[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 3451 Introduced in Senate (IS)]

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118th CONGRESS
  1st Session
                                S. 3451

   To amend titles XIX and XXI of the Social Security Act to provide 
 mental health and substance use services to incarcerated individuals, 
                        and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            December 7, 2023

  Mr. Booker introduced the following bill; which was read twice and 
                  referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
   To amend titles XIX and XXI of the Social Security Act to provide 
 mental health and substance use services to incarcerated individuals, 
                        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 ``Rehabilitation and Recovery During 
Incarceration Act''.

SEC. 2. MODIFYING MEDICAID AND CHIP EXCLUSIONS RELATING TO INCARCERATED 
              INDIVIDUALS TO ALLOW FOR PROVISION OF MENTAL HEALTH AND 
              SUBSTANCE USE SERVICES.

    (a) Medicaid Option.--
            (1) In general.--Section 1905(a) of the Social Security Act 
        (42 U.S.C. 1396d(a)) is amended, in the subdivision (A) 
        following paragraph (31), by inserting ``, or, at the option of 
        the State, in the case of an eligible inmate (as defined in 
        paragraph (4) of section 1902(nn)), with respect to mental 
        health and substance use services described in paragraph (5) of 
        such section'' before ``); or''.
            (2) Eligible inmate and mental health and substance use 
        services defined.--Section 1902(nn) of the Social Security Act 
        (42 U.S.C. 1396a(nn)) is amended--
                    (A) in the subsection header, by inserting ``; 
                Eligible Inmate; Mental Health and Substance Use 
                Services'' after ``Public Institution'';
                    (B) in the matter preceding paragraph (1), by 
                striking ``and this subsection'' and inserting ``, this 
                subsection, and the subdivision (A) following the last 
                numbered paragraph of section 1905(a)''; and
                    (C) by adding at the end the following new 
                paragraphs:
            ``(4) Eligible inmate.--The term `eligible inmate' means an 
        individual of any age who is an inmate of a public institution 
        and who--
                    ``(A) was determined eligible for medical 
                assistance under the State plan immediately before 
                becoming an inmate of such a public institution; or
                    ``(B) is determined eligible for such medical 
                assistance while an inmate of a public institution.
            ``(5) Mental health and substance use services.--The term 
        `mental health and substance use services' means such services 
        for the treatment of a mental health condition or substance use 
        disorder as the Secretary shall specify by regulation.''.
    (b) CHIP Option.--
            (1) In general.--Section 2110(b)(7) of the Social Security 
        Act (42 U.S.C. 1397jj(b)(7)) is amended--
                    (A) in the paragraph header, by striking 
                ``Exception'' and inserting ``Exceptions'';
                    (B) by striking ``In the case of'' and inserting 
                the following:
                    ``(A) Provision of screening, diagnostic, referral, 
                and case management services pre-release.--In the case 
                of''; and
                    (C) by adding at the end the following new 
                subparagraph:
                    ``(B) Provision of mental health and substance use 
                disorder services while an inmate.--
                            ``(i) In general.--In the case of a child 
                        who is an eligible inmate, the child shall not 
                        be considered to be described in paragraph 
                        (2)(A) with respect to mental health services 
                        and substance use disorder services otherwise 
                        covered under the State child health plan (or 
                        waiver of such plan).
                            ``(ii) Eligible inmate defined.--For 
                        purposes of this subparagraph, the term 
                        `eligible inmate' has the meaning given that 
                        term in section 1902(nn)(4), except that such 
                        section shall be applied by--
                                    ``(I) substituting `child health 
                                assistance' for `medical assistance' 
                                each place it appears; and
                                    ``(II) by substituting `State child 
                                health plan under title XXI' for `State 
                                plan'.''.
            (2) Technical amendment.--
                    (A) In general.--Section 5122(b) of division FF of 
                the Consolidated Appropriations Act, 2023 (Public Law 
                117-328) is amended by striking paragraph (1).
                    (B) Effective date.--The amendment made by this 
                paragraph shall take effect as if included in the 
                enactment of the Consolidated Appropriations Act, 2023 
                (Public Law 117-328).
    (c) Increased Federal Match for Mental Health and Substance Use 
Disorder Services Furnished to Incarcerated Individuals.--
            (1) Medicaid.--Section 1905 of the Social Security Act (42 
        U.S.C. 1396d) is amended--
                    (A) in subsection (b), by striking ``and (ii)'' and 
                inserting ``(ii), and (jj)''; and
                    (B) by adding at the end the following new 
                subsection:
    ``(jj) Increased FMAP for Mental Health and Substance Use Services 
Furnished to Inmates.--
            ``(1) In general.--Notwithstanding any other provision of 
        this title except for paragraph (3), the Federal medical 
        assistance percentage for a State, with respect to amounts 
        expended by the State for medical assistance for mental health 
        and substance use disorder services furnished to an eligible 
        inmate (as such terms are defined in section 1902(nn)) shall be 
        equal to 100 percent.
            ``(2) Exclusion of expenditures from territorial caps.--Any 
        payment made to a territory for expenditures for medical 
        assistance that are subject to the Federal medical assistance 
        percentage specified under paragraph (1) shall not be taken 
        into account for purposes of applying payment limits under 
        subsections (f) and (g) of section 1108.
            ``(3) Requirement to reinvest additional funds.--As a 
        condition for the receipt of the increase under paragraph (1) 
        to the Federal medical assistance percentage of a State, the 
        State shall demonstrate to the satisfaction of the Secretary 
        that the State will use the Federal funds attributable to such 
        increase only for the following purposes:
                    ``(A) To improve health information technology and 
                data sharing between State Medicaid programs, jails and 
                prisons, and community-based providers and support 
                organizations.
                    ``(B) To increase the treatment capacity of 
                community-based providers who are particularly attuned 
                to, and able to serve, the specific needs of 
                individuals who are involved with the justice system or 
                at risk of becoming involved in the justice system.
                    ``(C) To expand or enhance community-based reentry 
                services and supports provided by the State to 
                incarcerated and formerly incarcerated individuals, 
                including services and supports designed to meet the 
                health-related social needs of such individuals.''.
            (2) CHIP.--
                    (A) In general.--Section 2105 of the Social 
                Security Act (42 U.S.C. 1397ee) is amended--
                            (i) in subsection (b), by striking ``(11)'' 
                        and inserting ``(11), (12), and (13)''; and
                            (ii) in subsection (c), by adding at the 
                        end the following new paragraph:
            ``(13) Enhanced payment for coverage of mental health and 
        substance use disorder services.--
                    ``(A) In general.--Notwithstanding subsection (b) 
                and subject to subparagraph (B), the enhanced FMAP for 
                a State with respect to payments under subsection (a) 
                for expenditures under the State child health plan (or 
                a waiver of such plan) for mental health or substance 
                use disorder services furnished to a targeted low-
                income child or a targeted low-income pregnant woman 
                who is an eligible inmate (as such term is defined in 
                section 2110(b)(7)(B)(ii)) shall be equal to 100 
                percent.
                    ``(B) Requirement to reinvest additional funds.--
                The requirement described in paragraph (3) of section 
                1905(jj) shall apply to Federal funds attributable to 
                an increase in the enhanced Federal medical assistance 
                percentage of a State under subparagraph (A) in the 
                same manner as such requirement applies to Federal 
                funds attributable to an increase to the Federal 
                medical assistance percentage of a State under 
                paragraph (1) of such section.''.
                    (B) Adjusting state chip allotments to account for 
                increased payments for coverage of mental health and 
                substance use services furnished to eligible inmates.-- 
                Section 2104(m) of the Social Security Act (42 U.S.C. 
                1397dd(m)) is amended--
                            (i) in paragraph (2)(B), in the matter 
                        preceding clause (i), by striking ``and (12)'' 
                        and inserting ``(12), and (13)''; and
                            (ii) by adding at the end the following new 
                        paragraph:
            ``(13) Adjusting allotments to account for increased 
        federal payments for coverage of mental health and substance 
        use services for eligible inmates.--If a State, commonwealth, 
        or territory receives payment for a fiscal year under 
        subsection (a) of section 2105 for expenditures that are 
        subject to the enhanced FMAP specified under subsection (c)(13) 
        of such section, the amount of the allotment determined for the 
        State, commonwealth, or territory under this subsection--
                    ``(A) for such fiscal year shall be increased by 
                the projected expenditures for such year by the State, 
                commonwealth, or territory under the State child health 
                plan (or a waiver of such plan) for mental health and 
                substance use disorder services furnished to eligible 
                inmates (as defined in section 2110(b)(7)(B)(ii)(B)); 
                and
                    ``(B) once actual expenditures are available in the 
                subsequent fiscal year, the fiscal year allotment that 
                was adjusted by the amount described in subparagraph 
                (A) shall be adjusted on the basis of the difference 
                between--
                            ``(i) such projected amount of expenditures 
                        described in subparagraph (A) for such fiscal 
                        year described in such subparagraph by the 
                        State, commonwealth, or territory; and
                            ``(ii) the actual amount of expenditures 
                        for such fiscal year described in subparagraph 
                        (A) by the State, commonwealth, or territory 
                        under the State child health plan (or waiver of 
                        such plan) for mental health and substance use 
                        disorder services furnished to eligible inmates 
                        (as defined in section 
                        2110(b)(7)(B)(ii)(B)).''.
    (d) Conforming Amendments.--
            (1) Section 1905(a) of the Social Security Act (42 U.S.C. 
        1396d(a)), as amended by subsection (a), is amended, in the 
        matter following paragraph (31), by striking ``set forth in the 
        subdivision (B) following paragraph (30) of the first sentence 
        of this subsection'' and inserting ``set forth in the portion 
        of the first sentence of this subsection that follows the last 
        numbered paragraph of this subsection''.
            (2) Section 5122(a)(1) of division FF of the Consolidated 
        Appropriations Act, 2023 (Public Law 117-328) is amended by 
        striking ``case management'' and inserting ``targeted case 
        management services''.
    (e) Effective Date.--
            (1) In general.--Except as provided in paragraph (2), the 
        amendments made by this section shall apply with respect to 
        medical assistance, child health assistance, and pregnancy-
        related assistance provided on or after January 1, 2023.
            (2) Effective date of conforming amendment.--The amendment 
        made by paragraph (2) of subsection (d) shall take effect as if 
        included in the enactment of the Consolidated Appropriations 
        Act, 2023 (Public Law 117-328).

SEC. 3. REPORT BY COMPTROLLER GENERAL.

    Not later than the date that is 5 years after the date of enactment 
of this Act, the Comptroller General of the United States shall submit 
to Congress a report containing available information regarding 
incarcerated individuals that receive medical assistance or child 
health assistance under a State plan under title XIX or XXI of the 
Social Security Act (42 U.S.C. 1396 et seq., 1397aa et seq.) (as 
applicable) as a result of a State electing to provide coverage to 
eligible inmates pursuant to the amendments to such titles made by 
section 2. The information contained in the report may include 
information such as the following:
            (1) The number of such incarcerated individuals.
            (2) The access of such incarcerated individuals to health 
        care services, including specialty care, and health care 
        providers.
            (3) The quality of health care services provided to 
        incarcerated individuals.
            (4) Any impact of coverage under such a State plan on 
        recidivism.
            (5) The percentage of such incarcerated individuals who, 
        upon release, are--
                    (A) enrolled under such a State plan;
                    (B) connected to a provider in their community of 
                mental health, substance use disorder, or primary care 
                services; and
                    (C) receiving medication-assisted treatment for the 
                treatment of a substance use disorder.
            (6) Any other information the Comptroller General 
        determines necessary regarding the health of incarcerated 
        individuals.
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