[Congressional Record Volume 158, Number 52 (Thursday, March 29, 2012)]
[Senate]
[Pages S2248-S2250]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Ms. STABENOW (for herself and Mr. Reed):
  S. 2257. A bill to increase access to community behavioral health 
services for all Americans and to improve Medicaid reimbursement for 
community behavioral health services; to the Committee on Health, 
Education, Labor, and Pensions.
  Ms. STABENOW. 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. 2257

       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 ``Excellence in Mental Health 
     Act''.

     SEC. 2. ESTABLISHING COMMUNITY BEHAVIORAL HEALTH CENTERS.

       Section 1913 of the Public Health Service Act (42 U.S.C. 
     300x 2) is amended--
       (1) in subsection (a)(2)(A), by striking ``community mental 
     health services'' and inserting ``behavioral health services 
     (of the type offered by federally-qualified community 
     behavioral health centers consistent with subsection 
     (c)(3))'';
       (2) in subsection (b)--
       (A) by striking paragraph (1) and inserting the following:
       ``(1) services under the plan will be provided only through 
     appropriate, qualified community programs (which may include 
     federally-qualified community behavioral health centers, 
     child mental health programs, psychosocial rehabilitation 
     programs, mental health peer-support programs, outpatient 
     addiction treatment programs, acute detoxification services, 
     and mental health primary consumer-directed programs); and''; 
     and
       (B) in paragraph (2), by striking ``community mental health 
     centers'' and inserting ``federally-qualified community 
     behavioral health centers''; and
       (3) by striking subsection (c) and inserting the following:
       ``(c) Criteria for Federally-Qualified Community Behavioral 
     Health Centers.--
       ``(1) In general.--The Administrator shall certify, and 
     recertify at least every 5 years, federally-qualified 
     community behavioral health centers as meeting the criteria 
     specified in this subsection.
       ``(2) Regulations.--Not later than 18 months after the date 
     of the enactment of the Excellence in Mental Health Act, the 
     Administrator, in consultation with State Mental Health and 
     Substance Abuse Authorities, shall issue final regulations 
     for certifying non-profit or local government centers as 
     centers under paragraph (1).
       ``(3) Criteria.--The criteria referred to in subsection 
     (b)(2) are that the center performs each of the following:
       ``(A) Provide services in locations that ensure services 
     will be available and accessible promptly and in a manner 
     which preserves human dignity and assures continuity of care.
       ``(B) Provide services in a mode of service delivery 
     appropriate for the target population.
       ``(C) Provide individuals with a choice of service options 
     where there is more than one efficacious treatment.
       ``(D) Employ a core staff of clinical staff that is 
     multidisciplinary and culturally and linguistically 
     competent.
       ``(E) Provide services, within the limits of the capacities 
     of the center, to any individual residing or employed in the 
     service area of the center, regardless of the ability of the 
     individual to pay.
       ``(F) Provide, directly or through contract, to the extent 
     covered for adults in the State Medicaid plan under title XIX 
     of the Social Security Act and for children in accordance 
     with section 1905(r) of such Act regarding early and periodic 
     screening, diagnosis, and treatment, each of the following 
     services:
       ``(i) Screening, assessment, and diagnosis, including risk 
     assessment.
       ``(ii) Person-centered treatment planning or similar 
     processes, including risk assessment and crisis planning.
       ``(iii) Outpatient mental health and substance use 
     services, including screening, assessment, diagnosis, 
     psychotherapy, medication management, and integrated 
     treatment for mental illness and substance abuse which shall 
     be evidence-based (including cognitive behavioral therapy and 
     other such therapies which are evidence-based).
       ``(iv) Outpatient clinic primary care screening and 
     monitoring of key health indicators and health risk 
     (including screening for diabetes, hypertension, and 
     cardiovascular disease and monitoring of weight, height, body 
     mass index (BMI), blood pressure, blood glucose or HbA1C, and 
     lipid profile).
       ``(v) Crisis mental health services, including 24-hour 
     mobile crisis teams, emergency crisis intervention services, 
     and crisis stabilization.
       ``(vi) Targeted case management (services to assist 
     individuals gaining access to needed medical, social, 
     educational, and other services and applying for income 
     security and other benefits to which they may be entitled).
       ``(vii) Psychiatric rehabilitation services including 
     skills training, assertive community treatment, family 
     psychoeducation, disability self-management, supported 
     employment, supported housing services, therapeutic foster 
     care services, and such other evidence-based practices as the 
     Secretary may require.
       ``(viii) Peer support and counselor services and family 
     supports.
       ``(G) Maintain linkages, and where possible enter into 
     formal contracts with the following:
       ``(i) Federally qualified health centers.
       ``(ii) Inpatient psychiatric facilities and substance use 
     detoxification, post-detoxification step-down services, and 
     residential programs.
       ``(iii) Adult and youth peer support and counselor 
     services.
       ``(iv) Family support services for families of children 
     with serious mental or substance use disorders.
       ``(v) Other community or regional services, supports, and 
     providers, including schools, child welfare agencies, 
     juvenile and criminal justice agencies and facilities, 
     housing agencies and programs, employers, and other social 
     services.
       ``(vi) Onsite or offsite access to primary care services.
       ``(vii) Enabling services, including outreach, 
     transportation, and translation.
       ``(viii) Health and wellness services, including services 
     for tobacco cessation.
       ``(4) Rule of construction.--Nothing in paragraph (1) shall 
     be construed as prohibiting States receiving funds 
     appropriated through the Community Mental Health Services 
     Block Grant under subpart I of part B of this title from 
     financing qualified community programs (whether such programs 
     meet the definition of eligible programs prior to or after 
     the date of enactment of this subsection).
       ``(5) Limitation.--With respect to federally-qualified 
     behavioral health centers authorized under this subsection, 
     20 percent of the total number of such centers shall become 
     newly eligible to receive reimbursement under this section in 
     each of the first 5 years after the initial year of 
     eligibility through fiscal year 2022. In implementing this 
     paragraph, the Secretary shall ensure geographic diversity of 
     such sites, take into account the ability of such sites to 
     provide required services, and the ability of such sites to 
     report required data.''.

[[Page S2249]]

     SEC. 3. MEDICAID COVERAGE AND PAYMENT FOR COMMUNITY 
                   BEHAVIORAL HEALTH CENTER SERVICES.

       (a) Payment for Services Provided by Federally-Qualified 
     Community Behavioral Health Centers.--Section 1902(bb) of the 
     Social Security Act (42 U.S.C. 1396a(bb)) is amended--
       (1) in the heading, by striking ``and Rural Health 
     Clinics'' and inserting ``, Federally-Qualified Community 
     Behavioral Health Centers, and Rural Health Clinics'';
       (2) in paragraph (1), by inserting ``(and beginning with 
     fiscal year 2013 with respect to services furnished on or 
     after January 1, 2013, and each succeeding fiscal year, for 
     services described in section 1905(a)(2)(D) furnished by a 
     federally-qualified community behavioral health center)'' 
     after ``by a rural health clinic'';
       (3) in paragraph (2)--
       (A) by striking the heading and inserting ``Initial fiscal 
     year'';
       (B) by inserting ``(or, in the case of services described 
     in section 1905(a)(2)(D) furnished by a federally-qualified 
     community behavioral health center, for services furnished on 
     and after January 1, 2013, during fiscal year 2013)'' after 
     ``January 1, 2001, during fiscal year 2001'';
       (C) by inserting ``(or, in the case of services described 
     in section 1905(a)(2)(D) furnished by a federally-qualified 
     community behavioral health center, during fiscal years 2010 
     and 2011)'' after ``1999 and 2000''; and
       (D) by inserting ``(or, in the case of services described 
     in section 1905(a)(2)(D) furnished by a federally-qualified 
     community behavioral health center, during fiscal year 
     2013)'' before the period;
       (4) in paragraph (3)--
       (A) in the heading, by striking ``Fiscal year 2002 and 
     succeeding'' and inserting ``Succeeding''; and
       (B) by inserting ``(or, in the case of services described 
     in section 1905(a)(2)(D) furnished by a federally-qualified 
     community behavioral health center, for services furnished 
     during fiscal year 2013 or a succeeding fiscal year)'' after 
     ``2002 or a succeeding fiscal year'';
       (5) in paragraph (4)--
       (A) by inserting ``(or as a federally-qualified community 
     behavioral health center after fiscal year 2011)'' after ``or 
     rural health clinic after fiscal year 2000'';
       (B) by striking ``furnished by the center or'' and 
     inserting ``furnished by the federally qualified health 
     center, services described in section 1905(a)(2)(D) furnished 
     by the federally-qualified community behavioral health 
     center, or'';
       (C) in the second sentence, by striking ``or rural health 
     clinic'' and inserting ``, federally-qualified community 
     behavioral health center, or rural health clinic'';
       (6) in paragraph (5), in each of subparagraphs (A) and (B), 
     by striking ``or rural health clinic'' and inserting ``, 
     federally-qualified community behavioral health center, or 
     rural health clinic''; and
       (7) in paragraph (6), by striking ``or to a rural health 
     clinic'' and inserting ``, to a federally-qualified community 
     behavioral health center for services described in section 
     1905(a)(2)(D), or to a rural health clinic''.
       (b) Inclusion of Community Behavioral Health Center 
     Services in the Term Medical Assistance.--Section 1905(a)(2) 
     of the Social Security Act (42 U.S.C. 1396d(a)(2)) is 
     amended--
       (1) by striking ``and'' before ``(C)''; and
       (2) by inserting before the semicolon at the end the 
     following: ``, and (D) federally-qualified community 
     behavioral health center services (as defined in subsection 
     (l)(4))''.
       (c) Definition of Federally-Qualified Community Behavioral 
     Health Center Services.--Section 1905(l) of the Social 
     Security Act (42 U.S.C. 1396d(l)) is amended by adding at the 
     end the following paragraph:
       ``(4)(A) The term `community behavioral health center 
     services' means services furnished to an individual at a 
     federally-qualified community behavioral health center (as 
     defined by subparagraph (B)).
       ``(B) The term `federally qualified community behavioral 
     health center' means an entity that is certified under 
     section 1913(c) of the Public Health Service Act as meeting 
     the criteria described in paragraph (3) of such section.''.

     SEC. 4. 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 
     substance abuse services to individuals.
       ``(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 substance abuse 
     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 health and substance abuse 
     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;
       ``(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; and
       ``(D) acquiring information technology required to 
     accommodate the clinical needs of primary and specialty care 
     professionals.
       ``(3) Limitation.--Not to exceed 15 percent of grant funds 
     may be used for activities described in paragraph (2)(D).
       ``(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

[[Page S2250]]

       ``(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 such sums as may 
     be necessary for each of fiscal years 2013 through 2017.''.

     SEC. 5. EXPANDED PARTICIPATION IN 340B PROGRAM.

       Section 340B(a)(4) of the Public Health Service Act (42 
     U.S.C. 256b(a)(4)) is amended by adding at the end the 
     following:
       ``(P) An entity receiving funds under subpart I of part B 
     of title XIX of this Act for the provision of community 
     mental health services.
       ``(Q) An entity receiving funds under subpart II of part B 
     of title XIX of this Act for the provision of treatment 
     services for substance abuse.''.
                                 ______