[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 4170 Introduced in Senate (IS)]
<DOC>
117th CONGRESS
2d Session
S. 4170
To reauthorize programs related to mental health, and for other
purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
May 10, 2022
Mr. Cassidy (for himself and Mr. Murphy) introduced the following bill;
which was read twice and referred to the Committee on Health,
Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To reauthorize programs related to mental health, 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 ``Mental Health Reform Reauthorization
Act of 2022''.
SEC. 2. SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION.
Section 501(d) of the Public Health Service Act (42 U.S.C.
290aa(d)) is amended--
(1) in paragraph (5), by inserting ``coordination between
programs and Centers of Excellence regarding promising and best
practices and dissemination to the field and'' after ``,
including'';
(2) in paragraph (24)(E), by striking ``; and'' and
inserting a semicolon;
(3) in paragraph (25), by striking the period and inserting
``; and''; and
(4) by adding at the end the following:
``(26) coordinate with the Centers for Medicare & Medicaid
Services to promote coverage of evidence-based prevention and
treatment services, improve quality of care, and identify
opportunities for State Medicaid agencies and State mental
health and substance use disorder agencies to collaborate,
including through the braiding of funds, demonstration
programs, waivers, amendments to State plans under section
1912, other State flexibilities, and agency guidance for all
populations enrolled in Medicaid programs.''.
SEC. 3. COMMUNITY MENTAL HEALTH SERVICES BLOCK GRANT.
(a) Funding.--Section 1920 of the Public Health Service Act (42
U.S.C. 300x-9) is amended--
(1) in subsection (a), by striking ``$532,571,000 for each
of fiscal years 2018 through 2022'' and inserting
``1,000,000,000 for each of fiscal years 2023 through 2027'';
and
(2) by adding at the end the following:
``(d) Crisis Care.--
``(1) In general.--Except as provided in paragraph (3), a
State shall expend not less than 5 percent of the amount the
State receives pursuant to section 1911 for each fiscal year to
support evidenced-based programs.
``(2) Core elements.--At the discretion of the single State
agency responsible for the administration of the program of the
State under a grant under section 1911, funds expended pursuant
to paragraph (1) may be used to fund some or all of the core
crisis care service components, delivered according to
evidence-based principles, including the following:
``(A) Crisis call centers.
``(B) 24/7 mobile crisis services.
``(C) Crisis stabilization programs offering acute
care or subacute care in a hospital or appropriately
licensed facility, as determined by the Substance Abuse
and Mental Health Services Administration, with
referrals to inpatient or outpatient care.
``(3) State flexibility.--In lieu of expending 5 percent of
the amount the State receives pursuant to section 1911 for a
fiscal year to support evidence-based programs as required by
paragraph (1), a State may elect to expend not less than 10
percent of such amount to support such programs by the end of 2
consecutive fiscal years.
``(e) Prevention.--
``(1) In general.--Except as provided in paragraph (3), a
State shall expend not less than 5 percent of the amount the
State receives pursuant to section 1911 for each fiscal year to
support evidenced-based early identification and early
intervention programs that prevent or mitigate the development
of mental illness in individuals, including children and
adolescents, who may be at risk of developing a serious mental
illness or serious emotional disturbance, within the meaning of
such term as defined by the Secretary pursuant to section 1912,
or as determined through the use of evidence-based screening
instruments or clinical assessment.
``(2) Core elements.--At the discretion of the single State
agency responsible for the administration of the program of the
State under a grant under section 1911, funds expended pursuant
to paragraph (1) shall be used for evidence-based practices
that follow or exceed the quality of generally accepted
standards of care.
``(3) State flexibility.--In lieu of expending 5 percent of
the amount the State receives pursuant to section 1911 for a
fiscal year to support evidence-based early identification and
early intervention programs as required by paragraph (1), a
State may elect to expend not less than 10 percent of such
amount to support such programs by the end of 2 consecutive
fiscal years.
``(f) Reports by the Secretary.--
``(1) In general.--The Secretary shall--
``(A) commission longitudinal follow-up studies of
the population of individuals served by funds expended
pursuant to subsection (e)(1) to determine clinical
outcomes that may be associated with such funds,
including crisis services utilization and emergency
department visits and hospitalizations related to
mental illness, prevalence of suicidal behavior,
mortality, disability income, high school graduation
rates, employment status and successful timely
reunification, placement stability, and permanency for
children in foster care, disaggregated by mental
illness diagnosis; and
``(B) submit a biennial report summarizing
incremental findings of the studies conducted under
paragraph (1) to Congress.
``(2) Requirements.--In carrying out paragraph (1)(A), the
Secretary shall--
``(A) solicit feedback from stakeholders, including
pediatric experts, on outcomes to use for different age
groups and populations; and
``(B) consider how States who have received funding
are partnering with providers to increase access to
mental health services specific to adults and to
children.
``(g) Special Rule.--The requirements described in subsection
(b)(1)(A)(vi) for a State plan required under such section shall not
apply with respect to funds allocated for the purposes described in
subsections (d) and (e).''.
(b) Restrictions on Use of Payments.--Section 1916(a) of the Public
Health Service Act (42 U.S.C. 300x-5(a)) is amended--
(1) in paragraph (3), by adding ``or'' after the semicolon;
(2) in paragraph (4), by striking ``; or'' and inserting a
period; and
(3) by striking paragraph (5).
SEC. 4. GRANTS FOR JAIL DIVERSION PROGRAMS.
Section 520G of the Public Health Service Act (42 U.S.C. 290bb-38)
is amended--
(1) in subsection (c)(2)(A)(i)--
(A) by inserting ``support continuity of care
(including in consultation with the individual's mental
health clinician when feasible and with continuation of
previously prescribed psychotropic medication and
medication for the treatment of substance use disorder,
as appropriate),'' after ``evidence-based practices,'';
(B) by inserting ``to relevant medications approved
by the Food and Drug Administration'' after
``management and access''; and
(C) by inserting ``peer recovery support
services,'' after ``co-occurring substance use disorder
treatment,'';
(2) in subsection (e)(4) by inserting ``and response
(including suicide prevention)'' after ``crisis intervention'';
and
(3) in subsection (j), by striking ``$4,269,000 for each of
fiscal years 2018 through 2022'' and inserting ``$6,269,000 for
each of fiscal years 2023 through 2027''.
SEC. 5. ASSISTED OUTPATIENT TREATMENT.
Section 224 of the Protecting Access to Medicare Act of 2014
(Public Law 113-93; 42 U.S.C. 290aa note) is amended--
(1) in subsection (e)--
(A) in the matter preceding paragraph (1), by
striking ``each of fiscal years 2016, 2017, 2018, 2019,
2020, 2021, and 2022'' and inserting ``fiscal year
2027'';
(B) by striking paragraphs (2) and (3) and
inserting the following:
``(2) Impact of assisted outpatient treatment on rates of
psychiatric hospitalization, homelessness, arrest, and
incarceration of patients.
``(3) Significant variations in program design among
grantees, including variations in the role of courts in
monitoring and motivating patient progress, and the comparative
impacts of such variations upon program outcomes.''; and
(C) by adding at the end the following:
``(5) Use of psychiatric advance directives or other
methods for patient input in care.'';
(2) in subsection (f)(1), by striking ``local court'' and
inserting ``local civil court''; and
(3) in subsection (g)--
(A) in paragraph (1), by striking ``2015 through
2022'' and inserting ``2023 through 2027''; and
(B) in paragraph (2), by striking ``$15,000,000 for
each of'' and all that follows through ``2022'' and
inserting ``$21,000,000 for each of fiscal years 2023
through 2027''.
SEC. 6. PROJECTS FOR ASSISTANCE IN TRANSITION FROM HOMELESSNESS.
Part C of title V of the Public Health Service Act (42 U.S.C.
290cc-21 et seq.) is amended--
(1) in section 522(g)(1) (42 U.S.C. 290cc-22(g)(1)) by
striking ``20 percent'' and inserting ``25 percent''; and
(2) in section 535(a) (42 U.S.C. 290cc-35(a)), by striking
``$64,635,000 for each of fiscal years 2018 through 2022'' and
inserting ``$64,635,000 for each of fiscal years 2023 through
2027''.
SEC. 7. GRANTS TO SUPPORT MENTAL HEALTH AND SUBSTANCE USE DISORDER
PARITY IMPLEMENTATION.
(a) In General.--Section 2794(c) of the Public Health Service Act
(42 U.S.C. 300gg-94(c)) (as added by section 1003 of the Patient
Protection and Affordable Care Act (Public Law 111-148) is amended by
adding at the end the following:
``(3) Parity implementation.--
``(A) In general.--Beginning 60 days after the date
of enactment of the Parity Implementation Assistance
Act, the Secretary shall award grants to States to
implement the mental health and substance use disorder
parity provisions of section 2726, provided that in
order to receive such a grant, a State is required to
request and review from health insurance issuers
offering group or individual health insurance coverage
the comparative analyses and other information required
of such health insurance issuers under subsection
(a)(8)(A) of such section 2726 regarding the design and
application of nonquantitative treatment limitations
imposed on mental health or substance use disorder
benefits.
``(B) Authorization of appropriations.--For
purposes of awarding grants under subparagraph (A),
there are authorized to be appropriated $25,000,000 for
each of the first five fiscal years beginning after the
date of the enactment of this paragraph.''.
(b) Technical Amendment.--Section 2794 of the Public Health Service
Act (42 U.S.C. 300gg-95), as added by section 6603 of the Patient
Protection and Affordable Care Act (Public Law 111-148) is redesignated
as section 2795.
SEC. 8. ELIMINATING THE OPT-OUT FOR NON-FEDERAL GOVERNMENTAL HEALTH
PLANS.
Section 2722(a)(2) of the Public Health Service Act (42 U.S.C.
300gg-21(a)(2)) is amended by adding at the end the following new
subparagraph:
``(F) Sunset of election option.--
``(i) In general.--Notwithstanding the
preceding provisions of this paragraph--
``(I) no election described in
subparagraph (A) with respect to the
provisions of section 2726 may be made
on or after the date of enactment of
this subparagraph; and
``(II) except as provided in clause
(ii), no such election with respect to
the provisions of section 2726 expiring
on or after the date that is 180 days
after the date of such enactment may be
renewed.
``(ii) Exception for certain collectively
bargained plans.--Notwithstanding clause
(i)(II), a plan described in subparagraph
(B)(ii) that is subject to multiple agreements
described in such subparagraph of varying
lengths and that has an election in effect
under subparagraph (A) as of the date of
enactment of this subparagraph that expires on
or after the date that is 180 days after the
date of such enactment may extend such election
until the date on which the term of the last
such agreement expires.
``(iii) Guidance.--The Secretary shall
issue guidance to plans to support carrying out
activities under this section with regard to
section 2726, including the requirements under
subsection (a)(8) of such section. Such
guidance shall include an explanation of
documents that are required to be disclosed and
analyses that are required to be conducted
pursuant to such subsection (a)(8), including
how nonquantitative treatment limitations are
applied to mental health or substance use
disorder benefits and medical or surgical
benefits covered under the plan, in order for
such plan to demonstrate compliance with this
section and section 2726.''.
SEC. 9. MINORITY FELLOWSHIP PROGRAM.
Section 597 of the Public Health Service Act (42 U.S.C. 290ll) is
amended--
(1) in subsection (b), by inserting ``addiction medicine,''
after ``mental health counseling,''; and
(2) in subsection (c), by striking ``$12,669,000 for each
of fiscal years 2018 through 2022'' and inserting ``$25,000,000
for each of fiscal years 2023 through 2027''.
SEC. 10. PRIORITY MENTAL HEALTH NEEDS OF REGIONAL AND NATIONAL
SIGNIFICANCE.
Section 520A of the Public Health Service Act (42 U.S.C. 290bb-32)
is amended by striking ``2018 through 2022'' and inserting ``2023
through 2027''.
SEC. 11. ENCOURAGING INNOVATION AND EVIDENCE-BASED PROGRAMS WITHIN THE
NATIONAL MENTAL HEALTH AND SUBSTANCE USE POLICY
LABORATORY.
(a) Reauthorization.--Section 501A(e)(3) of the Public Health
Service Act (42 U.S.C. 290aa-0(e)(3)) is amended by striking ``2018
through 2020'' each place it appears and inserting ``2023 through
2027''.
(b) GAO Study.--Not later than 18 months after the date of
enactment of this Act, the Comptroller General of the United States
shall perform a report on the work of the National Mental Health and
Substance Use Policy Laboratory established under section 501A of the
Public Health Service Act (42 U.S.C. 290aa-0), including--
(1) the extent to which such Laboratory is meeting its
responsibilities as set forth in such section 501A; and
(2) any recommendations for improvement, including methods
to expand the use of evidence-based practices across programs,
recommendations to improve program evaluations for
effectiveness, and dissemination of resources to stakeholders
and the public.
SEC. 12. PROGRAMS FOR CHILDREN WITH A SERIOUS EMOTIONAL DISTURBANCE.
Section 565(f) of the Public Health Service Act (42 U.S.C. 290ff-
4(f)) is amended--
(1) in paragraph (1), by striking ``$119,026,000 for each
of fiscal years 2018 through 2022'' and inserting
``$125,000,000 for each of fiscal years 2023 through 2027'';
and
(2) by moving the margin of paragraph (2) 2 ems to the
right.
SEC. 13. MENTAL AND BEHAVIORAL HEALTH EDUCATION AND TRAINING GRANTS.
Section 756(f) of the Public Health Service Act (42 U.S.C. 294e-
1(f)) is amended--
(1) in the matter preceding paragraph (1)--
(A) by striking ``2019 through 2023'' and inserting
``2023 through 2027''; and
(B) by striking ``$50,000,000'' and inserting
``$102,000,000'';
(2) in paragraph (1), by striking ``$15,000,000'' and
inserting ``$30,500,000'';
(3) in paragraph (2), by striking ``$15,000,000'' and
inserting ``$30,500,000'';
(4) in paragraph (3), by striking ``$10,000,000'' and
inserting ``$20,500,000''; and
(5) in paragraph (4), by striking ``$10,000,000'' and
inserting ``$20,500,000''.
SEC. 14. DEVELOPMENT AND DISSEMINATION OF MODEL TRAINING PROGRAMS UNDER
HIPAA.
Section 11004 of the 21st Century Cures Act (Public Law 114-255; 42
U.S.C. 1320d-2 note) is amended--
(1) by redesignating subsections (c) through (e) as
subsections (d) through (f), respectively;
(2) by inserting after subsection (b) the following:
``(b) Reports to Congress.--The Secretary shall submit a report to
Congress--
``(1) not later than 1 year after the date of enactment of
the Mental Health Reform Reauthorization Act of 2022, on
actions taken pursuant to subsection (b); and
``(2) not later than 2 years after the date of submission
of the report under paragraph (1), on updates made to the model
programs and materials described in subsection (a) after the
release of the final regulations required under section 3221(i)
of the Coronavirus Aid, Relief, and Economic Security Act
(Public Law 116-136).''; and
(3) in subsection (f), as so redesignated, by striking
``this section--'' and all that follows through the end of
paragraph (3) and inserting the following: ``this section
$1,000,000 for each of fiscal years 2023 through 2027''.
SEC. 15. PROMOTING INTEGRATION OF PRIMARY CARE AND BEHAVIORAL HEALTH.
Section 520K of the Public Health Service Act (42 U.S.C. 290bb-42)
is amended--
(1) in subsection (c)(2)--
(A) in subparagraph (D), by striking ``; and'' and
inserting a semicolon;
(B) by redesignating subparagraph (E) as
subparagraph (F); and
(C) by inserting after subparagraph (D) the
following:
``(E) a description of how validated rating scales
will be implemented to support the improvement of
patient outcomes using measurement-based care,
including related to depression screening, patient
follow up, and symptom improvement; and''; and
(2) in subsection (h), by striking ``$51,878,000 for each
of fiscal years 2018 through 2022'' and inserting ``$52,877,000
for each of fiscal years 2023 through 2027''.
SEC. 16. PEDIATRIC MENTAL HEALTH CARE ACCESS GRANT PROGRAM.
Section 330M of the Public Health Service Act (42 U.S.C. 254c-19)
is amended--
(1) in subsection (b)--
(A) in paragraph (1)--
(i) in subparagraph (G)--
(I) by inserting ``developmental-
behavioral pediatricians,'' after
``adolescent psychiatrists,''; and
(II) by inserting ``, and which may
include addiction specialists,'' after
``mental health counselors'';
(ii) in subparagraph (H), by striking ``;
and'' and inserting a semicolon;
(iii) in subparagraph (I), by striking the
period and inserting ``; and''; and
(iv) by adding at the end the following:
``(J) maintain an up-to-date list of community-
based supports for children with mental health
conditions.'';
(B) in paragraph (2), by inserting ``, and which
may include a developmental-behavioral pediatrician and
an addiction specialist'' before the period at the end
of the first sentence; and
(C) by adding at the end the following:
``(3) Support to schools and emergency departments.--In
addition to the required activities specified in paragraph (1),
a statewide or regional network of pediatric mental health
teams referred to in subsection (a), with respect to which a
grant under such subsection may be used, may provide support to
schools and emergency departments.'';
(2) by redesignating subsection (g) as subsection (h);
(3) by inserting after subsection (f) the following:
``(g) Technical Assistance.--The Secretary may award a grant to an
eligible entity for purposes of providing technical assistance to
recipients of grants under subsection (a).''; and
(4) in subsection (h), as so redesignated, by striking
``$9,000,000 for the period of fiscal years 2018 through 2022''
and inserting ``$14,000,000 for each of fiscal years 2023
through 2025 and $30,000,000 for each of fiscal years 2026 and
2027''.
SEC. 17. TRAINING IN BEHAVIORAL HEALTH FOR PRIMARY CARE PROVIDERS
CARING FOR PEDIATRIC POPULATIONS.
The Advisory Committee on Training in Primary Care Medicine and
Dentistry of the Health Resources and Services Administration shall
convene and issue a report that includes--
(1) recommendations to optimize the content and
competencies of trainees and primary care providers treating
pediatric populations to address behavioral health conditions;
and
(2) best practices for training pediatric providers in
behavioral health conditions, utilization of evidence-based
screening tools, and follow up care to higher levels of care,
when appropriate.
SEC. 18. FIRST EPISODE PSYCHOSIS.
(a) Review of Use of Certain Funding.--Not later than 180 days
after the date of enactment of this Act, the Secretary of Health and
Human Services, acting through the Assistant Secretary for Mental
Health and Substance Use, shall conduct a review of the use by States
of funds made available under the Community Mental Health Services
Block Grant subpart I of part B of title XIX of the Public Health
Service Act (42 U.S.C. 300x et seq.) for First Episode Psychosis
activities. Such review shall consider the following:
(1) How the States use funds for evidence-based treatments
and services according to the standard of care for those with
serious mental illness, including the comprehensiveness of such
treatments to include all aspects of the recommended
intervention.
(2) How State mental health departments are coordinating
with State Medicaid departments in the delivery of the
treatments and services described in paragraph (1).
(3) What percentage of the State funding under the block
grant is being applied toward First Episode Psychosis in excess
of 10 percent of the amount of the grant, as broken down on a
State-by-State basis. The review shall also identify any States
that fail to expend the required 10 percent of block grant
funds on First Episode Psychosis activities.
(4) How many individuals are served by the expenditures
described in paragraph (3), broken down on a per-capita basis.
(5) How the funds are used to reach individuals in
underserved populations, including individuals in rural areas
and individuals from minority groups.
(b) Report and Guidance.--
(1) Report.--Not later than 6 months after the completion
of the review under subsection (a), the Secretary of Health and
Human Services, acting through the Assistant Secretary for
Mental Health and Substance Use, shall submit to the
appropriate authorization and appropriations committees of
Congress, a report on the finding made as a result of the
review conducted under subsection (a). Such report shall
include any recommendations with respect to any changes to the
Community Mental Health Services Block Grant program, including
the set aside required for First Episode Psychosis, that would
facilitate improved outcomes for the targeted population
involved.
(2) Guidance.--Not later than 1 year after the date on
which the report is submitted under paragraph (1), the
Secretary of Health and Human Services, acting through the
Assistant Secretary for Mental Health and Substance Use, shall
update the guidance provided to States under the Community
Mental Health Services Block Grant based on the findings and
recommendations of the report.
(c) Technical Assistance.--The Director of the National Institute
of Mental Health shall coordinate with the Assistant Secretary for
Mental Health and Substance Use in providing technical assistance to
State grantees and provider subgrantees in the delivery of services for
First Episode Psychosis under the Community Mental Health Services
Block Grant.
SEC. 19. CMS STUDY AND REPORT REGARDING ADHERENCE TO STANDARD OF CARE
FOR TREATMENT OF INDIVIDUALS WITH SERIOUS MENTAL ILLNESS
AND CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCE UNDER
MEDICARE AND MEDICAID.
(a) Study.--The Administrator of the Centers for Medicare &
Medicaid Services shall review claims relating to treatment of
individuals with serious mental illness and children with serious
emotional disturbance made under the Medicare program established under
title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) and the
Medicaid program established under title XIX of such Act (42 U.S.C.
1396 et seq.) and the State Children's Health Insurance Program under
title XXI of the Social Security Act (42 U.S.C. 1397aa et seq.) for
purposes of assessing the extent to which such individuals receive
evidence-based treatments according to the standard of care for those
with serious mental illness and serious emotional disturbance and the
extent to which the comprehensiveness of such treatments includes all
aspects of a recommended intervention under the applicable standard of
care.
(b) Report.--Not later than 6 months after the date of enactment of
this Act, the Administrator of the Centers for Medicare & Medicaid
Services shall submit to Congress a report on the study required by
subsection (a).
SEC. 20. GUIDANCE FOR STATES RELATING TO COVERAGE RECOMMENDATIONS OF
HEALTH CARE SERVICES AND INTERVENTIONS FOR INDIVIDUALS
WITH SERIOUS MENTAL ILLNESS AND CHILDREN WITH SERIOUS
EMOTIONAL DISTURBANCE.
Not later than 2 years after the date of enactment of this Act, the
Administrator of the Centers for Medicare & Medicaid Services, jointly
with the Assistant Secretary for Mental Health and Substance Use and
the Director of the National Institute of Mental Health--
(1) shall provide updated guidance to States concerning--
(A) coverage recommendations relating to health
care services and interventions for those with serious
mental illness, specifically First Episode Psychosis;
and
(B) the manner in which Federal funding provided to
States through programs administered by such agencies,
including the Community Mental Health Services Block
Grant program under subpart I of part B of title XIX of
the Public Health Service Act (42 U.S.C. 300x et seq.),
may be coordinated to support individuals with serious
mental illness and serious emotional disturbance; and
(2) may streamline relevant State reporting requirements if
such streamlining would result in making it easier for States
to coordinate funding under the programs described in paragraph
(1)(B) to improve treatments for individuals with serious
mental illness and serious emotional disturbance.
SEC. 21. GAO STUDY ON DATA COLLECTION AND PUBLIC REPORTING.
Not later than 18 months after the date of enactment of this Act,
the Comptroller General of the United States, in consultation with the
Assistant Secretary for Mental Health and Substance Use and the
Secretary of Health and Human Services, shall perform a study on areas
to improve data reporting across programs of the Substance Abuse and
Mental Health Services Administration. Such report and evaluation shall
include--
(1) recommendations for improvements to--
(A) data collected from recipients of grants,
contract, and cooperative agreements from the Substance
Abuse and Mental Health Services Administration;
(B) utilization of outcome measures and evidence-
based practices;
(C) program performance evaluations; and
(D) the impact of grant funding on different age
groups and populations, including children and
adolescents;
(2) a review of how the State plans required under section
1912 of the Public Health Service Act (42 U.S.C. 300x-1) and
section 1932 of such Act (42 U.S.C. 300x-32) and reports
required under section 1942 of such Act (42 U.S.C. 300x-52)
could be updated and simplified; and
(3) areas to improve dissemination and how data should be
reported to the public.
SEC. 22. PRIMARY CARE TRAINING AND ENHANCEMENT FOR MENTAL HEALTH.
Section 747(c)(2) of the Public Health Service Act (42 U.S.C.
293k(c)(2)) is amended--
(1) by striking ``Fifteen percent'' and inserting the
following:
``(A) Physician assistant training programs.--
Fifteen percent''; and
(2) by adding at the end the following:
``(B) Mental health programs.--Ten percent of the
amount appropriated pursuant to paragraph (1) in each
such fiscal year shall be allocated to training
programs focused on mental health, with an emphasis on
primary care for pediatric populations.''.
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