[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 4282 Introduced in Senate (IS)]

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116th CONGRESS
  2d Session
                                S. 4282

To amend the Community Mental Health Service Block Grant to authorize a 
      set-aside for crisis care services, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             July 22, 2020

  Mr. Manchin (for himself and Mr. Gardner) introduced the following 
  bill; which was read twice and referred to the Committee on Health, 
                     Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
To amend the Community Mental Health Service Block Grant to authorize a 
      set-aside for crisis care services, and for other purposes.

    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 ``Crisis Care Improvement and Suicide 
Prevention Act of 2020''.

SEC. 2. FINDINGS AND SENSE OF CONGRESS.

    (a) Findings.--Congress finds the following:
            (1) Fragmentation of mental health services and limited 
        access to crisis services complicates and elongates mental 
        health patient stays in emergency departments and under the 
        custody of law enforcement.
            (2) Emergency departments and the criminal justice system 
        do not have the capacity with existing resources and health 
        care professional shortages to address the needs of the rapidly 
        growing number of individuals with mental health conditions, 
        increasing the risk of adverse patient outcomes.
            (3) In 2017, 150,000 individuals in the United States died 
        from alcohol and drug-induced fatalities and suicides. Nearly 
        \1/3\, or more than 47,000 were suicides.
            (4) From 2016 to 2018, more than \1/4\ of hospital 
        emergency department ``frequent users'' in Illinois were 
        patients with presenting or underlying mental health 
        conditions, underscoring the need for additional funding, 
        continued access to real-time care and connection to long-term 
        treatment options.
            (5) Fifteen percent of men and 30 percent of women in 
        custody of county jails have severe mental illnesses.
            (6) Use of appropriate crisis facilities and interventions 
        in Maricopa County, Arizona, have saved emergency departments 
        an estimated $37,000,000 in 2016 and saved the equivalent of 37 
        police officer full-time equivalent salaries.
    (b) Sense of Congress.--It is the sense of Congress that--
            (1) for patients with mental health issues, coordination of 
        physical and mental health services and cooperation with law 
        enforcement are essential to ensure timely, appropriate care; 
        and
            (2) crisis care networks established at State and local 
        levels have saved resources and shown improved outcomes for 
        patients in crisis.

SEC. 3. EVIDENCE-BASED CRISIS CARE PROGRAMS.

    (a) In General.--Section 1912(b)(1) of the Public Health Service 
Act (42 U.S.C. 300x-1(b)(1))--
            (1) in subparagraph (A)--
                    (A) by redesignating clauses (vi) and (vii) as 
                clauses (vii) and (viii), respectively; and
                    (B) by inserting after clause (v), the following:
                            ``(vi) include a description of how the 
                        State supports evidenced-based programs that 
                        address the crisis care needs of individuals 
                        with serious mental disorders, and children 
                        with serious mental and emotional disturbances, 
                        that include at least one of the core 
                        components specified in subparagraph (F); ''; 
                        and
            (2) by adding at the end the following:
                    ``(F) Core components for crisis care services.--
                The core components of a program referred to in 
                subparagraph (A)(vi) include the following:
                            ``(i) Crisis call centers.
                            ``(ii) 24/7 mobile crisis services.
                            ``(iii) Crisis stabilization programs 
                        offering acute care or sub-acute care in a 
                        hospital or appropriately licensed facility, 
                        with referrals to inpatient or outpatient care, 
                        as determined by the Assistant Secretary for 
                        Mental Health and Substance Use.''.
    (b) Set-Aside for Evidence-Based Crisis Care Services.--Section 
1920 of the Public Health Service Act (42 U.S.C. 300x-9) is amended by 
adding at the end the following:
    ``(d) Crisis Care.--
            ``(1) In general.--Except as provided in paragraph (3), a 
        State shall expend at least 5 percent of the allotment of the 
        State pursuant to a funding agreement under section 1911 for 
        each fiscal year to support programs described in section 
        1912(b)(1)(A)(vi).
            ``(2) State flexibility.--In lieu of expending 5 percent of 
        the State's allotment for a fiscal year as required by 
        paragraph (1), a State may elect to expend not less than 10 
        percent of such amount by the end of 2 consecutive fiscal 
        years.
            ``(3) Funding contingency.--Paragraph (1) shall not apply 
        with respect to a fiscal year unless the amount made available 
        to carry out this section for that fiscal year exceeds the 
        amount appropriated to carry out this section for fiscal year 
        2020 by at least $35,000,000.''.
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