[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4388 Introduced in House (IH)]

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114th CONGRESS
  2d Session
                                H. R. 4388

   To amend the Public Health Service Act to authorize a primary and 
           behavioral health care integration grant program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            January 13, 2016

  Mr. Loebsack (for himself, Mr. Tonko, Mr. Kennedy, and Ms. Matsui) 
 introduced the following bill; which was referred to the Committee on 
                          Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
   To amend the Public Health Service Act to authorize a primary and 
           behavioral health care integration grant program.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Behavioral Health Care Integration 
Act of 2016''.

SEC. 2. PRIMARY AND BEHAVIORAL HEALTH CARE INTEGRATION GRANT PROGRAMS.

    Section 520K of the Public Health Service Act (42 U.S.C. 290bb-42) 
is amended to read as follows:

``SEC. 520K. INTEGRATION INCENTIVE GRANTS.

    ``(a) In General.--The Secretary shall establish a primary and 
behavioral health care integration grant program. The Secretary may 
award grants and cooperative agreements to eligible entities to expend 
funds for improvements in integrated settings with integrated 
practices.
    ``(b) Definitions.--In this section:
            ``(1) Integrated care.--The term `integrated care' means 
        full collaboration in merged or transformed practices offering 
        behavioral and physical health services within the same shared 
        practice space in the same facility, where the entity--
                    ``(A) provides services in a shared space that 
                ensures services will be available and accessible 
                promptly and in a manner which preserves human dignity 
                and assures continuity of care;
                    ``(B) ensures communication among the integrated 
                care team that is consistent and team-based;
                    ``(C) ensures shared decisionmaking between 
                behavioral health and primary care providers;
                    ``(D) provides evidence-based services in a mode of 
                service delivery appropriate for the target population;
                    ``(E) employs staff who are multidisciplinary and 
                culturally and linguistically competent;
                    ``(F) provides integrated services related to 
                screening, diagnosis, and treatment of mental illness 
                and substance use disorder and co-occurring primary 
                care conditions and chronic diseases; and
                    ``(G) provides targeted case management, including 
                services to assist individuals gaining access to needed 
                medical, social, educational, and other services and 
                applying for income security, housing, employment, and 
                other benefits to which they may be entitled.
            ``(2) Integrated care team.--The term `integrated care 
        team' means a team that includes--
                    ``(A) allopathic or osteopathic medical doctors, 
                such as a primary care physician and a psychiatrist;
                    ``(B) licensed clinical behavioral health 
                professionals, such as psychologists or social workers;
                    ``(C) a case manager; and
                    ``(D) other members, such as psychiatric advanced 
                practice nurses, physician assistants, peer-support 
                specialists or other allied health professionals, such 
                as mental health counselors.
            ``(3) Special population.--The term `special population' 
        means--
                    ``(A) adults with mental illnesses who have co-
                occurring primary care conditions with chronic 
                diseases;
                    ``(B) adults with serious mental illnesses who have 
                co-occurring primary care conditions with chronic 
                diseases;
                    ``(C) children and adolescents with serious 
                emotional disorders with co-occurring primary care 
                conditions and chronic diseases;
                    ``(D) older adults with mental illness who have co-
                occurring primary care conditions with chronic 
                conditions;
                    ``(E) individuals with substance use disorder; or
                    ``(F) individuals from populations for which there 
                is a significant disparity in the quality, outcomes, 
                cost, or use of mental health or substance use disorder 
                services or a significant disparity in access to such 
                services, as compared to the general population, such 
                as racial and ethnic minorities and rural populations.
    ``(c) Purpose.--The grant program under this section shall be 
designed to lead to full collaboration between primary and behavioral 
health in an integrated practice model to ensure that--
            ``(1) the overall wellness and physical health status of 
        individuals with serious mental illness and co-occurring 
        substance use disorders is supported through integration of 
        primary care into community mental health centers meeting the 
        criteria specified in section 1913(c) of the Social Security 
        Act or certified community behavioral health clinics described 
        in section 223 of the Protecting Access to Medicare Act of 
        2014; or
            ``(2) the mental health status of individuals with 
        significant co-occurring psychiatric and physical conditions 
        will be supported through integration of behavioral health into 
        primary care settings.
    ``(d) Eligible Entities.--To be eligible to receive a grant or 
cooperative agreement under this section, an entity shall be a State 
department of health, State mental health or addiction agency, State 
Medicaid agency, or licensed health care provider or institution. The 
Administrator may give preference to States that have existing 
integrated care models, such as those authorized by section 1945 of the 
Social Security Act.
    ``(e) Application.--An eligible entity desiring a grant or 
cooperative agreement under this section shall submit an application to 
the Administrator at such time, in such manner, and accompanied by such 
information as the Administrator may require, including a description 
of a plan to achieve fully collaborative agreements to provide services 
to special populations and--
            ``(1) a document that summarizes the State-specific 
        policies that inhibit the provision of integrated care, and the 
        specific steps that will be taken to address such barriers, 
        such as through licensing and billing procedures; and
            ``(2) a plan to develop and share a de-identified patient 
        registry to track treatment implementation and clinical 
        outcomes to inform clinical interventions, patient education, 
        and engagement with merged or transformed integrated practices 
        in compliance with applicable national and State health 
        information privacy laws.
    ``(f) Grant Amounts.--The maximum annual grant amount under this 
section shall be $2,000,000, of which not more than 10 percent may be 
allocated to State administrative functions, and the remaining amounts 
shall be allocated to health facilities that provide integrated care.
    ``(g) Duration.--A grant under this section shall be for a period 
of 5 years.
    ``(h) Report on Program Outcomes.--An entity receiving a grant or 
cooperative agreement under this section shall submit an annual report 
to the Administrator that includes--
            ``(1) the progress to reduce barriers to integrated care, 
        including regulatory and billing barriers, as described in the 
        entity's application under subsection (d); and
            ``(2) a description of functional outcomes of special 
        populations, such as--
                    ``(A) with respect to individuals with serious 
                mental illness, participation in supportive housing or 
                independent living programs, engagement in social or 
                education activities, participation in job training or 
                employment opportunities, attendance at scheduled 
                medical and mental health appointments, and compliance 
                with treatment plans;
                    ``(B) with respect to individuals with co-occurring 
                mental illness and primary care conditions and chronic 
                diseases, attendance at scheduled medical and mental 
                health appointments, compliance with treatment plans, 
                and participation in learning opportunities related to 
                improved health and lifestyle practice; and
                    ``(C) with respect to children and adolescents with 
                serious emotional disorders who have co-occurring 
                primary care conditions and chronic diseases, 
                attendance at scheduled medical and mental health 
                appointments, compliance with treatment plans, and 
                participation in learning opportunities at school and 
                extracurricular activities.
    ``(i) Technical Assistance Center for Primary-Behavioral Health 
Care Integration.--
            ``(1) In general.--The Secretary shall establish a program 
        through which such Secretary shall provide appropriate 
        information, training, and technical assistance to eligible 
        entities that receive a grant or cooperative agreement under 
        this section, in order to help such entities to meet the 
        requirements of this section, including assistance with--
                    ``(A) development and selection of integrated care 
                models;
                    ``(B) dissemination of evidence-based interventions 
                in integrated care;
                    ``(C) establishment of organizational practices to 
                support operational and administrative success; and
                    ``(D) other activities, as the Secretary determines 
                appropriate.
            ``(2) Additional dissemination of technical information.--
        The information and resources provided by the technical 
        assistance program established under paragraph (1) shall be 
        made available to States, political subdivisions of a State, 
        Indian tribes or tribal organizations (as defined in section 4 
        of the Indian Self-Determination and Education Assistance Act), 
        outpatient mental health and addiction treatment centers, 
        community mental health centers that meet the criteria under 
        section 1913(c), certified community behavioral health clinics 
        described in section 223 of the Protecting Access to Medicare 
        Act of 2014, primary care organizations such as Federally 
        qualified health centers or rural health centers, other 
        community-based organizations, or other entities engaging in 
        integrated care activities, as the Secretary determines 
        appropriate.
    ``(j) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated $50,000,000 for each of fiscal 
years 2017 through 2021, of which $2,000,000 shall be available to the 
technical assistance program under subsection (i).''.
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