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<dc:title>118 S4312 IS: United States Senate Commission on Mental Health Act of 2024</dc:title>
<dc:publisher>U.S. Senate</dc:publisher>
<dc:date>2024-05-09</dc:date>
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<dc:language>EN</dc:language>
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<distribution-code display="yes">II</distribution-code><congress>118th CONGRESS</congress><session>2d Session</session><legis-num>S. 4312</legis-num><current-chamber>IN THE SENATE OF THE UNITED STATES</current-chamber><action><action-date date="20240509">May 9, 2024</action-date><action-desc><sponsor name-id="S418">Mr. Fetterman</sponsor> (for himself and <cosponsor name-id="S394">Ms. Smith</cosponsor>) introduced the following bill; which was read twice and referred to the <committee-name committee-id="SSHR00">Committee on Health, Education, Labor, and Pensions</committee-name></action-desc></action><legis-type>A BILL</legis-type><official-title>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.</official-title></form><legis-body><section id="S1" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>United States Senate Commission on Mental Health Act of 2024</short-title></quote>.</text></section><section id="idb68376ded6954a098296adcf5b51d071"><enum>2.</enum><header>Purposes</header><text display-inline="no-display-inline">The purposes of this section are as follows:</text><paragraph id="id0381862ea8854010bd57eb63159187b0"><enum>(1)</enum><text>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.</text></paragraph><paragraph id="id3a303d816f364d74ac79a110a0380a39"><enum>(2)</enum><text>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. </text></paragraph></section><section id="id8ae30a14e0a74425973c7a449854dacc"><enum>3.</enum><header>Establishment of United States Senate Commission on Mental Health</header><subsection id="ided194f39fabb48b2b2c38784a148c968"><enum>(a)</enum><header>Establishment</header><text>There is established a United States Senate Commission on Mental Health (referred to in this Act as the <quote>Commission</quote>).</text></subsection><subsection id="idb13bf9bfddad4255a8f39118529f3aba"><enum>(b)</enum><header>Purposes</header><text>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.</text></subsection><subsection id="idd87e720e269545dcaf8c0bff31ad35a7"><enum>(c)</enum><header>Membership</header><paragraph commented="no" display-inline="no-display-inline" id="idc6045690d171427b9ff61c4f1b7ffe46"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">The Commission shall be composed of 8 members, as follows:</text><subparagraph id="ide76c500093e142868c2d4e8ca15a413b"><enum>(A)</enum><text>Six shall be Members of the Senate appointed by the President of the Senate, of which—</text><clause commented="no" display-inline="no-display-inline" id="id3f8de0f259bb4101889101eb657168d0"><enum>(i)</enum><text display-inline="yes-display-inline">3 shall be selected, after consultation with the majority leader of the Senate, from the majority party; and </text></clause><clause commented="no" display-inline="no-display-inline" id="id627b1865def340e99db529fe65d26e67"><enum>(ii)</enum><text display-inline="yes-display-inline">3 shall be selected, after consultation with the minority leader of the Senate, from the minority party.</text></clause></subparagraph><subparagraph id="iddb39cdf598e04a67b76a1a17fdcec234"><enum>(B)</enum><text>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. </text></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="idb0b3f809e9034de48793a868717e8fa2"><enum>(2)</enum><header>Period of appointment</header><text display-inline="yes-display-inline">Each member of the Commission shall be appointed for a term of 2 years. </text></paragraph><paragraph id="id00D2560375F64DE6B6ECCBD8E53AE2F8" commented="no"><enum>(3)</enum><header>Chair and vice chair</header><text display-inline="yes-display-inline">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). </text></paragraph><paragraph id="ID8AB9CAB7544542CBBCD32562861B7980"><enum>(4)</enum><header>No compensation</header><text>The members of the Commission shall serve without compensation for their work on the Commission.</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id085d78a8f6554d448e723582028a613d"><enum>(5)</enum><header display-inline="yes-display-inline">Travel expenses</header><text>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 <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/5/57">chapter 57</external-xref> of title 5, United States Code, while away from their homes or regular places of business in the performance of services for the Commission. </text></paragraph></subsection><subsection id="idf20338db8f6242b2a9409c63e2b68072" commented="no"><enum>(d)</enum><header>Retention of support</header><text>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.</text></subsection><subsection id="id12b736aa01534d8bbae30b0cfa475a16"><enum>(e)</enum><header>Meetings</header><text>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.</text></subsection><subsection id="id2ABA6BEF0A7647CD9CF8FFBE31E586FA"><enum>(f)</enum><header>Vacancies</header><text>A vacancy in the Commission—</text><paragraph id="id76B0CB8404734FF6A1DF2A252ED8694F"><enum>(1)</enum><text>shall not affect the powers of the Commission; and</text></paragraph><paragraph id="id484DA57A7CD74ED1BC86CBF65528ABB5"><enum>(2)</enum><text>shall be filled in the same manner as the original appointment. </text></paragraph></subsection></section><section id="id8838a465a85a4e6a8ca5c905e0ae9f8f"><enum>4.</enum><header>Duties of the Commission</header><subsection id="id63e647fe08674a47b0adcb37d0951769"><enum>(a)</enum><header>In general</header><text>The Commission shall study relevant issues regarding mental health care services and delivery and issue reports, as required under subsection (b).</text></subsection><subsection id="idcefd587ae8cf43d69c0009143de58c51"><enum>(b)</enum><header>Topics studied</header><paragraph id="id18d0233547524049913927d45f8729b3"><enum>(1)</enum><header>In general</header><text>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).</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="ide2a5cc3aab0d497e9f1eecad3852a467"><enum>(2)</enum><header>Initial topics</header><text display-inline="yes-display-inline">In the first year following the establishment of the Commission, the Commission shall consider the following topics:</text><subparagraph commented="no" display-inline="no-display-inline" id="ida804408cac1a4e53b89b63e67c3f9ff6"><enum>(A)</enum><text>Mental health care services coverage, including mental health parity requirements, under the Medicare program under title XVIII of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395">42 U.S.C. 1395 et seq.</external-xref>), the Medicaid program under title XIX of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396 et seq.</external-xref>), the State Children's Health Insurance Program under title XXI of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397aa">42 U.S.C. 1397aa et seq.</external-xref>), and, as the Commission determines appropriate, other health programs administered by the Federal Government, including—</text><clause commented="no" display-inline="no-display-inline" id="idbd14af33c66d4be0b1e11ff5208e020e"><enum>(i)</enum><text display-inline="yes-display-inline">the extent to which mental health care services are covered under such programs; and</text></clause><clause commented="no" display-inline="no-display-inline" id="ida94645e8727f49339a2b59986623fd15"><enum>(ii)</enum><text display-inline="yes-display-inline">the extent to which mental health parity requirements applicable to such programs are effective in meeting the mental health care needs of patients.</text></clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idca3a6f416fed4d5e811e6b04f9383e60"><enum>(B)</enum><text display-inline="yes-display-inline">Reimbursement rates for mental health care services with respect to mental health care providers, including—</text><clause id="id91b4165251b6489eb943c2b7973bc07d"><enum>(i)</enum><text>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;</text></clause><clause id="id3d659e09ee4f49a88cf0a0eae937d343"><enum>(ii)</enum><text>how reimbursement rates for all mental health care services differ from reimbursement rates for physical health care services under such programs; and</text></clause><clause id="idf7215630fb9743ac960ebb79dac16735"><enum>(iii)</enum><text>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.</text></clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id189c43c80a984bfba8bc5588805ed6a0"><enum>(C)</enum><text>Workforce challenges with respect to mental health care providers, including—</text><clause id="id27b4a556012841e7a057b6b787cf2cbe"><enum>(i)</enum><text>challenges and barriers that prevent individuals, including students, from entering mental health care professions;</text></clause><clause commented="no" display-inline="no-display-inline" id="id3a81f14a6432488a90aded74f0e41b94"><enum>(ii)</enum><text display-inline="yes-display-inline">challenges and barriers that students enrolled in mental health care professional training programs face while pursuing their degrees;</text></clause><clause commented="no" display-inline="no-display-inline" id="id50ed6a2532ae4f26b36d8b49fc277180"><enum>(iii)</enum><text display-inline="yes-display-inline">the challenges and barriers professors and staff in such training programs face;</text></clause><clause commented="no" display-inline="no-display-inline" id="idf7e16224bc91400d94f09fc31249827a"><enum>(iv)</enum><text display-inline="yes-display-inline">challenges and barriers mental health care providers face; and</text></clause><clause commented="no" display-inline="no-display-inline" id="id9f34036ecf9a40e5822fcbc93ad55d62"><enum>(v)</enum><text display-inline="yes-display-inline">factors that contribute to mental health care providers leaving the field.</text></clause></subparagraph></paragraph><paragraph id="ide3163d4547024684bb2243261cbbae11"><enum>(3)</enum><header>Topics in subsequent years</header><text>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.</text></paragraph><paragraph id="id526dc948da0e4bfda22423bbd7c9e22c"><enum>(4)</enum><header>Definition</header><text>In this subsection, the term <term>mental health parity</term> means—</text><subparagraph commented="no" display-inline="no-display-inline" id="id626817c5f4fe4fe4bb8a12acc3915b88"><enum>(A)</enum><text display-inline="yes-display-inline">with respect to the Medicare program under title XVIII of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395">42 U.S.C. 1395 et seq.</external-xref>), 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</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id8ff3a535d8d245a590a75c6a53d0d6e2"><enum>(B)</enum><text display-inline="yes-display-inline">with respect to the Medicaid program under title XIX of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396 et seq.</external-xref>) and the State Children's Health Insurance Program under title XXI of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397aa">42 U.S.C. 1397aa et seq.</external-xref>), the requirements set forth in the rule titled <quote>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</quote> (81 Fed. Reg. 18390).</text></subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="id4fce06c5c8be4145b8b87bc8dc37336f"><enum>(c)</enum><header display-inline="yes-display-inline">Annual report</header><paragraph commented="no" display-inline="no-display-inline" id="ida75c98f716304e2dbddfb6056b6e8227"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">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—</text><subparagraph commented="no" display-inline="no-display-inline" id="idfa4bc9be7d3547e6990ba30635a02c53"><enum>(A)</enum><text display-inline="yes-display-inline">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</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idbdb86024d7b241d29cabcb2f92e62d83"><enum>(B)</enum><text>policy recommendations for legislative and administrative actions to address issues identified through the report.</text></subparagraph></paragraph><paragraph id="id3da947b57b6741dfa30ff2b59c3b5ee8"><enum>(2)</enum><header>Contents of report</header><text>Each report submitted under paragraph (1) shall include a discussion of the topics considered under subsection (b) for the applicable year and the following:</text><subparagraph id="idf100478c7ae24af5b1c803825d66d75a"><enum>(A)</enum><text>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.</text></subparagraph><subparagraph id="id501f5685679e4269bf9c33959d5e0293"><enum>(B)</enum><text>A comprehensive needs and gap assessment across the continuum of mental health care services, using disaggregated data, for—</text><clause commented="no" display-inline="no-display-inline" id="id1bf9142580c24576b25d87661c93e269"><enum>(i)</enum><text display-inline="yes-display-inline">different age groups, such as for children, adolescents, adults, and older adults;</text></clause><clause commented="no" display-inline="no-display-inline" id="id3c62f47aabe54a9bb562283cca9b5433"><enum>(ii)</enum><text display-inline="yes-display-inline">student status, for each of the primary, secondary, and postsecondary levels;</text></clause><clause commented="no" display-inline="no-display-inline" id="id042bb26a31c846b993a7b68243921fc6"><enum>(iii)</enum><text display-inline="yes-display-inline">people with disabilities;</text></clause><clause commented="no" display-inline="no-display-inline" id="ide4c15f3219524ecd9550b78098710a94"><enum>(iv)</enum><text display-inline="yes-display-inline">individuals with co-morbidities, including substance use;</text></clause><clause commented="no" display-inline="no-display-inline" id="id2d7976dac55243aebca7f0d2f1f6b199"><enum>(v)</enum><text display-inline="yes-display-inline">racial and ethnic minorities;</text></clause><clause commented="no" display-inline="no-display-inline" id="idc5c877cb4e334f31bb6e3ec7b60e0923"><enum>(vi)</enum><text display-inline="yes-display-inline">LGBTQ+ individuals; </text></clause><clause commented="no" display-inline="no-display-inline" id="idca742a35606c4699b1ce4412e15c2a59"><enum>(vii)</enum><text display-inline="yes-display-inline">individuals residing in rural communities; and</text></clause><clause commented="no" display-inline="no-display-inline" id="id4290137e3e324af6b5cd32a196b323a1"><enum>(viii)</enum><text>members of Tribal communities.</text></clause></subparagraph><subparagraph id="ida9a0e1af8fe2468f92f4ee64a1141254"><enum>(C)</enum><text>Prioritizing health equity through building and maintaining a culturally competent and diverse mental health care workforce across the continuum of care.</text></subparagraph></paragraph></subsection></section><section id="ID8E18677BEB06432BA5DE4BCFA806C638"><enum>5.</enum><header>Termination of Commission</header><text display-inline="no-display-inline">The Commission shall terminate 10 years after the date of enactment of this Act. </text></section><section id="id8644da8ccc85477797314d15a0f23786"><enum>6.</enum><header>Authorization of Appropriations</header><text display-inline="no-display-inline">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. </text></section></legis-body></bill> 

