[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 10280 Introduced in House (IH)]
<DOC>
119th CONGRESS
2d Session
H. R. 10280
To provide for improvements in the implementation of the National
Suicide Prevention Lifeline, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
September 3, 2026
Ms. Matsui (for herself, Mr. Fitzpatrick, Mrs. Trahan, Ms. Schrier, Mr.
Beyer, Ms. Barragan, Mr. Carter of Louisiana, Ms. Balint, Mr. Raskin,
Mr. Goldman of New York, Mr. Smith of Washington, Ms. Salinas, Ms.
McClellan, Mr. Moulton, Mrs. Dingell, and Mrs. Watson Coleman)
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, Oversight and Government
Reform, and Education and Workforce, 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 2026''.
(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 new or
existing crisis call centers serving regional or local areas to--
``(1) purchase or upgrade call center technology;
``(2) provide for training of call center staff;
``(3) improve call center operations; and
``(4) provide for hiring of call center staff.
``(b) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $441,000,000 for fiscal year
2027, 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 2025 through 2029'' and inserting the following: ``section--
``(1) $10,000,000 for each of fiscal years 2025 and 2026;
and
``(2) $100,000,000 for each of fiscal years 2027 through
2029''.
SEC. 103. NATIONAL SUICIDE PREVENTION MEDIA CAMPAIGN.
(a) National Suicide Prevention Lifeline Program.--Section 520E-3
of the Public Health Service Act (42 U.S.C. 290bb-36c) is amended--
(1) in subsection (b)--
(A) by amending paragraph (4) to read as follows:
``(4) conducting the national suicide prevention media
campaign described in section 520E-5;'';
(B) by redesignating paragraph (6) as paragraph
(7); and
(C) by inserting after paragraph (5) the following:
``(6) improving awareness of the program, including through
targeted, age, and culturally appropriate outreach in schools
and to the general public more widely through advertisements in
highly trafficked areas or shared public spaces such as rail or
public transportation stations, on billboards, in stadiums, or
other such highly visible areas; and''; and
(2) by amending subsection (f) to read as follows:
``(f) Authorization of Appropriations.--There is authorized to be
appropriated--
``(1) to carry out subsection (b)(4), $10,000,000 for each
of fiscal years 2026 through 2030; and
``(2) to carry out this section, except for subsection
(b)(4), $101,621,000 for each of fiscal years 2023 through
2027.''.
(b) National Suicide Prevention Media Campaign.--The Public Health
Service Act is amended by inserting after section 520E-4 (42 U.S.C.
290bb-36d) the following:
``SEC. 520E-5. NATIONAL SUICIDE PREVENTION MEDIA CAMPAIGN.
``(a) In General.--
``(1) National media campaign.--Not later than the date
that is 3 years after the date of the enactment of this
section, the Secretary, in consultation with the Assistant
Secretary 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 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
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, the
administrator of the suicide prevention hotline maintained
under section 520E-3, 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, first
responders, 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).
``(2) Targeting certain local areas.--The Secretary shall,
to the maximum extent practicable, use funds made available to
carry out this section for media that target 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 to
carry out this section, 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
take into account--
``(I) 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) the number of unique
encounters with suicide prevention and
support resources of the Centers for
Disease Control and Prevention and the
Administration and assess engagement
with such suicide prevention and
support resources;
``(III) whether the national media
campaign has contributed to increased
awareness that suicidal individuals
should be engaged, rather than ignored;
and
``(IV) such other measures of
evaluation as the Secretary determines
are appropriate.
``(2) Optional uses.--The Secretary may use funds made
available to carry out this section 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 government or Tribal
organizations that the Secretary determines have
experience in suicide prevention, including the
Administration and the Centers for Disease Control and
Prevention.
``(B) Entertainment industry outreach, interactive
outreach, media projects and activities, public
information, news media outreach, outreach through
television programs, and corporate sponsorship and
participation.
``(3) Prohibition.--None of the funds made available to
carry out this section may be obligated or expended 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.
``(d) Report to Congress.--Not later than 18 months after the date
on which 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.''.
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 crisis receiving and stabilization facility or
crisis call center that has 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, new construction, and other capital improvement
costs, including the costs of amortizing the principal of, and paying
interest on, loans for such purposes.
``(d) Definitions.--In this section:
``(1) Crisis receiving and stabilization facility.--The
term `crisis receiving and stabilization facility' means a
freestanding, non-hospital facility that--
``(A) qualifies for licensure or certification as a
crisis receiving and stabilization facility, pursuant
to State law of the State in which such facility
furnishes crisis response services;
``(B) provides 23-hour observation and assessment
chairs or beds and 48-hour crisis stabilization
psychiatric beds inclusive of withdrawal management and
24-hour medical monitoring;
``(C) provides crisis response services 24 hours
per day, 7 days per week using a sliding scale of
payment, and neither rejects service nor limits
services on the basis of a patient's ability to pay,
place of residence, prior forensic engagement, acuity
of mental health or substance use condition,
intellectual or developmental disability, age or
related factors;
``(D) supports no-wrong-door admission capacity
available to law enforcement officers, emergency
medical personnel, and family members; and
``(E) maintains an average length-of-stay of less
than 150 hours.
``(2) Crisis response program facility.--The term `crisis
response program facility' means a facility used for the
purposes of mental health or substance use services that are
furnished to an individual, including children and adolescents,
experiencing a mental health or substance use crisis by--
``(A) a mobile crisis response team;
``(B) a crisis receiving and stabilization
facility;
``(C) a mental health or substance use urgent care
facility; or
``(D) other appropriate provider, as determined by
the Secretary.
``(3) Mental health and substance use urgent care
facility.--The term `mental health and substance use urgent
care facility' means an ambulatory facility in which
individuals experiencing a mental or behavioral health crisis
may receive crisis assessment services, crisis intervention
services, medication, and connection to other appropriate
services, without making an appointment prior to arriving at
the facility.
``(e) 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 332 of the Public
Health Service Act (42 U.S.C. 254e) is amended by adding at the end the
following:
``(l) The Secretary shall collect and publish in the Federal
Register data comparing the availability and need of crisis response
services in health professional shortage areas and in areas within such
health professional shortage areas, including--
``(1) the number of crisis call centers, mobile crisis
response units, and crisis receiving and stabilization
facilities in such areas; and
``(2) the number of behavioral and mental health
professionals providing crisis management services or working
in crisis response settings, including the settings described
in paragraph (1).''.
(b) Minority Fellowship Pilot Program for Crisis Management
Services.--Section 597 of the Public Health Service Act (42 U.S.C.
290ll) is amended--
(1) by amending subsection (b) to read as follows:
``(b) Training Covered.--The fellowships awarded under subsection
(a) shall be for postbaccalaureate training (including for master's and
doctoral degrees) for mental and substance use disorder treatment
professionals, including--
``(1) in the fields of psychiatry, addiction medicine,
nursing, social work, psychology, marriage and family therapy,
mental health counseling, and substance use disorder and
addiction counseling; and
``(2) in crisis management services (such as at a crisis
call center, as part of a mobile crisis team, or at a crisis
receiving and stabilization facility).''; and
(2) by amending subsection (c) to read as follows:
``(c) Authorization of Appropriations.--There are authorized to be
appropriated--
``(1) for carrying out this section (except with respect to
subsection (b)(2)), $25,000,000 for each of fiscal years 2023
through 2027; and
``(2) for awarding fellowships described in subsection
(b)(2), $10,000,000 for each of fiscal years 2027 through
2031.''.
(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)--
(i) by inserting ``or remote programs that
offer practicum hours'' after ``other field
placement programs'';
(ii) by inserting ``(which may include
training or a field practicum employing call,
text, or chat responders for mental health
crisis lines)'' after ``social work''; and
(iii) 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 (which may include
master's and doctoral level programs),'';
(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''; and
(2) by amending subsection (f) to read as follows:
``(f) Authorization of Appropriations.--
``(1) In general.--For each of fiscal years 2026 through
2030, there are authorized to be appropriated to carry out this
section $50,000,000, to be allocated as follows:
``(A) For grants described in subsection (a)(1),
$15,000,000.
``(B) For grants described in subsection (a)(2),
$15,000,000.
``(C) For grants described in subsection (a)(3),
$10,000,000.
``(D) For grants described in subsection (a)(4),
$10,000,000.
``(2) Additional authorization for crisis workforce
development.--For each of fiscal years 2027 through 2031, in
addition to the amounts under paragraph (1), there are
authorized to be appropriated to carry out this section with
respect to crisis workforce development $10,000,000.''.
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 (JJ), by striking ``and'' at
the end;
(B) in subparagraph (KK), by striking the period at
the end and inserting ``; and''; and
(C) by adding at the end the following new
subparagraph:
``(LL) crisis response services as defined in
subsection (ooo);''.
(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:
``(ooo) Crisis Response Services.--
``(1) In general.--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.
``(2) Crisis receiving and stabilization facility.--For
purposes of paragraph (1), the term `crisis receiving and
stabilization facility' means a facility that--
``(A) qualifies for licensure or certification as a
crisis receiving and stabilization facility, pursuant
to State law of the State in which such facility
furnishes services;
``(B) provides 23-hour observation and assessment
chairs or beds and 48-hour crisis stabilization
psychiatric beds inclusive of withdrawal management and
24-hour medical monitoring;
``(C) provides mental health or substance use
services 24 hours per day, 7 days per week using a
sliding scale of payment, and neither rejects service
nor limits services on the basis of a patient's ability
to pay, place of residence, prior forensic engagement,
acuity of mental health or substance use condition,
intellectual or developmental disability, age or
related factors;
``(D) supports no-wrong-door admission capacity
available to law enforcement officers, emergency
medical personnel, and family members; and
``(E) maintains an average length of stay of less
than 150 hours.
``(3) Mental health and substance use urgent care
facility.--For purposes of paragraph (1), the term `mental
health and substance use urgent care facility' means an
ambulatory facility where individuals experiencing a mental or
behavioral health crisis may walk in without an appointment to
receive crisis assessment services, crisis intervention
services, medication, and connection to other appropriate
services.''.
(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)(LL), 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(bb)''.
(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:
``(bb) 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(ooo))
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)(LL).''.
(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 (31), by striking ``;
and'' and inserting a semicolon;
(ii) by redesignating paragraph (32) as
paragraph (33); and
(iii) by inserting the following paragraph
after paragraph (31):
``(32) crisis response services (as defined in section
1861(ooo)); 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(ooo))'' 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) Group Health Plans and Health Insurance Issuers.--
(1) PHSA.--Part D of title XXVII of the Public Health
Service Act (42 U.S.C. 300gg-111 et seq.) is amended by adding
at the end the following new section:
``SEC. 2799A-12. REQUIRED COVERAGE OF CRISIS RESPONSE SERVICES.
``(a) In General.--A group health plan and a health insurance
issuer offering group or individual health insurance coverage shall
provide benefits under such plan or coverage for crisis response
services (as defined in section 1861(ooo) of the Social Security Act).
``(b) Application of Financial Requirements and Treatment
Limitations.--A group health plan and a health insurance issuer
offering group or individual health insurance coverage shall ensure
that, with respect to services for which benefits are required to be
provided under such plan or coverage under subsection (a)--
``(1) the financial requirements applicable to such
services are no more restrictive than the predominant financial
requirements applied to substantially all medical and surgical
benefits covered by the plan or coverage and there are no
separate cost-sharing requirements that are applicable only
with respect to such services; and
``(2) the treatment limitations applicable to such items
and services are no more restrictive than the predominant
treatment limitations applied to substantially all medical and
surgical benefits covered by the plan or coverage and there are
no separate treatment limitations that are applicable only with
respect to such services.
``(c) Definitions.--In this section, the terms `financial
requirement', `predominant', and `treatment limitation' have the
meaning given such terms in clauses (i) through (iii), respectively, of
section 2726(a)(3)(B), except that the term `financial requirement'
shall include aggregate lifetime limits and annual limits.''.
(2) ERISA.--
(A) In general.--Subpart B of part 7 of subtitle B
of title I of the Employee Retirement Income Security
Act of 1974 (29 U.S.C. 1185 et seq.) is amended by
adding at the end the following new section:
``SEC. 727. REQUIRED COVERAGE OF CRISIS RESPONSE SERVICES.
``(a) In General.--A group health plan and a health insurance
issuer offering group health insurance coverage shall provide benefits
under such plan or coverage for crisis response services (as defined in
section 1861(ooo) of the Social Security Act).
``(b) Application of Financial Requirements and Treatment
Limitations.--A group health plan and a health insurance issuer
offering group health insurance coverage shall ensure that, with
respect to services for which benefits are required to be provided
under such plan or coverage under subsection (a)--
``(1) the financial requirements applicable to such
services are no more restrictive than the predominant financial
requirements applied to substantially all medical and surgical
benefits covered by the plan or coverage and there are no
separate cost-sharing requirements that are applicable only
with respect to such services; and
``(2) the treatment limitations applicable to such items
and services are no more restrictive than the predominant
treatment limitations applied to substantially all medical and
surgical benefits covered by the plan or coverage and there are
no separate treatment limitations that are applicable only with
respect to such services.
``(c) Definitions.--In this section, the terms `financial
requirement', `predominant', and `treatment limitation' have the
meaning given such terms in clauses (i) through (iii), respectively, of
section 712(a)(3)(B), except that the term `financial requirement'
shall include aggregate lifetime limits and annual limits.''.
(B) Clerical amendment.--The table of contents in
section 1 of the Employee Retirement Income Security
Act of 1974 (29 U.S.C. 1001 note) is amended by
inserting after the item relating to section 726 the
following new item:
``Sec. 727. Required coverage of crisis response services.''.
(3) IRC.--
(A) In general.--Subchapter B of chapter 100 of the
Internal Revenue Code of 1986 is amended by adding at
the end the following new section:
``SEC. 9827. REQUIRED COVERAGE OF CRISIS RESPONSE SERVICES.
``(a) In General.--A group health plan shall provide benefits under
such plan for crisis response services (as defined in section 1861(ooo)
of the Social Security Act).
``(b) Application of Financial Requirements and Treatment
Limitations.--A group health plan shall ensure that, with respect to
services for which benefits are required to be provided under such plan
under subsection (a)--
``(1) the financial requirements applicable to such
services are no more restrictive than the predominant financial
requirements applied to substantially all medical and surgical
benefits covered by the plan and there are no separate cost-
sharing requirements that are applicable only with respect to
such services; and
``(2) the treatment limitations applicable to such items
and services are no more restrictive than the predominant
treatment limitations applied to substantially all medical and
surgical benefits covered by the plan and there are no separate
treatment limitations that are applicable only with respect to
such services.
``(c) Definitions.--In this section, the terms `financial
requirement', `predominant', and `treatment limitation' have the
meaning given such terms in clauses (i) through (iii), respectively, of
section 9812(a)(3)(B), except that the term `financial requirement'
shall include aggregate lifetime limits and annual limits.''.
(B) Clerical amendment.--The table of sections for
subchapter B of chapter 100 of the Internal Revenue
Code of 1986 is amended by adding at the end the
following new item:
``Sec. 9827. Required coverage of crisis response services.''.
(4) Effective date.--The amendments made by this subsection
shall apply with respect to plan years beginnign on or after
the date that is 3 years after the date of the enactment of
this Act.
(d) 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(ooo) 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.
(e) Reimbursement for Crisis Response Services for Veterans.--
Section 1725(h) of title 38, United States Code, is amended--
(1) in paragraph (1), in the matter preceding subparagraph
(A), by inserting ``, including crisis response services,''
after ``services''; and
(2) by adding at the end the following new paragraph:
``(4) The term `crisis response services' has the meaning
given such term in subsection (ooo) of section 1861 of the
Social Security Act (42 U.S.C. 1395x).''.
(f) Coverage Under FEHB.--
(1) In general.--Section 8902 of title 5, United States
Code, is amended by adding at the end the following:
``(q) 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 (ooo) 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.
(g) 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(ooo)).''.
SEC. 302. INCIDENT REPORTING.
(a) Establishment of 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 (referred
to in this section as the ``panel'') to issue recommendations relating
to the training requirements and protocols for 9-1-1 dispatchers.
(b) Purpose of Recommendations.--The purpose of the recommendations
to be issued under subsection (a) shall be to ensure that 9-1-1
dispatchers respond appropriately to individuals experiencing a
behavioral health crisis based on the characteristics of the incident
and the needs of the caller.
(c) Membership.--
(1) Appointment.--The panel shall be composed of members to
be appointed by the Secretary and shall include--
(A) psychiatrists;
(B) paramedics and other emergency medical services
personnel;
(C) law enforcement officers and 9-1-1 dispatchers;
(D) representatives from each segment of the crisis
response continuum, including 9-8-8 dispatchers;
(E) members of underserved communities;
(F) representatives of Tribes or Tribal
organizations;
(G) individuals with experience treating
individuals with serious mental illness or post-
traumatic stress disorder, including veterans and
servicemembers; and
(H) such other individuals as the Secretary
determines appropriate.
(2) Terms.--The Secretary shall appoint the members of the
panel to serve staggered 5-year terms.
(d) Recommendations.--
(1) Considerations.--In making recommendations under
subsection (a), 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;
(C) a process for--
(i) identifying 9-1-1 callers who may be
experiencing psychiatric symptoms or a mental
health crisis, substance use crisis, or co-
occurring crisis; and
(ii) 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; and
(D) establishing training, staffing, and protocol
requirements, including the measures described in
paragraph (2), to ensure that 9-1-1 and 9-8-8 dispatch
personnel are equipped to respond appropriately to the
individuals referred to in subparagraphs (E) through
(H) of subsection (c)(1).
(2) Measures to meet the needs of certain 9-1-1 callers.--
The measures referred to in paragraph (1)(D) include--
(A) training of dispatch personnel on cultural
competency, implicit bias, and evidence-based best
practices for individuals experiencing a behavioral or
mental health crisis; and
(B) procedures designed to recruit, retain, or
designate as dispatch personnel those individuals that
have specialized training or demonstrated experience
in--
(i) serving rural or medically underserved
communities; or
(ii) serving individuals with serious
mental illness or post-traumatic stress
disorder.
(3) Coordination with samhsa.--In developing
recommendations under paragraph (1), the panel shall coordinate
with the Assistant Secretary for Mental Health and Substance
Use for the purpose of ensuring consistency across Federal
behavioral health crisis response systems, including alignment
of--
(A) the training and protocol requirements for 9-1-
1 dispatchers; and
(B) the development of guidance, training
standards, and best practices issued by the Substance
Abuse and Mental Health Services Administration for the
9-8-8 Suicide and Crisis Lifeline.
(4) Updates.--The panel shall update recommendations issued
under subsection (a) not less frequently than once every 5
years.
(e) Data Collection and Reporting Standards.--
(1) In general.--The panel shall develop data collection
and reporting standards for use by the Secretary in collecting
and assessing outcomes for individuals who contact 9-1-1 or 9-
8-8 systems, including--
(A) the extent to which callers are successfully
connected to crisis care services;
(B) the frequency of law enforcement involvement in
such responses; and
(C) any disparities in response times, referrals,
or outcomes compared to the general population or
between different types of populations.
(2) Privacy.--In developing the standards under paragraph
(1), the panel shall ensure that data is collected in a manner
that protects caller privacy and confidentiality.
(3) Coordination.--In developing the standards under
paragraph (1), the panel shall coordinate with entities
participating in the National 911 Program, including--
(A) the National Highway Traffic Safety
Administration;
(B) the Federal Communications Commission;
(C) the Cybersecurity and Infrastructure Security
Agency;
(D) the National Telecommunications and Information
Administration; and
(E) State and local agencies operating 9-1-1 call
centers.
(f) Reports to Congress.--On the date of issuance of
recommendations under subsection (a), and on the date of issuance of
each update of such recommendations, the panel shall submit to Congress
a report containing the finding and recommendations of the panel.
(g) Nonapplicability of Termination Provision.--Section 1013(a)(2)
of title 5, United States Code (relating to the termination of advisory
committees), shall not apply to the Commission.
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) services furnished by crisis receiving and
stabilization facilities.''; 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 (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'';
(4) 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
(5) by adding at the end the following new subsection:
``(f) Definition.--In this section, the term `crisis receiving and
stabliziation facility' means a facility that--
``(1) qualifies for licensure or certification as a crisis
receiving and stabilization facility, pursuant to State law of
the State in which such facility furnishes the crisis response
services;
``(2) provides 23-hour observation and assessment chairs or
beds and 48-hour crisis stabilization psychiatric beds
inclusive of withdrawal management and 24-hour medical
monitoring;
``(3) provides such services 24 hours per day, 7 days per
week using a sliding scale of payment, and neither rejects
service nor limits services on the basis of a patient's ability
to pay, place of residence, prior forensic engagement, acuity
of mental health or substance use condition, intellectual or
developmental disability, age or related factors;
``(4) supports no-wrong-door admission capacity available
to law enforcement officers, emergency medical personnel, and
family members; and
``(5) maintains an average length of stay of less than 150
hours.''.
(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) In General.--Section 1905 of the Social Security Act (42 U.S.C.
1396d) is amended--
(1) in subsection (i)--
(A) by striking ``The term'' and inserting the
following: ``(1) Subject to paragraph (2), the term'';
and
(B) by adding at the end the following new
paragraph:
``(2) Beginning the day after the date of the enactment of
this paragraph, the term `institution for mental diseases' does
not include--
``(A) a clinic certified by the State as a
certified community behavioral health clinic for
purposes of participating in a demonstration program
conducted under section 223(d) of the Protecting Access
to Medicare Act of 2014;
``(B) a community mental health center that meets
the criteria specified in section 1913(c) of the Public
Health Service Act;
``(C) a crisis receiving and stabilization facility
(as defined in subsection (ll)(1)); or
``(D) a mental health and substance use urgent care
facility (as defined in subsection (ll)(2)).''; and
(2) by adding at the end the following new subsection:
``(ll) Crisis Receiving and Stabilization Facility; Mental Health
and Substance Use Urgent Care Facility.--
``(1) Crisis receiving and stabilization facility.--For
purposes of subsection (i)(2), the term `crisis receiving and
stabilization facility' means a facility that--
``(A) is licensed or certified to furnish crisis
response services under applicable State law;
``(B) is available to provide services 24 hours a
day and 7 days a week;
``(C) provides patients with, at a minimum, 23
hours of observation and assessment services, followed
by 48 hours of crisis stabilization services (including
withdrawal management and 24-hour medical monitoring);
``(D) does not deny or limit services on the basis
of a patient's ability to pay, place of residence,
prior engagement with the criminal justice system,
acuity of mental health or substance use condition,
intellectual or developmental disability, age, or
related factors;
``(E) applies a schedule of discounts to the
payment of fees or charges for the provision of its
services, which are adjusted on the basis of the
patient's ability to pay;
``(F) accepts patient referrals from law
enforcement officers, emergency medical personnel, and
family members; and
``(G) maintains an average length of stay of less
than 150 hours.
``(2) Mental health and substance use urgent care
facility.--For purposes of subsection (i)(2), the term `mental
health and substance use urgent care facility' means a facility
where individuals experiencing a mental or behavioral health
crisis may walk in without an appointment to receive crisis
assessment services, crisis intervention services, medication,
and connection to other appropriate services.''.
(b) Guidance.--Not later than 180 days after the date of enactment
of this section, the Secretary of Health and Human Services shall issue
guidance to States relating to the implementation of the amendments
made by subsection (a).
(c) Report.--
(1) In general.--Not later than 1 year after the date of
the enactment of this section, the Secretary, in collaboration
with the Attorney General and any other relevant Federal
officials (as determined by the Secretary), shall submit to
Congress a report that includes the following:
(A) Information with respect to the utilization of
crisis receiving and stabilization facilities during
the period following such date of enactment,
including--
(i) the number of patients served;
(ii) the type and duration of facility-
based services;
(iii) the number of referrals to community-
based outpatient care;
(iv) any trends observed in referrals made
by law enforcement agencies to such facilities;
and
(v) any other data relevant to assessing
the ability for these facilities to divert
mental health and substance use disorder
emergencies from law enforcement response.
(B) An analysis of the extent to which access to
crisis receiving and stabilization facilities is
associated with--
(i) reduced admissions to hospital
emergency rooms;
(ii) adverted admissions and readmissions
to psychiatric hospitals and other facilities
defined as Institutions for Mental Diseases;
and
(iii) decreased rates of incarceration in
penal facilities operated by a State or county.
(2) Crisis receiving and stabilization facility defined.--
In this subsection, the term ``crisis receiving and
stabilization facility'' has the meaning given such term in
subsection (ll) of section 1905 of the Social Security Act (42
U.S.C. 1396d).
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