[Congressional Record Volume 153, Number 157 (Wednesday, October 17, 2007)]
[Senate]
[Pages S12993-S12997]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. REED (for himself and Mr. Smith):
  S. 2182. A bill to amend the Public Health Service Act with respect 
to mental health services; to the Committee on Health, Education, 
Labor, and Pensions.
  Mr. REED. Mr. President, today I introduce the Community Mental 
Health Services Improvement Act. For decades, we have known that people 
suffering from mental illness die sooner, on average 25 years sooner, 
and have higher rates of disability than the general population. People 
with mental illness are at greater risk of preventable health 
conditions such as heart disease and diabetes. With this legislation, 
we are taking steps to address these disturbing trends.
  We know that mental health and physical health are inter-related: 
each contributes to the other. Yet historically mental health and 
physical health have been treated separately. The vision of this 
legislation is that the two should be integrated in a single medical 
home.
  In a recent survey, 91 percent of community mental health centers 
said that improving the quality of health care is a priority. However, 
only one-third have the capacity to provide health care on site, and 
only one-fifth provide medical referrals off site. The centers 
identified a lack of financial resources as the biggest barrier to 
integrating treatment.
  Accordingly, this legislation provides grants to integrate treatment 
for mental health, substance abuse, and primary and specialty care. 
Grantees can use the funds for screenings, basic health care services 
on site, referrals, or information technology.
  This legislation is also a comprehensive response to the workforce 
crisis identified by the President's New Freedom Commission on Mental 
Health. It provides grants for a wide range of innovative recruitment 
and retention efforts, from loan forgiveness and repayment programs, to 
placement and support for new mental health professionals, to expanding 
mental health education and training programs.
  Finally, this legislation provides grants for tele-mental health in 
medically-underserved areas, and invests in health IT for mental health 
providers. These proposals address the twin goals of improving the 
quality of mental health treatment while expanding access to that 
treatment in rural and underserved areas.
  This bipartisan legislation, which I am introducing with my colleague 
Senator Smith, has the overwhelming support of the mental health 
community. It has been endorsed by the National Council for Community 
Behavioral Healthcare, the National Alliance on Mental Illness, Mental 
Health America, the Campaign for Mental Health Reform, and the American 
Psychological Association. I am especially grateful for the support of 
the Rhode Island Council of Community Mental Health Organizations, 
whose members treat close to 15,000 Rhode Islanders of all ages.
  Today Senator Smith and I are also introducing the Community Mental 
Health Infrastructure Improvements Act. It should be obvious that this 
legislation is a necessary complement to the Community Mental Health 
Services Improvement Act: without community mental health centers, 
there can be no services to improve. Accordingly, this legislation 
provides grants to states for the construction and modernization of 
facilities that provide mental health services.
  As a member of the Senate Committee on Health, Education, Labor, and 
Pensions, I will work to include

[[Page S12994]]

these important initiatives in legislation that renews and improves 
Substance Abuse and Mental Health Services Administration, SAMHSA, 
programs. It is my hope that with its passage, we can begin to address 
the challenge of improving and expanding access to mental health 
services in a comprehensive way.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 2182

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Community Mental Health 
     Services Improvement Act''.

     SEC. 2. FINDINGS.

       Congress finds that--
       (1) almost 60,000,000 Americans, or one in four adults and 
     one in five children, have a mental illness that can be 
     diagnosed and treated in a given year;
       (2) mental illness costs our economy more than 
     $80,000,000,000 annually, accounting for 15 percent of the 
     total economic burden of disease;
       (3) alcohol and drug abuse contributes to the death of more 
     than 100,000 people and costs society upwards of half a 
     trillion dollars a year;
       (4) individuals with serious mental illness die on average 
     25 years sooner than individuals in the general population; 
     and
       (5) community mental and behavioral health organizations 
     provide cost-efficient and evidence-based treatment and care 
     for millions of Americans with mental illness and addiction 
     disorders.

     SEC. 3. CO-LOCATING PRIMARY AND SPECIALTY CARE IN COMMUNITY-
                   BASED MENTAL HEALTH SETTINGS.

       Subpart 3 of part B of title V of the Public Health Service 
     Act (42 U.S.C. 290bb-31 et seq.) is amended by adding at the 
     end the following:

     ``SEC. 520K. GRANTS FOR CO-LOCATING PRIMARY AND SPECIALTY 
                   CARE IN COMMUNITY-BASED MENTAL HEALTH SETTINGS.

       ``(a) Definitions.--In this section:
       ``(1) Eligible entity.--The term `eligible entity' means a 
     qualified community mental health program defined under 
     section 1913(b)(1).
       ``(2) Special populations.--The term `special populations' 
     refers to the following 3 groups:
       ``(A) Children and adolescents with mental and emotional 
     disturbances who have co-occurring primary care conditions 
     and chronic diseases.
       ``(B) Adults with mental illnesses who have co-occurring 
     primary care conditions and chronic diseases.
       ``(C) Older adults with mental illnesses who have co-
     occurring primary care conditions and chronic diseases.
       ``(b) Program Authorized.--The Secretary, acting through 
     the Administrator of the Substance Abuse and Mental Health 
     Services Administration and in coordination with the Director 
     of the Health Resources and Services Administration, shall 
     award grants to eligible entities to establish demonstration 
     projects for the provision of coordinated and integrated 
     services to special populations through the co-location of 
     primary and specialty care services in community-based mental 
     and behavioral health settings.
       ``(c) Application.--To be eligible to receive a grant under 
     this section, an eligible entity shall submit an application 
     to the Administrator at such time, in such manner, and 
     accompanied by such information as the Administrator may 
     require. Each such application shall include--
       ``(1) an assessment of the primary care needs of the 
     patients served by the eligible entity and a description of 
     how the eligible entity will address such needs; and
       ``(2) a description of partnerships, cooperative 
     agreements, or other arrangements with local primary care 
     providers, including community health centers, to provide 
     services to special populations.
       ``(d) Use of Funds.--
       ``(1) In general.--For the benefit of special populations, 
     an eligible entity shall use funds awarded under this section 
     for--
       ``(A) the provision, by qualified primary care 
     professionals on a reasonable cost basis, of--
       ``(i) primary care services on site at the eligible entity;
       ``(ii) diagnostic and laboratory services; or
       ``(iii) adult and pediatric eye, ear, and dental 
     screenings;
       ``(B) reasonable costs associated with medically necessary 
     referrals to qualified specialty care professionals as well 
     as to other coordinators of care or, if permitted by the 
     terms of the grant, for the provision, by qualified specialty 
     care professionals on a reasonable cost basis on site at the 
     eligible entity, of--
       ``(i) endocrinology services;
       ``(ii) oncology services;
       ``(iii) pulmonary/respiratory services; or
       ``(iv) cardiovascular services;
       ``(C) information technology required to accommodate the 
     clinical needs of primary and specialty care professionals; 
     or
       ``(D) facility improvements or modifications needed to 
     bring primary and specialty care professionals on site at the 
     eligible entity.
       ``(2) Limitation.--Not to exceed 15 percent of grant funds 
     may be used for activities described in subparagraphs (C) and 
     (D) of paragraph (1).
       ``(e) Geographic Distribution.--The Secretary shall ensure 
     that grants awarded under this section are equitably 
     distributed among the geographical regions of the United 
     States and between urban and rural populations.
       ``(f) Evaluation.--Not later than 3 months after a grant or 
     cooperative agreement awarded under this section expires, an 
     eligible entity shall submit to the Secretary the results of 
     an evaluation to be conducted by the entity concerning the 
     effectiveness of the activities carried out under the grant 
     or agreement.
       ``(g) Report.--Not later than 5 years after the date of 
     enactment of this section, the Secretary shall prepare and 
     submit to the appropriate committees of Congress a report 
     that shall evaluate the activities funded under this section. 
     The report shall include an evaluation of the impact of co-
     locating primary and specialty care in community mental and 
     behavioral health settings on overall patient health status 
     and recommendations on whether or not the demonstration 
     program under this section should be made permanent.
       ``(h) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section, 
     $50,000,0000 for fiscal year 2009 and such sums as may be 
     necessary for each of fiscal years 2010 through 2013.''.

     SEC. 4. INTEGRATING TREATMENT FOR MENTAL HEALTH AND SUBSTANCE 
                   ABUSE CO-OCCURRING DISORDERS.

       Section 520I of the Public Health Service Act (42 U.S.C. 
     290bb-40) is amended--
       (1) by striking subsection (i) and inserting the following:
       ``(j) Funding.--The Secretary shall make available to carry 
     out this section, $14,000,000 for fiscal year 2009, 
     $20,000,000 for fiscal year 2010, and such sums as may be 
     necessary for each of fiscal years 2011 through 2013. Such 
     sums shall be made available in equal amount from amounts 
     appropriated under sections 509 and 520A.''; and
       (2) by inserting before subsection (j), the following:
       ``(i) Community Mental Health Program.--For purposes of 
     eligibility under this section, the term `private nonprofit 
     organization' includes a qualified community mental health 
     program as defined under section 1913(b)(1).''.

     SEC. 5. IMPROVING THE MENTAL HEALTH WORKFORCE.

       (a) National Health Service Corps.--Section 332(a) of the 
     Public Health Service Act (42 U.S.C. 254e(a)) is amended--
       (1) in paragraph (1), by inserting after ``that meet the 
     requirements of section 334'' the following: ``and qualified 
     community mental health programs as defined in section 
     1913(b)(1),''; and
       (2) in paragraph (2)(A), by striking ``community mental 
     health center,''.
       (b) Recruitment and Retention of Mental Health 
     Professionals.--Subpart X of part D of title III of the 
     Public Health Service Act (42 U.S.C. 256f et seq.) is amended 
     by adding at the end the following:

     ``SEC. 340H. GRANTS FOR RECRUITMENT AND RETENTION OF MENTAL 
                   HEALTH PROFESSIONALS.

       ``(a) Establishment.--The Secretary, acting through the 
     Administrator of the Health Resources and Services 
     Administration, shall award grants to States, territories, 
     and Indian tribes or tribal organizations for innovative 
     programs to address the behavioral and mental health 
     workforce needs of designated mental health professional 
     shortage areas.
       ``(b) Use of Funds.--An eligible entity shall use grant 
     funds awarded under this section for--
       ``(1) loan forgiveness and repayment programs (to be 
     carried out in a manner similar to the loan repayment 
     programs carried out under subpart III of part D) for 
     behavioral and mental health professionals who--
       ``(A) agree to practice in designated mental health 
     professional shortage areas;
       ``(B) are graduates of programs in behavioral or mental 
     health;
       ``(C) agree to serve in community-based non-profit 
     entities, or as public mental health professionals for the 
     Federal, State or local government; and
       ``(D) agree to--
       ``(i) provide services to patients regardless of such 
     patients' ability to pay; and
       ``(ii) use a sliding payment scale for patients who are 
     unable to pay the total cost of services;
       ``(2) behavioral and mental health professional recruitment 
     and retention efforts, with a particular emphasis on 
     candidates from racial and ethnic minority and medically-
     underserved communities;
       ``(3) grants or low-interest or no-interest loans for 
     behavioral and mental health professionals who participate in 
     the Medicaid program under title XIX of the Social Security 
     Act to establish or expand practices in designated mental 
     health professional shortage areas, or to serve in qualified 
     community mental health programs as defined in section 
     1913(b)(1);
       ``(4) placement and support for behavioral and mental 
     health students, residents, trainees, and fellows or interns; 
     or
       ``(5) continuing behavioral and mental health education, 
     including distance-based education.

[[Page S12995]]

       ``(c) Application.--
       ``(1) In general.--Each eligible entity desiring a grant 
     under this section shall submit an application to the 
     Secretary at such time, in such manner, and containing such 
     information as the Secretary may reasonably require.
       ``(2) Assurances.--The application shall include assurances 
     that the applicant will meet the requirements of this 
     subsection and that the applicant possesses sufficient 
     infrastructure to manage the activities to be funded through 
     the grant and to evaluate and report on the outcomes 
     resulting from such activities.
       ``(d) Matching Requirement.--The Secretary may not make a 
     grant to an eligible entity under this section unless that 
     entity agrees that, with respect to the costs to be incurred 
     by the entity in carrying out the activities for which the 
     grant was awarded, the entity will provide non-Federal 
     contributions in an amount equal to not less than 35 percent 
     of Federal funds provided under the grant. The entity may 
     provide the contributions in cash or in kind, fairly 
     evaluated, including plant, equipment, and services, and may 
     provide the contributions from State, local, or private 
     sources.
       ``(e) Supplement Not Supplant.--A grant awarded under this 
     section shall be expended to supplement, and not supplant, 
     the expenditures of the eligible entity and the value of in-
     kind contributions for carrying out the activities for which 
     the grant was awarded.
       ``(f) Geographic Distribution.--The Secretary shall ensure 
     that grants awarded under this section are equitably 
     distributed among the geographical regions of the United 
     States and between urban and rural populations.
       ``(g) Evaluation.--Not later than 3 months after a grant 
     awarded under this section expires, an eligible entity shall 
     submit to the Secretary the results of an evaluation to be 
     conducted by the entity concerning the effectiveness of the 
     activities carried out under the grant.
       ``(h) Report.--Not later than 5 years after the date of 
     enactment of this section, the Secretary shall prepare and 
     submit to the appropriate committees of Congress a report 
     containing data relating to whether grants provided under 
     this section have increased access to behavioral and mental 
     health services in designated mental health professional 
     shortage areas.
       ``(i) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section, $10,000,000 for 
     fiscal year 2009, and such sums as may be necessary for each 
     of fiscal years 2010 through 2013.''.
       (c) Behavioral and Mental Health Education and Training 
     Programs.--Part A of title V of the Public Health Service Act 
     (42 U.S.C. 290aa et seq.) is amended by adding at the end the 
     following:

     ``SEC. 506C. GRANTS FOR BEHAVIORAL AND MENTAL HEALTH 
                   EDUCATION AND TRAINING PROGRAMS.

       ``(a) Definition.--For the purposes of this section, the 
     term `related mental health personnel' means an individual 
     who--
       ``(1) facilitates access to a medical, social, educational, 
     or other service; and
       ``(2) is not a mental health professional, but who is the 
     first point of contact with persons who are seeking mental 
     health services.
       ``(b) Establishment.--The Secretary, acting through the 
     Administrator of the Substance Abuse and Mental Health 
     Services Administration, shall establish a program to 
     increase the number of trained behavioral and mental health 
     professionals and related mental health personnel by awarding 
     grants on a competitive basis to mental and behavioral health 
     nonprofit organizations or accredited institutions of higher 
     education to enable such entities to establish or expand 
     accredited mental and behavioral health education programs.
       ``(c) Application.--
       ``(1) In general.--Each eligible entity desiring a grant 
     under this section shall submit an application to the 
     Secretary at such time, in such manner, and containing such 
     information as the Secretary may reasonably require.
       ``(2) Assurances.--The application shall include assurances 
     that the applicant will meet the requirements of this 
     subsection and that the applicant possesses sufficient 
     infrastructure to manage the activities to be funded through 
     the grant and to evaluate and report on the outcomes 
     resulting from such activities.
       ``(d) Priority.--In awarding grants under this section, the 
     Secretary shall give priority to applicants that--
       ``(1) demonstrate a familiarity with the use of evidenced-
     based methods in behavioral and mental health services;
       ``(2) provide interdisciplinary training experiences; and
       ``(3) demonstrate a commitment to training methods and 
     practices that emphasize the integrated treatment of mental 
     health and substance abuse disorders.
       ``(e) Use of Funds.--Funds awarded under this section shall 
     be used to--
       ``(1) establish or expand accredited behavioral and mental 
     health education programs, including improving the 
     coursework, related field placements, or faculty of such 
     programs; or
       ``(2) establish or expand accredited mental and behavioral 
     health training programs for related mental health personnel.
       ``(f) Requirements.--The Secretary may award a grant to an 
     eligible entity only if such entity agrees that--
       ``(1) any behavioral or mental health program assisted 
     under the grant will prioritize cultural competency and the 
     recruitment of trainees from racial and ethnic minority and 
     medically-underserved communities; and
       ``(2) with respect to any violation of the agreement 
     between the Secretary and the entity, the entity will pay 
     such liquidated damages as prescribed by the Secretary.
       ``(g) Geographic Distribution.--The Secretary shall ensure 
     that grants awarded under this section are equitably 
     distributed among the geographical regions of the United 
     States and between urban and rural populations.
       ``(h) Evaluation.--Not later than 3 months after a grant 
     awarded under this section expires, an eligible entity shall 
     submit to the Secretary the results of an evaluation to be 
     conducted by the entity concerning the effectiveness of the 
     activities carried out under the grant.
       ``(i) Report.--Not later than 5 years after the date of 
     enactment of this section, the Secretary shall prepare and 
     submit to the appropriate committees of Congress a report 
     containing data relating to whether grants provided under 
     this section have increased access to behavioral and mental 
     health services in designated mental health professional 
     shortage areas.
       ``(j) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section $4,000,0000 for 
     fiscal year 2009, and such sums as may be necessary for each 
     of fiscal years 2010 through 2013.''.

     SEC. 6. IMPROVING ACCESS TO MENTAL HEALTH SERVICES IN 
                   MEDICALLY-UNDERSERVED AREAS.

       Subpart 3 of part B of title V of the Public Health Service 
     Act (42 U.S.C. 290bb-31 et seq.) is amended by inserting 
     after section 520A the following:

     ``SEC. 520B. GRANTS FOR TELE-MENTAL HEALTH IN MEDICALLY-
                   UNDERSERVED AREAS.

       ``(a) Program Authorized.--The Secretary, acting through 
     the Administrator of the Substance Abuse and Mental Health 
     Services Administration, shall award grants to eligible 
     entities to provide tele-mental health in medically-
     underserved areas.
       ``(b) Eligible Entity.--To be eligible for assistance under 
     the program under subsection (a), an entity shall be a 
     qualified community mental health program (as defined in 
     section 1913(b)(1)).
       ``(c) Application.--
       ``(1) In general.--Each eligible entity desiring a grant 
     under this section shall submit an application to the 
     Secretary at such time, in such manner, and containing such 
     information as the Secretary may reasonably require.
       ``(2) Assurances.--The application shall include assurances 
     that the applicant will meet the requirements of this 
     subsection and that the applicant possesses sufficient 
     infrastructure to manage the activities to be funded through 
     the grant and to evaluate and report on the outcomes 
     resulting from such activities.
       ``(d) Use of Funds.--An eligible entity shall use funds 
     received under a grant under this section for--
       ``(1) the provision of tele-mental health services; or
       ``(2) infrastructure improvements for the provision of 
     tele-mental health services.
       ``(e) Geographic Distribution.--The Secretary shall ensure 
     that grants awarded under this section are equitably 
     distributed among the geographical regions of the United 
     States and between urban and rural populations.
       ``(f) Evaluation.--Not later than 3 months after a grant 
     awarded under this section expires, an eligible entity shall 
     submit to the Secretary the results of an evaluation to be 
     conducted by the entity concerning the effectiveness of the 
     activities carried out under the grant.
       ``(g) Report.--Not later than 5 years after the date of 
     enactment of this section, the Secretary shall prepare and 
     submit to the appropriate committees of Congress a report 
     that shall evaluate the activities funded under this section.
       ``(h) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section 
     $20,000,000 for fiscal year 2009, and such sums as may be 
     necessary for each of fiscal years 2010 through 2013.''.

     SEC. 7. IMPROVING HEALTH INFORMATION TECHNOLOGY FOR MENTAL 
                   HEALTH PROVIDERS.

       Part A of title V of the Public Health Service Act (42 
     U.S.C. 290aa et seq.), as amended by section 5(c), is further 
     amended by adding at the end the following:

     ``SEC. 506D. IMPROVING HEALTH INFORMATION TECHNOLOGY FOR 
                   MENTAL HEALTH PROVIDERS.

       ``(a) In General.--The Secretary, in consultation with the 
     Secretary of Veterans Affairs, shall collaborate with the 
     Administrator of the Substance Abuse and Mental Health 
     Services Administration and the National Coordinator for 
     Health Information Technology to--
       ``(1) develop and implement a plan for ensuring that 
     various components of the National Health Information 
     Infrastructure, including data and privacy standards, 
     electronic health records, and community and regional health 
     networks, address the needs of mental health and substance 
     abuse treatment providers; and
       ``(2) finance related infrastructure improvements, 
     technical support, personnel training, and ongoing quality 
     improvements.

[[Page S12996]]

       ``(b) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section 
     $10,000,000 for fiscal year 2009, and such sums as may be 
     necessary for each of fiscal years 2010 through 2013.''.

     SEC. 8. PAPERWORK REDUCTION STUDY.

       (a) In General.--Not later than 12 months after the date of 
     enactment of this Act, the Institute of Medicine shall submit 
     to the appropriate committees of Congress a report that 
     evaluates the combined paperwork burden of qualified 
     community mental health programs as defined in section 
     1913(b)(1) of the Public Health Service Act.
       (b) Scope.--In preparing the report under subsection (a), 
     the Institute of Medicine shall examine licensing, 
     certification, service definitions, claims payment, billing 
     codes, and financial auditing requirements utilized by the 
     Office of Management and Budget, the Centers for Medicare & 
     Medicaid Services, the Health Resources and Services 
     Administration, the Substance Abuse and Mental Health 
     Services Administration, the Office of the Inspector General, 
     State Medicaid agencies, State departments of health, State 
     departments of education, and State and local juvenile 
     justice and social service agencies to--
       (1) establish an estimate of the combined nationwide cost 
     of complying with the requirements described in this 
     paragraph, in terms of both administrative funding and staff 
     time;
       (2) establish an estimate of the per capita cost to each 
     qualified community mental health program defined in section 
     1913(b)(1) of the Public Health Service Act to comply with 
     the requirements of this paragraph, in terms of both 
     administrative funding and staff time; and
       (3) make administrative and statutory recommendations to 
     Congress, which may include a uniform methodology, to reduce 
     the paperwork burden experienced by qualified community 
     mental health programs defined in section 1913(b)(1) of the 
     Public Health Service Act.
       (c) Authorization of Appropriations.--There are authorized 
     to be appropriated to carry out this section $550,000 for 
     each of fiscal years 2009 and 2010.

     SEC. 9. WAGE STUDY.

       (a) In General.--Not later than 12 months after the date of 
     enactment of this Act, the Institute of Medicine shall 
     conduct a nationwide analysis, and submit a report to the 
     appropriate committees of Congress, concerning the 
     compensation structure of professional and paraprofessional 
     personnel employed by qualified community mental health 
     programs as defined under section 1913(b)(1) of the Public 
     Health Service Act, as compared with the compensation 
     structure of comparable health safety net providers and 
     relevant private sector health care employers.
       (b) Scope.--In preparing the report under subsection (a), 
     the Institute of Medicine shall examine compensation 
     disparities, if such disparities are determined to exist, by 
     type of personnel, type of provider or private sector 
     employer, and geographic region.
       (c) Authorization of Appropriations.--There are authorized 
     to be appropriated to carry out this section, $550,000 for 
     each of fiscal years 2009 and 20l0.
  By Mr. SMITH (for himself and Mr. Reed):
  S. 2183. A bill to amend the Public Health Service Act to provide 
grants for community-based mental health infrastructure improvement; to 
the Committee on Health, Education, Labor, and Pensions. '
  Mr. SMITH. Mr. President, I rise today with my colleague, Senator 
Jack Reed of Rhode Island, to introduce two bills, S. 2182 and S. 2183, 
that we hope will have a tremendous impact on the quality and 
accessibility of mental health care throughout the U.S. Our bills, the 
Community Mental Health Services Improvement Act and the Community-
Based Mental Health Infrastructure Improvement Act, support those 
programs that serve as an important line of defense against mental 
illnesses and suicide.
  Community mental health programs are the backbone of our mental 
health system by providing access to vital mental health care services 
to those in need. Unfortunately, community mental health centers are 
suffering under tremendous fiscal constraints to provide care in their 
communities. They operate, usually, on a small budget and with little 
resources to improve their facilities. Senator Reed and I are 
introducing these two bills to help community mental health centers 
obtain the resources necessary to meet their needs.
  The goal of the Community Mental Health Services Improvement Act is 
to provide funding to promote the provision of mental health services 
locally. The bill would establish a grant program for community mental 
health programs to provide health care services, screenings, referrals, 
information technology or facility improvements. The bill also 
establishes grants for programs that integrate treatment for 
individuals with a serious mental illness and a co-occurring substance 
abuse disorder. Grants also would be provided to mental health 
nonprofit organizations or accredited institutions to establish or 
expand accredited mental health education and training programs. 
Finally, this bill will provide grants to community mental health 
programs for tele-mental health in medically-underserved areas.
  The second bill that we are introducing today is one that is very 
important to mental health programs in my home State of Oregon. 
Currently, patients are waiting for important mental health care due to 
lack of building capacity. Our bill, the Community-Based Mental Health 
Infrastructure Improvements Act, would provide funding for bricks and 
mortar infrastructure for mental health programs in our communities. 
There is no Federal funding currently available for construction of 
community mental health facilities. This bill ensures that individuals 
with mental illness are not turned away because a facility does not 
have the resources to keep their building up to code or because a 
building expansion could not occur to keep up with a growing population 
because no funds were available.
  In developing this legislation, I worked with the Health Resources 
and Services Administration, HRSA, and the Substance Abuse and Mental 
Health Services Administration, SAMHSA, to determine how best to make 
funding available for community mental health programs. This bill would 
encourage a continuation of this important partnership between SAMHSA, 
HRSA and States to ensure that competitive grant funding is made 
available to community mental health programs throughout the country.
  We know that mental illness can affect people of any age, of any race 
and of any income. As a parent with a son who struggled with mental 
illness, I know all too well the indiscriminate nature of the illness 
and the frightening statistics of its regular occurrence for those we 
love. In any given year, more than a quarter of our Nation's adults, 60 
million people, suffer from a diagnosable mental disorder, many of whom 
suffer in silence. Mental disorders are the leading cause of disability 
for those aged 15-44 in the U.S. and in Canada.
  Mental illness is just as deadly and serious as a physical illness. 
Suicide takes the lives of more than 30,000 people each year, with more 
than 700,000 attempts. Suicides outnumber homicides three to one each 
year. People who suffer from mental illness also suffer from much 
higher rates of other chronic conditions, such as cardiovascular 
disease. However, unlike heart attacks and strokes, mental illness is 
not something that we, as a Nation, want to talk about.
  In a 2004 report by the Oregon Governor's Mental Health Taskforce, 
they found that in any given year 175,000 adults and 75,000 children 
under the age of 18 are in need of mental health services in my home 
State. Effective treatment exists for most people suffering. Help is 
out there, and these bills will help ensure that this help can be 
accessed effectively.
  I urge my colleagues on both sides of the aisle to support the 
important work of community mental health centers by voting for these 
bills.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
placed in the Record, as follows:

                                S. 2183

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Community-Based Mental 
     Health Infrastructure Improvements Act''.

     SEC. 2. COMMUNITY-BASED MENTAL HEALTH INFRASTRUCTURE 
                   IMPROVEMENT.

       Title V of the Public Health Service Act (42 U.S.C. 280g et 
     seq.) is amended by adding at the end the following:

  ``PART H--COMMUNITY-BASED MENTAL HEALTH INFRASTRUCTURE IMPROVEMENTS

     ``SEC. 560. GRANTS FOR COMMUNITY-BASED MENTAL HEALTH 
                   INFRASTRUCTURE IMPROVEMENTS.

       ``(a) Grants Authorized.--The Secretary may award grants to 
     eligible entities to expend funds for the construction or 
     modernization of facilities used to provide mental health and 
     behavioral health services to individuals.

[[Page S12997]]

       ``(b) Eligible Entity.--In this section, the term `eligible 
     entity' means--
       ``(1) a State that is the recipient of a Community Mental 
     Health Services Block Grant under subpart I of part B of 
     title XIX and a Substance Abuse Prevention and Treatment 
     Block Grant under subpart II of such part; or
       ``(2) an Indian tribe or a tribal organization (as such 
     terms are defined in sections 4(b) and 4(c) of the Indian 
     Self-Determination and Education Assistance Act).
       ``(c) Application.--A eligible entity desiring a grant 
     under this section shall submit to the Secretary an 
     application at such time, in such manner, and containing--
       ``(1) a plan for the construction or modernization of 
     facilities used to provide mental health and behavioral 
     health services to individuals that--
       ``(A) designates a single State or tribal agency as the 
     sole agency for the supervision and administration of the 
     grant;
       ``(B) contains satisfactory evidence that such agency so 
     designated will have the authority to carry out the plan;
       ``(C) provides for the designation of an advisory council, 
     which shall include representatives of nongovernmental 
     organizations or groups, and of the relevant State or tribal 
     agencies, that aided in the development of the plan and that 
     will implement and monitor any grant awarded to the eligible 
     entity under this section;
       ``(D) in the case of an eligible entity that is a State, 
     includes a copy of the State plan under section 1912(b) and 
     section 1932(b);
       ``(E)(i) includes a listing of the projects to be funded by 
     the grant; and
       ``(ii) in the case of an eligible entity that is a State, 
     explains how each listed project helps the State in 
     accomplishing its goals and objectives under the Community 
     Mental Health Services Block Grant under subpart I of part B 
     of title XIX and the Substance Abuse Prevention and Treatment 
     Block Grant under subpart II of such part;
       ``(F) includes assurances that the facilities will be used 
     for a period of not less than 10 years for the provision of 
     community-based mental health or substance abuse services for 
     those who cannot pay for such services, subject to subsection 
     (e); and
       ``(G) in the case of a facility that is not a public 
     facility, includes the name and executive director of the 
     entity who will provide services in the facility; and
       ``(2) with respect to each construction or modernization 
     project described in the application--
       ``(A) a description of the site for the project;
       ``(B) plans and specifications for the project and State or 
     tribal approval for the plans and specifications;
       ``(C) assurance that the title for the site is or will be 
     vested with either the public entity or private nonprofit 
     entity who will provide the services in the facility;
       ``(D) assurance that adequate financial resources will be 
     available for the construction or major rehabilitation of the 
     project and for the maintenance and operation of the 
     facility;
       ``(E) estimates of the cost of the project; and
       ``(F) the estimated length of time for completion of the 
     project.
       ``(d) Subgrants by States.--
       ``(1) In general.--A State that receives a grant under this 
     section may award a subgrant to a qualified community program 
     (as such term is used in section 1913(b)(1)).
       ``(2) Use of funds.--Subgrants awarded pursuant to 
     paragraph (1) may be used for activities such as--
       ``(A) the construction, expansion, and modernization of 
     facilities used to provide mental and behavioral health 
     services to individuals;
       ``(B) acquiring and leasing facilities and equipment 
     (including paying the costs of amortizing the principal of, 
     and paying the interest on, loans for such facilities and 
     equipment) to support or further the operation of the 
     subgrantee; and
       ``(C) the construction and structural modification 
     (including equipment acquisition) of facilities to permit the 
     integrated delivery of behavioral health and primary care of 
     specialty medical services to individuals with co-occurring 
     mental illnesses and chronic medical or surgical diseases at 
     a single service site.
       ``(e) Request To Transfer Obligation.--An eligible entity 
     that receives a grant under this section may submit a request 
     to the Secretary for permission to transfer the 10-year 
     obligation of facility use, as described in subsection 
     (c)(1)(F), to another facility.
       ``(f) Agreement to Federal Share.--As a condition of 
     receipt of a grant under this section, an eligible entity 
     shall agree, with respect to the costs to be incurred by the 
     entity in carrying out the activities for which such grant is 
     awarded, that the entity will make available non-Federal 
     contributions (which may include State or local funds, or 
     funds from the qualified community program) in an amount 
     equal to not less than $1 for every $1 of Federal funds 
     provided under the grant.
       ``(g) Reporting.--
       ``(1) Reporting by states.--During the 10-year period 
     referred to in subsection (c)(1)(F), the Secretary shall 
     require that a State that receives a grant under this section 
     submit, as part of the report of the State required under the 
     Community Mental Health Services Block Grant under subpart I 
     of part B of title XIX and the Substance Abuse Prevention and 
     Treatment Block Grant under subpart II of such part, a 
     description of the progress on--
       ``(A) the projects carried out pursuant to the grant under 
     this section; and
       ``(B) the assurances that the facilities involved continue 
     to be used for the purpose for which they were funded under 
     such grant during such 10-year period.
       ``(2) Reporting by indian tribes and tribal 
     organizations.--The Secretary shall establish reporting 
     requirements for Indian tribes and tribal organizations that 
     receive a grant under this section. Such reporting 
     requirements shall include that such Indian tribe or tribal 
     organization provide a description of the progress on--
       ``(A) the projects carried out pursuant to the grant under 
     this section; and
       ``(B) the assurances that the facilities involved continue 
     to be used for the purpose for which they were funded under 
     such grant during the 10-year period referred to in 
     subsection (c)(1)(F).
       ``(h) Failure to Meet Obligations.--
       ``(1) In general.--If an eligible entity that receives a 
     grant under this section fails to meet any of the obligations 
     of the entity required under this section, the Secretary 
     shall take appropriate steps, which may include--
       ``(A) requiring that the entity return the unused portion 
     of the funds awarded under this section for the projects that 
     are incomplete; and
       ``(B) extending the length of time that the entity must 
     ensure that the facility involved is used for the purposes 
     for which it is intended, as described in subsection 
     (c)(1)(F).
       ``(2) Hearing.--Prior to requesting the return of the funds 
     under paragraph (1)(B), the Secretary shall provide the 
     entity notice and opportunity for a hearing.
       ``(i) Collaboration.--The Secretary may establish 
     intergovernmental and interdepartmental memorandums of 
     agreement as necessary to carry out this section.
       ``(j) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section $20,000,000 for 
     fiscal year 2008 and such sums as may be necessary for each 
     of fiscal years 2009 through 2012.''.
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