1D95442788B121EE87"><enum>(7)</enum><text display-inline="yes-display-inline">in subsection (f)(2)—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="H9075463C268943D48E5D48DF912548BF"><enum>(A)</enum><text display-inline="yes-display-inline">by striking <quote>and behavioral health</quote> and inserting <quote>health and substance use disorder</quote>; and</text> </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H0083ACD717FC4DCBBD476214D7BFE9EB"><enum>(B)</enum><text display-inline="yes-display-inline">by striking <quote>suicide and substance abuse</quote> and inserting <quote>suicide and substance use disorders</quote>; and</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H57BB62FD83504FA996194EF4D06B8B82"><enum>(8)</enum><text display-inline="yes-display-inline">in subsection (h), by striking <quote>$5,000,000 for fiscal year 2005</quote> and all that follows through the period at the end and inserting <quote>$6,488,000 for each of fiscal years 2017 through 2021.</quote>.</text> </paragraph></section></subtitle><subtitle id="H6A8DECEE45084F53B65CD9BB7E7BC91D"><enum>B</enum><header>Other provisions</header> <section id="H687E484BEFBA4029B4057D9C92FB1C01"><enum>711.</enum><header>National Suicide Prevention Lifeline Program</header><text display-inline="no-display-inline">Subpart 3 of part B of title V of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290bb-31">42 U.S.C. 290bb–31 et seq.</external-xref>) is amended by inserting after section 520E–2 (<external-xref legal-doc="usc" parsable-cite="usc/42/290bb-36b">42 U.S.C. 290bb–36b</external-xref>) the following:</text>
<quoted-block display-inline="no-display-inline" id="HB8DABDC395124492B6C7A060B0CC8A44" style="OLC">
<section id="H07314142B1A34B21842D0E0A551412FC"><enum>520E–3.</enum><header>National Suicide Prevention Lifeline Program</header>
<subsection id="H91217AE9C45345BD939E2583EECB1E3E"><enum>(a)</enum><header>In general</header><text>The Secretary, acting through the Assistant Secretary, shall maintain the National Suicide Prevention Lifeline Program (referred to in this section as the <quote>Program</quote>), authorized under section 520A and in effect prior to the date of enactment of the <short-title>Helping Families in Mental Health Crisis Act of 2016</short-title>.</text>
</subsection><subsection id="H49368F73CD6944E7807F0B2DB3A0777B"><enum>(b)</enum><header>Activities</header><text>In maintaining the Program, the activities of the Secretary shall include—</text> <paragraph commented="no" id="H885D6C161ECE4DE68F44FE14C829637D"><enum>(1)</enum><text>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;</text>
</paragraph><paragraph id="H83D5F5320F7148EC85EE73FBA2F59A7C"><enum>(2)</enum><text>maintaining a suicide prevention hotline to link callers to local emergency, mental health, and social services resources; and</text>
</paragraph><paragraph id="H2E7C03D959A041C3A321434D4732F949"><enum>(3)</enum><text>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.</text>
</paragraph></subsection><subsection commented="no" id="HE34DA9F9EC934BB6A34D9590C018DF92"><enum>(c)</enum><header>Authorization of appropriations</header><text display-inline="yes-display-inline">To carry out this section, there are authorized to be appropriated $7,198,000 for each of fiscal years 2017 through 2021.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="HBE4653E81BBC4E4FAA49845518E972A0"><enum>712.</enum><header>Workforce development studies and reports</header>
<subsection id="H8AF9C85624824BFFB6CF219D1B9CE7AA"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">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.</text>
</subsection><subsection commented="no" id="H234839FA62714C8C9D8BAFDB5169C6D0"><enum>(b)</enum><header>Contents</header><text>The report under this section shall contain—</text> <paragraph commented="no" id="H187EF3DFC721426690D2F20996A08C64"><enum>(1)</enum><text>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;</text>
</paragraph><paragraph commented="no" id="HFCC47826F87F49C7BF6E8FFB5BEA2DC4"><enum>(2)</enum><text>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;</text>
</paragraph><paragraph commented="no" id="H7FBAF8C50C1A4696B6D3A558385184CC"><enum>(3)</enum><text>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;</text>
</paragraph><paragraph id="HC72A4E5799F340F68E8727273790044B"><enum>(4)</enum><text display-inline="yes-display-inline">information on the gaps in workforce development for mental health providers and professionals, including those who serve pediatric, adult, and geriatric patients; and</text>
</paragraph><paragraph commented="no" id="H18D3E649D05A46419507B6AAC96C7B97"><enum>(5)</enum><text display-inline="yes-display-inline">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.</text>
</paragraph></subsection></section><section commented="no" id="H715BCFBB7A594537B27D487A26676B59"><enum>713.</enum><header>Minority Fellowship Program</header><text display-inline="no-display-inline">Title V of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290aa">42 U.S.C. 290aa et seq.</external-xref>) is amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H7EF47D615C3E406EA8A9AC6B9A7E2FED" style="OLC">
<part commented="no" id="HFC996B7F52D84396B4B024515E48E5FA"><enum>K</enum><header>Minority Fellowship Program</header>
<section commented="no" id="HAB5D228A803848E888487D61F83D00D9"><enum>597.</enum><header>Fellowships</header>
<subsection commented="no" id="H15AEF7CD0B2743A0B0CA1760D6121AEF"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">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—</text>
<paragraph commented="no" id="HD83A99E6AD9B4BE98B2E6F8F90020100"><enum>(1)</enum><text>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;</text>
</paragraph><paragraph commented="no" id="H86D61642104B439DAA1335B02AACC95B"><enum>(2)</enum><text>improving the quality of mental illness and substance use disorder prevention and treatment delivered to racial and ethnic minorities; and</text>
</paragraph><paragraph commented="no" id="H42B55B2BF4374028BEBBBA89F4C3C5E1"><enum>(3)</enum><text>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.</text>
</paragraph></subsection><subsection commented="no" id="H4F89985C9E9A4932A6AA98C5DC014DAC"><enum>(b)</enum><header>Training covered</header><text display-inline="yes-display-inline">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.</text>
</subsection><subsection id="H2CF067103852461BB485BF5538B9AA4C"><enum>(c)</enum><header>Authorization of appropriations</header><text display-inline="yes-display-inline">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.</text></subsection></section></part><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section commented="no" id="H059745B959914407A6E2A65204098120"><enum>714.</enum><header>Center and program repeals</header><text display-inline="no-display-inline">Part B of title V of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290bb">42 U.S.C. 290bb et seq.</external-xref>) is amended by striking the second section 514 (<external-xref legal-doc="usc" parsable-cite="usc/42/290bb-9">42 U.S.C. 290bb–9</external-xref>), relating to methamphetamine and amphetamine treatment initiatives, and sections 514A, 517, 519A, 519C, 519E, 520D, and 520H (<external-xref legal-doc="usc" parsable-cite="usc/42/290bb-8">42 U.S.C. 290bb–8</external-xref>, 290bb–23, 290bb–25a, 290bb–25c, 290bb–25e, 290bb–35, and 290bb–39).</text>
</section><section commented="no" display-inline="no-display-inline" id="HBFF5930A57334737A29014372630B142" section-type="subsequent-section"><enum>715.</enum><header display-inline="yes-display-inline">National violent death reporting system</header><text display-inline="no-display-inline">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 (<external-xref legal-doc="usc" parsable-cite="usc/42/241">42 U.S.C. 241 et seq.</external-xref>). Participation in the system by the States shall be voluntary.</text>
</section><section id="HD46FDAEBA8BD4F29A16CBA5A8E56978B"><enum>716.</enum><header>Sense of Congress on prioritizing Native American youth and suicide prevention programs</header>
<subsection id="HFE53216E7F5B4446A73B76EB05C09B79"><enum>(a)</enum><header>Findings</header><text display-inline="yes-display-inline">The Congress finds as follows:</text> <paragraph id="H76C165C8108344D78EA0D71B8EC5A179"><enum>(1)</enum><text>Suicide is the eighth leading cause of death among American Indians and Alaska Natives across all ages.</text>
</paragraph><paragraph id="H8303C6D0245E48F1BA48708EA0A98E57"><enum>(2)</enum><text>Among American Indians and Alaska Natives who are 10 to 34 years of age, suicide is the second leading cause of death.</text>
</paragraph><paragraph id="H9018C80DE7DF4F7B800D65EF50EF0A08"><enum>(3)</enum><text>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).</text>
</paragraph></subsection><subsection id="H8B1CAE25B8544392BA294945408259A7"><enum>(b)</enum><header>Sense of Congress</header><text display-inline="yes-display-inline">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.</text>
</subsection></section><section id="H29D9917EE4C24FCF935E0AA19F6C3CC9"><enum>717.</enum><header>Peer professional workforce development grant program</header>
<subsection id="HA57CEC6831E74757A4D477D43E66750D"><enum>(a)</enum><header>In general</header><text>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.</text>
</subsection><subsection id="HB9655BF58AEC4A5A845D52F9C943CFF7"><enum>(b)</enum><header>Purposes</header><text>The purposes of grants under this section are—</text> <paragraph id="H6D158F8EF0F24B60B55F4FB744765685"><enum>(1)</enum><text>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</text>
</paragraph><paragraph id="H8EBD9D1B92334A5989B003042A095867"><enum>(2)</enum><text>to help communities develop the infrastructure to train and certify peers as behavioral health paraprofessionals.</text>
</paragraph></subsection><subsection id="H9B126D2C34D649859B79882040C952FE"><enum>(c)</enum><header>Eligible entities</header><text>To be eligible to receive a grant under this section, an entity shall be a community college or other entity the Secretary deems appropriate.</text>
</subsection><subsection id="HCA7A3F0ECA934F12B670E198ACC16E8F"><enum>(d)</enum><header>Geographic distribution</header><text>In awarding grants under this section, the Secretary shall seek to achieve an appropriate national balance in the geographic distribution of such awards.</text>
</subsection><subsection id="HDCC74F53A5884CEE94CF6ED752911A95"><enum>(e)</enum><header>Special consideration</header><text>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.</text>
</subsection><subsection commented="no" id="H2E4DE8CFB8294EDDA4A83857906C3E18"><enum>(f)</enum><header>Authorization of appropriations</header><text display-inline="yes-display-inline">To carry out this section, there is authorized to be appropriated $10,000,000 for the period of fiscal years 2018 through 2022.</text>
</subsection></section><section commented="no" id="H97329C38BB724D10B46C110D4286282D"><enum>718.</enum><header>National Health Service Corps</header>
<subsection commented="no" id="H20AA68E27AEF4CDCB601C188C636DE78"><enum>(a)</enum><header>Definitions</header>
<paragraph commented="no" id="HF58A6178EAE44A32AEC99579930ADBEC"><enum>(1)</enum><header>Primary health services</header><text>Section 331(a)(3)(D) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/254d">42 U.S.C. 254d(a)(3)</external-xref>) is amended by inserting <quote>(including pediatric mental health subspecialty services)</quote> after <quote>pediatrics</quote>.</text>
</paragraph><paragraph commented="no" id="HD7458F6A16F941C8AB1A3E990C374EF6"><enum>(2)</enum><header>Behavioral and mental health professionals</header><text display-inline="yes-display-inline">Clause (i) of section 331(a)(3)(E) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/254d">42 U.S.C. 254d(a)(3)(E)</external-xref>) is amended by inserting <quote>(and pediatric subspecialists thereof)</quote> before the period at the end.</text>
</paragraph></subsection><subsection commented="no" id="HF32E6CAEE3AD4E0898BBAA9FBE5C3ED1"><enum>(b)</enum><header>Eligibility To participate in loan repayment program</header><text display-inline="yes-display-inline">Section 338B(b)(1)(B) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/254l-1">42 U.S.C. 254l–1(b)(1)(B)</external-xref>) is amended by inserting <quote>, including any physician child and adolescent psychiatry residency or fellowship training program</quote> after <quote>be enrolled in an approved graduate training program in medicine, osteopathic medicine, dentistry, behavioral and mental health, or other health profession</quote>.</text>
</subsection></section><section id="H314DFEEC0BC54E01B6BF6094FC8F69B9"><enum>719.</enum><header>Adult suicide prevention</header>
<subsection id="HFFD48AF234E84D58B4A447062BCEDBB7"><enum>(a)</enum><header>Grants</header>
<paragraph id="HAABF7266D28C4C95B471EAA3C409A939"><enum>(1)</enum><header>Authority</header><text>The Assistant Secretary for Mental Health and Substance Use (referred to in this section as the <quote>Assistant Secretary</quote>) may award grants to eligible entities in order to implement suicide prevention efforts amongst adults 25 and older.</text>
</paragraph><paragraph id="HE94F68077E8842998607F95D756104F8"><enum>(2)</enum><header>Purpose</header><text>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.</text>
</paragraph><paragraph id="H0285FA653A764489B984A6E25B520739"><enum>(3)</enum><header>Recipients</header><text>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.</text>
</paragraph><paragraph id="H005BCB739DB543E195AF4C7F4D85C42B"><enum>(4)</enum><header>Nature of activities</header><text>The grants awarded under paragraph (1) shall be used to implement programs that—</text> <subparagraph id="H44CB8E7885474793891BDBA755E1B22A"><enum>(A)</enum><text>screen for suicide risk in adults and provide intervention and referral to treatment;</text>
</subparagraph><subparagraph id="HAA42FD6A7BE6411EA47B047F9F42F648"><enum>(B)</enum><text>implement evidence-based practices to treat individuals who are at suicide risk, including appropriate followup services; and</text>
</subparagraph><subparagraph id="HEB2E8611DF5F4F019F45D545842C9ADA"><enum>(C)</enum><text>raise awareness, reduce stigma, and foster open dialogue about suicide prevention.</text> </subparagraph></paragraph></subsection><subsection id="HA17524F841ED4E949469506EE538B7F0"><enum>(b)</enum><header>Additional activities</header><text>The Assistant Secretary shall—</text>
<paragraph id="HFFBE6B121BDB42C6AF78CEC8FD952861"><enum>(1)</enum><text>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;</text>
</paragraph><paragraph id="HFD081A3868514151922E656C87EA2980"><enum>(2)</enum><text>disseminate the findings from the evaluation as the Assistant Secretary considers appropriate; and</text> </paragraph><paragraph id="HC6BF6D577DB04CB6AB8A6E3629A3599E"><enum>(3)</enum><text>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—</text>
<subparagraph id="HE17B5CD38C784D45B523CA7F5F95E1B9"><enum>(A)</enum><text>selection and implementation of evidence-based interventions and frameworks to prevent suicide, such as the Zero Suicide framework; and</text>
</subparagraph><subparagraph id="H30244B04F87044349F02B438633801C7"><enum>(B)</enum><text>other activities as the Assistant Secretary determines appropriate.</text> </subparagraph></paragraph></subsection><subsection id="HAC56C06918694F08934DFAF5B10FBB3A"><enum>(c)</enum><header>Duration</header><text>A grant under this section shall be for a period of not more than 5 years.</text>
</subsection><subsection id="H1E24E5F52866464A8BF114E4999B9036"><enum>(d)</enum><header>Authorization of appropriations</header>
<paragraph commented="no" id="H5DF8FCD8171B48D996357E1C69F95BD6"><enum>(1)</enum><header>In general</header><text>There is authorized to be appropriated to carry out this section $30,000,000 for the period of fiscal years 2018 through 2022.</text>
</paragraph><paragraph id="HA2AC47F5B68445F4B8E2A64FB8CC1B3C"><enum>(2)</enum><header>Use of certain funds</header><text>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).</text>
</paragraph></subsection></section><section commented="no" id="H13AB170BC3FA417CB862EBFF72F6FFF2" section-type="subsequent-section"><enum>720.</enum><header>Crisis intervention grants for police officers and first responders</header>
<subsection commented="no" id="H02B67C0C20D446B993244FA40374D718"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Assistant Secretary for Mental Health and Substance Use may award grants to entities such as law enforcement agencies and first responders—</text>
<paragraph commented="no" id="H2E564D43486F4CEEB3D2772BD9DD1A08"><enum>(1)</enum><text display-inline="yes-display-inline">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 (<external-xref legal-doc="usc" parsable-cite="usc/42/3796dd">42 U.S.C. 3796dd</external-xref> note)))—</text>
<subparagraph commented="no" id="HD4DC2D8CBF294219B6218C50AA5C721A"><enum>(A)</enum><text>to recognize individuals who have mental illness and how to properly intervene with individuals with mental illness; and</text>
</subparagraph><subparagraph commented="no" id="HBCCD57FFF2084EE5BAF21F0E67610E46"><enum>(B)</enum><text>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</text>
</subparagraph></paragraph><paragraph commented="no" id="HD126E708A5014F89ACB4CA1895C88332"><enum>(2)</enum><text>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.</text>
</paragraph></subsection><subsection commented="no" id="HA04B77CBB8A648C28CCCEAA914F32E52"><enum>(b)</enum><header>Authorization of appropriations</header><text display-inline="yes-display-inline">There are authorized to be appropriated to carry out this section $9,000,000 for the period of fiscal years 2018 through 2020.</text>
</subsection></section><section commented="no" id="H8F984C8CEAD545D6BE94F81A21715AA6" section-type="subsequent-section"><enum>721.</enum><header>Demonstration grant program to train health service psychologists in community-based mental health</header>
<subsection commented="no" id="H0F7EE453D6F946A9816630C2CB686918"><enum>(a)</enum><header>Establishment</header><text display-inline="yes-display-inline">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.</text>
</subsection><subsection commented="no" id="HF936953155794A40ACB6545F1EA308FF"><enum>(b)</enum><header>Eligible institutions</header><text display-inline="yes-display-inline">For purposes of this section, the term <quote>eligible institutions</quote> includes American Psychological Association-accredited doctoral, internship, and postdoctoral residency schools or programs in health service psychology that—</text>
<paragraph commented="no" id="H2E3E480AFB844B9B8B3D95E5EA9CF1C0"><enum>(1)</enum><text>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</text>
</paragraph><paragraph commented="no" id="H5ECC4AFC1C894D348ADF7E00203B2578"><enum>(2)</enum><text>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.</text>
</paragraph></subsection><subsection commented="no" id="H0318DBAE783C47068A6DF305DA9A7726"><enum>(c)</enum><header>Priorities</header><text>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.</text>
</subsection><subsection commented="no" id="HCDF277D757BE48E5A58FD1D0299B9A13"><enum>(d)</enum><header>Authorization of appropriations</header><text>There is authorized to be appropriated to carry out this section $12,000,000 for the period of fiscal years 2018 through 2022.</text>
</subsection></section><section id="H86F5F9224F474F35931D775A9DE81C78"><enum>722.</enum><header>Investment in tomorrow’s pediatric health care workforce</header><text display-inline="no-display-inline">Section 775(e) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/295f">42 U.S.C. 295f(e)</external-xref>) is amended to read as follows:</text> <quoted-block display-inline="no-display-inline" id="HFF7D0A35B2564BC8A6443284BFA16B96" style="OLC"> <subsection id="H5A0ED00D5D1B4F329DF1B0784D822DBC"><enum>(e)</enum><header>Authorization of appropriations</header><text display-inline="yes-display-inline">To carry out this section, there is authorized to be appropriated $12,000,000 for the period of fiscal years 2018 through 2022.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="H7AEB8E80490043FF979907D3E780E74A"><enum>723.</enum><header>CUTGO compliance</header><text display-inline="no-display-inline">Section 319D(f) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/247d-4">42 U.S.C. 247d–4(f)</external-xref>) is amended by striking <quote>$138,300,000 for each of fiscal years 2014 through 2018</quote> and inserting <quote>$138,300,000 for each of fiscal years 2014 through 2016 and $58,000,000 for each of fiscal years 2017 and 2018</quote>.</text>
</section></subtitle><enum>VIII</enum><header>Mental Health Parity</header>
<section id="HBE0D9532EF3C4155A1CE29C41264541F"><enum>801.</enum><header>Enhanced compliance with mental health and substance use disorder coverage requirements</header>
<subsection id="HC3118CAB428C47B78295F65718088331"><enum>(a)</enum><header>Compliance program guidance document</header><text>Section 2726(a) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300gg-26">42 U.S.C. 300gg–26(a)</external-xref>) is amended by adding at the end the following:</text>
<quoted-block id="H5B89F0E78194415D956BE67FF0979187" style="OLC">
<paragraph id="H17FCE9C138A64DC8BC666112A7E766C5"><enum>(6)</enum><header>Compliance program guidance document</header>
<subparagraph id="H974353019EDB42DBAD718B6601496EE4"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">Not later than 12 months after the date of enactment of the <short-title>Helping Families in Mental Health Crisis Act of 2016</short-title>, 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 <external-xref legal-doc="usc" parsable-cite="usc/26/9812">section 9812</external-xref> of the Internal Revenue Code of 1986, as applicable.</text>
</subparagraph><subparagraph id="H97485091CB004538B22E08F96B6B96F1"><enum>(B)</enum><header>Examples illustrating compliance and noncompliance</header>
<clause id="H617930011D364DDE88480364389FD476"><enum>(i)</enum><header>In general</header><text>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 <external-xref legal-doc="usc" parsable-cite="usc/26/9812">section 9812</external-xref> of the Internal Revenue Code of 1986, as applicable, based on investigations of violations of such sections, including—</text>
<subclause id="H195B0C11A69140BCAA74879FC5AF08F5"><enum>(I)</enum><text>examples illustrating requirements for information disclosures and nonquantitative treatment limitations; and</text>
</subclause><subclause id="H5D8DDF45D1364B669BD8D5188D9C2194"><enum>(II)</enum><text>descriptions of the violations uncovered during the course of such investigations.</text> </subclause></clause><clause id="H1364E9E49C0845DB86FBAB03471D71BA"><enum>(ii)</enum><header>Nonquantitative treatment limitations</header><text>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.</text>
</clause><clause id="H600A3AEFD4C544AE8D817938567DDEE0"><enum>(iii)</enum><header>Access to additional information regarding compliance</header><text>In developing and issuing the compliance program guidance document required under this paragraph, the Secretaries specified in subparagraph (A)—</text>
<subclause id="H5F3B0A6605E54C86BB11F8287726CC0A"><enum>(I)</enum><text>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 <external-xref legal-doc="usc" parsable-cite="usc/26/9812">section 9812</external-xref> of the Internal Revenue Code of 1986, as applicable; and</text>
</subclause><subclause id="HCA8433DA743D4A2599BCF56BE1D221D9"><enum>(II)</enum><text>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 <external-xref legal-doc="usc" parsable-cite="usc/26/9812">section 9812</external-xref> of the Internal Revenue Code of 1986, as applicable.</text>
</subclause></clause></subparagraph><subparagraph id="H9FE0D2E39B1F441793BA1114AE2B6ABC"><enum>(C)</enum><header>Recommendations</header><text display-inline="yes-display-inline">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 <external-xref legal-doc="usc" parsable-cite="usc/26/9812">section 9812</external-xref> 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 <external-xref legal-doc="usc" parsable-cite="usc/26/9812">section 9812</external-xref> of the Internal Revenue Code of 1986, as applicable, in relation to nonquantitative treatment limitations on medical and surgical benefits.</text>
</subparagraph><subparagraph id="HA4ED8C2216B440F5A66D753FF57DDD58"><enum>(D)</enum><header>Updating the compliance program guidance document</header><text>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 <external-xref legal-doc="usc" parsable-cite="usc/26/9812">section 9812</external-xref> of the Internal Revenue Code of 1986, as applicable.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H9B613FD3B5F44F50BDB4D5AA89407797"><enum>(b)</enum><header>Additional guidance</header><text>Section 2726(a) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300gg-26">42 U.S.C. 300gg–26(a)</external-xref>), as amended by subsection (a), is further amended by adding at the end the following:</text>
<quoted-block id="HB0194E25867D485697F5C11928B26C5C" style="OLC">
<paragraph id="H59C458DE22DD4D5EA3ADE44BB8BA2B45"><enum>(7)</enum><header>Additional guidance</header>
<subparagraph id="H5AED9E99474042E0AE8407BD15145A3A"><enum>(A)</enum><header>In general</header><text>Not later than 1 year after the date of enactment of the <short-title>Helping Families in Mental Health Crisis Act of 2016</short-title>, 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 <external-xref legal-doc="usc" parsable-cite="usc/26/9812">section 9812</external-xref> of the Internal Revenue Code of 1986, as applicable,.</text>
</subparagraph><subparagraph id="H6A40BF239CC7426E92903EB17534ECEB"><enum>(B)</enum><header>Disclosure</header>
<clause id="H264AF046CEA44AE6BF5F4A8A8ABA9C63"><enum>(i)</enum><header>Guidance for plans and issuers</header><text display-inline="yes-display-inline">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 <external-xref legal-doc="usc" parsable-cite="usc/26/9812">section 9812</external-xref> of the Internal Revenue Code of 1986, as applicable, (and any regulations promulgated pursuant to such sections, as applicable).</text>
</clause><clause id="H2939ABB1D54C4AAE96FA6FB620BB8D15"><enum>(ii)</enum><header>Documents for participants, beneficiaries, contracting providers, or authorized representatives</header><text display-inline="yes-display-inline">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 <external-xref legal-doc="usc" parsable-cite="usc/26/9812">section 9812</external-xref> 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—</text>
<subclause id="H3AECB8CAD82149799169C1B5ECA2F73F"><enum>(I)</enum><text>nonquantitative treatment limitations for both medical and surgical benefits and mental health and substance use disorder benefits;</text>
</subclause><subclause id="H8841B94FA40E40A4A646C32B9B9C0BC8"><enum>(II)</enum><text>the processes, strategies, evidentiary standards, and other factors used to apply the limitations described in subclause (I); and</text>
</subclause><subclause id="H1999D088C130440B88AFDBC3BE73060E"><enum>(III)</enum><text>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.</text>
</subclause></clause></subparagraph><subparagraph id="HD94B7DC05F7F483089B43A7F1883D60D"><enum>(C)</enum><header>Nonquantitative treatment limitations</header><text display-inline="yes-display-inline">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 <external-xref legal-doc="usc" parsable-cite="usc/26/9812">section 9812</external-xref> of the Internal Revenue Code of 1986, as applicable, (and any regulations promulgated pursuant to such respective section), including—</text>
<clause id="H718F566AF7D94B89B31A678BCCFE18E8"><enum>(i)</enum><text>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—</text>
<subclause id="H132AC2FF55A2426FA3983DFAE2C94553"><enum>(I)</enum><text>medical management standards based on medical necessity or appropriateness, or whether a treatment is experimental or investigative;</text>
</subclause><subclause id="HD8D10A0C488249FA8B5042B153F52A06"><enum>(II)</enum><text>limitations with respect to prescription drug formulary design; and</text> </subclause><subclause id="H37C421E3E17C4679AB3C4F360D27C11D"><enum>(III)</enum><text>use of fail-first or step therapy protocols;</text>
</subclause></clause><clause id="H4A9B4C7E6537498FAB445AF6443BF6C6"><enum>(ii)</enum><text>examples of methods of determining—</text> <subclause id="H2BC9B0B657F14364A60940D75B5D4779"><enum>(I)</enum><text>network admission standards (such as credentialing); and</text>
</subclause><subclause id="H52A307D6415443C798FBE38BFA746EDE"><enum>(II)</enum><text>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;</text>
</subclause></clause><clause id="H558C988C475F43DCBD67BC9EE2D75554"><enum>(iii)</enum><text>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;</text>
</clause><clause id="H860F3504CBE44C05BD9E5B5C31386A9A"><enum>(iv)</enum><text>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;</text>
</clause><clause id="H9F9EE6DD0A62470B94EE08C4BA1266BA"><enum>(v)</enum><text>examples of how specific evidentiary standards may be used to determine whether treatments are considered experimental or investigative;</text>
</clause><clause id="H51169FE55908431184F274DA26A5D015"><enum>(vi)</enum><text>examples of how specific evidentiary standards may be applied to each service category or classification of benefits;</text>
</clause><clause id="H1528290B440545D8BAB0162118467A93"><enum>(vii)</enum><text>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;</text>
</clause><clause id="HCD3BE37A048F478D99179F314B002F87"><enum>(viii)</enum><text>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</text>
</clause><clause id="H62C5BE06E3A740CAAC8F2C27C41593FD"><enum>(ix)</enum><text display-inline="yes-display-inline">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 <external-xref legal-doc="usc" parsable-cite="usc/26/9812">section 9812</external-xref> of the Internal Revenue Code of 1986, as applicable.</text>
</clause></subparagraph><subparagraph id="H35DA3A88040E43BD83605631369C28BA"><enum>(D)</enum><header>Public comment</header><text>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.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="HDF9A3AD96EC24C8FB48AC8DAF08CDE63"><enum>(c)</enum><header>Availability of plan information</header>
<paragraph id="H2AF09D8B718B4B1C8B55EA73A37E3865"><enum>(1)</enum><header>PHSA amendment</header><text display-inline="yes-display-inline">Paragraph (4) of section 2726(a) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300gg-26">42 U.S.C. 300gg–26(a)</external-xref>) is amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H6B27FC1E2E6346FE8912373CB0BD7D5A" style="OLC">
<paragraph id="H69F78248818D49B4A463A3491EA6C548"><enum>(4)</enum><header>Availability of plan information</header><text display-inline="yes-display-inline">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.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="HF8223B07B298407E8846C71D256CB449"><enum>(2)</enum><header>ERISA amendment</header><text display-inline="yes-display-inline">Paragraph (4) of section 712(a) of the Employee Retirement Income Security Act of 1974 (<external-xref legal-doc="usc" parsable-cite="usc/29/1185a">29 U.S.C. 1185a(a)</external-xref>) is amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H9AF7D769D6A14173A4048EE8E00E81FF" style="OLC">
<paragraph id="H62B33C4C00AE4369B5420C919BCE1E42"><enum>(4)</enum><header>Availability of plan information</header><text display-inline="yes-display-inline">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.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="HBC1B8FF977474EFCB0BABB2099D94A11"><enum>(3)</enum><header>IRC amendment</header><text display-inline="yes-display-inline">Paragraph (4) of <external-xref legal-doc="usc" parsable-cite="usc/26/9812">section 9812(a)</external-xref> of the Internal Revenue Code of 1986 is amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H1DE454B1F8C4488BA7AD18F0D58315A7" style="OLC">
<paragraph id="H7AEDC87A9B634FDEBE62BE8CC64F313C"><enum>(4)</enum><header>Availability of plan information</header><text display-inline="yes-display-inline">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.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H858EDE103BC8476BBD7E532895092903"><enum>(d)</enum><header>Improving compliance</header>
<paragraph id="H7700C1D8F51448F28704DEB7312598F5"><enum>(1)</enum><header>In general</header><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/42/300gg-26">42 U.S.C. 300gg–26</external-xref>), section 712 of the Employee Retirement Income Security Act of 1974 (<external-xref legal-doc="usc" parsable-cite="usc/29/1185a">29 U.S.C. 1185a</external-xref>), or <external-xref legal-doc="usc" parsable-cite="usc/26/9812">section 9812</external-xref> 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.</text>
</paragraph><paragraph id="HF594AF8CB59A48B189AFAF410339F945"><enum>(2)</enum><header>Rule of construction</header><text>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.</text>
</paragraph></subsection></section><section commented="no" id="H4956C84975CD40A38595929DB8A0E854"><enum>802.</enum><header>Action plan for enhanced enforcement of mental health and substance use disorder coverage</header>
<subsection commented="no" id="HFBEBF9F135044297842AB49324BB429E"><enum>(a)</enum><header>Public meeting</header>
<paragraph commented="no" id="H07BA13B9D1E94950A21434C9EF0B6391"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">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 (<external-xref legal-doc="usc" parsable-cite="usc/42/300gg-26">42 U.S.C. 300gg–26</external-xref>), section 712 of the Employee Retirement Income Security Act of 1974 (<external-xref legal-doc="usc" parsable-cite="usc/29/1185a">29 U.S.C. 1185a</external-xref>), and <external-xref legal-doc="usc" parsable-cite="usc/26/9812">section 9812</external-xref> of the Internal Revenue Code of 1986, and any comparable provisions of State law (in this section collectively referred to as <quote>mental health parity and addiction equity requirements</quote>).</text>
</paragraph><paragraph commented="no" id="HB5633CF2BA8148BFB7DE952D3AE6D1CD"><enum>(2)</enum><header>Stakeholders</header><text>The stakeholders described in this paragraph shall include each of the following:</text> <subparagraph commented="no" id="H4FB626ACA1734C8EBBC6C7EB0AF568C4"><enum>(A)</enum><text>The Federal Government, including representatives from—</text>
<clause commented="no" id="HADE98FD813BA4DC5B7B73814DAA84F9F"><enum>(i)</enum><text>the Department of Health and Human Services;</text> </clause><clause commented="no" id="H95E0FA7FC05F4FE7BB5E861F2C3B914B"><enum>(ii)</enum><text>the Department of the Treasury;</text>
</clause><clause commented="no" id="HD217F2976A894BAEBDB14F1578DA7244"><enum>(iii)</enum><text>the Department of Labor; and</text> </clause><clause commented="no" id="H7FB53D88B3AF4FE2BA83C14066CCA220"><enum>(iv)</enum><text>the Department of Justice.</text>
</clause></subparagraph><subparagraph commented="no" id="H413B1A2EBF7443ACBD41D5179875BA63"><enum>(B)</enum><text>State governments, including—</text> <clause commented="no" id="HB943526A869A44FC9AB063A9229CAD4A"><enum>(i)</enum><text>State health insurance commissioners;</text>
</clause><clause commented="no" id="H4C847ADC374B4D63848B4F52B3B44635"><enum>(ii)</enum><text>appropriate State agencies, including agencies on public health or mental health; and</text> </clause><clause commented="no" id="H1017F82F41564D5496E6C2BC010F688D"><enum>(iii)</enum><text>State attorneys general or other representatives of State entities involved in the enforcement of mental health parity and addiction equity requirements.</text>
</clause></subparagraph><subparagraph commented="no" id="HE6834874B7B044138EA498C8082E55A9"><enum>(C)</enum><text>Representatives from key stakeholder groups, including—</text> <clause commented="no" id="H16E5FF29891E4804A426AA21142CE218"><enum>(i)</enum><text>the National Association of Insurance Commissioners;</text>
</clause><clause commented="no" id="H7990C7E862904EE892CDFA743AA31CF0"><enum>(ii)</enum><text>health insurance providers;</text> </clause><clause commented="no" id="HBE25531AF37B4A298A4724464B867529"><enum>(iii)</enum><text>providers of mental health and substance use disorder treatment;</text>
</clause><clause commented="no" id="HDDEFCBC2D59747B18FA8899BC7C28A0B"><enum>(iv)</enum><text>employers; and</text> </clause><clause commented="no" id="HF43F44CB4DCC498BA8B05DAE4CFB775D"><enum>(v)</enum><text>patients or their advocates.</text>
</clause></subparagraph></paragraph></subsection><subsection commented="no" id="HCF233E5A67E344AF8569DF7896CFC5FD"><enum>(b)</enum><header>Action plan</header><text>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.</text>
</subsection><subsection commented="no" id="H22194BA8C34D46008A23FF4AE1434756"><enum>(c)</enum><header>Content</header><text>The action plan under this section shall—</text> <paragraph commented="no" id="HF5F34FA76C49495EB09214829D231328"><enum>(1)</enum><text>reflect the input of the stakeholders participating in the public meeting under subsection (a);</text>
</paragraph><paragraph commented="no" id="HBD6622B07CDF4FB6BDDDB83C2613EF6F"><enum>(2)</enum><text>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;</text>
</paragraph><paragraph commented="no" id="HC5B4288EC7F84E8C9BBB12AF553283CC"><enum>(3)</enum><text>provide a timeline for implementing the action plan; and</text> </paragraph><paragraph commented="no" id="HE97AF327FC74496A8CAC5F7473E7D2C7"><enum>(4)</enum><text>provide specific examples of how such objectives may be met, which may include—</text>
<subparagraph commented="no" id="HBBAA80ACEFB74993891477705C0DF5FB"><enum>(A)</enum><text>providing common educational information and documents to patients about their rights under mental health parity and addiction equity requirements;</text>
</subparagraph><subparagraph commented="no" id="H49FD720622FA445F959F5E8FD738F1B9"><enum>(B)</enum><text>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;</text>
</subparagraph><subparagraph commented="no" id="HEA98FB3585A143B3B82B84238CA54FC1"><enum>(C)</enum><text>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</text>
</subparagraph><subparagraph commented="no" id="H7B26D3FBE4C74F76B2DCAD08D1337B50"><enum>(D)</enum><text>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.</text>
</subparagraph></paragraph></subsection></section><section id="H3E89CD22EF8A46669E672BE8F9DF67C8"><enum>803.</enum><header>Report on investigations regarding parity in mental health and substance use disorder benefits</header>
<subsection id="HB7284B30A3DA4F1A9E4FECE6F6E97389"><enum>(a)</enum><header>In general</header><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/42/300gg-26">42 U.S.C. 300gg–26</external-xref>), section 712 of the Employee Retirement Income Security Act of 1974 (<external-xref legal-doc="usc" parsable-cite="usc/29/1185a">29 U.S.C. 1185a</external-xref>), and <external-xref legal-doc="usc" parsable-cite="usc/26/9812">section 9812</external-xref> of the Internal Revenue Code of 1986.</text>
</subsection><subsection id="H88FE58FF41324ECDAF6AE09BF4BCE4B3"><enum>(b)</enum><header>Contents</header><text>Subject to subsection (c), a report under subsection (a) shall, with respect to investigations described in such subsection, include each of the following:</text>
<paragraph id="HBF9E6D1DDE7F4CA9BE8079AD7F217849"><enum>(1)</enum><text>The number of closed Federal investigations conducted during the covered reporting period.</text> </paragraph><paragraph id="H11959F557E024BEFA10049481E9A529C"><enum>(2)</enum><text>Each benefit classification examined by any such investigation conducted during the covered reporting period.</text>
</paragraph><paragraph id="H0D62E7E3E9A64AFCA1808B4FDE7CDB87"><enum>(3)</enum><text>Each subject matter, including compliance with requirements for quantitative and nonquantitative treatment limitations, of any such investigation conducted during the covered reporting period.</text>
</paragraph><paragraph id="HF096A9F8588048378713DB7B8545351D"><enum>(4)</enum><text>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.</text>
</paragraph></subsection><subsection id="HEDC4A5E6902F42F89379D8BC183020F8"><enum>(c)</enum><header>Limitation</header><text display-inline="yes-display-inline">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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1320d-2">42 U.S.C. 1320d–2</external-xref> note).</text>
</subsection></section><section id="H37D933C03D6842BAAD4E62D6DB27D3AA"><enum>804.</enum><header>GAO study on parity in mental health and substance use disorder benefits</header><text display-inline="no-display-inline">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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1396b">42 U.S.C. 1396b(m)</external-xref>), and health plans provided under the State Children’s Health Insurance Program under title XXI of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397aa">42 U.S.C. 1397aa et seq.</external-xref>) comply with section 2726 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300gg-26">42 U.S.C. 300gg–26</external-xref>), section 712 of the Employee Retirement Income Security Act of 1974 (<external-xref legal-doc="usc" parsable-cite="usc/29/1185a">29 U.S.C. 1185a</external-xref>), and <external-xref legal-doc="usc" parsable-cite="usc/26/9812">section 9812</external-xref> of the Internal Revenue Code of 1986, including—</text>
<paragraph id="H6A3D2F3D39364F098FB5503787B51CD4"><enum>(1)</enum><text>how nonquantitative treatment limitations, including medical necessity criteria, of such plans or issuers comply with such sections;</text>
</paragraph><paragraph id="H051C6E5DAB044A57B09BE5D2CF247189"><enum>(2)</enum><text>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;</text>
</paragraph><paragraph id="HAE6610FA83B04E2C8175BB339DE8057D"><enum>(3)</enum><text>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</text>
</paragraph><paragraph id="H781CBE742E2B4E89B6D7BAC255630E52"><enum>(4)</enum><text>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.</text>
</paragraph></section><section id="H7BE8F84C815C47B1B2B95C24B4C982DC"><enum>805.</enum><header>Information and awareness on eating disorders</header>
<subsection id="H07433B3EA4AB4B8F90623B295547A85E"><enum>(a)</enum><header>Information</header><text>The Secretary of Health and Human Services (in this section referred to as the <quote>Secretary</quote>) may—</text> <paragraph id="H52DF5B0BF38E4BE5BC0F8C81FF9D5FED"><enum>(1)</enum><text>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—</text>
<subparagraph id="H92D0EEFFCEE04CD1B4EBA53C94AF31BF"><enum>(A)</enum><text>updated findings and current research related to eating disorders, as appropriate; and</text> </subparagraph><subparagraph id="HE8D576E918984F5EA1C58C2E979337F0"><enum>(B)</enum><text>information about eating disorders, including information related to males and females;</text>
</subparagraph></paragraph><paragraph id="HC0BDD71FB91B45A2B44785DEFABA9A57"><enum>(2)</enum><text>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</text>
</paragraph><paragraph id="HB943352812D04D878F55F65F72713F9A"><enum>(3)</enum><text>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).</text>
</paragraph></subsection><subsection id="HA698ADFA22E147A1B2E2C39D38D99EEE"><enum>(b)</enum><header>Awareness</header><text>The Secretary may advance public awareness on—</text> <paragraph id="H7B512BB0EFBA45439E588B29A344BB33"><enum>(1)</enum><text>the types of eating disorders;</text>
</paragraph><paragraph id="HFAA0DBB0499948778736548E25C5BDBF"><enum>(2)</enum><text>the seriousness of eating disorders, including prevalence, comorbidities, and physical and mental health consequences;</text>
</paragraph><paragraph id="HA70E54FD4E064C66BAA93D0E34C94D83"><enum>(3)</enum><text>methods to identify, intervene, refer for treatment, and prevent behaviors that may lead to the development of eating disorders;</text>
</paragraph><paragraph id="HD6AD3BD8A1E745E1826472BF9BD1D842"><enum>(4)</enum><text>discrimination and bullying based on body size;</text> </paragraph><paragraph id="H7EB4232092B949EA91F6B5BFA457C70C"><enum>(5)</enum><text>the effects of media on self-esteem and body image; and</text>
</paragraph><paragraph id="H0D2BB12A0D6F49578EB1A30A3CB1043F"><enum>(6)</enum><text>the signs and symptoms of eating disorders.</text> </paragraph></subsection></section><section id="H0CA4F45591BA498890A21EF46181A702"><enum>806.</enum><header>Education and training on eating disorders</header><text display-inline="no-display-inline">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—</text>
<paragraph id="H34AA41A5F2EB47B787EC58769F6B4C8D"><enum>(1)</enum><text>identify individuals with eating disorders;</text> </paragraph><paragraph id="H463B7A7E5E9B460CB987CEB45EE63C63"><enum>(2)</enum><text>provide early intervention services for individuals with eating disorders;</text>
</paragraph><paragraph id="HDA3EF8B31C774821961A8C3BE810E6DB"><enum>(3)</enum><text>refer patients with eating disorders for appropriate treatment;</text> </paragraph><paragraph id="H1BD3ED5461A1458591F2D8D7C88123CF"><enum>(4)</enum><text>prevent the development of eating disorders; or</text>
</paragraph><paragraph id="H1DEF73E57DDF4BA4B298FFDF265A9AF8"><enum>(5)</enum><text>provide appropriate treatment services for individuals with eating disorders.</text> </paragraph></section><section id="HA6FF88AF155C4618B45083C6FE0E5797"><enum>807.</enum><header>GAO study on preventing discriminatory coverage limitations for individuals with serious mental illness and substance use disorders</header><text display-inline="no-display-inline">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 (<external-xref legal-doc="usc" parsable-cite="usc/42/300gg-91">42 U.S.C. 300gg–91</external-xref>)), including Medicaid managed care plans under section 1903 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396b">42 U.S.C. 1396b</external-xref>), to ensure compliance of such plans and coverage with sections 2726 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300gg-26">42 U.S.C. 300gg–26</external-xref>), 712 of the Employee Retirement Income Security Act of 1974 (<external-xref legal-doc="usc" parsable-cite="usc/29/1185a">29 U.S.C. 1185a</external-xref>), and 9812 of the Internal Revenue Code of 1986 (in this section collectively referred to as the <quote>parity law</quote>), including—</text>
<paragraph id="H1B89426A2A0244228E26251EA9BB9C95"><enum>(1)</enum><text>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;</text>
</paragraph><paragraph id="H59A53B87F1314E8386EF0F7C518DFD86"><enum>(2)</enum><text>a description of actions that Federal departments and agencies are taking to ensure that such plans and coverage comply with the parity law; and</text>
</paragraph><paragraph id="H838AC15C0DEE4DB989036BE6F3D3CC91"><enum>(3)</enum><text>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.</text>
</paragraph></section><section commented="no" id="H306E73876BA849969369AA8593ACFFBA"><enum>808.</enum><header>Clarification of existing parity rules</header><text display-inline="no-display-inline">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 (<external-xref legal-doc="usc" parsable-cite="usc/42/300gg-26">42 U.S.C. 300gg–26</external-xref>), section 712 of the Employee Retirement Income Security Act of 1974 (<external-xref legal-doc="usc" parsable-cite="usc/29/1185a">29 U.S.C. 1185a</external-xref>), and <external-xref legal-doc="usc" parsable-cite="usc/26/9812">section 9812</external-xref> of the Internal Revenue Code of 1986.</text>
</section>
Passed the House of Representatives July 6, 2016.Karen L. Haas,Clerk