[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4851 Introduced in House (IH)]

<DOC>






118th CONGRESS
  1st Session
                                H. R. 4851

   To provide for improvements in the implementation of the National 
          Suicide Prevention Lifeline, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 25, 2023

 Mr. Cardenas (for himself, Mr. Fitzpatrick, Ms. Blunt Rochester, Mr. 
   Moulton, Ms. Matsui, Mrs. Napolitano, Mr. Beyer, Mr. Raskin, Ms. 
 Strickland, Mr. Gomez, Mr. Pocan, Mr. Tonko, Ms. Moore of Wisconsin, 
  Ms. Barragan, Ms. Underwood, Ms. Clarke of New York, Mr. Trone, Ms. 
Balint, Mr. Lynch, Ms. Schrier, Ms. Craig, and Ms. Jayapal) introduced 
 the following bill; which was referred to the Committee on Energy and 
 Commerce, and in addition to the Committees on Ways and Means, Armed 
 Services, Veterans' Affairs, and Oversight and Accountability, for a 
 period to be subsequently determined by the Speaker, in each case for 
consideration of such provisions as fall within the jurisdiction of the 
                          committee concerned

_______________________________________________________________________

                                 A BILL


 
   To provide for improvements in the implementation of the National 
          Suicide Prevention Lifeline, 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.

    (a) Short Title.--This Act may be cited as the ``9-8-8 
Implementation Act of 2023''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title.
   TITLE I--SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

Sec. 101. Regional and local lifeline call center program.
Sec. 102. Mental Health Crisis Response Partnership Pilot Program.
Sec. 103. National suicide prevention media campaign.
         TITLE II--HEALTH RESOURCES AND SERVICES ADMINISTRATION

Sec. 201. Health center capital grants.
Sec. 202. Expanding behavioral health workforce training programs.
         TITLE III--BEHAVIORAL HEALTH CRISIS SERVICES EXPANSION

Sec. 301. Coverage of crisis response services.
Sec. 302. Incident reporting.
                     TITLE IV--MEDICAID AMENDMENTS

Sec. 401. Revisions to the State option to provide qualifying 
                            community-based mobile crisis intervention 
                            services and other services under State 
                            plans under the Medicaid program.
Sec. 402. Revisions to the IMD exclusion under Medicaid.

   TITLE I--SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

SEC. 101. REGIONAL AND LOCAL LIFELINE CALL CENTER PROGRAM.

    Part B of title V of the Public Health Service Act (42 U.S.C. 290bb 
et seq.) is amended by inserting after section 520E-4 (42 U.S.C. 290bb-
36d) the following:

``SEC. 520E-5. REGIONAL AND LOCAL LIFELINE CALL CENTER PROGRAM.

    ``(a) In General.--The Secretary shall award grants to crisis call 
centers to--
            ``(1) purchase or upgrade call center technology;
            ``(2) provide for training of call center staff;
            ``(3) improve call center operations; and
            ``(4) hiring of call center staff.
    ``(b) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $441,000,000 for fiscal year 
2024, to remain available until expended.''.

SEC. 102. MENTAL HEALTH CRISIS RESPONSE PARTNERSHIP PILOT PROGRAM.

    Section 520F(e) of the Public Health Service Act (42 U.S.C. 290bb-
37(e)) is amended by striking ``section, $10,000,000 for each of fiscal 
years 2023 through 2027'' and inserting the following: ``section--
            ``(1) $10,000,000 for fiscal year 2023; and
            ``(2) $100,000,000 for each of fiscal years 2024 through 
        2027''.

SEC. 103. NATIONAL SUICIDE PREVENTION MEDIA CAMPAIGN.

    Subpart 3 of part B of title V of the Public Health Service Act (42 
U.S.C. 290bb-31 et seq.) is amended by adding at the end the following:

``SEC. 5200. NATIONAL SUICIDE PREVENTION MEDIA CAMPAIGN.

    ``(a) National Suicide Prevention Media Campaign.--
            ``(1) In general.--Not later than the date that is 3 years 
        after the date of the enactment of this Act, the Secretary, in 
        consultation with the Assistant Secretary for Mental Health and 
        Substance Use and the Director of the Centers for Disease 
        Control and Prevention (referred to in this section as the 
        `Director'), shall conduct a national suicide prevention media 
        campaign (referred to in this section as the `national media 
        campaign'), for purposes of--
                    ``(A) preventing suicide in the United States;
                    ``(B) educating families, friends, and communities 
                on how to address suicide and suicidal thoughts, 
                including when to encourage individuals with suicidal 
                risk to seek help; and
                    ``(C) increasing awareness of suicide prevention 
                resources of the Centers for Disease Control and 
                Prevention and the Substance Abuse and Mental Health 
                Services Administration (including the suicide 
                prevention hotline maintained under section 520E-3, any 
                suicide prevention mobile application of the Centers 
                for Disease Control and Prevention or the Substance 
                Abuse Mental Health Services Administration, and other 
                support resources determined appropriate by the 
                Secretary).
            ``(2) Additional consultation.--In addition to consulting 
        with the Assistant Secretary and the Director under this 
        section, the Secretary shall consult with, as appropriate, 
        State, local, Tribal, and territorial health departments, 
        primary health care providers, hospitals with emergency 
        departments, mental and behavioral health services providers, 
        crisis response services providers, paramedics, law 
        enforcement, suicide prevention and mental health 
        professionals, patient advocacy groups, survivors of suicide 
        attempts, and representatives of television and social media 
        platforms in planning the national media campaign to be 
        conducted under paragraph (1).
    ``(b) Target Audiences.--
            ``(1) Tailoring advertisements and other communications.--
        In conducting the national media campaign under subsection 
        (a)(1), the Secretary may tailor culturally competent 
        advertisements and other communications of the campaign across 
        all available media for a target audience (such as a particular 
        geographic location or demographic) across the lifespan.
            ``(2) Targeting certain local areas.--The Secretary shall, 
        to the maximum extent practicable, use amounts made available 
        under subsection (f) for media that targets certain local areas 
        or populations at disproportionate risk for suicide.
    ``(c) Use of Funds.--
            ``(1) Required uses.--
                    ``(A) In general.--The Secretary shall, if 
                reasonably feasible with the funds made available under 
                subsection (f), carry out the following, with respect 
                to the national media campaign:
                            ``(i) Testing and evaluation of 
                        advertising.
                            ``(ii) Evaluation of the effectiveness of 
                        the national media campaign.
                            ``(iii) Operational and management 
                        expenses.
                            ``(iv) The creation of an educational 
                        toolkit for television and social media 
                        platforms to use in discussing suicide and 
                        raising awareness about how to prevent suicide.
                    ``(B) Specific requirements.--
                            ``(i) Testing and evaluation of 
                        advertising.--In testing and evaluating 
                        advertising under subparagraph (A)(i), the 
                        Secretary shall test all advertisements after 
                        use in the national media campaign to evaluate 
                        the extent to which such advertisements have 
                        been effective in carrying out the purposes of 
                        the national media campaign.
                            ``(ii) Evaluation of effectiveness of 
                        national media campaign.--In evaluating the 
                        effectiveness of the national media campaign 
                        under subparagraph (A)(ii), the Secretary 
                        shall--
                                    ``(I) take into account the number 
                                of unique calls that are made to the 
                                suicide prevention hotline maintained 
                                under section 520E-3 and assess whether 
                                there are any State and regional 
                                variations with respect to the capacity 
                                to answer such calls;
                                    ``(II) take into account the number 
                                of unique encounters with suicide 
                                prevention and support resources of the 
                                Centers for Disease Control and 
                                Prevention and the Substance Abuse and 
                                Mental Health Services Administration 
                                and assess engagement with such suicide 
                                prevention and support resources;
                                    ``(III) assess whether the national 
                                media campaign has contributed to 
                                increased awareness that suicidal 
                                individuals should be engaged, rather 
                                than ignored; and
                                    ``(IV) take into account such other 
                                measures of evaluation as the Secretary 
                                determines are appropriate.
            ``(2) Optional uses.--The Secretary may use amounts made 
        available under subsection (f) for the following, with respect 
        to the national media campaign:
                    ``(A) Partnerships with professional and civic 
                groups, community-based organizations, including faith-
                based organizations, and Federal agencies or Tribal 
                organizations that the Secretary determines have 
                experience in suicide prevention, including the 
                Substance Abuse and Mental Health Services 
                Administration and the Centers for Disease Control and 
                Prevention.
                    ``(B) Entertainment industry outreach, interactive 
                outreach, media projects and activities, the 
                dissemination of public information, news media 
                outreach, outreach through television programs, and 
                corporate sponsorship and participation.
    ``(d) Prohibitions.--None of the amounts made available under 
subsection (f) may be obligated or expended for any of the following:
            ``(1) To supplant Federal suicide prevention campaigns in 
        effect as of the date of the enactment of this section.
            ``(2) For partisan political purposes, or to express 
        advocacy in support of or to defeat any clearly identified 
        candidate, clearly identified ballot initiative, or clearly 
        identified legislative or regulatory proposal.
    ``(e) Report to Congress.--Not later than 18 months after 
implementation of the national media campaign has begun, the Secretary, 
in coordination with the Assistant Secretary and the Director, shall, 
with respect to the first year of the national media campaign, submit 
to Congress a report that describes--
            ``(1) the strategy of the national media campaign and 
        whether specific objectives of such campaign were accomplished, 
        including whether such campaign impacted the number of calls 
        made to lifeline crisis centers and the capacity of such 
        centers to manage such calls;
            ``(2) steps taken to ensure that the national media 
        campaign operates in an effective and efficient manner 
        consistent with the overall strategy and focus of the national 
        media campaign;
            ``(3) plans to purchase advertising time and space;
            ``(4) policies and practices implemented to ensure that 
        Federal funds are used responsibly to purchase advertising time 
        and space and eliminate the potential for waste, fraud, and 
        abuse; and
            ``(5) all contracts entered into with a corporation, a 
        partnership, or an individual working on behalf of the national 
        media campaign.
    ``(f) Authorization of Appropriations.--For purposes of carrying 
out this section, there is authorized to be appropriated $10,000,000 
for each of fiscal years 2024 through 2028.''.

         TITLE II--HEALTH RESOURCES AND SERVICES ADMINISTRATION

SEC. 201. HEALTH CENTER CAPITAL GRANTS.

    Subpart 1 of part D of title III of the Public Health Service Act 
(42 U.S.C. 254b et seq.) is amended by adding at the end the following:

``SEC. 330Q. HEALTH CENTER CAPITAL GRANTS.

    ``(a) In General.--The Secretary shall award grants to eligible 
entities for capital projects.
    ``(b) Eligible Entity.--In this section, the term `eligible entity' 
is an entity that is--
            ``(1) a health center funded under section 330, or in the 
        case of a Tribe or Tribal organization, eligible, to be awarded 
        without regard to the time limitation in subsection (e)(3) and 
        subsections (e)(6)(A)(iii), (e)(6)(B)(iii), and (r)(2)(B) of 
        such section; or
            ``(2) a mental health and substance use crisis receiving 
        and stabilization program and crisis call center that have a 
        working relationship with one or more local community mental 
        health and substance use organizations, community mental health 
        centers, and certified community behavioral health clinics, or 
        other local mental health and substance use care providers, 
        including inpatient and residential treatment settings.
    ``(c) Use of Funds.--Amounts made available to a recipient of a 
grant or cooperative agreement pursuant to subsection (a) shall be used 
for crisis response program facility alteration, renovation, 
remodeling, expansion, construction, and other capital improvement 
costs, including the costs of amortizing the principal of, and paying 
interest on, loans for such purposes.
    ``(d) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $1,000,000,000, to remain 
available until expended.''.

SEC. 202. EXPANDING BEHAVIORAL HEALTH WORKFORCE TRAINING PROGRAMS.

    (a) National Health Service Corps.--Section 331(a)(3)(E)(i) of the 
Public Health Service Act (254d(a)(3)(E)(i)) is amended by striking 
``and psychiatrists'' and inserting ``psychiatrists and professionals 
who provide crisis management services (such as at a crisis call 
center, as part of a mobile crisis team, or through crisis receiving 
and stabilization program)''.
    (b) Minority Fellowship Program.--Section 597(b) of the Public 
Health Service Act (42 U.S.C. 290ll(b)) is amended by inserting 
``crisis management services (such as at a crisis call center, as part 
of a mobile crisis team, or through crisis receiving and stabilization 
program),'' after ``mental health counseling,''.
    (c) Behavioral Health Workforce Education and Training.--Section 
756 of the Public Health Service Act (42 U.S.C. 294e-1) is amended--
            (1) in subsection (a)--
                    (A) in paragraph (1), by inserting ``crisis 
                management (such as at a crisis call center, as part of 
                a mobile crisis team, or through crisis receiving and 
                stabilization program),'' after ``occupational 
                therapy,'';
                    (B) in paragraph (2), by inserting ``and providing 
                crisis management services (such as at a crisis call 
                center, as part of a mobile crisis team, or through 
                crisis receiving and stabilization program)'' after 
                ``treatment services,'';
                    (C) in paragraph (3), by inserting ``and providing 
                crisis management services (such as at a crisis call 
                center, as part of a mobile crisis team, or through 
                crisis receiving and stabilization program),'' after 
                ``behavioral health services''; and
                    (D) in paragraph (4), by inserting ``including for 
                the provision of crisis management services (such as at 
                a crisis call center, as part of a mobile crisis team, 
                or through crisis receiving and stabilization 
                program),'' after ``paraprofessional field'';
            (2) in subsection (d)(2), by inserting ``or that emphasize 
        training in crisis management and meeting the crisis needs of 
        diverse populations specified in (b)(2), including effective 
        outreach and engagement'' after ``partnerships''; and
            (3) by adding at the end the following:
    ``(g) Additional Funding.--
            ``(1) In general.--For each of fiscal years 2024 through 
        2028, in addition to funding made available under subsection 
        (f), there are authorized to be appropriated $15,000,000 for 
        workforce development for crisis management, as specified in 
        paragraphs (1) through (4) of subsection (a).
            ``(2) Priority.--In making grants for the purpose specified 
        in paragraph (1), the Secretary shall give priority to programs 
        demonstrating effective recruitment and retention efforts for 
        individuals and groups from different racial, ethnic, cultural, 
        geographic, religious, linguistic, and class backgrounds, and 
        different genders and sexual orientations, as specified in 
        subsection (b)(2).''.

         TITLE III--BEHAVIORAL HEALTH CRISIS SERVICES EXPANSION

SEC. 301. COVERAGE OF CRISIS RESPONSE SERVICES.

    (a) Coverage Under the Medicare Program.--
            (1) In general.--Section 1861(s)(2) of the Social Security 
        Act (42 U.S.C. 1395x(s)(2)) is amended--
                    (A) in subparagraph (II), by striking ``and'' at 
                the end;
                    (B) in subparagraph (JJ), by striking the period at 
                the end and inserting ``; and''; and
                    (C) by adding at the end the following new 
                subparagraph:
                    ``(KK) crisis response services as defined in 
                subsection (nnn);''.
            (2) Crisis response services defined.--Section 1861 of the 
        Social Security Act (42 U.S.C. 1395x) is amended by adding at 
        the end the following new subsection:
    ``(nnn) Crisis Response Services.--The term `crisis response 
services' means mental health or substance use services that are 
furnished by a mobile crisis response team, a crisis receiving and 
stabilization facility, mental health or substance use urgent care 
facility, or other appropriate provider, as determined by the 
Secretary, to an individual, including children and adolescents, 
experiencing a mental health or substance use crisis.''.
            (3) Payment.--
                    (A) In general.--Section 1833(a)(1) of the Social 
                Security Act (42 U.S.C. 1395l(a)(1)) is amended--
                            (i) by striking ``and (HH)'' and inserting 
                        ``(HH)''; and
                            (ii) by inserting before the semicolon at 
                        the end the following: ``and (II) with respect 
                        to crisis response services described in 
                        section 1861(s)(2)(KK), the amounts paid shall 
                        be 80 percent of the lesser of the actual 
                        charge for the service or the amount determined 
                        under the payment basis established under 
                        section 1834(aa)''.
                    (B) Establishment of payment basis.--Section 1834 
                of the Social Security Act (42 U.S.C. 1395m) is amended 
                by adding at the end the following new subsection:
    ``(aa) Payment for Crisis Response Services.--The Secretary shall 
establish a payment basis determined appropriate by the Secretary with 
respect to crisis response services (as defined in section 1861(nnn)) 
furnished by a provider of services or supplier.''.
            (4) Ambulance transport of individuals in crisis.--
                    (A) In general.--Section 1834(l) of the Social 
                Security Act (42 U.S.C. 1395m(l)) is amended by adding 
                at the end the following new paragraph:
            ``(18) Transportation of individuals in crisis.--With 
        respect to ambulance services furnished on or after the date 
        that is 3 years after the date of the enactment of the 
        Behavioral Health Crisis Services Expansion Act, the 
        regulations described in section 1861(s)(7) shall provide 
        coverage under such section for ambulance and other qualified 
        emergency transport services to transport an individual 
        experiencing a mental health or substance crisis to an 
        appropriate facility, such as a community mental health center 
        (as defined in section 1861(ff)(3)(B)) or other facility or 
        provider identified by the Secretary, as appropriate, for 
        crisis response services described in section 
        1861(s)(2)(KK).''.
                    (B) Conforming amendment.--Section 1861(s)(7) of 
                such Act (42 U.S.C. 1395x(s)(7)) is amended by striking 
                ``section 1834(l)(14)'' and inserting ``paragraphs (14) 
                and (18) of section 1834(l)''.
            (5) Effective date.--The amendments made by this subsection 
        shall apply to services furnished on or after the date that is 
        3 years after the date of the enactment of this Act.
    (b) Mandatory Coverage of Crisis Response Services Under the 
Medicaid Program.--Title XIX of the Social Security Act (42 U.S.C. 1396 
et seq.) is amended--
            (1) in section 1902(a)(10)(A), in the matter preceding 
        clause (i), by striking ``and (30)'' and inserting ``(30), and 
        (31)''; and
            (2) in section 1905--
                    (A) in subsection (a)--
                            (i) in paragraph (30), by striking ``; 
                        and'' and inserting a semicolon;
                            (ii) by redesignating paragraph (31) as 
                        paragraph (32); and
                            (iii) by inserting the following paragraph 
                        after paragraph (30):
            ``(31) crisis response services (as defined in section 
        1861(nnn)); and''.
            (3) Presumptive eligibility determination by crisis 
        response service providers.--Section 1902(a)(47)(B) of the 
        Social Security Act (42 U.S.C. 1396a(a)(47)(B)) is amended by 
        inserting ``or provider of crisis response services (as defined 
        in section 1861(nnn))'' after ``any hospital''.
            (4) Effective date.--
                    (A) In general.--Except as provided in subparagraph 
                (B), the amendments made by this section shall take 
                effect on the date that is 3 years after the date of 
                the enactment of this Act.
                    (B) Delay permitted if state legislation 
                required.--In the case of a State plan under title XIX 
                of the Social Security Act (42 U.S.C. 1396 et seq.) 
                which the Secretary of Health and Human Services 
                determines requires State legislation (other than 
                legislation appropriating funds) in order for the plan 
                to meet the additional requirements imposed by the 
                amendments made by this section, the State plan shall 
                not be regarded as failing to comply with the 
                requirements of such title solely on the basis of the 
                failure of the plan to meet such additional 
                requirements before the first day of the first calendar 
                quarter beginning after the close of the first regular 
                session of the State legislature that begins after the 
                date of enactment of this Act. For purposes of the 
                previous sentence, in the case of a State that has a 2-
                year legislative session, each year of such session 
                shall be deemed to be a separate regular session of the 
                State legislature.
    (c) Essential Health Benefits.--Section 1302(b)(1)(E) of the 
Patient Protection and Affordable Care Act (42 U.S.C. 18022(b)(1)(E)) 
is amended by inserting ``and crisis response services (as defined in 
section 1861(nnn) of the Social Security Act)'' before the period.
    (d) Group Health Plans and Health Insurance Issuers.--
            (1) In general.--Section 2707 of the Public Health Service 
        Act (42 U.S.C. 300gg-6) is amended by adding at the end the 
        following:
    ``(e) Crisis Response Services.--A group health plan or a health 
insurance issuer offering group or individual health insurance coverage 
shall ensure that such coverage includes crisis response services (as 
defined in section 1861(nnn) of the Social Security Act).''.
            (2) Application to grandfathered plans.--Section 
        1251(a)(4)(A) of the Public Health Service Act (42 U.S.C. 
        18011(a)(4)(A)) is amended by adding at the end the following 
        new clause:
                            ``(v) Section 2707(e) (relating to coverage 
                        of crisis response services).''.
    (e) Tricare Coverage.--
            (1) In general.--The Secretary of Defense shall provide 
        coverage under the TRICARE program for crisis response 
        services, as defined in section 1861(nnn) of the Social 
        Security Act (42 U.S.C. 1395x).
            (2) Tricare program defined.--In this section, the term 
        ``TRICARE program'' has the meaning given the term in section 
        1072 of title 10, United States Code.
    (f) Reimbursement for Crisis Response Services for Veterans.--
Section 1725(f)(1) of title 38, United States Code, is amended, in the 
matter preceding subparagraph (A), by inserting ``, including crisis 
response services (as defined in subsection (nnn) of section 1861 of 
the Social Security Act (42 U.S.C. 1395x)),'' after ``services''.
    (g) Coverage Under FEHB.--
            (1) In general.--Section 8902 of title 5, United States 
        Code, is amended by adding at the end the following:
    ``(p) Each contract for a plan under this chapter shall require the 
carrier to provide coverage for crisis response services, as that term 
is defined in subsection (nnn) of section 1861 of the Social Security 
Act (42 U.S.C. 1395x).''.
            (2) Effective date.--The amendment made by paragraph (1) 
        shall apply beginning with respect to the third contract year 
        for chapter 89 of title 5, United States Code, that begins on 
        or after the date that is 3 years after the date of enactment 
        of this Act.
    (h) Coverage Under CHIP.--Section 2103(c)(5) of the Social Security 
Act (42 U.S.C. 1397cc(c)(5)) is amended--
            (1) in subparagraph (A), by striking ``and'' at the end;
            (2) in subparagraph (B), by striking the period and 
        inserting ``; and''; and
            (3) by adding at the end the following new subparagraph:
                    ``(C) beginning on the date that is 3 years after 
                the date of the enactment of this subparagraph, crisis 
                response services (as defined in section 1861(nnn)).''.

SEC. 302. INCIDENT REPORTING.

    (a) Establishment of Protocol Panel.--The Secretary of Health and 
Human Services (referred to in this section as the ``Secretary''), in 
consultation with the Attorney General, shall convene a panel for the 
purposes of making recommendations for training and protocol for 9-1-1 
dispatchers to respond appropriately to individuals experiencing a 
behavioral health crisis based on the characteristics of the incident 
and the needs of the caller.
    (b) Panelists.--The Secretary shall appoint individuals to serve 
staggered 10-year terms on the panel established under subsection (a). 
Such individuals shall include--
            (1) psychiatrists;
            (2) paramedics and other emergency medical services 
        personnel;
            (3) law enforcement officers and 9-1-1 dispatchers;
            (4) representatives from each segment of the crisis 
        response continuum, including 9-8-8 dispatchers;
            (5) members of underserved communities including ethnic and 
        racial minority groups and sexual orientation and gender 
        minority groups;
            (6) representatives from Tribes or Tribal organizations; 
        and
            (7) other individuals, as the Secretary determines 
        appropriate.
    (c) Recommendations.--
            (1) Topics.--In issuing recommendations under this section, 
        the panel shall consider--
                    (A) connecting 9-1-1 callers to crisis care 
                services instead of responding with law enforcement 
                officers;
                    (B) integrating the 9-8-8 system into the 9-1-1 
                system, or transferring calls from the 9-1-1 system to 
                the 9-8-8 system as appropriate; and
                    (C) a process for identifying 9-1-1 callers who may 
                be experiencing psychiatric symptoms or a mental health 
                crisis, substance use crisis, or co-occurring crisis 
                and evaluating the level of need of such callers, as 
                defined by relevant, standardized assessment tools such 
                as the Level of Care Utilization System (LOCUS), the 
                Child and Adolescent Level of Care Utilization System 
                (CALOCUS), and the American Society of Addiction 
                Medicine (ASAM) Criteria.
            (2) Updates.--The panel shall update recommendations issued 
        under this section not less frequently than every 5 years.

                     TITLE IV--MEDICAID AMENDMENTS

SEC. 401. REVISIONS TO THE STATE OPTION TO PROVIDE QUALIFYING 
              COMMUNITY-BASED MOBILE CRISIS INTERVENTION SERVICES AND 
              OTHER SERVICES UNDER STATE PLANS UNDER THE MEDICAID 
              PROGRAM.

    (a) In General.--Section 1947 of the Social Security Act (42 U.S.C. 
1396w-6) is amended--
            (1) in subsection (a)--
                    (A) by striking ``for qualifying community-based 
                mobile crisis intervention services'' and inserting 
                ``for--
            ``(1) qualifying community-based mobile crisis intervention 
        services;
            ``(2) regional and local lifeline call center operations; 
        and
            ``(3) programs for the purpose receiving and stabilization 
        individuals (including beds in homes and facilities for such 
        purpose).''; and
                    (B) by striking ``during the 5-year period'';
            (2) in subsection (c)--
                    (A) by striking ``85 percent.'' and inserting the 
                following: ``85 percent, and for medical assistance for 
                items described in paragraphs (2) and (3) of subsection 
                (a) furnished during such quarter shall be equal to 85 
                percent.''; and
                    (B) by striking ``occurring during the period 
                described in subsection (a) that a State'' and 
                inserting ``in which a State provides medical 
                assistance for qualifying community-based mobile crisis 
                intervention services under this section and'';
            (3) in subsection (e), by adding at the end at the 
        following new sentence: ``There is appropriated, out of any 
        funds in the Treasury not otherwise appropriated, $5,000,000 to 
        the Secretary for the purposes described in the preceding 
        sentence to remain available until expended.''; and
            (4) in subsection (d)(2)--
                    (A) in subparagraph (A), by striking ``for the 
                fiscal year preceding the first fiscal quarter 
                occurring during the period described in subsection 
                (a)'' and inserting ``for the fiscal year preceding the 
                first fiscal quarter in which the State provides 
                medical assistance for qualifying community-based 
                mobile crisis intervention services under this 
                section''; and
                    (B) in subparagraph (B), by striking ``occurring 
                during the period described in subsection (a)'' and 
                inserting ``occurring during a fiscal quarter''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
take effect as if included in the enactment of the American Rescue Plan 
Act of 2021 (Public Law 117-2).

SEC. 402. REVISIONS TO THE IMD EXCLUSION UNDER MEDICAID.

    (a) Shrinking of the IMD Exclusion Under Medicaid.--Section 
1905(a)(1) of the Social Security Act (42 U.S.C. 1396d(a)(1)) is 
amended by inserting ``, except for, services that, beginning the day 
after the date of the enactment of the 9-8-8 National Suicide 
Prevention Lifeline Implementation Act of 2022, are furnished in 
psychiatric acute care crisis beds administered by community behavioral 
health organizations certified under section 223 of the Protecting 
Access to Medicare Act of 2014, mental health centers that meet the 
criteria of section 1913(c) of the Public Health Service Act, crisis 
receiving and stabilization facilities, and the mental health and 
substance use urgent care facilities''.
    (b) Guidance Relating to IMD Exclusion.--Not later than 180 days 
after the date of the enactment of this Act, the Secretary of Health 
and Human Services shall issue guidance that crisis stabilization units 
(as described in section 1905(a)(1) of the Social Security Act (42 
U.S.C. 1396d(a)(1)) are excluded from the prohibition specified in the 
parenthetical of paragraph (1) of section 1905(a) (relating to services 
in an institution for mental diseases), including the following 
facilities and services:
            (1) Subacute crisis receiving in inpatient or other 
        facilities specified by the Secretary that provide short-term 
        observation for all referrals to individuals in severe 
        distress, as further defined by the Secretary, with up to 23 
        consecutive hours of supervised care to assist with 
        deescalating the severity of a mental health or substance use 
        crisis or need for urgent care in a sub-acute inpatient 
        setting.
            (2) Short term crisis stabilization services assisting with 
        deescalating the severity of individuals in severe distress, as 
        defined by the Secretary, or need for urgent care associated 
        with a substance use or mental health disorder in an inpatient 
        or residential setting with reimbursement limited to 72 hours.
    (c) Reports on Crisis Stabilization Utilization.--Not later than 1 
year after the date of the enactment of this Act, the Secretary shall 
submit to the appropriate congressional committees of jurisdiction a 
report addressing the utilization of facility-based crisis services, 
including the number of patients served, type and duration of facility-
based services, linkage to community-based resources, and information 
on the total number of law enforcement drop-offs and other data 
relevant for diverting mental health and substance use disorder 
emergencies from law enforcement response.
                                 <all>