119 HR 10280 IH: 9–8–8 Implementation Act of 2026
U.S. House of Representatives
2026-09-03
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.
1.(a)This Act may be cited as the 9–8–8 Implementation Act of 2026
.(b)The table of contents for this Act is as follows:Sec. 1. Short title.Title I—Substance Abuse and Mental Health Services AdministrationSec. 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 AdministrationSec. 201. Health center capital grants.Sec. 202. Expanding behavioral health workforce training programs.Title III—Behavioral Health Crisis Services ExpansionSec. 301. Coverage of crisis response services.Sec. 302. Incident reporting.Title IV—Medicaid amendmentsSec. 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.<enum>I</enum><header>Substance Abuse and Mental Health Services Administration</header><section id="HD147CB00F5F7416F9B3F19C2795D0E5E"><enum>101.</enum><header>Regional and local lifeline call center program</header><text display-inline="no-display-inline">Part B of title V of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290bb">42 U.S.C. 290bb et seq.</external-xref>) is amended by inserting after section 520E–4 (42 U.S.C. 290bb-36d) the following:</text><quoted-block id="HC89F742802AB4E4FB3F230558E5864FF" style="OLC"><section id="H6C35D3F42172452FAE55603138E99E14"><enum>520E–5.</enum><header>Regional and local lifeline call center program</header><subsection id="H9C95CA5F9FE94B818909FEB516865903"><enum>(a)</enum><header>In general</header><text>The Secretary shall award grants to new or existing crisis call centers serving regional or local areas to—</text><paragraph id="HC23243A3874F4B7180EACC640CE4A126"><enum>(1)</enum><text>purchase or upgrade call center technology;</text></paragraph><paragraph id="H5D6B5CA4B3A94B8B9600825ACE61091F"><enum>(2)</enum><text>provide for training of call center staff;</text></paragraph><paragraph id="HF5DF829E3BC944E584E8E2D51661232B"><enum>(3)</enum><text>improve call center operations; and</text></paragraph><paragraph id="HDE2D5D467FB447299959B7FF9D74F476"><enum>(4)</enum><text>provide for hiring of call center staff.</text></paragraph></subsection><subsection id="H48AA4DB3E3B54CFF82E9916C1282F140"><enum>(b)</enum><header>Authorization of appropriations</header><text>There is authorized to be appropriated to carry out this section $441,000,000 for fiscal year 2027, to remain available until expended.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></section><section id="H7ACF5515CDFD4AF18992D1224E41581C" display-inline="no-display-inline"><enum>102.</enum><header>Mental Health Crisis Response Partnership Pilot Program</header><text display-inline="no-display-inline">Section 520F(e) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290bb-37">42 U.S.C. 290bb–37(e)</external-xref>) is amended by striking <quote>section, $10,000,000 for each of fiscal years 2025 through 2029</quote> and inserting the following:</text><quoted-block style="OLC" id="H0614FECA90E041E28A309B7D3747F891" display-inline="yes-display-inline"><text>section—</text><paragraph id="H95B57CF724ED4271A7F5C9F5AB3B5BC3"><enum>(1)</enum><text display-inline="yes-display-inline">$10,000,000 for each of fiscal years 2025 and 2026; and</text></paragraph><paragraph id="H0F3F2992E3AF4EB7853135E3752D93FE"><enum>(2)</enum><text>$100,000,000 for each of fiscal years 2027 through 2029</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></section><section id="HA7F71DE34F844FDC97068F0F816F50C1"><enum>103.</enum><header>National suicide prevention media campaign</header><subsection id="HD2EE9CB4D7A94436BAC7F2B8A28AE4E5"><enum>(a)</enum><header>National suicide prevention lifeline program</header><text>Section 520E–3 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290bb-36c">42 U.S.C. 290bb–36c</external-xref>) is amended—</text><paragraph id="HF94B7E6B359A49CD8EFD196DB95C9F77"><enum>(1)</enum><text display-inline="yes-display-inline">in subsection (b)—</text><subparagraph id="HAD9D895AD8F646D2B85B847F31934626"><enum>(A)</enum><text>by amending paragraph (4) to read as follows:</text><quoted-block style="OLC" display-inline="no-display-inline" id="H55219E9C7FBD405F94A64138B91FE29A"><paragraph id="HF25DB382CBE24D1D819DBB6F85437B7C"><enum>(4)</enum><text display-inline="yes-display-inline">conducting the national suicide prevention media campaign described in section 520E–5;</text></paragraph><after-quoted-block>;</after-quoted-block></quoted-block></subparagraph><subparagraph id="H525F1503ED8540B5B3246AB5B265939F"><enum>(B)</enum><text>by redesignating paragraph (6) as paragraph (7); and</text></subparagraph><subparagraph id="H9AD7E248FBE74996ADD995732FF34F2E"><enum>(C)</enum><text>by inserting after paragraph (5) the following:</text><quoted-block style="OLC" id="HB885273524354AFB8F0194784779CCED" display-inline="no-display-inline"><paragraph id="HE2F586BEB62C4B21AF0026F5C0F23BF5"><enum>(6)</enum><text display-inline="yes-display-inline">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</text></paragraph><after-quoted-block>; and</after-quoted-block></quoted-block></subparagraph></paragraph><paragraph id="H4074234F0ECB4F72886FCD06A5E38CB4"><enum>(2)</enum><text>by amending subsection (f) to read as follows:</text><quoted-block style="OLC" display-inline="no-display-inline" id="HA7F6E20BD6AA4CF98F2510155844ACBD"><subsection id="HE3E61282DA1448B9945C71ADB9CCE63A"><enum>(f)</enum><header>Authorization of appropriations</header><text display-inline="yes-display-inline">There is authorized to be appropriated—</text><paragraph id="HB8CBC87DB458417ABB0032D7C3119370"><enum>(1)</enum><text display-inline="yes-display-inline">to carry out subsection (b)(4), $10,000,000 for each of fiscal years 2026 through 2030; and</text></paragraph><paragraph id="H000FE8082A344BFF8507D73AEAEFB456"><enum>(2)</enum><text display-inline="yes-display-inline">to carry out this section, except for subsection (b)(4), $101,621,000 for each of fiscal years 2023 through 2027.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection><subsection id="HDAA30E371AE44020BD3A8DEEEBF7BFF1"><enum>(b)</enum><header>National suicide prevention media campaign</header><text>The Public Health Service Act is amended by inserting after section 520E–4 (<external-xref legal-doc="usc" parsable-cite="usc/42/290bb-36d">42 U.S.C. 290bb–36d</external-xref>) the following:</text><quoted-block style="OLC" display-inline="no-display-inline" id="H8800BBDD80694ED9877E992ACEC02B81"><section id="H671772B82F1F4470A6FF9CFCC352CD7A"><enum>520E–5.</enum><header>National suicide prevention media campaign</header><subsection id="H0CDAC4E2E0B145F3B718A41D1F9C63E8"><enum>(a)</enum><header>In general</header><paragraph id="HF54BB893FAD94B4FB147E5A2E9D89975"><enum>(1)</enum><header>National media campaign</header><text display-inline="yes-display-inline">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 <quote>Director</quote>), shall conduct a national suicide prevention media campaign (referred to in this section as the <quote>national media campaign</quote>), for purposes of—</text><subparagraph id="H1A9911F528CC44949E08D435C0C8F4AA"><enum>(A)</enum><text display-inline="yes-display-inline">preventing suicide in the United States;</text></subparagraph><subparagraph id="H916A8626CC5D44EFBFC696911F1810BE"><enum>(B)</enum><text display-inline="yes-display-inline">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</text></subparagraph><subparagraph id="H42741E8DFE4B42D9A90B477E976CEB2B"><enum>(C)</enum><text display-inline="yes-display-inline">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.</text></subparagraph></paragraph><paragraph id="H7446CFFF877E48688C3FA02C631278EC"><enum>(2)</enum><header>Additional consultation</header><text display-inline="yes-display-inline">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).</text></paragraph></subsection><subsection id="H831412E8ECF44AD296D8BC29D6BB9188"><enum>(b)</enum><header>Target audiences</header><paragraph id="H1FC29F425F3740F79AEE5834643185D3"><enum>(1)</enum><header>Tailoring advertisements and other communications</header><text display-inline="yes-display-inline">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).</text></paragraph><paragraph id="HB5AB5BAA6F47411C881232F9FD2AB65F"><enum>(2)</enum><header>Targeting certain local areas</header><text display-inline="yes-display-inline">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.</text></paragraph></subsection><subsection id="H361DEB8BDFD24B6282AA807F93D4AE61"><enum>(c)</enum><header>Use of funds</header><paragraph id="H0D1AD78A2CE94781808F2FCE3D1C65F9"><enum>(1)</enum><header>Required uses</header><subparagraph id="HCAF49C9DDB094DA78C489C304743F555"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">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:</text><clause id="H731B74669542489F81C2BFCD5A4D3B6C"><enum>(i)</enum><text display-inline="yes-display-inline">Testing and evaluation of advertising.</text></clause><clause id="H194BE5F7DDCD48CEA04B78E92CDAD9DB"><enum>(ii)</enum><text display-inline="yes-display-inline">Evaluation of the effectiveness of the national media campaign.</text></clause><clause id="HC61DEC6E08F847BF9CDF7B8735D360E6"><enum>(iii)</enum><text display-inline="yes-display-inline">Operational and management expenses.</text></clause><clause id="HB642D28EE00E4E0BA3D2626C887CA4D3"><enum>(iv)</enum><text display-inline="yes-display-inline">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.</text></clause></subparagraph><subparagraph id="H2658F4A1C18F4B7DB23822FC3A39606E"><enum>(B)</enum><header>Specific requirements</header><clause id="HC82DBF86BA204530B9979AD8CA0640FE"><enum>(i)</enum><header>Testing and evaluation of advertising</header><text display-inline="yes-display-inline">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.</text></clause><clause id="H9B366A9993C6474CB64B8D4F4E717551"><enum>(ii)</enum><header>Evaluation of effectiveness of national media campaign</header><text display-inline="yes-display-inline">In evaluating the effectiveness of the national media campaign under subparagraph (A)(ii), the Secretary shall take into account—</text><subclause id="H8759727D57AF45E589A8962208E03C98"><enum>(I)</enum><text display-inline="yes-display-inline">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;</text></subclause><subclause id="H4888B0E634254A078EF014F8ACC07F62"><enum>(II)</enum><text display-inline="yes-display-inline">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;</text></subclause><subclause id="H06D28706C6B84D21B0B9AF855C01C95B"><enum>(III)</enum><text display-inline="yes-display-inline">whether the national media campaign has contributed to increased awareness that suicidal individuals should be engaged, rather than ignored; and</text></subclause><subclause id="H2A801FA096874E91970213FE1AC30D6E"><enum>(IV)</enum><text display-inline="yes-display-inline">such other measures of evaluation as the Secretary determines are appropriate.</text></subclause></clause></subparagraph></paragraph><paragraph id="H3684B87A23E34699ADDBC7E1B2A33F7B"><enum>(2)</enum><header>Optional uses</header><text display-inline="yes-display-inline">The Secretary may use funds made available to carry out this section for the following, with respect to the national media campaign:</text><subparagraph id="H1A0B2318A3CE41FA9578F5E974AB1B6E"><enum>(A)</enum><text display-inline="yes-display-inline">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.</text></subparagraph><subparagraph id="HA8DA98443046418294AAADFF88829B9E"><enum>(B)</enum><text display-inline="yes-display-inline">Entertainment industry outreach, interactive outreach, media projects and activities, public information, news media outreach, outreach through television programs, and corporate sponsorship and participation.</text></subparagraph></paragraph><paragraph id="HAD16613EBF934A618C7CF1578A230A56"><enum>(3)</enum><header>Prohibition</header><text display-inline="yes-display-inline">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.</text></paragraph></subsection><subsection id="HB86233D523EA47DC98D895445CBBC647"><enum>(d)</enum><header>Report to Congress</header><text display-inline="yes-display-inline">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—</text><paragraph id="H8585684DC12447B7B46E6BB1A4FF6022"><enum>(1)</enum><text display-inline="yes-display-inline">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;</text></paragraph><paragraph id="H8E99232D47CA4113B35B49ED7CA9C9C6"><enum>(2)</enum><text display-inline="yes-display-inline">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;</text></paragraph><paragraph id="H71FAC28A52AD49C999D0C13103D6DB77"><enum>(3)</enum><text display-inline="yes-display-inline">plans to purchase advertising time and space;</text></paragraph><paragraph id="H9561DA3F4BBD47DBAD144A3377698E57"><enum>(4)</enum><text display-inline="yes-display-inline">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</text></paragraph><paragraph id="HBE9F7150AF1C455783470746F1BD68AD"><enum>(5)</enum><text display-inline="yes-display-inline">all contracts entered into with a corporation, a partnership, or an individual working on behalf of the national media campaign.</text></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection></section><enum>II</enum><header>Health Resources and Services Administration</header><section id="HAF446AEB7B7D4181991568E6B5B9E69B"><enum>201.</enum><header>Health center capital grants</header><text display-inline="no-display-inline">Subpart 1 of part D of title III of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/254b">42 U.S.C. 254b et seq.</external-xref>) is amended by adding at the end the following:</text><quoted-block id="HB160AF299AE14DC39AFA884029E34F6B" style="OLC"><section id="H3D7D9698920E4687B03D8C1EFBB9AD96"><enum>330Q.</enum><header>Health center capital grants</header><subsection id="H2DE04D788AFF4441AE4DB443D1F9FD99"><enum>(a)</enum><header>In general</header><text>The Secretary shall award grants to eligible entities for capital projects.</text></subsection><subsection id="HEB44AE3C5E34495C937BD44E521F507B"><enum>(b)</enum><header>Eligible entity</header><text>In this section, the term eligible entity is an entity that is—</text><paragraph id="H2CB0CFA085964E2CB2B610DCD993663F"><enum>(1)</enum><text>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</text></paragraph><paragraph id="HD6338F040F3343E1A71AF19FE76848FA"><enum>(2)</enum><text>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.</text></paragraph></subsection><subsection id="H5DFE80B2E435458F900AAC694F9048A1"><enum>(c)</enum><header>Use of funds</header><text>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.</text></subsection><subsection id="HEB5E6E8177D3417FB1270D9845C8F01A"><enum>(d)</enum><header>Definitions</header><text>In this section:</text><paragraph id="H5107B00274074CA48BBCEF3A7B6D1210"><enum>(1)</enum><header>Crisis receiving and stabilization facility</header><text display-inline="yes-display-inline">The term <term>crisis receiving and stabilization facility</term> means a freestanding, non-hospital facility that—</text><subparagraph id="H80DFA898951740068F9F7DBE70A9C145"><enum>(A)</enum><text>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;</text></subparagraph><subparagraph id="H545FDC27AAF845CEBA22A938B64B5A6F"><enum>(B)</enum><text>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;</text></subparagraph><subparagraph id="H559625E3891B4D44812174EE4CCA6B78"><enum>(C)</enum><text>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;</text></subparagraph><subparagraph id="H779084373F304390A143D2FA09A5A1DF"><enum>(D)</enum><text>supports no-wrong-door admission capacity available to law enforcement officers, emergency medical personnel, and family members; and</text></subparagraph><subparagraph id="HD12F86D4BE584DA19727712733284125"><enum>(E)</enum><text>maintains an average length-of-stay of less than 150 hours.</text></subparagraph></paragraph><paragraph id="H0E5F357A45834CEDB95EE58D6AB35921"><enum>(2)</enum><header>Crisis response program facility</header><text display-inline="yes-display-inline">The term <term>crisis response program facility</term> 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—</text><subparagraph id="H1FDD5B6ACBA544BFBBC4ED9EFBED929C"><enum>(A)</enum><text>a mobile crisis response team;</text></subparagraph><subparagraph id="H5F969CFD63654770972CA6A86028DFB8"><enum>(B)</enum><text>a crisis receiving and stabilization facility;</text></subparagraph><subparagraph id="H3BFCE42E74E94FDE98E584DBB38BC0DD"><enum>(C)</enum><text>a mental health or substance use urgent care facility; or</text></subparagraph><subparagraph id="H5F2FABE344724A22BD86C9256807C018"><enum>(D)</enum><text>other appropriate provider, as determined by the Secretary.</text></subparagraph></paragraph><paragraph id="H2322A152713546868EC16A5167560BED"><enum>(3)</enum><header>Mental health and substance use urgent care facility</header><text display-inline="yes-display-inline">The term <term>mental health and substance use urgent care facility</term> 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.</text></paragraph></subsection><subsection id="H507C5258B2134569A1D69B176DB4CB0B"><enum>(e)</enum><header>Authorization of appropriations</header><text>There are authorized to be appropriated to carry out this section $1,000,000,000, to remain available until expended.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></section><section id="HD6A67A1A053949D990CD66690B2DB975"><enum>202.</enum><header>Expanding behavioral health workforce training programs</header><subsection id="H76816CA5FD114B2FBBCF289F892503C7"><enum>(a)</enum><header>National Health Service Corps</header><text>Section 332 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/254e">42 U.S.C. 254e</external-xref>) is amended by adding at the end the following:</text><quoted-block id="H2F694C211EAC43FFBD9A8F1A500782B3" style="OLC"><subsection id="H22A1191956494A6D86C137721918E236"><enum>(l)</enum><text>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—</text><paragraph id="HAC1DC52839834452BBD0D8085A4A1B52"><enum>(1)</enum><text>the number of crisis call centers, mobile crisis response units, and crisis receiving and stabilization facilities in such areas; and</text></paragraph><paragraph id="HE2688F83EB1347E998E7E8BBB2869734"><enum>(2)</enum><text>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).</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subsection><subsection id="H2F44E088E6B34B3CB5883B9254B85095"><enum>(b)</enum><header>Minority fellowship pilot program for crisis management services</header><text>Section 597 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290ll">42 U.S.C. 290ll</external-xref>) is amended—</text><paragraph id="H87160666694A428694A5CC68A8C9E3B2"><enum>(1)</enum><text>by amending subsection (b) to read as follows:</text><quoted-block style="OLC" id="H6C455A10554E42889F6ED85DA253CF53" display-inline="no-display-inline"><subsection id="H9FFAE6E4B76747C2901858214FCD65AF"><enum>(b)</enum><header>Training covered</header><text display-inline="yes-display-inline">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—</text><paragraph id="H3E25B210B0D943AEA66A0B025D3B1A84"><enum>(1)</enum><text>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</text></paragraph><paragraph id="HDFDD6CED006C48B986DC1C42D75B1137"><enum>(2)</enum><text display-inline="yes-display-inline">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).</text></paragraph></subsection><after-quoted-block>; and</after-quoted-block></quoted-block></paragraph><paragraph id="H3A85AA7A864A420AAF6DC406DBF48A0F"><enum>(2)</enum><text>by amending subsection (c) to read as follows:</text><quoted-block id="H7937949FCBBC42098D4705595ABA2C39" style="OLC"><subsection id="H509B8474146C4F858B67DD6C7BBA8657"><enum>(c)</enum><header>Authorization of appropriations</header><text>There are authorized to be appropriated—</text><paragraph id="H052EC16AF85547E29ACE06CFC253D891"><enum>(1)</enum><text>for carrying out this section (except with respect to subsection (b)(2)), $25,000,000 for each of fiscal years 2023 through 2027; and</text></paragraph><paragraph id="H300CE5CABB714FFC9FBE348E339FE0A2"><enum>(2)</enum><text display-inline="yes-display-inline">for awarding fellowships described in subsection (b)(2), $10,000,000 for each of fiscal years 2027 through 2031.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection><subsection id="H59415B7756154C6E9059D21B7D34BE10"><enum>(c)</enum><header>Behavioral health workforce education and training</header><text>Section 756 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/294e-1">42 U.S.C. 294e–1</external-xref>) is amended—</text><paragraph id="H8B1F3ADF8DE54C5799592958023C4AC8"><enum>(1)</enum><text>in subsection (a)—</text><subparagraph id="HA28C484BF0244028BFF3737637FE172B"><enum>(A)</enum><text>in paragraph (1)—</text><clause id="HB622A9270A0548A6825177C00ADD1E7E"><enum>(i)</enum><text>by inserting <quote>or remote programs that offer practicum hours</quote> after <quote>other field placement programs</quote>;</text></clause><clause id="H6D03574D9ABF4425AB41C70EB57488CB"><enum>(ii)</enum><text>by inserting <quote>(which may include training or a field practicum employing call, text, or chat responders for mental health crisis lines)</quote> after <quote>social work</quote>; and</text></clause><clause id="H8C4B80B45250456EB1ACBBEBAA27FFF7"><enum>(iii)</enum><text>by inserting <quote>crisis management (such as at a crisis call center, as part of a mobile crisis team, or through crisis receiving and stabilization program),</quote> after <quote>occupational therapy (which may include master’s and doctoral level programs),</quote>;</text></clause></subparagraph><subparagraph id="HFC701C59EC054ED7876D3B791C58515B"><enum>(B)</enum><text>in paragraph (2), by inserting <quote>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)</quote> after <quote>treatment services,</quote>;</text></subparagraph><subparagraph id="H6ACB3CBD26D44F8B9C059F11832FE252"><enum>(C)</enum><text>in paragraph (3), by inserting <quote>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)</quote> after <quote>behavioral health services</quote>; and</text></subparagraph><subparagraph id="HAA5F7E87783640C698CB136FBD61D018"><enum>(D)</enum><text>in paragraph (4), by inserting <quote>, 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),</quote> after <quote>paraprofessional field</quote>; and</text></subparagraph></paragraph><paragraph id="H2B3F1F006ED4428581822F4E54AD8DC2"><enum>(2)</enum><text>by amending subsection (f) to read as follows:</text><quoted-block id="HD7ED7710EE9A40E0B0B15DC5158A2349" style="OLC"><subsection id="H8A4915EFCA81444FBCF42ADEEFDCFE71"><enum>(f)</enum><header>Authorization of appropriations</header><paragraph id="HAAE96CB5DEEA48D09BE2ED578B5C36F2"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">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:</text><subparagraph id="H36A93CB9D9964798B25ABD1D0054C19E"><enum>(A)</enum><text>For grants described in subsection (a)(1), $15,000,000.</text></subparagraph><subparagraph id="H8F46AF96647B4D839301F25760C9B211"><enum>(B)</enum><text>For grants described in subsection (a)(2), $15,000,000.</text></subparagraph><subparagraph id="HAB27C5914DF649B3B8788FC54E122184"><enum>(C)</enum><text>For grants described in subsection (a)(3), $10,000,000.</text></subparagraph><subparagraph id="H1C6D207086264C078DACB11AA9CED22D"><enum>(D)</enum><text>For grants described in subsection (a)(4), $10,000,000.</text></subparagraph></paragraph><paragraph id="H62CF8E6E8ECE40B7869DAF86AE768E24"><enum>(2)</enum><header>Additional authorization for crisis workforce development</header><text>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.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection></section><enum>III</enum><header>Behavioral Health Crisis Services Expansion</header><section id="H4FEA739B898A406DA87C7BEB21A0881E"><enum>301.</enum><header>Coverage of crisis response services</header><subsection id="H97A3619F781E41CABA5A73B8D90407F4"><enum>(a)</enum><header>Coverage under the Medicare program</header><paragraph id="H3BEDDC1F36E64BD8B460803C2743D6DD"><enum>(1)</enum><header>In general</header><text>Section 1861(s)(2) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(s)(2)</external-xref>) is amended—</text><subparagraph id="H523E9E9067E0426495336EDDD52775A0"><enum>(A)</enum><text>in subparagraph (JJ), by striking <quote>and</quote> at the end;</text></subparagraph><subparagraph id="HD69131EC313B45F591FDF72447101ABB"><enum>(B)</enum><text>in subparagraph (KK), by striking the period at the end and inserting <quote>; and</quote>; and</text></subparagraph><subparagraph id="H8D0E94C39F2046FEBFC3579372D5D692"><enum>(C)</enum><text>by adding at the end the following new subparagraph:</text><quoted-block id="HAFCFB27E678C4647869991D59849DFF2" style="OLC"><subparagraph id="HC944344959A84D4B9159895C6614AEBD"><enum>(LL)</enum><text>crisis response services as defined in subsection (ooo);</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph><paragraph id="H0329F652A89648D49E96A52DB8D6BB02"><enum>(2)</enum><header>Crisis response services defined</header><text>Section 1861 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x</external-xref>) is amended by adding at the end the following new subsection:</text><quoted-block style="OLC" id="H046ED3A8374942978B1CFD70E2772673" display-inline="no-display-inline"><subsection id="H075306DD24F6479D927B3FEB75EAD674"><enum>(ooo)</enum><header>Crisis response services</header><paragraph id="HAF30967EC4ED4F43921DFE4A69336DFC"><enum>(1)</enum><header>In general</header><text>The term <term>crisis response services</term> 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.</text></paragraph><paragraph id="H3E4148F8136D4909807EFB7B01A09DC5"><enum>(2)</enum><header>Crisis receiving and stabilization facility</header><text>For purposes of paragraph (1), the term <term>crisis receiving and stabilization facility</term> means a facility that—</text><subparagraph id="H690E402AAC7641D583D8999B22D43F9E"><enum>(A)</enum><text display-inline="yes-display-inline">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;</text></subparagraph><subparagraph id="H5D8DFFD41C7D4047A514EDCD5FD3487D"><enum>(B)</enum><text display-inline="yes-display-inline">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;</text></subparagraph><subparagraph id="HB51182E6296B418C8D4B2798D89A592F"><enum>(C)</enum><text display-inline="yes-display-inline">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;</text></subparagraph><subparagraph id="HC282619418904FA9B6121F794C5DB560"><enum>(D)</enum><text display-inline="yes-display-inline">supports no-wrong-door admission capacity available to law enforcement officers, emergency medical personnel, and family members; and</text></subparagraph><subparagraph id="HEAC0E4E403114120AD6CAB77C8BAA7D4"><enum>(E)</enum><text display-inline="yes-display-inline">maintains an average length of stay of less than 150 hours.</text></subparagraph></paragraph><paragraph id="H8FFEE8E53E0B48F6B802ABEC51E38C9E"><enum>(3)</enum><header>Mental health and substance use urgent care facility</header><text display-inline="yes-display-inline">For purposes of paragraph (1), the term <term>mental health and substance use urgent care facility</term> 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.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph><paragraph id="H12614AC970B24AA58672DFA2E702144F"><enum>(3)</enum><header>Payment</header><subparagraph id="H693ADEFC48DB4B29A20AA773A6486B3F"><enum>(A)</enum><header>In general</header><text>Section 1833(a)(1) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395l">42 U.S.C. 1395l(a)(1)</external-xref>) is amended—</text><clause id="H00A93C8561084F328DFC2C79DCC9E3F0"><enum>(i)</enum><text>by striking <quote>and (HH)</quote> and inserting <quote>(HH)</quote>; and</text></clause><clause id="H9E471283CB2C46ABBFC4E3737592F620"><enum>(ii)</enum><text>by inserting before the semicolon at the end the following: <quote>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)</quote>.</text></clause></subparagraph><subparagraph id="H43836793D0B440228530EA83B6F9344D"><enum>(B)</enum><header>Establishment of payment basis</header><text>Section 1834 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395m">42 U.S.C. 1395m</external-xref>) is amended by adding at the end the following new subsection:</text><quoted-block style="OLC" id="HD7BF46A196BA42D18E41CFA418BDA938" display-inline="no-display-inline"><subsection id="H4FD44EC0375F4BED97846732223F3F4E"><enum>(bb)</enum><header>Payment for crisis response services</header><text display-inline="yes-display-inline">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.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph><paragraph id="HB8D4BFF0A1F342EBA73D5FD54899DD4C"><enum>(4)</enum><header>Ambulance transport of individuals in crisis</header><subparagraph id="H6C419DE3D74A4FC68634128CBC8A8175"><enum>(A)</enum><header>In general</header><text>Section 1834(l) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395m">42 U.S.C. 1395m(l)</external-xref>) is amended by adding at the end the following new paragraph:</text><quoted-block id="H61E9B17AD83E4FE18DE88B0F2CF417B7" style="OLC"><paragraph id="H9528203A50804325B0F2D16048E365D0"><enum>(18)</enum><header>Transportation of individuals in crisis</header><text display-inline="yes-display-inline">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).</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph><subparagraph id="H4288ABA2CC6148C18F8BB80FD7D6D7B0"><enum>(B)</enum><header>Conforming amendment</header><text>Section 1861(s)(7) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(s)(7)</external-xref>) is amended by striking <quote>section 1834(l)(14)</quote> and inserting <quote>paragraphs (14) and (18) of section 1834(l)</quote>.</text></subparagraph></paragraph><paragraph id="HEF143D61ACBD4CFCBAB24EFA0D41577B"><enum>(5)</enum><header>Effective date</header><text>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.</text></paragraph></subsection><subsection id="H79BD5F0A81FA4CA8807D3E75652A6179"><enum>(b)</enum><header>Mandatory coverage of crisis response services under the medicaid program</header><text>Title XIX of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396 et seq.</external-xref>) is amended—</text><paragraph id="HA918597364174CBAB378419275F7F639"><enum>(1)</enum><text>in section 1902(a)(10)(A), in the matter preceding clause (i), by striking <quote>and (30)</quote> and inserting <quote>(30), and (31)</quote>; and</text></paragraph><paragraph id="HE4008C8A9BFD4D65908316BC79A0DF58"><enum>(2)</enum><text>in section 1905—</text><subparagraph id="H2E705D342C124ACDA1CEA49C1296180E"><enum>(A)</enum><text>in subsection (a)—</text><clause id="H0E7296371AB240F7A2FF28ACE8DA3C34"><enum>(i)</enum><text>in paragraph (31), by striking <quote>; and</quote> and inserting a semicolon;</text></clause><clause id="H42F8874657274872835E517A47DC0EE8"><enum>(ii)</enum><text>by redesignating paragraph (32) as paragraph (33); and</text></clause><clause id="HB8D279794A734B9B9F3232157D0920D9"><enum>(iii)</enum><text>by inserting the following paragraph after paragraph (31):</text><quoted-block id="H2B54561E48E94FD896FAE66D2DDB3DED" style="OLC"><paragraph id="H764735D20DEC4EF0B8231173890203E7"><enum>(32)</enum><text>crisis response services (as defined in section 1861(ooo)); and</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></clause></subparagraph></paragraph><paragraph id="H749059E4174248D1A48148B25F125C76"><enum>(3)</enum><header>Presumptive eligibility determination by crisis response service providers</header><text>Section 1902(a)(47)(B) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a(a)(47)(B)</external-xref>) is amended by inserting <quote>or provider of crisis response services (as defined in section 1861(ooo))</quote> after <quote>any hospital</quote>.</text></paragraph><paragraph id="HFD814102B720466F90A01DD6AC5DA167"><enum>(4)</enum><header>Effective date</header><subparagraph id="HC4D128CEA9B64B52B049BFE79D392018"><enum>(A)</enum><header>In general</header><text>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.</text></subparagraph><subparagraph id="H8210D09F99F043DE80A3BC1FC6DFBE46"><enum>(B)</enum><header>Delay permitted if State legislation required</header><text>In the case of a State plan under title XIX of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396 et seq.</external-xref>) 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.</text></subparagraph></paragraph></subsection><subsection id="HFF7D221524D547A0985EF21ABA29DB35"><enum>(c)</enum><header>Group health plans and health insurance issuers</header><paragraph id="HA844B7BBF55149B48A01C3DD81E4F109"><enum>(1)</enum><header>PHSA</header><text display-inline="yes-display-inline">Part D of title XXVII of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300gg-111">42 U.S.C. 300gg–111 et seq.</external-xref>) is amended by adding at the end the following new section:</text><quoted-block style="OLC" id="HA178D03212484C259884971BD56AFA74" display-inline="no-display-inline"><section id="HAA489EBAEF5B4795B8F1DAEAF736BF6A"><enum>2799A–12.</enum><header>Required coverage of crisis response services</header><subsection id="H71D37E2F8110433B8C54E7D97FE57B8D"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">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).</text></subsection><subsection id="H76D79D95AABD44DABF5A415FA10211F4"><enum>(b)</enum><header>Application of financial requirements and treatment limitations</header><text>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)—</text><paragraph id="H37644620B9C84FC7B21AFB844930B828"><enum>(1)</enum><text display-inline="yes-display-inline">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</text></paragraph><paragraph id="H96B51D47C96E4D6D93492D0DD736F83C"><enum>(2)</enum><text display-inline="yes-display-inline">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.</text></paragraph></subsection><subsection id="HAA3315AB4C8B415C8C3D47145F471526"><enum>(c)</enum><header>Definitions</header><text display-inline="yes-display-inline">In this section, the terms <term>financial requirement</term>, <term>predominant</term>, and <term>treatment limitation</term> have the meaning given such terms in clauses (i) through (iii), respectively, of section 2726(a)(3)(B), except that the term <term>financial requirement</term> shall include aggregate lifetime limits and annual limits.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></paragraph><paragraph id="H89A0465EFC1F402BBE5D0AC4716E57CB"><enum>(2)</enum><header>ERISA</header><subparagraph id="HF6C3ED23D44A4D9EB3D1D6367F06BE58"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">Subpart B of part 7 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 (<external-xref legal-doc="usc" parsable-cite="usc/29/1185">29 U.S.C. 1185 et seq.</external-xref>) is amended by adding at the end the following new section:</text><quoted-block style="OLC" id="HEE5A9EB1959E4CA2BBB7AF151ECC7EB6" display-inline="no-display-inline"><section id="HE7547300921342429E012D0C4BA17D73"><enum>727.</enum><header>Required coverage of crisis response services</header><subsection id="H8ED637CD4BF54F59AE9E491EEB6630DA"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">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).</text></subsection><subsection id="H01CED0A4D0A240D1BFBA8606FF69A449"><enum>(b)</enum><header>Application of financial requirements and treatment limitations</header><text>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)—</text><paragraph id="HAEBD46985B484127AA583E798DB7D641"><enum>(1)</enum><text display-inline="yes-display-inline">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</text></paragraph><paragraph id="HD70C17FB36324F988ADB173260BE7B8B"><enum>(2)</enum><text display-inline="yes-display-inline">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.</text></paragraph></subsection><subsection id="H86FFBB4C1AAB47369F006E2E136457B7"><enum>(c)</enum><header>Definitions</header><text display-inline="yes-display-inline">In this section, the terms <term>financial requirement</term>, <term>predominant</term>, and <term>treatment limitation</term> have the meaning given such terms in clauses (i) through (iii), respectively, of section 712(a)(3)(B), except that the term <term>financial requirement</term> shall include aggregate lifetime limits and annual limits.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph><subparagraph id="H110AF55BA86D4A92922F9330CCBD8E94"><enum>(B)</enum><header>Clerical amendment</header><text>The table of contents in section 1 of the Employee Retirement Income Security Act of 1974 (<external-xref legal-doc="usc" parsable-cite="usc/29/1001">29 U.S.C. 1001</external-xref> note) is amended by inserting after the item relating to section 726 the following new item:</text><quoted-block style="OLC" display-inline="no-display-inline" id="H2D61A3FBEAD04F00A940A8BC46AE4BA6"><toc regeneration="no-regeneration"><toc-entry level="section" bold="off">Sec. 727. Required coverage of crisis response services.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph><paragraph id="HE50BCB7259EA46C6BEE1C26F5B19A06C"><enum>(3)</enum><header>IRC</header><subparagraph id="H25F033A590D145BAB68ECD473491726D"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">Subchapter B of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/26/100">chapter 100</external-xref> of the Internal Revenue Code of 1986 is amended by adding at the end the following new section:</text><quoted-block style="OLC" id="H18CC6D2562624EF88D9718FDE6917C78" display-inline="no-display-inline"><section id="H832DD7E4437F48BE9BA8158774774E36"><enum>9827.</enum><header>Required coverage of crisis response services</header><subsection id="H6EE0D290CBD2449FB1696EA6C0F9FF64"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">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).</text></subsection><subsection id="H362BC9B18B6E4D4187838CD3339A277D"><enum>(b)</enum><header>Application of financial requirements and treatment limitations</header><text>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)—</text><paragraph id="H6A51B7FDDAFC454D9DD64DD22935E34A"><enum>(1)</enum><text display-inline="yes-display-inline">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</text></paragraph><paragraph id="H89C2A5261EF54CCEBFB5473C9916BE6F"><enum>(2)</enum><text display-inline="yes-display-inline">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.</text></paragraph></subsection><subsection id="HA74C244D42734D00BE660DCAF3EBB160"><enum>(c)</enum><header>Definitions</header><text display-inline="yes-display-inline">In this section, the terms <term>financial requirement</term>, <term>predominant</term>, and <term>treatment limitation</term> have the meaning given such terms in clauses (i) through (iii), respectively, of section 9812(a)(3)(B), except that the term <term>financial requirement</term> shall include aggregate lifetime limits and annual limits.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph><subparagraph id="HFE90F5758F4C46DB8E7CCED5B3F99036"><enum>(B)</enum><header>Clerical amendment</header><text>The table of sections for subchapter B of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/26/100">chapter 100</external-xref> of the Internal Revenue Code of 1986 is amended by adding at the end the following new item:</text><quoted-block style="OLC" display-inline="no-display-inline" id="H7C1FBE3F612C464C9721B95B21EA9D09"><toc regeneration="no-regeneration"><toc-entry level="section">Sec. 9827. Required coverage of crisis response services.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph><paragraph id="HAD5FC1B8B94140349604C2CDAC913E82"><enum>(4)</enum><header>Effective date</header><text>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.</text></paragraph></subsection><subsection id="H87D837AFA1D645C7B25C69E25B0EEA15"><enum>(d)</enum><header>TRICARE coverage</header><paragraph id="H0DD50482BE274ABFB83992824E2DBC15"><enum>(1)</enum><header>In general</header><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x</external-xref>).</text></paragraph><paragraph id="HCD9BD9395AF240B48473298DFC4C2510"><enum>(2)</enum><header>TRICARE program defined</header><text>In this section, the term <term>TRICARE program</term> has the meaning given the term in section 1072 of title 10, United States Code.</text></paragraph></subsection><subsection id="HC147F82F52394635992090139B72E425"><enum>(e)</enum><header>Reimbursement for crisis response services for veterans</header><text>Section 1725(h) of title 38, United States Code, is amended—</text><paragraph id="H0E97AEF8CA944ECAB8BD538B780F6D4C"><enum>(1)</enum><text>in paragraph (1), in the matter preceding subparagraph (A), by inserting <quote>, including crisis response services,</quote> after <quote>services</quote>; and</text></paragraph><paragraph id="H0B056BC342894A5CA48FBF6CE47B5791"><enum>(2)</enum><text>by adding at the end the following new paragraph:</text><quoted-block style="USC" id="H8B5C0B05115C4CE8AE29262C2DF0A40C" display-inline="no-display-inline"><paragraph id="HB2D30608971D4A0A8AE7EBC8006C26A1"><enum>(4)</enum><text display-inline="yes-display-inline">The term <term>crisis response services</term> has the meaning given such term in subsection (ooo) of section 1861 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x</external-xref>).</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection><subsection id="HDEA48B38B7AD46E1B3893F3377A2D9F9"><enum>(f)</enum><header>Coverage under FEHB</header><paragraph id="H0224AE288C854573AA23655CEE952A6F"><enum>(1)</enum><header>In general</header><text>Section 8902 of title 5, United States Code, is amended by adding at the end the following:</text><quoted-block id="HA80E0909DF054A5CB3F3F1171F7B2456" style="OLC"><subsection id="H29248903083F4D6DB42FFEBE6FC007DE"><enum>(q)</enum><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x</external-xref>).</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph><paragraph id="H324D7FBC53AF4B2A9D93E71061330CCF"><enum>(2)</enum><header>Effective date</header><text>The amendment made by paragraph (1) shall apply beginning with respect to the third contract year for <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/5/89">chapter 89</external-xref> 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.</text></paragraph></subsection><subsection id="HBBA7DCC45FDF4BFCA3B208C876426330"><enum>(g)</enum><header>Coverage under CHIP</header><text>Section 2103(c)(5) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397cc">42 U.S.C. 1397cc(c)(5)</external-xref>) is amended—</text><paragraph id="H69C0B6CD8A394E8CB85628454824D655"><enum>(1)</enum><text>in subparagraph (A), by striking <quote>and</quote> at the end;</text></paragraph><paragraph id="HC860EFB0107E4C6494BEAEFF3DE95924"><enum>(2)</enum><text>in subparagraph (B), by striking the period and inserting <quote>; and</quote>; and</text></paragraph><paragraph id="H1644ACBEC49C4BF68AD35A9BE77D2F49"><enum>(3)</enum><text>by adding at the end the following new subparagraph:</text><quoted-block style="OLC" id="HEC8E5DF850254BFDBE1EC0F8839D689D" display-inline="no-display-inline"><subparagraph id="HF3CDB67C23154D60831A888B8404BA3F"><enum>(C)</enum><text display-inline="yes-display-inline">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)).</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection></section><section id="HB2D1113E9A52403194F2AA489D712FCB"><enum>302.</enum><header>Incident reporting</header><subsection id="H74B59DD064DC4359BDAA82041F506732"><enum>(a)</enum><header>Establishment of panel</header><text display-inline="yes-display-inline">The Secretary of Health and Human Services (referred to in this section as the <quote>Secretary</quote>), in consultation with the Attorney General, shall convene a panel (referred to in this section as the <quote>panel</quote>) to issue recommendations relating to the training requirements and protocols for 9–1–1 dispatchers.</text></subsection><subsection id="HD0C84D741164455D94BE7F73704810E6"><enum>(b)</enum><header>Purpose of recommendations</header><text>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.</text></subsection><subsection id="HC51E031BFEA4408CB149D95506E22B3E"><enum>(c)</enum><header>Membership</header><paragraph id="HED938ED3033D4739B558EB6E0B54A148"><enum>(1)</enum><header>Appointment</header><text>The panel shall be composed of members to be appointed by the Secretary and shall include—</text><subparagraph id="H5B8C4C80B3DC490AA5F7C129D283A48F"><enum>(A)</enum><text>psychiatrists;</text></subparagraph><subparagraph id="HF5ECDC63277E4CDCB75CE8F65C6FF5D2"><enum>(B)</enum><text>paramedics and other emergency medical services personnel;</text></subparagraph><subparagraph id="HF71B494EB1D5431EB3DCE62B9F3AAC35"><enum>(C)</enum><text>law enforcement officers and 9–1–1 dispatchers;</text></subparagraph><subparagraph id="HA14FED85B21F4490B22A9A91D5C7CB08"><enum>(D)</enum><text>representatives from each segment of the crisis response continuum, including 9–8–8 dispatchers;</text></subparagraph><subparagraph id="H5A8B0A92D69C480CBF58567B26B5576A"><enum>(E)</enum><text>members of underserved communities;</text></subparagraph><subparagraph id="H89948F5CDBFD422E98CD345A7B02BCC2"><enum>(F)</enum><text>representatives of Tribes or Tribal organizations;</text></subparagraph><subparagraph id="HBD91D614B49F4AA9B84C706D47C6D3E8"><enum>(G)</enum><text display-inline="yes-display-inline">individuals with experience treating individuals with serious mental illness or post-traumatic stress disorder, including veterans and servicemembers; and</text></subparagraph><subparagraph id="H8E3D7BAE8F8A4862887A4C1C37ABEBB9"><enum>(H)</enum><text>such other individuals as the Secretary determines appropriate.</text></subparagraph></paragraph><paragraph id="H8F82CD68E9194245B75849A659D27518"><enum>(2)</enum><header>Terms</header><text display-inline="yes-display-inline">The Secretary shall appoint the members of the panel to serve staggered 5-year terms.</text></paragraph></subsection><subsection id="HC2E2AF8947A344638DEAE7E49A92071A"><enum>(d)</enum><header>Recommendations</header><paragraph id="HA86C9273E3F247DEA0D346DA74684B77"><enum>(1)</enum><header>Considerations</header><text>In making recommendations under subsection (a), the panel shall consider—</text><subparagraph id="HE7CAE6BE979E4E7F91A64ADFACD6537E"><enum>(A)</enum><text>connecting 9–1–1 callers to crisis care services instead of responding with law enforcement officers;</text></subparagraph><subparagraph id="HD5C7A40A111047CAB8835B3C0CF05696"><enum>(B)</enum><text>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;</text></subparagraph><subparagraph id="H69DBE3F59B6949F499A5F92E2CB70AF8"><enum>(C)</enum><text>a process for—</text><clause id="H5BDFD7975B1E4E3DAD660FD3B847A31A"><enum>(i)</enum><text>identifying 9–1–1 callers who may be experiencing psychiatric symptoms or a mental health crisis, substance use crisis, or co-occurring crisis; and</text></clause><clause id="H40B7A9DC9375409691809570A7898C74"><enum>(ii)</enum><text>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</text></clause></subparagraph><subparagraph id="HACF73B9C748C401281CD3BE89280111C"><enum>(D)</enum><text display-inline="yes-display-inline">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).</text></subparagraph></paragraph><paragraph id="H8C0C361BB22646838A877BAC93B45549"><enum>(2)</enum><header>Measures to meet the needs of certain 9–1–1 callers</header><text>The measures referred to in paragraph (1)(D) include—</text><subparagraph id="HA3A513D3564D4D5A80D6348D3FD80383"><enum>(A)</enum><text display-inline="yes-display-inline">training of dispatch personnel on cultural competency, implicit bias, and evidence-based best practices for individuals experiencing a behavioral or mental health crisis; and</text></subparagraph><subparagraph id="H5E2B0B16599E4021B3D7D332A20DBD1B"><enum>(B)</enum><text display-inline="yes-display-inline">procedures designed to recruit, retain, or designate as dispatch personnel those individuals that have specialized training or demonstrated experience in—</text><clause id="H33719DC3FFB2495BB2D2B45F65B57AE0"><enum>(i)</enum><text>serving rural or medically underserved communities; or</text></clause><clause id="HB124718F6EEC40A29E781A3675733DF5"><enum>(ii)</enum><text display-inline="yes-display-inline">serving individuals with serious mental illness or post-traumatic stress disorder.</text></clause></subparagraph></paragraph><paragraph id="H1D945CAD4D3C488FB3EA644AD1DDF1EF"><enum>(3)</enum><header>Coordination with SAMHSA</header><text display-inline="yes-display-inline">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—</text><subparagraph id="HB4F6E88D158D47D586DEEB6C3D9523E9"><enum>(A)</enum><text>the training and protocol requirements for 9–1–1 dispatchers; and</text></subparagraph><subparagraph id="H23B709C405114A8EB7358E418A8C9F9B"><enum>(B)</enum><text display-inline="yes-display-inline">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.</text></subparagraph></paragraph><paragraph id="H96CE438AC8B44C1B8E83C7D47D677755"><enum>(4)</enum><header>Updates</header><text>The panel shall update recommendations issued under subsection (a) not less frequently than once every 5 years.</text></paragraph></subsection><subsection id="H66A47AFEBA634CDE9594F8632E8B1BD1"><enum>(e)</enum><header>Data collection and reporting standards</header><paragraph id="H35C0A509896A41EFA5195BAF254C8BD3"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">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—</text><subparagraph id="H83FEE9B83F454F33921365BA888E7A35"><enum>(A)</enum><text>the extent to which callers are successfully connected to crisis care services;</text></subparagraph><subparagraph id="HC12DF91CBFBB4D66960F050FD0AB0E08"><enum>(B)</enum><text>the frequency of law enforcement involvement in such responses; and</text></subparagraph><subparagraph id="H454BC8AEE3984F7194F261A5D28FB6E7"><enum>(C)</enum><text>any disparities in response times, referrals, or outcomes compared to the general population or between different types of populations.</text></subparagraph></paragraph><paragraph id="H2D5E7A80D01E4F2BB2181E5468CDAD28"><enum>(2)</enum><header>Privacy</header><text display-inline="yes-display-inline">In developing the standards under paragraph (1), the panel shall ensure that data is collected in a manner that protects caller privacy and confidentiality.</text></paragraph><paragraph id="HE3DBF093FF8E45B0BFC50B2E6E0908EF"><enum>(3)</enum><header>Coordination</header><text>In developing the standards under paragraph (1), the panel shall coordinate with entities participating in the National 911 Program, including—</text><subparagraph id="H4643562A11BD4FF0BB2E30E474DC9A18"><enum>(A)</enum><text>the National Highway Traffic Safety Administration;</text></subparagraph><subparagraph id="H3C7623FA04944D56A8886D5184911CEB"><enum>(B)</enum><text>the Federal Communications Commission;</text></subparagraph><subparagraph id="H382CE31624D54A7AB628ADB116E2797F"><enum>(C)</enum><text>the Cybersecurity and Infrastructure Security Agency;</text></subparagraph><subparagraph id="HA2A7D9DC8EEF4FD29F91AAFA7AB2E608"><enum>(D)</enum><text display-inline="yes-display-inline">the National Telecommunications and Information Administration; and</text></subparagraph><subparagraph id="HF19ABF8EEA1C44868A13BFACCEAB1000"><enum>(E)</enum><text display-inline="yes-display-inline">State and local agencies operating 9–1–1 call centers.</text></subparagraph></paragraph></subsection><subsection id="HC9B7C79D3A71498AA92160B4C44A6F22"><enum>(f)</enum><header>Reports to Congress</header><text>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.</text></subsection><subsection id="H470A8EEB0EA34EEF960A473DD527DC76"><enum>(g)</enum><header>Nonapplicability of termination provision</header><text display-inline="yes-display-inline">Section 1013(a)(2) of title 5, United States Code (relating to the termination of advisory committees), shall not apply to the Commission.</text></subsection></section><enum>IV</enum><header>Medicaid amendments</header><section id="HE3C912B6946B44B99C2978A4047D9E29"><enum>401.</enum><header>Revisions to the State option to provide qualifying community-based mobile crisis intervention services and other services under State plans under the Medicaid program</header><subsection id="HED38C79671AE41F284654472ECC7CC9D"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 1947 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396w-6">42 U.S.C. 1396w–6</external-xref>) is amended—</text><paragraph id="H4580119AE18F4D7C8B5248221FBE3A46"><enum>(1)</enum><text>in subsection (a)—</text><subparagraph id="H1B9ED973E09A4AD5A08B2D86F343D775"><enum>(A)</enum><text>by striking <quote>for qualifying community-based mobile crisis intervention services</quote> and inserting</text><quoted-block style="OLC" id="H3258F2672A284E819219F876A8453941" display-inline="yes-display-inline"><text>for—</text><paragraph id="H943CA000381C44E4A0804B9507A7BF39"><enum>(1)</enum><text display-inline="yes-display-inline">qualifying community-based mobile crisis intervention services;</text></paragraph><paragraph id="HE8F13CECE79C4F9CBD5F13DE9CA9647A"><enum>(2)</enum><text display-inline="yes-display-inline">regional and local lifeline call center operations; and</text></paragraph><paragraph id="H3DA318808C3A430799825D9456AB14CD"><enum>(3)</enum><text display-inline="yes-display-inline">services furnished by crisis receiving and stabilization facilities.</text></paragraph><after-quoted-block>; and</after-quoted-block></quoted-block></subparagraph><subparagraph id="HC1B7921CA003455686E82573D34F1F01"><enum>(B)</enum><text>by striking <quote>during the 5-year period</quote>;</text></subparagraph></paragraph><paragraph id="HCF0FAFA5A04E45CA80CB521E93E87563"><enum>(2)</enum><text>in subsection (c)—</text><subparagraph id="H44960316908047B4B4E9C367A6FFA952"><enum>(A)</enum><text>by striking <quote>85 percent.</quote> and inserting the following: <quote>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.</quote>; and</text></subparagraph><subparagraph id="H58812FDF4EEC42E7A169E6D14C7BA9CB"><enum>(B)</enum><text>by striking <quote>occurring during the period described in subsection (a) that a State</quote> and inserting <quote>in which a State provides medical assistance for qualifying community-based mobile crisis intervention services under this section and</quote>;</text></subparagraph></paragraph><paragraph id="HB134B75D978F485786375067C34067D5"><enum>(3)</enum><text>in subsection (d)(2)—</text><subparagraph id="HFEF84D954AF547188E03AEAD8FEE5ADD"><enum>(A)</enum><text>in subparagraph (A), by striking <quote>for the fiscal year preceding the first fiscal quarter occurring during the period described in subsection (a)</quote> and inserting <quote>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</quote>; and</text></subparagraph><subparagraph id="H38795F1FD6A64FB4928D46D483CD7241"><enum>(B)</enum><text>in subparagraph (B), by striking <quote>occurring during the period described in subsection (a)</quote> and inserting <quote>occurring during a fiscal quarter</quote>;</text></subparagraph></paragraph><paragraph id="H7F9E307F31EC44718EEEC0767A0D0066"><enum>(4)</enum><text>in subsection (e), by adding at the end at the following new sentence: <quote>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.</quote>; and</text></paragraph><paragraph id="H90B4A2EAF1294D289ADFF2F8D7099CD6"><enum>(5)</enum><text>by adding at the end the following new subsection:</text><quoted-block style="OLC" id="HC44C0E11DB394FC781DA09F0B84E923E" display-inline="no-display-inline"><subsection id="HC5DC877C69384053B7C1EE6FB33A0455"><enum>(f)</enum><header>Definition</header><text display-inline="yes-display-inline">In this section, the term <term>crisis receiving and stabliziation facility</term> means a facility that—</text><paragraph id="H65DAA62102254CEC807B7601DF996D82"><enum>(1)</enum><text display-inline="yes-display-inline">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;</text></paragraph><paragraph id="H0E9F9B967A494339A69589D9237C5A49"><enum>(2)</enum><text display-inline="yes-display-inline">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;</text></paragraph><paragraph id="H2CA608FF1EB442528A5FB2FB0958D4A7"><enum>(3)</enum><text display-inline="yes-display-inline">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;</text></paragraph><paragraph id="HCFA1C9F2BDC04734B975AD137A26B034"><enum>(4)</enum><text display-inline="yes-display-inline">supports no-wrong-door admission capacity available to law enforcement officers, emergency medical personnel, and family members; and</text></paragraph><paragraph id="H77A067EF884048F8B48C7D4A2EB72531"><enum>(5)</enum><text display-inline="yes-display-inline">maintains an average length of stay of less than 150 hours.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection><subsection id="HA37A109E4C24422B870D1CF6FBDA7292"><enum>(b)</enum><header>Effective date</header><text>The amendments made by subsection (a) shall take effect as if included in the enactment of the American Rescue Plan Act of 2021 (<external-xref legal-doc="public-law" parsable-cite="pl/117/2">Public Law 117–2</external-xref>).</text></subsection></section><section id="H6D73E343B8674D46A8BB79052A3A7DE0"><enum>402.</enum><header>Revisions to the IMD exclusion under Medicaid</header><subsection id="HA850A83AF81E4D6785158510AB9FC91F"><enum>(a)</enum><header>In general</header><text>Section 1905 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396d">42 U.S.C. 1396d</external-xref>) is amended—</text><paragraph id="HEB2E9F5CDD1940D5941C76616BC89086"><enum>(1)</enum><text>in subsection (i)—</text><subparagraph id="H78971E86140B4BDAB4E33912C46091AE"><enum>(A)</enum><text>by striking <quote>The term</quote> and inserting the following:</text><quoted-block style="OLC" id="H82E3924CE07749F0A3879F4D8F5ED27B" display-inline="yes-display-inline"><paragraph id="H7E7E0218E115439B929BB5FFEBE2DE20" display-inline="yes-display-inline"><enum>(1)</enum><text display-inline="yes-display-inline">Subject to paragraph (2), the term</text></paragraph><after-quoted-block>; and</after-quoted-block></quoted-block></subparagraph><subparagraph id="H2776AA90E59842D7AD1FC8886684D12A"><enum>(B)</enum><text>by adding at the end the following new paragraph:</text><quoted-block style="OLC" id="HDFD02F8AA4034CB2B9DEE37264472D3B" display-inline="no-display-inline"><paragraph id="HA3A6F2CFBCEE45F38B1ECD32D453521D"><enum>(2)</enum><text display-inline="yes-display-inline">Beginning the day after the date of the enactment of this paragraph, the term <term>institution for mental diseases</term> does not include—</text><subparagraph id="H814AD0E1FC6243EFA433902B4B769A81"><enum>(A)</enum><text>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;</text></subparagraph><subparagraph id="HFC4BBF5A0CB64515BE35F31A9DD2C437"><enum>(B)</enum><text>a community mental health center that meets the criteria specified in section 1913(c) of the Public Health Service Act;</text></subparagraph><subparagraph id="HA5B24D31C82C4F978887E988EC560899"><enum>(C)</enum><text>a crisis receiving and stabilization facility (as defined in subsection (ll)(1)); or</text></subparagraph><subparagraph id="HB0D475AD621E458BB84DC7448240834B"><enum>(D)</enum><text>a mental health and substance use urgent care facility (as defined in subsection (ll)(2)).</text></subparagraph></paragraph><after-quoted-block>; and</after-quoted-block></quoted-block></subparagraph></paragraph><paragraph id="HF66638891CAA444A9B75E6AB91244BA4"><enum>(2)</enum><text>by adding at the end the following new subsection:</text><quoted-block style="OLC" id="H79BD734E8E7941A588BBD60C0456DFDC" display-inline="no-display-inline"><subsection id="HAE0F46AFEE5D42079AFA74D8444D42DA"><enum>(ll)</enum><header>Crisis receiving and stabilization facility; mental health and substance use urgent care facility</header><paragraph id="H5579A04E61BD4F14B034E0B465B37EB5"><enum>(1)</enum><header>Crisis receiving and stabilization facility</header><text>For purposes of subsection (i)(2), the term <term>crisis receiving and stabilization facility</term> means a facility that—</text><subparagraph id="H7D1FEF25C9834FC5A45853146A7D0C26" commented="no"><enum>(A)</enum><text>is licensed or certified to furnish crisis response services under applicable State law;</text></subparagraph><subparagraph id="HBB8D691219E94CEE83044FD0C5C8EA78"><enum>(B)</enum><text>is available to provide services 24 hours a day and 7 days a week;</text></subparagraph><subparagraph id="H75696F3D909D478E9CF6962D0D965E67" commented="no"><enum>(C)</enum><text>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);</text></subparagraph><subparagraph id="HC4292DC83F2244EFB398DE5D14CE049B"><enum>(D)</enum><text>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;</text></subparagraph><subparagraph id="H86D7A7368A904E0EBBA5EA85BD3A85DF" commented="no"><enum>(E)</enum><text display-inline="yes-display-inline">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;</text></subparagraph><subparagraph id="HF277152791CE461AABF5728384728F7A" commented="no"><enum>(F)</enum><text>accepts patient referrals from law enforcement officers, emergency medical personnel, and family members; and</text></subparagraph><subparagraph id="H3EB6ABDF81F549F68135F7D6B184D387" commented="no"><enum>(G)</enum><text>maintains an average length of stay of less than 150 hours.</text></subparagraph></paragraph><paragraph id="H1C338229F98E42498F577A64CFDC1A06"><enum>(2)</enum><header>Mental health and substance use urgent care facility</header><text>For purposes of subsection (i)(2), the term <term>mental health and substance use urgent care facility</term> 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.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection><subsection id="H6812581FE35F4B16B489DB9FBBC1B2F6" commented="no"><enum>(b)</enum><header>Guidance</header><text>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 <internal-xref idref="HA850A83AF81E4D6785158510AB9FC91F" legis-path="2.(a)">subsection (a)</internal-xref>.</text></subsection><subsection id="H48D1642CD212457BBD7AF83AD9978438"><enum>(c)</enum><header>Report</header><paragraph id="H55BDDC94931A4CD5A8FCACAEC5BE3F79"><enum>(1)</enum><header>In general</header><text>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:</text><subparagraph id="H63C9BFBEAC7B40829A59016DAA11FD6C"><enum>(A)</enum><text>Information with respect to the utilization of crisis receiving and stabilization facilities during the period following such date of enactment, including—</text><clause id="HD21249E04ECA4832AA58E10844346AB1"><enum>(i)</enum><text>the number of patients served;</text></clause><clause id="H6752C34C37F84273B37B743473F972AC"><enum>(ii)</enum><text>the type and duration of facility-based services;</text></clause><clause id="H25E897B416E34351A8614165467EDA21"><enum>(iii)</enum><text>the number of referrals to community-based outpatient care;</text></clause><clause id="HC4744A20223948618BF972C173D32D0F"><enum>(iv)</enum><text>any trends observed in referrals made by law enforcement agencies to such facilities; and</text></clause><clause id="HEEE7C4F9B0754350A41D0AEDEB5E9573"><enum>(v)</enum><text display-inline="yes-display-inline">any other data relevant to assessing the ability for these facilities to divert mental health and substance use disorder emergencies from law enforcement response.</text></clause></subparagraph><subparagraph id="H6DB0236E3ED34805BC6FAC62972C6A0B"><enum>(B)</enum><text>An analysis of the extent to which access to crisis receiving and stabilization facilities is associated with—</text><clause id="HFD889CFEA72C48F0A891184DA74AE9CA"><enum>(i)</enum><text display-inline="yes-display-inline">reduced admissions to hospital emergency rooms;</text></clause><clause id="H4EBF60F67B6D4CB49B21ACE55C40665A"><enum>(ii)</enum><text display-inline="yes-display-inline">adverted admissions and readmissions to psychiatric hospitals and other facilities defined as Institutions for Mental Diseases; and</text></clause><clause id="H439BBA7CBA424839B94EF643C77A310B"><enum>(iii)</enum><text>decreased rates of incarceration in penal facilities operated by a State or county.</text></clause></subparagraph></paragraph><paragraph id="HDDBD0135AD6B492F92720C07C85C9A04"><enum>(2)</enum><header>Crisis receiving and stabilization facility defined</header><text display-inline="yes-display-inline">In this subsection, the term <term>crisis receiving and stabilization facility</term> has the meaning given such term in subsection (ll) of section 1905 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396d">42 U.S.C. 1396d</external-xref>).</text></paragraph></subsection></section>