[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 4312 Introduced in Senate (IS)]

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118th CONGRESS
  2d Session
                                S. 4312

To establish a United States Senate Commission on Mental Health for the 
purpose of providing to Congress and the President independent, expert 
policy recommendations to improve access to and affordability of mental 
                         health care services.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              May 9, 2024

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

_______________________________________________________________________

                                 A BILL


 
To establish a United States Senate Commission on Mental Health for the 
purpose of providing to Congress and the President independent, expert 
policy recommendations to improve access to and affordability of mental 
                         health care services.

    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 ``United States Senate Commission on 
Mental Health Act of 2024''.

SEC. 2. PURPOSES.

    The purposes of this section are as follows:
            (1) To establish the United States Senate Commission on 
        Mental Health to review available data, research, policies, and 
        other pertinent information regarding mental health care 
        services and delivery.
            (2) To facilitate discussion among relevant stakeholders, 
        including Federal agencies, to understand what policies have 
        successfully improved mental health care services and delivery 
        and to develop recommendations for congressional and executive 
        action to improve access to, and affordability of, mental 
        health care services.

SEC. 3. ESTABLISHMENT OF UNITED STATES SENATE COMMISSION ON MENTAL 
              HEALTH.

    (a) Establishment.--There is established a United States Senate 
Commission on Mental Health (referred to in this Act as the 
``Commission'').
    (b) Purposes.--The purpose of the Commission is to provide Congress 
and the President independent, expert policy recommendations to improve 
mental health care services, including improving equitable access and 
affordability.
    (c) Membership.--
            (1) In general.--The Commission shall be composed of 8 
        members, as follows:
                    (A) Six shall be Members of the Senate appointed by 
                the President of the Senate, of which--
                            (i) 3 shall be selected, after consultation 
                        with the majority leader of the Senate, from 
                        the majority party; and
                            (ii) 3 shall be selected, after 
                        consultation with the minority leader of the 
                        Senate, from the minority party.
                    (B) Two shall be experts with a demonstrated 
                academic and professional background in mental health 
                care, selected by the majority leader of the Senate, 
                after consultation with the minority leader of the 
                Senate.
            (2) Period of appointment.--Each member of the Commission 
        shall be appointed for a term of 2 years.
            (3) Chair and vice chair.--On the commencement of each 2-
        year period of appointment of the members of the Commission, 
        the members of the Commission shall select a Chair from among 
        the members appointed under paragraph (1)(A)(i), and a Vice 
        Chair from among the members appointed under paragraph 
        (1)(A)(ii).
            (4) No compensation.--The members of the Commission shall 
        serve without compensation for their work on the Commission.
            (5) Travel expenses.--A member of the Commission shall be 
        allowed travel expenses, including per diem in lieu of 
        subsistence, at rates authorized for employees of agencies 
        under subchapter I of chapter 57 of title 5, United States 
        Code, while away from their homes or regular places of business 
        in the performance of services for the Commission.
    (d) Retention of Support.--The Commission shall retain and make use 
of such staff, materials, and infrastructure of the Senate as is 
necessary to carry out the duties of the Commission.
    (e) Meetings.--The Commission shall conduct meetings, not less 
frequently than every 90 days, with relevant stakeholders across the 
United States, including mental health care providers (such as 
physicians, psychiatrists, psychologists, counselors, and therapists), 
patients, and individuals representing advocacy groups, academic and 
research institutions, nonprofit organizations, industry, and other 
relevant stakeholders, as determined by the Commission.
    (f) Vacancies.--A vacancy in the Commission--
            (1) shall not affect the powers of the Commission; and
            (2) shall be filled in the same manner as the original 
        appointment.

SEC. 4. DUTIES OF THE COMMISSION.

    (a) In General.--The Commission shall study relevant issues 
regarding mental health care services and delivery and issue reports, 
as required under subsection (b).
    (b) Topics Studied.--
            (1) In general.--Each calendar year, the Commission shall 
        study specific topics relating to improving mental health care 
        services and delivery, including improving equitable access and 
        affordability with respect to such services, in accordance with 
        paragraphs (2) and (3), including by convening meetings 
        described in section 3(e).
            (2) Initial topics.--In the first year following the 
        establishment of the Commission, the Commission shall consider 
        the following topics:
                    (A) Mental health care services coverage, including 
                mental health parity requirements, under the Medicare 
                program under title XVIII of the Social Security Act 
                (42 U.S.C. 1395 et seq.), the Medicaid program under 
                title XIX of such Act (42 U.S.C. 1396 et seq.), the 
                State Children's Health Insurance Program under title 
                XXI of such Act (42 U.S.C. 1397aa et seq.), and, as the 
                Commission determines appropriate, other health 
                programs administered by the Federal Government, 
                including--
                            (i) the extent to which mental health care 
                        services are covered under such programs; and
                            (ii) the extent to which mental health 
                        parity requirements applicable to such programs 
                        are effective in meeting the mental health care 
                        needs of patients.
                    (B) Reimbursement rates for mental health care 
                services with respect to mental health care providers, 
                including--
                            (i) the extent to which reimbursement rates 
                        under the programs described in subparagraph 
                        (A)(i), impact the affordability, 
                        accessibility, and availability of mental 
                        health care services;
                            (ii) how reimbursement rates for all mental 
                        health care services differ from reimbursement 
                        rates for physical health care services under 
                        such programs; and
                            (iii) the probable impact of increasing the 
                        rates of mental health reimbursement rates 
                        under such programs, including the cost to the 
                        Federal Government and the number of providers 
                        and patients who would be impacted.
                    (C) Workforce challenges with respect to mental 
                health care providers, including--
                            (i) challenges and barriers that prevent 
                        individuals, including students, from entering 
                        mental health care professions;
                            (ii) challenges and barriers that students 
                        enrolled in mental health care professional 
                        training programs face while pursuing their 
                        degrees;
                            (iii) the challenges and barriers 
                        professors and staff in such training programs 
                        face;
                            (iv) challenges and barriers mental health 
                        care providers face; and
                            (v) factors that contribute to mental 
                        health care providers leaving the field.
            (3) Topics in subsequent years.--After the submission of 
        the first report under subsection (c) that addresses the topics 
        described in paragraph (2), the Commission shall consider such 
        topics each year as the Commission determines appropriate.
            (4) Definition.--In this subsection, the term ``mental 
        health parity'' means--
                    (A) with respect to the Medicare program under 
                title XVIII of the Social Security Act (42 U.S.C. 1395 
                et seq.), and other applicable plans administered by 
                the Federal Government, efforts to ensure that 
                reimbursement rates for mental health care services are 
                equivalent to reimbursement rates for physical health 
                care services under such program or such plans; and
                    (B) with respect to the Medicaid program 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 such Act (42 U.S.C. 1397aa et seq.), the 
                requirements set forth in the rule titled ``Medicaid 
                and Children's Health Insurance Programs; Mental Health 
                Parity and Addiction Equity Act of 2008; the 
                Application of Mental Health Parity Requirements to 
                Coverage Offered by Medicaid Managed Care 
                Organizations, the Children's Health Insurance Program 
                (CHIP), and Alternative Benefit Plans'' (81 Fed. Reg. 
                18390).
    (c) Annual Report.--
            (1) In general.--Not later than January 1 each year, 
        beginning with the first year that begins at least 2 years 
        after the date of enactment of this Act, the Commission shall 
        submit to Congress, the Secretary of Health and Human Services, 
        and, as appropriate, the heads of other relevant Federal 
        agencies a report, based on the studies carried out under 
        subsection (b), regarding the state of mental health care 
        services and delivery, including a needs and gap assessment 
        across the continuum of mental health care. Each report shall 
        include--
                    (A) an analysis of the current barriers to 
                accessing affordable and equitable mental health care 
                services, challenges facing the mental health care 
                workforce, and successful efforts by State, local, or 
                Tribal entities to improve mental health care services 
                and delivery; and
                    (B) policy recommendations for legislative and 
                administrative actions to address issues identified 
                through the report.
            (2) Contents of report.--Each report submitted under 
        paragraph (1) shall include a discussion of the topics 
        considered under subsection (b) for the applicable year and the 
        following:
                    (A) The most current and comprehensive data and 
                research on the state of mental health care in the 
                United States, including barriers to accessing mental 
                health care.
                    (B) A comprehensive needs and gap assessment across 
                the continuum of mental health care services, using 
                disaggregated data, for--
                            (i) different age groups, such as for 
                        children, adolescents, adults, and older 
                        adults;
                            (ii) student status, for each of the 
                        primary, secondary, and postsecondary levels;
                            (iii) people with disabilities;
                            (iv) individuals with co-morbidities, 
                        including substance use;
                            (v) racial and ethnic minorities;
                            (vi) LGBTQ+ individuals;
                            (vii) individuals residing in rural 
                        communities; and
                            (viii) members of Tribal communities.
                    (C) Prioritizing health equity through building and 
                maintaining a culturally competent and diverse mental 
                health care workforce across the continuum of care.

SEC. 5. TERMINATION OF COMMISSION.

    The Commission shall terminate 10 years after the date of enactment 
of this Act.

SEC. 6. AUTHORIZATION OF APPROPRIATIONS.

    To carry out this Act, there is authorized to be appropriated such 
sums as may be necessary for each of fiscal years 2025 through 2034.
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