[Congressional Record Volume 162, Number 108 (Wednesday, July 6, 2016)]
[House]
[Pages H4301-H4325]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          HELPING FAMILIES IN MENTAL HEALTH CRISIS ACT OF 2016

  Mr. MURPHY of Pennsylvania. Mr. Speaker, I move to suspend the rules 
and pass the bill (H.R. 2646) to make available needed psychiatric, 
psychological, and supportive services for individuals with mental 
illness and families in mental health crisis, and for other purposes, 
as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 2646

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

     SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

       (a) Short Title.--This Act may be cited as the ``Helping 
     Families in Mental Health Crisis Act of 2016''.
       (b) Table of Contents.--The table of contents for this Act 
     is as follows:

Sec. 1. Short title; table of contents.

    TITLE I--ASSISTANT SECRETARY FOR MENTAL HEALTH AND SUBSTANCE USE

Sec. 101. Assistant Secretary for Mental Health and Substance Use.
Sec. 102. Improving oversight of mental health and substance use 
              programs.
Sec. 103. National Mental Health and Substance Use Policy Laboratory.
Sec. 104. Peer-support specialist programs.
Sec. 105. Prohibition against lobbying using Federal funds by systems 
              accepting Federal funds to protect and advocate the 
              rights of individuals with mental illness.
Sec. 106. Reporting for protection and advocacy organizations.
Sec. 107. Grievance procedure.
Sec. 108. Center for Behavioral Health Statistics and Quality.
Sec. 109. Strategic plan.
Sec. 110. Authorities of centers for mental health services and 
              substance abuse treatment.
Sec. 111. Advisory councils.
Sec. 112. Peer review.

               TITLE II--MEDICAID MENTAL HEALTH COVERAGE

Sec. 201. Rule of construction related to Medicaid coverage of mental 
              health services and primary care services furnished on 
              the same day.
Sec. 202. Optional limited coverage of inpatient services furnished in 
              institutions for mental diseases.
Sec. 203. Study and report related to Medicaid managed care regulation.
Sec. 204. Guidance on opportunities for innovation.
Sec. 205. Study and report on Medicaid emergency psychiatric 
              demonstration project.
Sec. 206. Providing EPSDT services to children in IMDs.
Sec. 207. Electronic visit verification system required for personal 
              care services and home health care services under 
              Medicaid.

[[Page H4302]]

   TITLE III--INTERDEPARTMENTAL SERIOUS MENTAL ILLNESS COORDINATING 
                               COMMITTEE

Sec. 301. Interdepartmental Serious Mental Illness Coordinating 
              Committee.

             TITLE IV--COMPASSIONATE COMMUNICATION ON HIPAA

Sec. 401. Sense of Congress.
Sec. 402. Confidentiality of records.
Sec. 403. Clarification of circumstances under which disclosure of 
              protected health information is permitted.
Sec. 404. Development and dissemination of model training programs.

   TITLE V--INCREASING ACCESS TO TREATMENT FOR SERIOUS MENTAL ILLNESS

Sec. 501. Assertive community treatment grant program for individuals 
              with serious mental illness.
Sec. 502. Strengthening community crisis response systems.
Sec. 503. Increased and extended funding for assisted outpatient grant 
              program for individuals with serious mental illness.
Sec. 504. Liability protections for health professional volunteers at 
              community health centers.

      TITLE VI--SUPPORTING INNOVATIVE AND EVIDENCE-BASED PROGRAMS

Subtitle A--Encouraging the Advancement, Incorporation, and Development 
                      of Evidence-Based Practices

Sec. 601. Encouraging innovation and evidence-based programs.
Sec. 602. Promoting access to information on evidence-based programs 
              and practices.
Sec. 603. Sense of Congress.

    Subtitle B--Supporting the State Response to Mental Health Needs

Sec. 611. Community Mental Health Services Block Grant.

     Subtitle C--Strengthening Mental Health Care for Children and 
                              Adolescents

Sec. 621. Tele-mental health care access grants.
Sec. 622. Infant and early childhood mental health promotion, 
              intervention, and treatment.
Sec. 623. National Child Traumatic Stress Initiative.

         TITLE VII--GRANT PROGRAMS AND PROGRAM REAUTHORIZATION

       Subtitle A--Garrett Lee Smith Memorial Act Reauthorization

Sec. 701. Youth interagency research, training, and technical 
              assistance centers.
Sec. 702. Youth suicide early intervention and prevention strategies.
Sec. 703. Mental health and substance use disorder services on campus.

                      Subtitle B--Other Provisions

Sec. 711. National Suicide Prevention Lifeline Program.
Sec. 712. Workforce development studies and reports.
Sec. 713. Minority Fellowship Program.
Sec. 714. Center and program repeals.
Sec. 715. National violent death reporting system.
Sec. 716. Sense of Congress on prioritizing Native American youth and 
              suicide prevention programs.
Sec. 717. Peer professional workforce development grant program.
Sec. 718. National Health Service Corps.
Sec. 719. Adult suicide prevention.
Sec. 720. Crisis intervention grants for police officers and first 
              responders.
Sec. 721. Demonstration grant program to train health service 
              psychologists in community-based mental health.
Sec. 722. Investment in tomorrow's pediatric health care workforce.
Sec. 723. CUTGO compliance.

                    TITLE VIII--MENTAL HEALTH PARITY

Sec. 801. Enhanced compliance with mental health and substance use 
              disorder coverage requirements.
Sec. 802. Action plan for enhanced enforcement of mental health and 
              substance use disorder coverage.
Sec. 803. Report on investigations regarding parity in mental health 
              and substance use disorder benefits.
Sec. 804. GAO study on parity in mental health and substance use 
              disorder benefits.
Sec. 805. Information and awareness on eating disorders.
Sec. 806. Education and training on eating disorders.
Sec. 807. GAO study on preventing discriminatory coverage limitations 
              for individuals with serious mental illness and substance 
              use disorders.
Sec. 808. Clarification of existing parity rules.

    TITLE I--ASSISTANT SECRETARY FOR MENTAL HEALTH AND SUBSTANCE USE

     SEC. 101. ASSISTANT SECRETARY FOR MENTAL HEALTH AND SUBSTANCE 
                   USE.

       (a) Assistant Secretary.--Section 501(c) of the Public 
     Health Service Act (42 U.S.C. 290aa) is amended to read as 
     follows:
       ``(c) Assistant Secretary and Deputy Assistant Secretary.--
       ``(1) Assistant secretary.--
       ``(A) Appointment.--The Administration shall be headed by 
     an official to be known as the Assistant Secretary for Mental 
     Health and Substance Use (hereinafter in this title referred 
     to as the `Assistant Secretary') who shall be appointed by 
     the President, by and with the advice and consent of the 
     Senate.
       ``(B) Qualifications.--In selecting the Assistant 
     Secretary, the President shall give preference to individuals 
     who have--
       ``(i) a doctoral degree in medicine, osteopathic medicine, 
     or psychology;
       ``(ii) clinical and research experience regarding mental 
     health and substance use disorders; and
       ``(iii) an understanding of biological, psychosocial, and 
     pharmaceutical treatments of mental illness and substance use 
     disorders.
       ``(2) Deputy assistant secretary.--The Assistant Secretary, 
     with the approval of the Secretary, may appoint a Deputy 
     Assistant Secretary and may employ and prescribe the 
     functions of such officers and employees, including 
     attorneys, as are necessary to administer the activities to 
     be carried out through the Administration.''.
       (b) Transfer of Authorities.--The Secretary of Health and 
     Human Services shall delegate to the Assistant Secretary for 
     Mental Health and Substance Use all duties and authorities 
     that--
       (1) as of the day before the date of enactment of this Act, 
     were vested in the Administrator of the Substance Abuse and 
     Mental Health Services Administration; and
       (2) are not terminated by this Act.
       (c) Evaluation.--Section 501(d) of the Public Health 
     Service Act (42 U.S.C. 290aa(d)) is amended--
       (1) in paragraph (17), by striking ``and'' at the end;
       (2) in paragraph (18), by striking the period at the end 
     and inserting a semicolon; and
       (3) by adding at the end the following:
       ``(19) evaluate, in consultation with the Assistant 
     Secretary for Financial Resources, the information used for 
     oversight of grants under programs related to mental illness 
     and substance use disorders, including co-occurring illness 
     or disorders, administered by the Center for Mental Health 
     Services;
       ``(20) periodically review Federal programs and activities 
     relating to the diagnosis or prevention of, or treatment or 
     rehabilitation for, mental illness and substance use 
     disorders to identify any such programs or activities that 
     have proven to be effective or efficient in improving 
     outcomes or increasing access to evidence-based programs;
       ``(21) establish standards for the appointment of peer-
     review panels to evaluate grant applications and recommend 
     standards for mental health grant programs; and''.
       (d) Standards for Grant Programs.--Section 501(d) of the 
     Public Health Service Act (42 U.S.C. 290aa(d)), as amended by 
     subsection (c), is further amended by adding at the end the 
     following:
       ``(22) in consultation with the National Mental Health and 
     Substance Use Policy Laboratory, and after providing an 
     opportunity for public input, set standards for grant 
     programs under this title for mental health and substance use 
     services, which may address--
       ``(A) the capacity of the grantee to implement the award;
       ``(B) requirements for the description of the program 
     implementation approach;
       ``(C) the extent to which the grant plan submitted by the 
     grantee as part of its application must explain how the 
     grantee will reach the population of focus and provide a 
     statement of need, including to what extent the grantee will 
     increase the number of clients served and the estimated 
     percentage of clients receiving services who report positive 
     functioning after 6 months or no past-month substance use, as 
     applicable;
       ``(D) the extent to which the grantee must collect and 
     report on required performance measures; and
       ``(E) the extent to which the grantee is proposing 
     evidence-based practices and the extent to which--
       ``(i) those evidence-based practices must be used with 
     respect to a population similar to the population for which 
     the evidence-based practices were shown to be effective; or
       ``(ii) if no evidence-based practice exists for a 
     population of focus, the way in which the grantee will 
     implement adaptations of evidence-based practices, promising 
     practices, or cultural practices.''.
       (e) Emergency Response.--Section 501(m) of the Public 
     Health Service Act (42 U.S.C. 290aa(m)) is amended by adding 
     at the end the following:
       ``(4) Availability of funds through following fiscal 
     year.--Amounts made available for carrying out this 
     subsection shall remain available through the end of the 
     fiscal year following the fiscal year for which such amounts 
     are appropriated.''.
       (f) Member of Council on Graduate Medical Education.--
     Section 762 of the Public Health Service Act (42 U.S.C. 290o) 
     is amended--
       (1) in subsection (b)--
       (A) by redesignating paragraphs (4), (5), and (6) as 
     paragraphs (5), (6), and (7), respectively; and
       (B) by inserting after paragraph (3) the following:
       ``(4) the Assistant Secretary for Mental Health and 
     Substance Use;''; and
       (2) in subsection (c), by striking ``(4), (5), and (6)'' 
     each place it appears and inserting ``(5), (6), and (7)''.
       (g) Conforming Amendments.--Title V of the Public Health 
     Service Act (42 U.S.C. 290aa et seq.), as amended by the 
     previous provisions of this section, is further amended--

[[Page H4303]]

       (1) by striking ``Administrator of the Substance Abuse and 
     Mental Health Services Administration'' each place it appears 
     and inserting ``Assistant Secretary for Mental Health and 
     Substance Use''; and
       (2) by striking ``Administrator'' each place it appears 
     (including in any headings) and inserting ``Assistant 
     Secretary'', except where the term ``Administrator'' 
     appears--
       (A) in each of subsections (e) and (f) of section 501 of 
     such Act (42 U.S.C. 290aa), including the headings of such 
     subsections, within the term ``Associate Administrator'';
       (B) in section 507(b)(6) of such Act (42 U.S.C. 
     290bb(b)(6)), within the term ``Administrator of the Health 
     Resources and Services Administration'';
       (C) in section 507(b)(6) of such Act (42 U.S.C. 
     290bb(b)(6)), within the term ``Administrator of the Centers 
     for Medicare & Medicaid Services'';
       (D) in section 519B(c)(1)(B) of such Act (42 U.S.C. 290bb-
     25b(c)(1)(B)), within the term ``Administrator of the 
     National Highway Traffic Safety Administration''; or
       (E) in each of sections 519B(c)(1)(B), 520C(a), and 520D(a) 
     of such Act (42 U.S.C. 290bb-25b(c)(1)(B), 290bb-34(a), 
     290bb-35(a)), within the term ``Administrator of the Office 
     of Juvenile Justice and Delinquency Prevention''.
       (h) References.--After executing subsections (a), (b), and 
     (f), any reference in statute, regulation, or guidance to the 
     Administrator of the Substance Abuse and Mental Health 
     Services Administration shall be construed to be a reference 
     to the Assistant Secretary for Mental Health and Substance 
     Use.

     SEC. 102. IMPROVING OVERSIGHT OF MENTAL HEALTH AND SUBSTANCE 
                   USE PROGRAMS.

       Title V of the Public Health Service Act is amended by 
     inserting after section 501 of such Act (42 U.S.C. 290aa) the 
     following:

     ``SEC. 501A. IMPROVING OVERSIGHT OF MENTAL HEALTH AND 
                   SUBSTANCE USE PROGRAMS.

       ``(a) Activities.--For the purpose of ensuring efficient 
     and effective planning and evaluation of mental illness and 
     substance use disorder programs and related activities, the 
     Assistant Secretary for Planning and Evaluation, in 
     consultation with the Assistant Secretary for Mental Health 
     and Substance Use, shall--
       ``(1) collect and organize relevant data on homelessness, 
     involvement with the criminal justice system, 
     hospitalizations, mortality outcomes, and other measures the 
     Secretary deems appropriate from across Federal departments 
     and agencies;
       ``(2) evaluate programs related to mental illness and 
     substance use disorders, including co-occurring illness or 
     disorders, across Federal departments and agencies, as 
     appropriate, including programs related to--
       ``(A) prevention, intervention, treatment, and recovery 
     support services, including such services for individuals 
     with a serious mental illness or serious emotional 
     disturbance;
       ``(B) the reduction of homelessness and involvement with 
     the criminal justice system among individuals with a mental 
     illness or substance use disorder; and
       ``(C) public health and health services; and
       ``(3) consult, as appropriate, with the Assistant 
     Secretary, the Behavioral Health Coordinating Council of the 
     Department of Health and Human Services, other agencies 
     within the Department of Health and Human Services, and other 
     relevant Federal departments.
       ``(b) Recommendations.--The Assistant Secretary for 
     Planning and Evaluation shall develop an evaluation strategy 
     that identifies priority programs to be evaluated by the 
     Assistant Secretary and priority programs to be evaluated by 
     other relevant agencies within the Department of Health and 
     Human Services. The Assistant Secretary for Planning and 
     Evaluation shall provide recommendations on improving 
     programs and activities based on the evaluation described in 
     subsection (a)(2) as needing improvement.''.

     SEC. 103. NATIONAL MENTAL HEALTH AND SUBSTANCE USE POLICY 
                   LABORATORY.

       Title V of the Public Health Service Act (42 U.S.C. 290aa 
     et seq.) is amended by inserting after section 501A, as added 
     by section 102 of this Act, the following:

     ``SEC. 501B. NATIONAL MENTAL HEALTH AND SUBSTANCE USE POLICY 
                   LABORATORY.

       ``(a) In General.--There shall be established within the 
     Administration a National Mental Health and Substance Use 
     Policy Laboratory (referred to in this section as the 
     `Laboratory').
       ``(b) Responsibilities.--The Laboratory shall--
       ``(1) continue to carry out the authorities and activities 
     that were in effect for the Office of Policy, Planning, and 
     Innovation as such Office existed prior to the date of 
     enactment of the Helping Families in Mental Health Crisis Act 
     of 2016;
       ``(2) identify, coordinate, and facilitate the 
     implementation of policy changes likely to have a significant 
     effect on mental health, mental illness, and the prevention 
     and treatment of substance use disorder services;
       ``(3) collect, as appropriate, information from grantees 
     under programs operated by the Administration in order to 
     evaluate and disseminate information on evidence-based 
     practices, including culturally and linguistically 
     appropriate services, as appropriate, and service delivery 
     models;
       ``(4) provide leadership in identifying and coordinating 
     policies and programs, including evidence-based programs, 
     related to mental illness and substance use disorders;
       ``(5) recommend ways in which payers may implement program 
     and policy findings of the Administration and the Laboratory 
     to improve outcomes and reduce per capita program costs;
       ``(6) in consultation with the Assistant Secretary for 
     Planning and Evaluation, as appropriate, periodically review 
     Federal programs and activities relating to the diagnosis or 
     prevention of, or treatment or rehabilitation for, mental 
     illness and substance use disorders, including by--
       ``(A) identifying any such programs or activities that are 
     duplicative;
       ``(B) identifying any such programs or activities that are 
     not evidence-based, effective, or efficient; and
       ``(C) formulating recommendations for coordinating, 
     eliminating, or improving programs or activities identified 
     under subparagraph (A) or (B) and merging such programs or 
     activities into other successful programs or activities; and
       ``(7) carry out other activities as deemed necessary to 
     continue to encourage innovation and disseminate evidence-
     based programs and practices, including programs and 
     practices with scientific merit.
       ``(c) Evidence-Based Practices and Service Delivery 
     Models.--
       ``(1) In general.--In selecting evidence-based best 
     practices and service delivery models for evaluation and 
     dissemination, the Laboratory--
       ``(A) shall give preference to models that improve--
       ``(i) the coordination between mental health and physical 
     health providers;
       ``(ii) the coordination among such providers and the 
     justice and corrections system; and
       ``(iii) the cost effectiveness, quality, effectiveness, and 
     efficiency of health care services furnished to individuals 
     with serious mental illness or serious emotional disturbance, 
     in mental health crisis, or at risk to themselves, their 
     families, and the general public; and
       ``(B) may include clinical protocols and practices used in 
     the Recovery After Initial Schizophrenia Episode (RAISE) 
     project and the North American Prodrome Longitudinal Study 
     (NAPLS) of the National Institute of Mental Health.
       ``(2) Deadline for beginning implementation.--The 
     Laboratory shall begin implementation of the duties described 
     in this section not later than January 1, 2018.
       ``(3) Consultation.--In carrying out the duties under this 
     section, the Laboratory shall consult with--
       ``(A) representatives of the National Institute of Mental 
     Health, the National Institute on Drug Abuse, and the 
     National Institute on Alcohol Abuse and Alcoholism, on an 
     ongoing basis;
       ``(B) other appropriate Federal agencies;
       ``(C) clinical and analytical experts with expertise in 
     psychiatric medical care and clinical psychological care, 
     health care management, education, corrections health care, 
     and mental health court systems, as appropriate; and
       ``(D) other individuals and agencies as determined 
     appropriate by the Assistant Secretary.''.

     SEC. 104. PEER-SUPPORT SPECIALIST PROGRAMS.

       (a) In General.--Not later than 2 years after the date of 
     enactment of this Act, the Comptroller General of the United 
     States shall conduct a study on peer-support specialist 
     programs in up to 10 States (to be selected by the 
     Comptroller General) that receive funding from the Substance 
     Abuse and Mental Health Services Administration and submit to 
     the Committee on Health, Education, Labor, and Pensions of 
     the Senate and the Committee on Energy and Commerce of the 
     House of Representatives a report containing the results of 
     such study.
       (b) Contents of Study.--In conducting the study under 
     subsection (a), the Comptroller General of the United States 
     shall examine and identify best practices in the selected 
     States related to training and credential requirements for 
     peer-support specialist programs, such as--
       (1) hours of formal work or volunteer experience related to 
     mental illness and substance use disorders conducted through 
     such programs;
       (2) types of peer-support specialist exams required for 
     such programs in the States;
       (3) codes of ethics used by such programs in the States;
       (4) required or recommended skill sets of such programs in 
     the State; and
       (5) requirements for continuing education.

     SEC. 105. PROHIBITION AGAINST LOBBYING USING FEDERAL FUNDS BY 
                   SYSTEMS ACCEPTING FEDERAL FUNDS TO PROTECT AND 
                   ADVOCATE THE RIGHTS OF INDIVIDUALS WITH MENTAL 
                   ILLNESS.

       Section 105(a) of the Protection and Advocacy for 
     Individuals with Mental Illness Act (42 U.S.C. 10805(a)) is 
     amended--
       (1) in paragraph (9), by striking ``and'' at the end;
       (2) in paragraph (10), by striking the period at the end 
     and inserting ``; and''; and
       (3) by adding at the end the following:
       ``(11) agree to refrain, during any period for which 
     funding is provided to the system under this part, from using 
     Federal funds to pay the salary or expenses of any grant or 
     contract recipient, or agent acting for such recipient, 
     related to any activity designed to

[[Page H4304]]

     influence the enactment of legislation, appropriations, 
     regulation, administrative action, or Executive order 
     proposed or pending before the Congress or any State or local 
     government, including any legislative body, other than for 
     normal and recognized executive-legislative relationships or 
     participation by an agency or officer of a State, local, or 
     tribal government in policymaking and administrative 
     processes within the executive branch of that government.''.

     SEC. 106. REPORTING FOR PROTECTION AND ADVOCACY 
                   ORGANIZATIONS.

       (a) Public Availability of Reports.--Section 105(a)(7) of 
     the Protection and Advocacy for Individuals with Mental 
     Illness Act (42 U.S.C. 10805(a)(7)) is amended by striking 
     ``is located a report'' and inserting ``is located, and make 
     publicly available, a report''.
       (b) Detailed Accounting.--Section 114(a) of the Protection 
     and Advocacy for Individuals with Mental Illness Act (42 
     U.S.C. 10824(a)) is amended--
       (1) in paragraph (3), by striking ``and'' at the end;
       (2) in paragraph (4), by striking the period at the end and 
     inserting ``; and''; and
       (3) by adding at the end the following:
       ``(5) using data from the existing required annual program 
     progress reports submitted by each system funded under this 
     title, a detailed accounting for each such system of how 
     funds are spent, disaggregated according to whether the funds 
     were received from the Federal Government, the State 
     government, a local government, or a private entity.''.

     SEC. 107. GRIEVANCE PROCEDURE.

       Section 105 of the Protection and Advocacy for Individuals 
     with Mental Illness Act (42 U.S.C. 10805), as amended, is 
     further amended by adding at the end the following:
       ``(d) Grievance Procedure.--The Secretary shall establish 
     an independent grievance procedure for persons described in 
     subsection (a)(9).''.

     SEC. 108. CENTER FOR BEHAVIORAL HEALTH STATISTICS AND 
                   QUALITY.

       Title V of the Public Health Service Act (42 U.S.C. 290aa 
     et seq.) is amended--
       (1) in section 501(b) (42 U.S.C. 290aa(b)), by adding at 
     the end the following:
       ``(4) The Center for Behavioral Health Statistics and 
     Quality.'';
       (2) in section 502(a)(1) (42 U.S.C. 290aa-1(a)(1))--
       (A) in subparagraph (C), by striking ``and'' at the end;
       (B) in subparagraph (D), by striking the period at the end 
     and inserting ``; and''; and
       (C) by inserting after subparagraph (D) the following:
       ``(E) the Center for Behavioral Health Statistics and 
     Quality.''; and
       (3) in part B (42 U.S.C. 290bb et seq.) by adding at the 
     end the following new subpart:

    ``Subpart 4--Center for Behavioral Health Statistics and Quality

     ``SEC. 520L. CENTER FOR BEHAVIORAL HEALTH STATISTICS AND 
                   QUALITY.

       ``(a) Establishment.--There is established in the 
     Administration a Center for Behavioral Health Statistics and 
     Quality (in this section referred to as the `Center'). The 
     Center shall be headed by a Director (in this section 
     referred to as the `Director') appointed by the Secretary 
     from among individuals with extensive experience and academic 
     qualifications in research and analysis in behavioral health 
     care or related fields.
       ``(b) Duties.--The Director of the Center shall--
       ``(1) coordinate the Administration's integrated data 
     strategy by coordinating--
       ``(A) surveillance and data collection (including that 
     authorized by section 505);
       ``(B) evaluation;
       ``(C) statistical and analytic support;
       ``(D) service systems research; and
       ``(E) performance and quality information systems;
       ``(2) recommend a core set of measurement standards for 
     grant programs administered by the Administration; and
       ``(3) coordinate evaluation efforts for the grant programs, 
     contracts, and collaborative agreements of the 
     Administration.
       ``(c) Biannual Report to Congress.--Not later than 2 years 
     after the date of enactment of this section, and every 2 
     years thereafter, the Director of the Center shall submit to 
     Congress a report on the quality of services furnished 
     through grant programs of the Administration, including 
     applicable measures of outcomes for individuals and public 
     outcomes such as--
       ``(1) the number of patients screened positive for 
     unhealthy alcohol use who receive brief counseling as 
     appropriate; the number of patients screened positive for 
     tobacco use and receiving smoking cessation interventions; 
     the number of patients with a new diagnosis of major 
     depressive episode who are assessed for suicide risk; the 
     number of patients screened positive for clinical depression 
     with a documented followup plan; and the number of patients 
     with a documented pain assessment that have a followup 
     treatment plan when pain is present; and satisfaction with 
     care;
       ``(2) the incidence and prevalence of mental illness and 
     substance use disorders; the number of suicide attempts and 
     suicide completions; overdoses seen in emergency rooms 
     resulting from alcohol and drug use; emergency room boarding; 
     overdose deaths; emergency psychiatric hospitalizations; new 
     criminal justice involvement while in treatment; stable 
     housing; and rates of involvement in employment, education, 
     and training; and
       ``(3) such other measures for outcomes of services as the 
     Director may determine.
       ``(d) Staffing Composition.--The staff of the Center may 
     include individuals with advanced degrees and field expertise 
     as well as clinical and research experience in mental illness 
     and substance use disorders such as--
       ``(1) professionals with clinical and research expertise in 
     the prevention and treatment of, and recovery from, mental 
     illness and substance use disorders;
       ``(2) professionals with training and expertise in 
     statistics or research and survey design and methodologies; 
     and
       ``(3) other related fields in the social and behavioral 
     sciences, as specified by relevant position descriptions.
       ``(e) Grants and Contracts.--In carrying out the duties 
     established in subsection (b), the Director may make grants 
     to, and enter into contracts and cooperative agreements with, 
     public and nonprofit private entities.
       ``(f) Definition.--In this section, the term `emergency 
     room boarding' means the practice of admitting patients to an 
     emergency department and holding such patients in the 
     department until inpatient psychiatric beds become 
     available.''.

     SEC. 109. STRATEGIC PLAN.

       Section 501 of the Public Health Service Act (42 U.S.C. 
     290aa) is further amended--
       (1) by redesignating subsections (l) through (o) as 
     subsections (m) through (p), respectively; and
       (2) by inserting after subsection (k) the following:
       ``(l) Strategic Plan.--
       ``(1) In general.--Not later than December 1, 2017, and 
     every 5 years thereafter, the Assistant Secretary shall 
     develop and carry out a strategic plan in accordance with 
     this subsection for the planning and operation of evidence-
     based programs and grants carried out by the Administration.
       ``(2) Coordination.--In developing and carrying out the 
     strategic plan under this section, the Assistant Secretary 
     shall take into consideration the report of the 
     Interdepartmental Serious Mental Illness Coordinating 
     Committee under section 301 of the Helping Families in Mental 
     Health Crisis Act of 2016.
       ``(3) Publication of plan.--Not later than December 1, 
     2017, and every 5 years thereafter, the Assistant Secretary 
     shall--
       ``(A) submit the strategic plan developed under paragraph 
     (1) to the appropriate committees of Congress; and
       ``(B) post such plan on the Internet website of the 
     Administration.
       ``(4) Contents.--The strategic plan developed under 
     paragraph (1) shall--
       ``(A) identify strategic priorities, goals, and measurable 
     objectives for mental illness and substance use disorder 
     activities and programs operated and supported by the 
     Administration, including priorities to prevent or eliminate 
     the burden of mental illness and substance use disorders;
       ``(B) identify ways to improve services for individuals 
     with a mental illness or substance use disorder, including 
     services related to the prevention of, diagnosis of, 
     intervention in, treatment of, and recovery from, mental 
     illness or substance use disorders, including serious mental 
     illness or serious emotional disturbance, and access to 
     services and supports for individuals with a serious mental 
     illness or serious emotional disturbance;
       ``(C) ensure that programs provide, as appropriate, access 
     to effective and evidence-based prevention, diagnosis, 
     intervention, treatment, and recovery services, including 
     culturally and linguistically appropriate services, as 
     appropriate, for individuals with a mental illness or 
     substance use disorder;
       ``(D) identify opportunities to collaborate with the Health 
     Resources and Services Administration to develop or improve--
       ``(i) initiatives to encourage individuals to pursue 
     careers (especially in rural and underserved areas and 
     populations) as psychiatrists, psychologists, psychiatric 
     nurse practitioners, physician assistants, occupational 
     therapists, clinical social workers, certified peer-support 
     specialists, licensed professional counselors, or other 
     licensed or certified mental health professionals, including 
     such professionals specializing in the diagnosis, evaluation, 
     or treatment of individuals with a serious mental illness or 
     serious emotional disturbance; and
       ``(ii) a strategy to improve the recruitment, training, and 
     retention of a workforce for the treatment of individuals 
     with mental illness or substance use disorders, or co-
     occurring illness or disorders;
       ``(E) identify opportunities to improve collaboration with 
     States, local governments, communities, and Indian tribes and 
     tribal organizations (as such terms are defined in section 4 
     of the Indian Self-Determination and Education Assistance Act 
     (25 U.S.C. 450b)); and
       ``(F) specify a strategy to disseminate evidenced-based and 
     promising best practices related to prevention, diagnosis, 
     early intervention, treatment, and recovery services related 
     to mental illness, particularly for individuals with a 
     serious mental illness and children and adolescents with a 
     serious emotional disturbance, and substance use 
     disorders.''.

     SEC. 110. AUTHORITIES OF CENTERS FOR MENTAL HEALTH SERVICES 
                   AND SUBSTANCE ABUSE TREATMENT.

       (a) Center for Mental Health Services.--Section 520(b) of 
     the Public Health Service Act (42 U.S.C. 290bb-31(b)) is 
     amended--

[[Page H4305]]

       (1) by redesignating paragraphs (3) through (15) as 
     paragraphs (4) through (16), respectively;
       (2) by inserting after paragraph (2) the following:
       ``(3) collaborate with the Director of the National 
     Institute of Mental Health to ensure that, as appropriate, 
     programs related to the prevention and treatment of mental 
     illness and the promotion of mental health are carried out in 
     a manner that reflects the best available science and 
     evidence-based practices, including culturally and 
     linguistically appropriate services;'';
       (3) in paragraph (5), as so redesignated, by inserting 
     ``through policies and programs that reduce risk and promote 
     resiliency'' before the semicolon;
       (4) in paragraph (6), as so redesignated, by inserting ``in 
     collaboration with the Director of the National Institute of 
     Mental Health,'' before ``develop'';
       (5) in paragraph (8), as so redesignated, by inserting ``, 
     increase meaningful participation of individuals with mental 
     illness in programs and activities of the Administration,'' 
     before ``and protect the legal'';
       (6) in paragraph (10), as so redesignated, by striking 
     ``professional and paraprofessional personnel pursuant to 
     section 303'' and inserting ``paraprofessional personnel and 
     health professionals'';
       (7) in paragraph (11), as so redesignated, by inserting 
     ``and telemental health,'' after ``rural mental health,'';
       (8) in paragraph (12), as so redesignated, by striking 
     ``establish a clearinghouse for mental health information to 
     assure the widespread dissemination of such information'' and 
     inserting ``disseminate mental health information, including 
     evidenced-based practices,'';
       (9) in paragraph (15), as so redesignated, by striking 
     ``and'' at the end;
       (10) in paragraph (16), as so redesignated, by striking the 
     period and inserting ``; and''; and
       (11) by adding at the end the following:
       ``(17) consult with other agencies and offices of the 
     Department of Health and Human Services to ensure, with 
     respect to each grant awarded by the Center for Mental Health 
     Services, the consistent documentation of the application of 
     criteria when awarding grants and the ongoing oversight of 
     grantees after such grants are awarded.''.
       (b) Director of the Center for Substance Abuse Treatment.--
     Section 507 of the Public Health Service Act (42 U.S.C. 
     290bb) is amended--
       (1) in subsection (a)--
       (A) by striking ``treatment of substance abuse'' and 
     inserting ``treatment of substance use disorders''; and
       (B) by striking ``abuse treatment systems'' and inserting 
     ``use disorder treatment systems''; and
       (2) in subsection (b)--
       (A) in paragraph (3), by striking ``abuse'' and inserting 
     ``use disorder'';
       (B) in paragraph (4), by striking ``individuals who abuse 
     drugs'' and inserting ``individuals who use drugs'';
       (C) in paragraph (9), by striking ``carried out by the 
     Director'';
       (D) by striking paragraph (10);
       (E) by redesignating paragraphs (11) through (14) as 
     paragraphs (10) through (13), respectively;
       (F) in paragraph (12), as so redesignated, by striking ``; 
     and'' and inserting a semicolon; and
       (G) by striking paragraph (13), as so redesignated, and 
     inserting the following:
       ``(13) ensure the consistent documentation of the 
     application of criteria when awarding grants and the ongoing 
     oversight of grantees after such grants are awarded; and
       ``(14) work with States, providers, and individuals in 
     recovery, and their families, to promote the expansion of 
     recovery support services and systems of care oriented 
     towards recovery.''.

     SEC. 111. ADVISORY COUNCILS.

       Section 502(b) of the Public Health Service Act (42 U.S.C. 
     290aa-1(b)) is amended--
       (1) in paragraph (2)--
       (A) in subparagraph (E), by striking ``and'' after the 
     semicolon;
       (B) by redesignating subparagraph (F) as subparagraph (I); 
     and
       (C) by inserting after subparagraph (E), the following:
       ``(F) for the advisory councils appointed under subsections 
     (a)(1)(A) and (a)(1)(D), the Director of the National 
     Institute of Mental Health;
       ``(G) for the advisory councils appointed under subsections 
     (a)(1)(A), (a)(1)(B), and (a)(1)(C), the Director of the 
     National Institute on Drug Abuse;
       ``(H) for the advisory councils appointed under subsections 
     (a)(1)(A), (a)(1)(B), and (a)(1)(C), the Director of the 
     National Institute on Alcohol Abuse and Alcoholism; and''; 
     and
       (2) in paragraph (3), by adding at the end the following:
       ``(C) Not less than half of the members of the advisory 
     council appointed under subsection (a)(1)(D)--
       ``(i) shall have--

       ``(I) a medical degree;
       ``(II) a doctoral degree in psychology; or
       ``(III) an advanced degree in nursing or social work from 
     an accredited graduate school or be a certified physician 
     assistant; and

       ``(ii) shall specialize in the mental health field.''.

     SEC. 112. PEER REVIEW.

       Section 504(b) of the Public Health Service Act (42 U.S.C. 
     290aa-3(b)) is amended by adding at the end the following: 
     ``In the case of any such peer review group that is reviewing 
     a grant, cooperative agreement, or contract related to mental 
     illness treatment, not less than half of the members of such 
     peer review group shall be licensed and experienced 
     professionals in the prevention, diagnosis, or treatment of, 
     or recovery from, mental illness or substance use disorders 
     and have a medical degree, a doctoral degree in psychology, 
     or an advanced degree in nursing or social work from an 
     accredited program.''.

               TITLE II--MEDICAID MENTAL HEALTH COVERAGE

     SEC. 201. RULE OF CONSTRUCTION RELATED TO MEDICAID COVERAGE 
                   OF MENTAL HEALTH SERVICES AND PRIMARY CARE 
                   SERVICES FURNISHED ON THE SAME DAY.

       Nothing in title XIX of the Social Security Act (42 U.S.C. 
     1396 et seq.) shall be construed as prohibiting separate 
     payment under the State plan under such title (or under a 
     waiver of the plan) for the provision of a mental health 
     service or primary care service under such plan, with respect 
     to an individual, because such service is--
       (1) a primary care service furnished to the individual by a 
     provider at a facility on the same day a mental health 
     service is furnished to such individual by such provider (or 
     another provider) at the facility; or
       (2) a mental health service furnished to the individual by 
     a provider at a facility on the same day a primary care 
     service is furnished to such individual by such provider (or 
     another provider) at the facility.

     SEC. 202. OPTIONAL LIMITED COVERAGE OF INPATIENT SERVICES 
                   FURNISHED IN INSTITUTIONS FOR MENTAL DISEASES.

       (a) In General.--Section 1903(m)(2) of the Social Security 
     Act (42 U.S.C. 1396b(m)(2)) is amended by adding at the end 
     the following new subparagraph:
       ``(I)(i) Notwithstanding the limitation specified in the 
     subdivision (B) following paragraph (29) of section 1905(a) 
     and subject to clause (ii), a State may, under a risk 
     contract entered into by the State under this title (or under 
     section 1115) with a medicaid managed care organization or a 
     prepaid inpatient health plan (as defined in section 438.2 of 
     title 42, Code of Federal Regulations (or any successor 
     regulation)), make a monthly capitation payment to such 
     organization or plan for enrollees with the organization or 
     plan who are over 21 years of age and under 65 years of age 
     and are receiving inpatient treatment in an institution for 
     mental diseases (as defined in section 1905(i)), so long as 
     each of the following conditions is met:
       ``(I) The institution is a hospital providing inpatient 
     psychiatric or substance use disorder services or a sub-acute 
     facility providing psychiatric or substance use disorder 
     crisis residential services.
       ``(II) The length of stay in such an institution for such 
     treatment is for a short-term stay of no more than 15 days 
     during the period of the monthly capitation payment.
       ``(III) The provision of such treatment meets the following 
     criteria for consideration as services or settings that are 
     provided in lieu of services or settings covered under the 
     State plan:
       ``(aa) The State determines that the alternative service or 
     setting is a medically appropriate and cost-effective 
     substitute for the service or setting covered under the State 
     plan.
       ``(bb) The enrollee is not required by the managed care 
     organization or prepaid inpatient health plan to use the 
     alternative service or setting.
       ``(cc) Such treatment is authorized and identified in such 
     contract, and will be offered to such enrollees at the option 
     of the managed care organization or prepaid inpatient health 
     plan.
       ``(ii) For purposes of setting the amount of such a monthly 
     capitation payment, a State may use the utilization of 
     services provided to an individual under this subparagraph 
     when developing the inpatient psychiatric or substance use 
     disorder component of such payment, but the amount of such 
     payment for such services may not exceed the cost of the same 
     services furnished through providers included under the State 
     plan.''.
       (b) Effective Date.--The amendment made by subsection (a) 
     shall apply beginning on July 5, 2016, or the date of the 
     enactment of this Act, whichever is later.

     SEC. 203. STUDY AND REPORT RELATED TO MEDICAID MANAGED CARE 
                   REGULATION.

       (a) Study.--The Secretary of Health and Human Services, 
     acting through the Administrator of the Centers for Medicare 
     & Medicaid Services, shall conduct a study on coverage under 
     the Medicaid program under title XIX of the Social Security 
     Act (42 U.S.C. 1396 et seq.) of services provided through a 
     medicaid managed care organization (as defined in section 
     1903(m) of such Act (42 U.S.C. 1396b(m)) or a prepaid 
     inpatient health plan (as defined in section 438.2 of title 
     42, Code of Federal Regulations (or any successor 
     regulation)) with respect to individuals over the age of 21 
     and under the age of 65 for the treatment of a mental health 
     disorder in institutions for mental diseases (as defined in 
     section 1905(i) of such Act (42 U.S.C. 1396d(i))). Such study 
     shall include information on the following:
       (1) The extent to which States, including the District of 
     Columbia and each territory or possession of the United 
     States, are providing capitated payments to such 
     organizations or plans for enrollees who are receiving 
     services in institutions for mental diseases.

[[Page H4306]]

       (2) The number of individuals receiving medical assistance 
     under a State plan under such title XIX, or a waiver of such 
     plan, who receive services in institutions for mental 
     diseases through such organizations and plans.
       (3) The range of and average number of months, and the 
     length of stay during such months, that such individuals are 
     receiving such services in such institutions.
       (4) How such organizations or plans determine when to 
     provide for the furnishing of such services through an 
     institution for mental diseases in lieu of other benefits 
     (including the full range of community-based services) under 
     their contract with the State agency administering the State 
     plan under such title XIX, or a waiver of such plan, to 
     address psychiatric or substance use disorder treatment.
       (5) The extent to which the provision of services within 
     such institutions has affected the capitated payments for 
     such organizations or plans.
       (b) Report.--Not later than three years after the date of 
     the enactment of this Act, the Secretary shall submit to 
     Congress a report on the study conducted under subsection 
     (a).

     SEC. 204. GUIDANCE ON OPPORTUNITIES FOR INNOVATION.

       Not later than one year after the date of the enactment of 
     this Act, the Administrator of the Centers for Medicare & 
     Medicaid Services shall issue a State Medicaid Director 
     letter regarding opportunities to design innovative service 
     delivery systems, including systems for providing community-
     based services, for individuals with serious mental illness 
     or serious emotional disturbance who are receiving medical 
     assistance under title XIX of the Social Security Act (42 
     U.S.C. 1396 et seq.). The letter shall include opportunities 
     for demonstration projects under section 1115 of such Act (42 
     U.S.C. 1315), to improve care for such individuals.

     SEC. 205. STUDY AND REPORT ON MEDICAID EMERGENCY PSYCHIATRIC 
                   DEMONSTRATION PROJECT.

       (a) Collection of Information.--The Secretary of Health and 
     Human Services, acting through the Administrator of the 
     Centers for Medicare & Medicaid Services, shall, with respect 
     to each State that has participated in the demonstration 
     project established under section 2707 of the Patient 
     Protection and Affordable Care Act (42 U.S.C. 1396a note), 
     collect from each such State information on the following:
       (1) The number of institutions for mental diseases (as 
     defined in section 1905(i) of the Social Security Act (42 
     U.S.C. 1396d(i))) and beds in such institutions that received 
     payment for the provision of services to individuals who 
     receive medical assistance under a State plan under the 
     Medicaid program under title XIX of the Social Security Act 
     (42 U.S.C. 1396 et seq.) (or under a waiver of such plan) 
     through the demonstration project in each such State as 
     compared to the total number of institutions for mental 
     diseases and beds in the State.
       (2) The extent to which there is a reduction in 
     expenditures under the Medicaid program under title XIX of 
     the Social Security Act (42 U.S.C. 1396 et seq.) or other 
     spending on the full continuum of physical or mental health 
     care for individuals who receive treatment in an institution 
     for mental diseases under the demonstration project, 
     including outpatient, inpatient, emergency, and ambulatory 
     care, that is attributable to such individuals receiving 
     treatment in institutions for mental diseases under the 
     demonstration project.
       (3) The number of forensic psychiatric hospitals, the 
     number of beds in such hospitals, and the number of forensic 
     psychiatric beds in other hospitals in such State, based on 
     the most recent data available, to the extent practical, as 
     determined by such Administrator.
       (4) The amount of any disproportionate share hospital 
     payments under section 1923 of the Social Security Act (42 
     U.S.C. 1396r-4) that institutions for mental diseases in the 
     State received during the period beginning on July 1, 2012, 
     and ending on June 30, 2015, and the extent to which the 
     demonstration project reduced the amount of such payments.
       (5) The most recent data regarding all facilities or sites 
     in the State in which any individuals with serious mental 
     illness who are receiving medical assistance under a State 
     plan under the Medicaid program under title XIX of the Social 
     Security Act (42 U.S.C. 1396 et seq.) (or under a waiver of 
     such plan) are treated during the period referred to in 
     paragraph (4), to the extent practical, as determined by the 
     Administrator, including--
       (A) the types of such facilities or sites (such as an 
     institution for mental diseases, a hospital emergency 
     department, or other inpatient hospital);
       (B) the average length of stay in such a facility or site 
     by such an individual, disaggregated by facility type; and
       (C) the payment rate under the State plan (or a waivers of 
     such plan) for services furnished to such an individual for 
     that treatment, disaggregated by facility type, during the 
     period in which the demonstration project is in operation.
       (6) The extent to which the utilization of hospital 
     emergency departments during the period in which the 
     demonstration project was is in operation differed, with 
     respect to individuals who are receiving medical assistance 
     under a State plan under the Medicaid program under title XIX 
     of the Social Security Act (42 U.S.C. 1396 et seq.) (or under 
     a waiver of such plan), between--
       (A) those individuals who received treatment in an 
     institution for mental diseases under the demonstration 
     project;
       (B) those individuals who met the eligibility requirements 
     for the demonstration project but who did not receive 
     treatment in an institution for mental diseases under the 
     demonstration project; and
       (C) those individuals with serious mental illness who did 
     not meet such eligibility requirements and did not receive 
     treatment for such illness in an institution for mental 
     diseases.
       (b) Report.--Not later than two years after the date of the 
     enactment of this Act, the Secretary of Health and Human 
     Services shall submit to Congress a report that summarizes 
     and analyzes the information collected under subsection (a). 
     Such report may be submitted as part of the report required 
     under section 2707(f) of the Patient Protection and 
     Affordable Care Act (42 U.S.C. 1396a note) or separately.

     SEC. 206. PROVIDING EPSDT SERVICES TO CHILDREN IN IMDS.

       (a) In General.--Section 1905(a)(16) of the Social Security 
     Act (42 U.S.C. 1396d(a)(16)) is amended--
       (1) by striking ``effective January 1, 1973'' and inserting 
     ``(A) effective January 1, 1973''; and
       (2) by inserting before the semicolon at the end the 
     following: ``, and, (B) for individuals receiving services 
     described in subparagraph (A), early and periodic screening, 
     diagnostic, and treatment services (as defined in subsection 
     (r)), whether or not such screening, diagnostic, and 
     treatment services are furnished by the provider of the 
     services described in such subparagraph''.
       (b) Effective Date.--The amendment made by subsection (a) 
     shall apply with respect to items and services furnished in 
     calendar quarters beginning on or after January 1, 2019.

     SEC. 207. ELECTRONIC VISIT VERIFICATION SYSTEM REQUIRED FOR 
                   PERSONAL CARE SERVICES AND HOME HEALTH CARE 
                   SERVICES UNDER MEDICAID.

       (a) In General.--Section 1903 of the Social Security Act 
     (42 U.S.C. 1396b) is amended by inserting after subsection 
     (k) the following new subsection:
       ``(l)(1) Subject to paragraphs (3) and (4), with respect to 
     any amount expended for personal care services or home health 
     care services requiring an in-home visit by a provider that 
     are provided under a State plan under this title (or under a 
     waiver of the plan) and furnished in a calendar quarter 
     beginning on or after January 1, 2019 (or, in the case of 
     home health care services, on or after January 1, 2023), 
     unless a State requires the use of an electronic visit 
     verification system for such services furnished in such 
     quarter under the plan or such waiver, the Federal medical 
     assistance percentage shall be reduced--
       ``(A) in the case of personal care services--
       ``(i) for calendar quarters in 2019 and 2020, by .25 
     percentage points;
       ``(ii) for calendar quarters in 2021, by .5 percentage 
     points;
       ``(iii) for calendar quarters in 2022, by .75 percentage 
     points; and
       ``(iv) for calendar quarters in 2023 and each year 
     thereafter, by 1 percentage point; and
       ``(B) in the case of home health care services--
       ``(i) for calendar quarters in 2023 and 2024, by .25 
     percentage points;
       ``(ii) for calendar quarters in 2025, by .5 percentage 
     points;
       ``(iii) for calendar quarters in 2026, by .75 percentage 
     points; and
       ``(iv) for calendar quarters in 2027 and each year 
     thereafter, by 1 percentage point.
       ``(2) Subject to paragraphs (3) and (4), in implementing 
     the requirement for the use of an electronic visit 
     verification system under paragraph (1), a State shall--
       ``(A) consult with agencies and entities that provide 
     personal care services, home health care services, or both 
     under the State plan (or under a waiver of the plan) to 
     ensure that such system--
       ``(i) is minimally burdensome;
       ``(ii) takes into account existing best practices and 
     electronic visit verification systems in use in the State; 
     and
       ``(iii) is conducted in accordance with the requirements of 
     HIPAA privacy and security law (as defined in section 3009 of 
     the Public Health Service Act);
       ``(B) take into account a stakeholder process that includes 
     input from beneficiaries, family caregivers, individuals who 
     furnish personal care services or home health care services, 
     and other stakeholders, as determined by the State in 
     accordance with guidance from the Secretary; and
       ``(C) ensure that individuals who furnish personal care 
     services, home health care services, or both under the State 
     plan (or under a waiver of the plan) are provided the 
     opportunity for training on the use of such system.
       ``(3) Paragraphs (1) and (2) shall not apply in the case of 
     a State that, as of the date of the enactment of this 
     subsection, requires the use of any system for the electronic 
     verification of visits conducted as part of both personal 
     care services and home health care services, so long as the 
     State continues to require the use of such system with 
     respect to the electronic verification of such visits.
       ``(4)(A) In the case of a State described in subparagraph 
     (B), the reduction under paragraph (1) shall not apply--

[[Page H4307]]

       ``(i) in the case of personal care services, for calendar 
     quarters in 2019; and
       ``(ii) in the case of home health care services, for 
     calendar quarters in 2023.
       ``(B) For purposes of subparagraph (A), a State described 
     in this subparagraph is a State that demonstrates to the 
     Secretary that the State--
       ``(i) has made a good faith effort to comply with the 
     requirements of paragraphs (1) and (2) (including by taking 
     steps to adopt the technology used for an electronic visit 
     verification system); or
       ``(ii) in implementing such a system, has encountered 
     unavoidable system delays.
       ``(5) In this subsection:
       ``(A) The term `electronic visit verification system' 
     means, with respect to personal care services or home health 
     care services, a system under which visits conducted as part 
     of such services are electronically verified with respect 
     to--
       ``(i) the type of service performed;
       ``(ii) the individual receiving the service;
       ``(iii) the date of the service;
       ``(iv) the location of service delivery;
       ``(v) the individual providing the service; and
       ``(vi) the time the service begins and ends.
       ``(B) The term `home health care services' means services 
     described in section 1905(a)(7) provided under a State plan 
     under this title (or under a waiver of the plan).
       ``(C) The term `personal care services' means personal care 
     services provided under a State plan under this title (or 
     under a waiver of the plan), including services provided 
     under section 1905(a)(24), 1915(c), 1915(i), 1915(j), or 
     1915(k) or under a wavier under section 1115.
       ``(6)(A) In the case in which a State requires personal 
     care service and home health care service providers to 
     utilize an electronic visit verification system operated by 
     the State or a contractor on behalf of the State, the 
     Secretary shall pay to the State, for each quarter, an amount 
     equal to 90 per centum of so much of the sums expended during 
     such quarter as are attributable to the design, development, 
     or installation of such system, and 75 per centum of so much 
     of the sums for the operation and maintenance of such system.
       ``(B) Subparagraph (A) shall not apply in the case in which 
     a State requires personal care service and home health care 
     service providers to utilize an electronic visit verification 
     system that is not operated by the State or a contractor on 
     behalf of the State.''.
       (b) Collection and Dissemination of Best Practices.--Not 
     later than January 1, 2018, the Secretary of Health and Human 
     Services shall, with respect to electronic visit verification 
     systems (as defined in subsection (l)(5) of section 1903 of 
     the Social Security Act (42 U.S.C. 1396b), as inserted by 
     subsection (a)), collect and disseminate best practices to 
     State Medicaid Directors with respect to--
       (1) training individuals who furnish personal care 
     services, home health care services, or both under the State 
     plan under title XIX of such Act (or under a waiver of the 
     plan) on such systems and the operation of such systems and 
     the prevention of fraud with respect to the provision of 
     personal care services or home health care services (as 
     defined in such subsection (l)(5)); and
       (2) the provision of notice and educational materials to 
     family caregivers and beneficiaries with respect to the use 
     of such electronic visit verification systems and other means 
     to prevent such fraud.
       (c) Rules of Construction.--
       (1) No employer-employee relationship established.--Nothing 
     in the amendment made by this section may be construed as 
     establishing an employer-employee relationship between the 
     agency or entity that provides for personal care services or 
     home health care services and the individuals who, under a 
     contract with such an agency or entity, furnish such services 
     for purposes of part 552 of title 29, Code of Federal 
     Regulations (or any successor regulations).
       (2) No particular or uniform electronic visit verification 
     system required.--Nothing in the amendment made by this 
     section shall be construed to require the use of a particular 
     or uniform electronic visit verification system (as defined 
     in subsection (l)(5) of section 1903 of the Social Security 
     Act (42 U.S.C. 1396b), as inserted by subsection (a)) by all 
     agencies or entities that provide personal care services or 
     home health care under a State plan under title XIX of the 
     Social Security Act (or under a waiver of the plan) (42 
     U.S.C. 1396 et seq.).
       (3) No limits on provision of care.--Nothing in the 
     amendment made by this section may be construed to limit, 
     with respect to personal care services or home health care 
     services provided under a State plan under title XIX of the 
     Social Security Act (or under a waiver of the plan) (42 
     U.S.C. 1396 et seq.), provider selection, constrain 
     beneficiaries' selection of a caregiver, or impede the manner 
     in which care is delivered.
       (4) No prohibition on state quality measures 
     requirements.--Nothing in the amendment made by this section 
     shall be construed as prohibiting a State, in implementing an 
     electronic visit verification system (as defined in 
     subsection (l)(5) of section 1903 of the Social Security Act 
     (42 U.S.C. 1396b), as inserted by subsection (a)), from 
     establishing requirements related to quality measures for 
     such system.

   TITLE III--INTERDEPARTMENTAL SERIOUS MENTAL ILLNESS COORDINATING 
                               COMMITTEE

     SEC. 301. INTERDEPARTMENTAL SERIOUS MENTAL ILLNESS 
                   COORDINATING COMMITTEE.

       (a) Establishment.--
       (1) In general.--Not later than 3 months after the date of 
     enactment of this Act, the Secretary of Health and Human 
     Services, or the designee of the Secretary, shall establish a 
     committee to be known as the ``Interdepartmental Serious 
     Mental Illness Coordinating Committee'' (in this section 
     referred to as the ``Committee'').
       (2) Federal advisory committee act.--Except as provided in 
     this section, the provisions of the Federal Advisory 
     Committee Act (5 U.S.C. App.) shall apply to the Committee.
       (b) Meetings.--The Committee shall meet not fewer than 2 
     times each year.
       (c) Responsibilities.--Not later than 1 year after the date 
     of enactment of this Act, and 5 years after such date of 
     enactment, the Committee shall submit to Congress a report 
     including--
       (1) a summary of advances in serious mental illness and 
     serious emotional disturbance research related to the 
     prevention of, diagnosis of, intervention in, and treatment 
     and recovery of, serious mental illnesses, serious emotional 
     disturbances, and advances in access to services and support 
     for individuals with a serious mental illness or serious 
     emotional disturbance;
       (2) an evaluation of the effect on public health of Federal 
     programs related to serious mental illness or serious 
     emotional disturbance, including measurements of public 
     health outcomes such as--
       (A) rates of suicide, suicide attempts, prevalence of 
     serious mental illness, serious emotional disturbances, and 
     substance use disorders, overdose, overdose deaths, emergency 
     hospitalizations, emergency room boarding, preventable 
     emergency room visits, involvement with the criminal justice 
     system, crime, homelessness, and unemployment;
       (B) increased rates of employment and enrollment in 
     educational and vocational programs;
       (C) quality of mental illness and substance use disorder 
     treatment services; and
       (D) any other criteria as may be determined by the 
     Secretary;
       (3) a plan to improve outcomes for individuals with serious 
     mental illness or serious emotional disturbances, including 
     reducing incarceration for such individuals, reducing 
     homelessness, and increasing employment; and
       (4) specific recommendations for actions that agencies can 
     take to better coordinate the administration of mental health 
     services for people with serious mental illness or serious 
     emotional disturbances.
       (d) Committee Extension.--Upon the submission of the second 
     report under subsection (c), the Secretary shall submit a 
     recommendation to Congress on whether to extend the operation 
     of the Committee.
       (e) Membership.--
       (1) Federal members.--The Committee shall be composed of 
     the following Federal representatives, or their designees:
       (A) The Secretary of Health and Human Services, who shall 
     serve as the Chair of the Committee.
       (B) The Director of the National Institutes of Health.
       (C) The Assistant Secretary for Health of the Department of 
     Health and Human Services.
       (D) The Assistant Secretary for Mental Health and Substance 
     Use.
       (E) The Attorney General of the United States.
       (F) The Secretary of Veterans Affairs.
       (G) The Secretary of Defense.
       (H) The Secretary of Housing and Urban Development.
       (I) The Secretary of Education.
       (J) The Secretary of Labor.
       (K) The Commissioner of Social Security.
       (L) The Administrator of the Centers for Medicare & 
     Medicaid Services.
       (2) Non-federal members.--The Committee shall also include 
     not less than 14 non-Federal public members appointed by the 
     Secretary of Health and Human Services, of which--
       (A) at least 2 members shall be individuals with lived 
     experience with serious mental illness or serious emotional 
     disturbance;
       (B) at least 1 member shall be a parent or legal guardian 
     of an individual with a history of a serious mental illness 
     or serious emotional disturbance;
       (C) at least 1 member shall be a representative of a 
     leading research, advocacy, or service organization for 
     individuals with serious mental illness or serious emotional 
     disturbance;
       (D) at least 2 members shall be--
       (i) a licensed psychiatrist with experience treating 
     serious mental illnesses or serious emotional disturbances;
       (ii) a licensed psychologist with experience treating 
     serious mental illnesses or serious emotional disturbances;
       (iii) a licensed clinical social worker with experience 
     treating serious mental illness or serious emotional 
     disturbances; or
       (iv) a licensed psychiatric nurse, nurse practitioner, or 
     physician assistant with experience treating serious mental 
     illnesses or serious emotional disturbances;
       (E) at least 1 member shall be a licensed mental health 
     professional with a specialty in treating children and 
     adolescents with serious emotional disturbances;

[[Page H4308]]

       (F) at least 1 member shall be a mental health professional 
     who has research or clinical mental health experience working 
     with minorities;
       (G) at least 1 member shall be a mental health professional 
     who has research or clinical mental health experience working 
     with medically underserved populations;
       (H) at least 1 member shall be a State certified mental 
     health peer-support specialist;
       (I) at least 1 member shall be a judge with experience 
     adjudicating cases within a mental health court;
       (J) at least 1 member shall be a law enforcement officer or 
     corrections officer with extensive experience in interfacing 
     with individuals with a serious mental illness or serious 
     emotional disturbance, or in a mental health crisis; and
       (K) at least 1 member shall be a homeless services provider 
     with experience working with individuals with serious mental 
     illness, with serious emotional disturbance, or having mental 
     health crisis.
       (3) Terms.--A member of the Committee appointed under 
     paragraph (2) shall serve for a term of 3 years, and may be 
     reappointed for one or more additional 3-year terms. Any 
     member appointed to fill a vacancy for an unexpired term 
     shall be appointed for the remainder of such term. A member 
     may serve after the expiration of the member's term until a 
     successor has been appointed.
       (f) Working Groups.--In carrying out its functions, the 
     Committee may establish working groups. Such working groups 
     shall be composed of Committee members, or their designees, 
     and may hold such meetings as are necessary.
       (g) Sunset.--The Committee shall terminate on the date that 
     is 6 years after the date on which the Committee is 
     established under subsection (a)(1).

             TITLE IV--COMPASSIONATE COMMUNICATION ON HIPAA

     SEC. 401. SENSE OF CONGRESS.

       (a) Findings.--Congress finds the following:
       (1) The vast majority of individuals with mental illness 
     are capable of understanding their illness and caring for 
     themselves.
       (2) Persons with serious mental illness (in this section 
     referred to as ``SMI''), including schizophrenia spectrum, 
     bipolar disorders, and major depressive disorder, may be 
     significantly impaired in their ability to understand or make 
     sound decisions for their care and needs. By nature of their 
     illness, cognitive impairments in reasoning and judgment, as 
     well as the presence of hallucinations, delusions, and severe 
     emotional distortions, they may lack the awareness they even 
     have a mental illness (a condition known as anosognosia), and 
     thus may be unable to make sound decisions regarding their 
     care, nor follow through consistently and effectively on 
     their care needs.
       (3) Persons with mental illness or SMI may require and 
     benefit from mental health treatment in order to recover to 
     the fullest extent of their ability; these beneficial 
     interventions may include psychiatric care, psychological 
     care, medication, peer support, educational support, 
     employment support, and housing support.
       (4) Persons with SMI who are provided with professional and 
     supportive services may still experience times when their 
     symptoms may greatly impair their abilities to make sound 
     decisions for their personal care or may discontinue their 
     care as a result of this impaired decisionmaking resulting in 
     a further deterioration of their condition. They may 
     experience a temporary or prolonged impairment as a result of 
     their diminished capacity to care for themselves.
       (5) Episodes of psychiatric crises among those with SMI can 
     result in neurological harm to the individual's brain.
       (6) Persons with SMI--
       (A) are at high risk for other chronic physical illnesses, 
     with approximately 50 percent having two or more co-occurring 
     chronic physical illnesses such as cardiac, pulmonary, 
     cancer, and endocrine disorders; and
       (B) have three times the odds of having chronic bronchitis, 
     five times the odds of having emphysema, and four times the 
     odds of having COPD, are more than four times as likely to 
     have fluid and electrolyte disorders, and are nearly three 
     times as likely to be nicotine dependent.
       (7) Some psychotropic medications, such as second 
     generation antipsychotics, significantly increase risk for 
     chronic illnesses such as diabetes and cardiovascular 
     disease.
       (8) When the individual fails to seek or maintain treatment 
     for these physical conditions over a long term, it can result 
     in the individual becoming gravely disabled, or developing 
     life-threatening illnesses. Early and consistent treatment 
     can ameliorate or reduce symptoms or cure the disease.
       (9) Persons with SMI die 7 to 24 years earlier than their 
     age cohorts primarily because of complications from their 
     chronic physical illness and failure to seek or maintain 
     treatment resulting from emotional and cognitive impairments 
     from their SMI.
       (10) It is beneficial to the person with SMI and chronic 
     illness to seek and maintain continuity of medical care and 
     treatment for their mental illness to prevent further 
     deterioration and harm to their own safety.
       (11) When the individual with SMI is significantly 
     diminished in their capacity to care for themselves long term 
     or acutely, other supportive interventions to assist their 
     care may be necessary to protect their health and safety.
       (12) Prognosis for the physical and psychiatric health of 
     those with SMI may improve when responsible caregivers 
     facilitate and participate in care.
       (13) When an individual with SMI is chronically 
     incapacitated in their ability to care for themselves, 
     caregivers can pursue legal guardianship to facilitate care 
     in appropriate areas while being mindful to allow the 
     individual to make decisions for themselves in areas where 
     they are capable.
       (14) Individuals with SMI who have prolonged periods of 
     being significantly functional can, during such periods, 
     design and sign an advanced directive to predefine and choose 
     medications, providers, treatment plans, and hospitals, and 
     provide caregivers with guardianship the ability to help in 
     those times when a patient's psychiatric symptoms worsen to 
     the point of making them incapacitated or leaving them with a 
     severely diminished capacity to make informed decisions about 
     their care which may result in harm to their physical and 
     mental health.
       (15) All professional and support efforts should be made to 
     help the individual with SMI and acute or chronic physical 
     illnesses to understand and follow through on treatment.
       (16) When individuals with SMI, even after efforts to help 
     them understand, have failed to care for themselves, there 
     exists confusion in the health care community around what is 
     currently permissible under HIPAA rules. This confusion may 
     hinder communication with responsible caregivers who may be 
     able to facilitate care for the patient with SMI in instances 
     when the individual does not give permission for disclosure.
       (b) Sense of Congress.--It is the sense of the Congress 
     that, for the sake of the health and safety of persons with 
     serious mental illness, more clarity is needed surrounding 
     the existing HIPAA privacy rule promulgated pursuant to 
     section 264(c) of the Health Insurance Portability and 
     Accountability Act (42 U.S.C. 1320d-2 note) to permit health 
     care professionals to communicate, when necessary, with 
     responsible known caregivers of such persons, the limited, 
     appropriate protected health information of such persons in 
     order to facilitate treatment, but not including 
     psychotherapy notes.

     SEC. 402. CONFIDENTIALITY OF RECORDS.

       Not later than one year after the date on which the 
     Secretary of Health and Human Services first finalizes 
     regulations updating part 2 of title 42, Code of Federal 
     Regulations (relating to confidentiality of alcohol and drug 
     abuse patient records) after the date of enactment of this 
     Act, the Secretary shall convene relevant stakeholders to 
     determine the effect of such regulations on patient care, 
     health outcomes, and patient privacy. The Secretary shall 
     submit to the Committee on Energy and Commerce of the House 
     of Representatives and the Committee on Health, Education, 
     Labor, and Pensions of the Senate, and make publicly 
     available, a report on the findings of such stakeholders.

     SEC. 403. CLARIFICATION OF CIRCUMSTANCES UNDER WHICH 
                   DISCLOSURE OF PROTECTED HEALTH INFORMATION IS 
                   PERMITTED.

       (a) In General.--Not later than one year after the date of 
     enactment of this section, the Secretary of Health and Human 
     Services shall promulgate final regulations clarifying the 
     circumstances under which, consistent with the provisions of 
     subpart C of title XI of the Social Security Act (42 U.S.C. 
     1320d et seq.) and regulations promulgated pursuant to 
     section 264(c) of the Health Insurance Portability and 
     Accountability Act of 1996 (42 U.S.C. 1320d-2 note), a health 
     care provider or covered entity may disclose the protected 
     health information of a patient with a mental illness, 
     including for purposes of--
       (1) communicating (including with respect to treatment, 
     side effects, risk factors, and the availability of community 
     resources) with a family member of such patient, caregiver of 
     such patient, or other individual to the extent that such 
     family member, caregiver, or individual is involved in the 
     care of the patient;
       (2) communicating with a family member of the patient, 
     caregiver of such patient, or other individual involved in 
     the care of the patient in the case that the patient is an 
     adult;
       (3) communicating with the parent or caregiver of a patient 
     in the case that the patient is a minor;
       (4) considering the patient's capacity to agree or object 
     to the sharing of the protected health information of the 
     patient;
       (5) communicating and sharing information with the family 
     or caregivers of the patient when--
       (A) the patient consents;
       (B) the patient does not consent, but the patient lacks the 
     capacity to agree or object and the communication or sharing 
     of information is in the patient's best interest;
       (C) the patient does not consent and the patient is not 
     incapacitated or in an emergency circumstance, but the 
     ability of the patient to make rational health care decisions 
     is significantly diminished by reason of the physical or 
     mental health condition of the patient; and
       (D) the patient does not consent, but such communication 
     and sharing of information is necessary to prevent impending 
     and serious deterioration of the patient's mental or physical 
     health;
       (6) involving a patient's family members, caregivers, or 
     others involved in the patient's care or care plan, including 
     facilitating treatment and medication adherence,

[[Page H4309]]

     in dealing with patient failures to adhere to medication or 
     other therapy;
       (7) listening to or receiving information with respect to 
     the patient from the family or caregiver of such patient 
     receiving mental illness treatment;
       (8) communicating with family members of the patient, 
     caregivers of the patient, law enforcement, or others when 
     the patient presents a serious and imminent threat of harm to 
     self or others; and
       (9) communicating to law enforcement and family members of 
     the patient or caregivers of the patient about the admission 
     of the patient to receive care at a facility or the release 
     of a patient who was admitted to a facility for an emergency 
     psychiatric hold or involuntary treatment.
       (b) Coordination.--The Secretary of Health and Human 
     Services shall carry out this section in coordination with 
     the Director of the Office for Civil Rights within the 
     Department of Health and Human Services.
       (c) Consistency With Guidance.--The Secretary of Health and 
     Human Services shall ensure that the regulations under this 
     section are consistent with the guidance entitled ``HIPAA 
     Privacy Rule and Sharing Information Related to Mental 
     Health'', issued by the Department of Health and Human 
     Services on February 20, 2014.

     SEC. 404. DEVELOPMENT AND DISSEMINATION OF MODEL TRAINING 
                   PROGRAMS.

       (a) Initial Programs and Materials.--Not later than one 
     year after the date of the enactment of this Act, the 
     Secretary of Health and Human Services (in this section 
     referred to as the ``Secretary'') shall develop and 
     disseminate--
       (1) a model program and materials for training health care 
     providers (including physicians, emergency medical personnel, 
     psychologists, counselors, therapists, behavioral health 
     facilities and clinics, care managers, and hospitals) 
     regarding the circumstances under which, consistent with the 
     standards governing the privacy and security of individually 
     identifiable health information promulgated by the Secretary 
     under subpart C of title XI of the Social Security Act (42 
     U.S.C. 1320d et seq.) and regulations promulgated pursuant to 
     section 264(c) of the Health Insurance Portability and 
     Accountability Act of 1996 (42 U.S.C. 1320d-2 note), the 
     protected health information of patients with a mental 
     illness may be disclosed with and without patient consent;
       (2) a model program and materials for training lawyers and 
     others in the legal profession on such circumstances; and
       (3) a model program and materials for training patients and 
     their families regarding their rights to protect and obtain 
     information under the standards specified in paragraph (1).
       (b) Periodic Updates.--The Secretary shall--
       (1) periodically review and update the model programs and 
     materials developed under subsection (a); and
       (2) disseminate the updated model programs and materials.
       (c) Contents.--The programs and materials developed under 
     subsection (a) shall address the guidance entitled ``HIPAA 
     Privacy Rule and Sharing Information Related to Mental 
     Health'', issued by the Department of Health and Human 
     Services on February 20, 2014.
       (d) Coordination.--The Secretary shall carry out this 
     section in coordination with the Director of the Office for 
     Civil Rights within the Department of Health and Human 
     Services, the Assistant Secretary for Mental Health and 
     Substance Use, the Administrator of the Health Resources and 
     Services Administration, and the heads of other relevant 
     agencies within the Department of Health and Human Services.
       (e) Input of Certain Entities.--In developing the model 
     programs and materials required by subsections (a) and (b), 
     the Secretary shall solicit the input of relevant national, 
     State, and local associations, medical societies, and 
     licensing boards.
       (f) Funding.--There are authorized to be appropriated to 
     carry out this section $4,000,000 for fiscal year 2018, 
     $2,000,000 for each of fiscal years 2019 and 2020, and 
     $1,000,000 for each of fiscal years 2021 and 2022.

   TITLE V--INCREASING ACCESS TO TREATMENT FOR SERIOUS MENTAL ILLNESS

     SEC. 501. ASSERTIVE COMMUNITY TREATMENT GRANT PROGRAM FOR 
                   INDIVIDUALS WITH SERIOUS MENTAL ILLNESS.

       Part B of title V of the Public Health Service Act (42 
     U.S.C. 290bb et seq.) is amended by inserting after section 
     520L the following:

     ``SEC. 520M. ASSERTIVE COMMUNITY TREATMENT GRANT PROGRAM FOR 
                   INDIVIDUALS WITH SERIOUS MENTAL ILLNESS.

       ``(a) In General.--The Assistant Secretary shall award 
     grants to eligible entities--
       ``(1) to establish assertive community treatment programs 
     for individuals with serious mental illness; or
       ``(2) to maintain or expand such programs.
       ``(b) Eligible Entities.--To be eligible to receive a grant 
     under this section, an entity shall be a State, county, city, 
     tribe, tribal organization, mental health system, health care 
     facility, or any other entity the Assistant Secretary deems 
     appropriate.
       ``(c) Special Consideration.--In selecting among applicants 
     for a grant under this section, the Assistant Secretary may 
     give special consideration to the potential of the 
     applicant's program to reduce hospitalization, homelessness, 
     and involvement with the criminal justice system while 
     improving the health and social outcomes of the patient.
       ``(d) Additional Activities.--The Assistant Secretary 
     shall--
       ``(1) not later than the end of fiscal year 2021, submit a 
     report to the appropriate congressional committees on the 
     grant program under this section, including an evaluation 
     of--
       ``(A) cost savings and public health outcomes such as 
     mortality, suicide, substance abuse, hospitalization, and use 
     of services;
       ``(B) rates of involvement with the criminal justice system 
     of patients;
       ``(C) rates of homelessness among patients; and
       ``(D) patient and family satisfaction with program 
     participation; and
       ``(2) provide appropriate information, training, and 
     technical assistance to grant recipients under this section 
     to help such recipients to establish, maintain, or expand 
     their assertive community treatment programs.
       ``(e) Authorization of Appropriations.--
       ``(1) In general.--To carry out this section, there is 
     authorized to be appropriated $5,000,000 for the period of 
     fiscal years 2018 through 2022.
       ``(2) Use of certain funds.--Of the funds appropriated to 
     carry out this section in any fiscal year, no more than 5 
     percent shall be available to the Assistant Secretary for 
     carrying out subsection (d).''.

     SEC. 502. STRENGTHENING COMMUNITY CRISIS RESPONSE SYSTEMS.

       Section 520F of the Public Health Service Act (42 U.S.C. 
     290bb-37) is amended to read as follows:

     ``SEC. 520F. STRENGTHENING COMMUNITY CRISIS RESPONSE SYSTEMS.

       ``(a) In General.--The Secretary shall award competitive 
     grants--
       ``(1) to State and local governments and Indian tribes and 
     tribal organizations to enhance community-based crisis 
     response systems; or
       ``(2) to States to develop, maintain, or enhance a database 
     of beds at inpatient psychiatric facilities, crisis 
     stabilization units, and residential community mental health 
     and residential substance use disorder treatment facilities, 
     for individuals with serious mental illness, serious 
     emotional disturbance, or substance use disorders.
       ``(b) Application.--
       ``(1) In general.--To receive a grant or cooperative 
     agreement under subsection (a), an entity shall submit to the 
     Secretary an application, at such time, in such manner, and 
     containing such information as the Secretary may require.
       ``(2) Community-based crisis response plan.--An application 
     for a grant under subsection (a)(1) shall include a plan 
     for--
       ``(A) promoting integration and coordination between local 
     public and private entities engaged in crisis response, 
     including first responders, emergency health care providers, 
     primary care providers, law enforcement, court systems, 
     health care payers, social service providers, and behavioral 
     health providers;
       ``(B) developing a plan for entering into memoranda of 
     understanding with public and private entities to implement 
     crisis response services;
       ``(C) expanding the continuum of community-based services 
     to address crisis intervention and prevention; and
       ``(D) developing models for minimizing hospital 
     readmissions, including through appropriate discharge 
     planning.
       ``(3) Beds database plan.--An application for a grant under 
     subsection (a)(2) shall include a plan for developing, 
     maintaining, or enhancing a real-time Internet-based bed 
     database to collect, aggregate, and display information about 
     beds in inpatient psychiatric facilities and crisis 
     stabilization units, and residential community mental health 
     and residential substance use disorder treatment facilities, 
     to facilitate the identification and designation of 
     facilities for the temporary treatment of individuals in 
     mental or substance use disorder crisis.
       ``(c) Database Requirements.--A bed database described in 
     this section is a database that--
       ``(1) includes information on inpatient psychiatric 
     facilities, crisis stabilization units, and residential 
     community mental health and residential substance use 
     disorder facilities in the State involved, including contact 
     information for the facility or unit;
       ``(2) provides real-time information about the number of 
     beds available at each facility or unit and, for each 
     available bed, the type of patient that may be admitted, the 
     level of security provided, and any other information that 
     may be necessary to allow for the proper identification of 
     appropriate facilities for treatment of individuals in mental 
     or substance use disorder crisis; and
       ``(3) enables searches of the database to identify 
     available beds that are appropriate for the treatment of 
     individuals in mental or substance use disorder crisis.
       ``(d) Evaluation.--An entity receiving a grant under 
     subsection (a)(1) shall submit to the Secretary, at such 
     time, in such manner, and containing such information as the 
     Secretary may reasonably require, a report, including an 
     evaluation of the effect of such grant on--
       ``(1) local crisis response services and measures of 
     individuals receiving crisis planning and early intervention 
     supports;
       ``(2) individuals reporting improved functional outcomes; 
     and
       ``(3) individuals receiving regular followup care following 
     a crisis.
       ``(e) Authorization of Appropriations.--There is authorized 
     to be appropriated to

[[Page H4310]]

     carry out this section, $5,000,000 for the period of fiscal 
     years 2018 through 2022.''.

     SEC. 503. INCREASED AND EXTENDED FUNDING FOR ASSISTED 
                   OUTPATIENT GRANT PROGRAM FOR INDIVIDUALS WITH 
                   SERIOUS MENTAL ILLNESS.

       Section 224(g) of the Protecting Access to Medicare Act of 
     2014 (42 U.S.C. 290aa note) is amended--
       (1) in paragraph (1), by striking ``2018'' and inserting 
     ``2022''; and
       (2) in paragraph (2), by striking ``is authorized to be 
     appropriated to carry out this section $15,000,000 for each 
     of fiscal years 2015 through 2018'' and inserting ``are 
     authorized to be appropriated to carry out this section 
     $15,000,000 for each of fiscal years 2015 through 2017, 
     $20,000,000 for fiscal year 2018, $19,000,000 for each of 
     fiscal years 2019 and 2020, and $18,000,000 for each of 
     fiscal years 2021 and 2022''.

     SEC. 504. LIABILITY PROTECTIONS FOR HEALTH PROFESSIONAL 
                   VOLUNTEERS AT COMMUNITY HEALTH CENTERS.

       Section 224 of the Public Health Service Act (42 U.S.C. 
     233) is amended by adding at the end the following:
       ``(q)(1) For purposes of this section, a health 
     professional volunteer at an entity described in subsection 
     (g)(4) shall, in providing a health professional service 
     eligible for funding under section 330 to an individual, be 
     deemed to be an employee of the Public Health Service for a 
     calendar year that begins during a fiscal year for which a 
     transfer was made under paragraph (4)(C). The preceding 
     sentence is subject to the provisions of this subsection.
       ``(2) In providing a health service to an individual, a 
     health care practitioner shall for purposes of this 
     subsection be considered to be a health professional 
     volunteer at an entity described in subsection (g)(4) if the 
     following conditions are met:
       ``(A) The service is provided to the individual at the 
     facilities of an entity described in subsection (g)(4), or 
     through offsite programs or events carried out by the entity.
       ``(B) The entity is sponsoring the health care practitioner 
     pursuant to paragraph (3)(B).
       ``(C) The health care practitioner does not receive any 
     compensation for the service from the individual or from any 
     third-party payer (including reimbursement under any 
     insurance policy or health plan, or under any Federal or 
     State health benefits program), except that the health care 
     practitioner may receive repayment from the entity described 
     in subsection (g)(4) for reasonable expenses incurred by the 
     health care practitioner in the provision of the service to 
     the individual.
       ``(D) Before the service is provided, the health care 
     practitioner or the entity described in subsection (g)(4) 
     posts a clear and conspicuous notice at the site where the 
     service is provided of the extent to which the legal 
     liability of the health care practitioner is limited pursuant 
     to this subsection.
       ``(E) At the time the service is provided, the health care 
     practitioner is licensed or certified in accordance with 
     applicable law regarding the provision of the service.
       ``(3) Subsection (g) (other than paragraphs (3) and (5)) 
     and subsections (h), (i), and (l) apply to a health care 
     practitioner for purposes of this subsection to the same 
     extent and in the same manner as such subsections apply to an 
     officer, governing board member, employee, or contractor of 
     an entity described in subsection (g)(4), subject to 
     paragraph (4) and subject to the following:
       ``(A) The first sentence of paragraph (1) applies in lieu 
     of the first sentence of subsection (g)(1)(A).
       ``(B) With respect to an entity described in subsection 
     (g)(4), a health care practitioner is not a health 
     professional volunteer at such entity unless the entity 
     sponsors the health care practitioner. For purposes of this 
     subsection, the entity shall be considered to be sponsoring 
     the health care practitioner if--
       ``(i) with respect to the health care practitioner, the 
     entity submits to the Secretary an application meeting the 
     requirements of subsection (g)(1)(D); and
       ``(ii) the Secretary, pursuant to subsection (g)(1)(E), 
     determines that the health care practitioner is deemed to be 
     an employee of the Public Health Service.
       ``(C) In the case of a health care practitioner who is 
     determined by the Secretary pursuant to subsection (g)(1)(E) 
     to be a health professional volunteer at such entity, this 
     subsection applies to the health care practitioner (with 
     respect to services performed on behalf of the entity 
     sponsoring the health care practitioner pursuant to 
     subparagraph (B)) for any cause of action arising from an act 
     or omission of the health care practitioner occurring on or 
     after the date on which the Secretary makes such 
     determination.
       ``(D) Subsection (g)(1)(F) applies to a health care 
     practitioner for purposes of this subsection only to the 
     extent that, in providing health services to an individual, 
     each of the conditions specified in paragraph (2) is met.
       ``(4)(A) Amounts in the fund established under subsection 
     (k)(2) shall be available for transfer under subparagraph (C) 
     for purposes of carrying out this subsection.
       ``(B) Not later May 1 of each fiscal year, the Attorney 
     General, in consultation with the Secretary, shall submit to 
     the Congress a report providing an estimate of the amount of 
     claims (together with related fees and expenses of witnesses) 
     that, by reason of the acts or omissions of health 
     professional volunteers, will be paid pursuant to this 
     section during the calendar year that begins in the following 
     fiscal year. Subsection (k)(1)(B) applies to the estimate 
     under the preceding sentence regarding health professional 
     volunteers to the same extent and in the same manner as such 
     subsection applies to the estimate under such subsection 
     regarding officers, governing board members, employees, and 
     contractors of entities described in subsection (g)(4).
       ``(C) Not later than December 31 of each fiscal year, the 
     Secretary shall transfer from the fund under subsection 
     (k)(2) to the appropriate accounts in the Treasury an amount 
     equal to the estimate made under subparagraph (B) for the 
     calendar year beginning in such fiscal year, subject to the 
     extent of amounts in the fund.
       ``(5)(A) This subsection takes effect on October 1, 2017, 
     except as provided in subparagraph (B).
       ``(B) Effective on the date of the enactment of this 
     subsection--
       ``(i) the Secretary may issue regulations for carrying out 
     this subsection, and the Secretary may accept and consider 
     applications submitted pursuant to paragraph (3)(B); and
       ``(ii) reports under paragraph (4)(B) may be submitted to 
     the Congress.''.

      TITLE VI--SUPPORTING INNOVATIVE AND EVIDENCE-BASED PROGRAMS

Subtitle A--Encouraging the Advancement, Incorporation, and Development 
                      of Evidence-Based Practices

     SEC. 601. ENCOURAGING INNOVATION AND EVIDENCE-BASED PROGRAMS.

       Section 501B of the Public Health Service Act, as inserted 
     by section 103, is further amended, by inserting after 
     subsection (c) the following new subsection:
       ``(d) Promoting Innovation.--
       ``(1) In general.--The Assistant Secretary, in coordination 
     with the Laboratory, may award grants to States, local 
     governments, Indian tribes or tribal organizations (as such 
     terms are defined in section 4 of the Indian Self-
     Determination and Education Assistance Act), educational 
     institutions, and nonprofit organizations to develop 
     evidence-based interventions, including culturally and 
     linguistically appropriate services, as appropriate, for--
       ``(A) evaluating a model that has been scientifically 
     demonstrated to show promise, but would benefit from further 
     applied development, for--
       ``(i) enhancing the prevention, diagnosis, intervention, 
     treatment, and recovery of mental illness, serious emotional 
     disturbance, substance use disorders, and co-occurring 
     illness or disorders; or
       ``(ii) integrating or coordinating physical health services 
     and mental illness and substance use disorder services; and
       ``(B) expanding, replicating, or scaling evidence-based 
     programs across a wider area to enhance effective screening, 
     early diagnosis, intervention, and treatment with respect to 
     mental illness, serious mental illness, and serious emotional 
     disturbance, primarily by--
       ``(i) applying delivery of care, including training staff 
     in effective evidence-based treatment; or
       ``(ii) integrating models of care across specialties and 
     jurisdictions.
       ``(2) Consultation.--In awarding grants under this 
     paragraph, the Assistant Secretary shall, as appropriate, 
     consult with the advisory councils described in section 502, 
     the National Institute of Mental Health, the National 
     Institute on Drug Abuse, and the National Institute on 
     Alcohol Abuse and Alcoholism, as appropriate.
       ``(3) Authorization of appropriations.--There are 
     authorized to be appropriated--
       ``(A) to carry out paragraph (1)(A), $7,000,000 for the 
     period of fiscal years 2018 through 2020; and
       ``(B) to carry out paragraph (1)(B), $7,000,000 for the 
     period of fiscal years 2018 through 2020.''.

     SEC. 602. PROMOTING ACCESS TO INFORMATION ON EVIDENCE-BASED 
                   PROGRAMS AND PRACTICES.

       Part D of title V of the Public Health Service Act is 
     amended by inserting after section 543 of such Act (42 U.S.C. 
     290dd-2 ) the following:

     ``SEC. 544. PROMOTING ACCESS TO INFORMATION ON EVIDENCE-BASED 
                   PROGRAMS AND PRACTICES.

       ``(a) In General.--The Assistant Secretary shall improve 
     access to reliable and valid information on evidence-based 
     programs and practices, including information on the strength 
     of evidence associated with such programs and practices, 
     related to mental illness and substance use disorders for 
     States, local communities, nonprofit entities, and other 
     stakeholders by posting on the website of the National 
     Registry of Evidence-Based Programs and Practices evidence-
     based programs and practices that have been reviewed by the 
     Assistant Secretary pursuant to the requirements of this 
     section.
       ``(b) Notice.--
       ``(1) Periods.--In carrying out subsection (a), the 
     Assistant Secretary may establish an initial period for the 
     submission of applications for evidence-based programs and 
     practices to be posted publicly in accordance with subsection 
     (a) (and may establish subsequent such periods). The 
     Assistant Secretary shall publish notice of such application 
     periods in the Federal Register.
       ``(2) Addressing gaps.--Such notice may solicit 
     applications for evidence-based practices and programs to 
     address gaps in information identified by the Assistant 
     Secretary, the Assistant Secretary for Planning

[[Page H4311]]

     and Evaluation, the Assistant Secretary for Financial 
     Resources, or the National Mental Health and Substance Use 
     Policy Laboratory, including pursuant to priorities 
     identified in the strategic plan established under section 
     501(l).
       ``(c) Requirements.--The Assistant Secretary shall 
     establish minimum requirements for applications referred to 
     in this section, including applications related to the 
     submission of research and evaluation.
       ``(d) Review and Rating.--The Assistant Secretary shall 
     review applications prior to public posting, and may 
     prioritize the review of applications for evidence-based 
     practices and programs that are related to topics included in 
     the notice established under subsection (b). The Assistant 
     Secretary shall utilize a rating and review system, which 
     shall include information on the strength of evidence 
     associated with such programs and practices and a rating of 
     the methodological rigor of the research supporting the 
     application. The Assistant Secretary shall make the metrics 
     used to evaluate applications and the resulting ratings 
     publicly available.''.

     SEC. 603. SENSE OF CONGRESS.

       It is the sense of the Congress that the National Institute 
     of Mental Health should conduct or support research on the 
     determinants of self-directed and other violence connected to 
     mental illness.

    Subtitle B--Supporting the State Response to Mental Health Needs

     SEC. 611. COMMUNITY MENTAL HEALTH SERVICES BLOCK GRANT.

       (a) Formula Grants.--Section 1911(b) of the Public Health 
     Service Act (42 U.S.C. 300x(b)) is amended--
       (1) by redesignating paragraphs (1) through (3) as 
     paragraphs (2) through (4), respectively; and
       (2) by inserting before paragraph (2) (as so redesignated), 
     the following:
       ``(1) providing community mental health services for adults 
     with a serious mental illness and children with a serious 
     emotional disturbance as defined in accordance with section 
     1912(c);''.
       (b) State Plan.--Subsection (b) of section 1912 of the 
     Public Health Service Act (42 U.S.C. 300x-1) is amended to 
     read as follows:
       ``(b) Criteria for Plan.--The criteria specified in this 
     subsection are as follows:
       ``(1) System of care.--The plan provides a description of 
     the system of care of the State, including as follows:
       ``(A) Comprehensive community-based health systems.--The 
     plan shall--
       ``(i) identify the single State agency to be responsible 
     for the administration of the program under the grant and any 
     third party with whom the agency will contract (subject to 
     such third party complying with the requirements of this 
     part) for administering mental health services through such 
     program;
       ``(ii) provide for an organized community-based system of 
     care for individuals with mental illness, and describe 
     available services and resources in a comprehensive system of 
     care, including services for individuals with mental health 
     and behavioral health co-occurring illness or disorders;
       ``(iii) include a description of the manner in which the 
     State and local entities will coordinate services to maximize 
     the efficiency, effectiveness, quality, and cost 
     effectiveness of services and programs to produce the best 
     possible outcomes (including health services, rehabilitation 
     services, employment services, housing services, educational 
     services, substance use disorder services, legal services, 
     law enforcement services, social services, child welfare 
     services, medical and dental care services, and other support 
     services to be provided with Federal, State, and local public 
     and private resources) with other agencies to enable 
     individuals receiving services to function outside of 
     inpatient or residential institutions, to the maximum extent 
     of their capabilities, including services to be provided by 
     local school systems under the Individuals with Disabilities 
     Education Act;
       ``(iv) include a description of how the State--

       ``(I) promotes evidence-based practices, including those 
     evidence-based programs that address the needs of individuals 
     with early serious mental illness regardless of the age of 
     the individual at onset;
       ``(II) provides comprehensive individualized treatment; or
       ``(III) integrates mental and physical health services;

       ``(v) include a description of case management services in 
     the State;
       ``(vi) include a description of activities that seek to 
     engage individuals with serious mental illness or serious 
     emotional disturbance and their caregivers where appropriate 
     in making health care decisions, including activities that 
     enhance communication between individuals, families, 
     caregivers, and treatment providers; and
       ``(vii) as appropriate to and reflective of the uses the 
     State proposes for the block grant monies--

       ``(I) a description of the activities intended to reduce 
     hospitalizations and hospital stays using the block grant 
     monies;
       ``(II) a description of the activities intended to reduce 
     incidents of suicide using the block grant monies; and
       ``(III) a description of how the State integrates mental 
     health and primary care using the block grant monies.

       ``(B) Mental health system data and epidemiology.--The plan 
     shall contain an estimate of the incidence and prevalence in 
     the State of serious mental illness among adults and serious 
     emotional disturbance among children and presents 
     quantitative targets and outcome measures for programs and 
     services provided under this subpart.
       ``(C) Children's services.--In the case of children with 
     serious emotional disturbance (as defined in accordance with 
     subsection (c)), the plan shall provide for a system of 
     integrated social services, educational services, child 
     welfare services, juvenile justice services, law enforcement 
     services, and substance use disorder services that, together 
     with health and mental health services, will be provided in 
     order for such children to receive care appropriate for their 
     multiple needs (such system to include services provided 
     under the Individuals with Disabilities Education Act).
       ``(D) Targeted services to rural and homeless 
     populations.--The plan shall describe the State's outreach to 
     and services for individuals who are homeless and how 
     community-based services will be provided to individuals 
     residing in rural areas.
       ``(E) Management services.--The plan shall--
       ``(i) describe the financial resources available, the 
     existing mental health workforce, and the workforce trained 
     in treating individuals with co-occurring mental illness and 
     substance use disorders;
       ``(ii) provide for the training of providers of emergency 
     health services regarding mental health;
       ``(iii) describe the manner in which the State intends to 
     expend the grant under section 1911 for the fiscal year 
     involved; and
       ``(iv) describe the manner in which the State intends to 
     comply with each of the funding agreements in this subpart 
     and subpart III.
       ``(2) Goals and objectives.--The plan establishes goals and 
     objectives for the period of the plan, including targets and 
     milestones that are intended to be met, and the activities 
     that will be undertaken to achieve those goals and 
     objectives.''.
       (c) Best Practices in Clinical Care Models.--Section 1920 
     of the Public Health Service Act (42 U.S.C. 300x-9) is 
     amended by adding at the end the following:
       ``(c) Best Practices in Clinical Care Models.--A State 
     shall expend not less than 10 percent of the amount the State 
     receives for carrying out this subpart in each fiscal year to 
     support evidence-based programs that address the needs of 
     individuals with early serious mental illness, including 
     psychotic disorders, regardless of the age of the individual 
     at the onset of such illness.''.
       (d) Additional Provisions.--Section 1915(b) of the Public 
     Health Service Act (42 U.S.C. 300x-4(b)) is amended--
       (1) by amending paragraph (1) to read as follows:
       ``(1) In general.--A funding agreement for a grant under 
     section 1911 is that the State involved will maintain State 
     expenditures for community mental health services at a level 
     that is not less than the average of the amounts prescribed 
     by this paragraph (prior to any waiver under paragraph (3)) 
     for such expenditures by such State for each of the two 
     fiscal years immediately preceding the fiscal year for which 
     the State is applying for the grant.'';
       (2) in paragraph (2)--
       (A) by striking ``under subsection (a)'' and inserting 
     ``specified in paragraph (1)''; and
       (B) by striking ``principle'' and inserting ``principal'';
       (3) by amending paragraph (3) to read as follows:
       ``(3) Waiver.--
       ``(A) In general.--The Secretary may, upon the request of a 
     State, waive the requirement established in paragraph (1) in 
     whole or in part, if the Secretary determines that 
     extraordinary economic conditions in the State in the fiscal 
     year involved or in the previous fiscal year justify the 
     waiver.
       ``(B) Date certain for action upon request.--The Secretary 
     shall approve or deny a request for a waiver under this 
     paragraph not later than 120 days after the date on which the 
     request is made.
       ``(C) Applicability of waiver.--A waiver provided by the 
     Secretary under this paragraph shall be applicable only to 
     the fiscal year involved.''; and
       (4) in paragraph (4)--
       (A) by amending subparagraph (A) to read as follows:
       ``(A) In general.--
       ``(i) Determination and reduction.--The Secretary shall 
     determine, in the case of each State, and for each fiscal 
     year, whether the State maintained material compliance with 
     the agreement made under paragraph (1). If the Secretary 
     determines that a State has failed to maintain such 
     compliance for a fiscal year, the Secretary shall reduce the 
     amount of the allotment under section 1911 for the State, for 
     the first fiscal year beginning after such determination is 
     final, by an amount equal to the amount constituting such 
     failure for the previous fiscal year about which the 
     determination was made.
       ``(ii) Alternative sanction.--The Secretary may by 
     regulation provide for an alternative method of imposing a 
     sanction for a failure by a State to maintain material 
     compliance with the agreement under paragraph (1) if the 
     Secretary determines that such alternative method would be 
     more equitable and would be a more effective incentive for 
     States to maintain such material compliance.''; and
       (B) in subparagraph (B)--
       (i) by inserting after the subparagraph designation the 
     following: ``Submission of information to the secretary.--''; 
     and

[[Page H4312]]

       (ii) by striking ``subparagraph (A)'' and inserting 
     ``subparagraph (A)(i)''.
       (e) Application for Grant.--Section 1917(a) of the Public 
     Health Service Act (42 U.S.C. 300x-6(a)) is amended--
       (1) in paragraph (1), by striking ``1941'' and inserting 
     ``1942(a)''; and
       (2) in paragraph (5), by striking ``1915(b)(3)(B)'' and 
     inserting ``1915(b)''.

     Subtitle C--Strengthening Mental Health Care for Children and 
                              Adolescents

     SEC. 621. TELE-MENTAL HEALTH CARE ACCESS GRANTS.

       Title III of the Public Health Service Act is amended by 
     inserting after section 330L of such Act (42 U.S.C. 254c-18) 
     the following new section:

     ``SEC. 330M. TELE-MENTAL HEALTH CARE ACCESS GRANTS.

       ``(a) In General.--The Secretary, acting through the 
     Administrator of the Health Resources and Services 
     Administration and in coordination with other relevant 
     Federal agencies, shall award grants to States, political 
     subdivisions of States, Indian tribes, and tribal 
     organizations (for purposes of this section, as such terms 
     are defined in section 4 of the Indian Self-Determination and 
     Education Assistance Act (25 U.S.C. 450b)) to promote 
     behavioral health integration in pediatric primary care by--
       ``(1) supporting the development of statewide child mental 
     health care access programs; and
       ``(2) supporting the improvement of existing statewide 
     child mental health care access programs.
       ``(b) Program Requirements.--
       ``(1) In general.--A child mental health care access 
     program referred to in subsection (a), with respect to which 
     a grant under such subsection may be used, shall--
       ``(A) be a statewide network of pediatric mental health 
     teams that provide support to pediatric primary care sites as 
     an integrated team;
       ``(B) support and further develop organized State networks 
     of child and adolescent psychiatrists and psychologists to 
     provide consultative support to pediatric primary care sites;
       ``(C) conduct an assessment of critical behavioral 
     consultation needs among pediatric providers and such 
     providers' preferred mechanisms for receiving consultation 
     and training and technical assistance;
       ``(D) develop an online database and communication 
     mechanisms, including telehealth, to facilitate consultation 
     support to pediatric practices;
       ``(E) provide rapid statewide clinical telephone or 
     telehealth consultations when requested between the pediatric 
     mental health teams and pediatric primary care providers;
       ``(F) conduct training and provide technical assistance to 
     pediatric primary care providers to support the early 
     identification, diagnosis, treatment, and referral of 
     children with behavioral health conditions or co-occurring 
     intellectual and other developmental disabilities;
       ``(G) provide information to pediatric providers about, and 
     assist pediatric providers in accessing, child psychiatry and 
     psychology consultations and in scheduling and conducting 
     technical assistance;
       ``(H) assist with referrals to specialty care and community 
     or behavioral health resources; and
       ``(I) establish mechanisms for measuring and monitoring 
     increased access to child and adolescent psychiatric and 
     psychology services by pediatric primary care providers and 
     expanded capacity of pediatric primary care providers to 
     identify, treat, and refer children with mental health 
     problems.
       ``(2) Pediatric mental health teams.--In this subsection, 
     the term `pediatric mental health team' means a team of case 
     coordinators, child and adolescent psychiatrists, and 
     licensed clinical mental health professionals, such as a 
     psychologist, social worker, or mental health counselor.
       ``(c) Application.--A State, political subdivision of a 
     State, Indian tribe, or tribal organization seeking 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 require, including a plan 
     for the rigorous evaluation of activities that are carried 
     out with funds received under such grant.
       ``(d) Evaluation.--A State, political subdivision of a 
     State, Indian tribe, or tribal organization that receives a 
     grant under this section shall prepare and submit an 
     evaluation of activities carried out with funds received 
     under such grant to the Secretary at such time, in such 
     manner, and containing such information as the Secretary may 
     reasonably require, including a process and outcome 
     evaluation.
       ``(e) Matching Requirement.--The Secretary may not award a 
     grant under this section unless the State, political 
     subdivision of a State, Indian tribe, or tribal organization 
     involved agrees, with respect to the costs to be incurred by 
     the State, political subdivision of a State, Indian tribe, or 
     tribal organization in carrying out the purpose described in 
     this section, to make available non-Federal contributions (in 
     cash or in kind) toward such costs in an amount that is not 
     less than 20 percent of Federal funds provided in the grant.
       ``(f) Authorization of Appropriations.--To carry this 
     section, there are authorized to be appropriated $9,000,000 
     for the period of fiscal years 2018 through 2020.''.

     SEC. 622. INFANT AND EARLY CHILDHOOD MENTAL HEALTH PROMOTION, 
                   INTERVENTION, AND TREATMENT.

       Part Q of title III of the Public Health Service Act (42 
     U.S.C. 290h et seq.) is amended by adding at the end the 
     following:

     ``SEC. 399Z-2. INFANT AND EARLY CHILDHOOD MENTAL HEALTH 
                   PROMOTION, INTERVENTION, AND TREATMENT.

       ``(a) Grants.--The Secretary shall--
       ``(1) award grants to eligible entities, including human 
     services agencies, to develop, maintain, or enhance infant 
     and early childhood mental health promotion, intervention, 
     and treatment programs, including--
       ``(A) programs for infants and children at significant risk 
     of developing, showing early signs of, or having been 
     diagnosed with mental illness including serious emotional 
     disturbance; and
       ``(B) multigenerational therapy and other services that 
     support the caregiving relationship; and
       ``(2) ensure that programs funded through grants under this 
     section are evidence-informed or evidence-based models, 
     practices, and methods that are, as appropriate, culturally 
     and linguistically appropriate, and can be replicated in 
     other appropriate settings.
       ``(b) Eligible Children and Entities.--In this section:
       ``(1) Eligible child.--The term `eligible child' means a 
     child from birth to not more than 5 years of age who--
       ``(A) is at risk for, shows early signs of, or has been 
     diagnosed with a mental illness, including serious emotional 
     disturbance; and
       ``(B) may benefit from infant and early childhood 
     intervention or treatment programs or specialized preschool 
     or elementary school programs that are evidence-based or that 
     have been scientifically demonstrated to show promise but 
     would benefit from further applied development.
       ``(2) Eligible entity.--The term `eligible entity' means a 
     nonprofit institution that--
       ``(A) is accredited or approved by a State mental health or 
     education agency, as applicable, to provide for children from 
     infancy to 5 years of age mental health promotion, 
     intervention, or treatment services that are evidence-based 
     or that have been scientifically demonstrated to show promise 
     but would benefit from further applied development; and
       ``(B) provides programs described in subsection (a) that 
     are evidence-based or that have been scientifically 
     demonstrated to show promise but would benefit from further 
     applied development.
       ``(c) Application.--An eligible entity seeking a grant 
     under subsection (a) shall submit to the Secretary an 
     application at such time, in such manner, and containing such 
     information as the Secretary may require.
       ``(d) Use of Funds for Early Intervention and Treatment 
     Programs.--An eligible entity may use amounts awarded under a 
     grant under subsection (a)(1) to carry out the following:
       ``(1) Provide age-appropriate mental health promotion and 
     early intervention services or mental illness treatment 
     services, which may include specialized programs, for 
     eligible children at significant risk of developing, showing 
     early signs of, or having been diagnosed with a mental 
     illness, including serious emotional disturbance. Such 
     services may include social and behavioral services as well 
     as multigenerational therapy and other services ?that support 
     the caregiving relationship.
       ``(2) Provide training for health care professionals with 
     expertise in infant and early childhood mental health care 
     with respect to appropriate and relevant integration with 
     other disciplines such as primary care clinicians, early 
     intervention specialists, child welfare staff, home visitors, 
     early care and education providers, and others who work with 
     young children and families.
       ``(3) Provide mental health consultation to personnel of 
     early care and education programs (including licensed or 
     regulated center-based and home-based child care, home 
     visiting, preschool special education, and early intervention 
     programs) who work with children and families.
       ``(4) Provide training for mental health clinicians in 
     infant and early childhood in promising and evidence-based 
     practices and models for infant and early childhood mental 
     health treatment and early intervention, including with 
     regard to practices for identifying and treating mental 
     illness and behavioral disorders of infants and children 
     resulting from exposure or repeated exposure to adverse 
     childhood experiences or childhood trauma.
       ``(5) Provide age-appropriate assessment, diagnostic, and 
     intervention services for eligible children, including early 
     mental health promotion, intervention, and treatment 
     services.
       ``(e) Matching Funds.--The Secretary may not award a grant 
     under this section to an eligible entity unless the eligible 
     entity agrees, with respect to the costs to be incurred by 
     the eligible entity in carrying out the activities described 
     in subsection (d), to make available non-Federal 
     contributions (in cash or in kind) toward such costs in an 
     amount that is not less than 10 percent of the total amount 
     of Federal funds provided in the grant.
       ``(f) Authorization of Appropriations.--To carry this 
     section, there are authorized to be appropriated $20,000,000 
     for the period of fiscal years 2018 through 2022.''.

     SEC. 623. NATIONAL CHILD TRAUMATIC STRESS INITIATIVE.

       Section 582 of the Public Health Service Act (42 U.S.C. 
     290hh-1; relating to grants to address the problems of 
     persons who experience violence related stress) is amended--

[[Page H4313]]

       (1) in subsection (a), by striking ``developing programs'' 
     and all that follows and inserting the following: 
     ``developing and maintaining programs that provide for--
       ``(1) the continued operation of the National Child 
     Traumatic Stress Initiative (referred to in this section as 
     the `NCTSI'), which includes a coordinating center that 
     focuses on the mental, behavioral, and biological aspects of 
     psychological trauma response; and
       ``(2) the development of knowledge with regard to evidence-
     based practices for identifying and treating mental illness, 
     behavioral disorders, and physical health conditions of 
     children and youth resulting from witnessing or experiencing 
     a traumatic event.'';
       (2) in subsection (b)--
       (A) by striking ``subsection (a) related'' and inserting 
     ``subsection (a)(2) (related'';
       (B) by striking ``treating disorders associated with 
     psychological trauma'' and inserting ``treating mental 
     illness and behavioral and biological disorders associated 
     with psychological trauma)''; and
       (C) by striking ``mental health agencies and programs that 
     have established clinical and basic research'' and inserting 
     ``universities, hospitals, mental health agencies, and other 
     programs that have established clinical expertise and 
     research'';
       (3) by redesignating subsections (c) through (g) as 
     subsections (g) through (k), respectively;
       (4) by inserting after subsection (b), the following:
       ``(c) Child Outcome Data.--The NCTSI coordinating center 
     shall collect, analyze, report, and make publicly available 
     NCTSI-wide child treatment process and outcome data regarding 
     the early identification and delivery of evidence-based 
     treatment and services for children and families served by 
     the NCTSI grantees.
       ``(d) Training.--The NCTSI coordinating center shall 
     facilitate the coordination of training initiatives in 
     evidence-based and trauma-informed treatments, interventions, 
     and practices offered to NCTSI grantees, providers, and 
     partners.
       ``(e) Dissemination.--The NCTSI coordinating center shall, 
     as appropriate, collaborate with the Secretary in the 
     dissemination of evidence-based and trauma-informed 
     interventions, treatments, products, and other resources to 
     appropriate stakeholders.
       ``(f) Review.--The Secretary shall, consistent with the 
     peer-review process, ensure that NCTSI applications are 
     reviewed by appropriate experts in the field as part of a 
     consensus review process. The Secretary shall include review 
     criteria related to expertise and experience in child trauma 
     and evidence-based practices.'';
       (5) in subsection (g) (as so redesignated), by striking 
     ``with respect to centers of excellence are distributed 
     equitably among the regions of the country'' and inserting 
     ``are distributed equitably among the regions of the United 
     States'';
       (6) in subsection (i) (as so redesignated), by striking 
     ``recipient may not exceed 5 years'' and inserting 
     ``recipient shall not be less than 4 years, but shall not 
     exceed 5 years''; and
       (7) in subsection (j) (as so redesignated), by striking 
     ``$50,000,000'' and all that follows through ``2006'' and 
     inserting ``$46,887,000 for each of fiscal years 2017 through 
     2021''.

         TITLE VII--GRANT PROGRAMS AND PROGRAM REAUTHORIZATION

       Subtitle A--Garrett Lee Smith Memorial Act Reauthorization

     SEC. 701. YOUTH INTERAGENCY RESEARCH, TRAINING, AND TECHNICAL 
                   ASSISTANCE CENTERS.

       Section 520C of the Public Health Service Act (42 U.S.C. 
     290bb-34) is amended--
       (1) by striking the section heading and inserting ``suicide 
     prevention technical assistance center.'';
       (2) in subsection (a), by striking ``and in consultation 
     with'' and all that follows through the period at the end of 
     paragraph (2) and inserting ``shall establish a research, 
     training, and technical assistance resource center to provide 
     appropriate information, training, and technical assistance 
     to States, political subdivisions of States, federally 
     recognized Indian tribes, tribal organizations, institutions 
     of higher education, public organizations, or private 
     nonprofit organizations regarding the prevention of suicide 
     among all ages, particularly among groups that are at high 
     risk for suicide.'';
       (3) by striking subsections (b) and (c);
       (4) by redesignating subsection (d) as subsection (b);
       (5) in subsection (b), as so redesignated--
       (A) by striking the subsection heading and inserting 
     ``Responsibilities of the Center.--'';
       (B) in the matter preceding paragraph (1), by striking 
     ``The additional research'' and all that follows through 
     ``nonprofit organizations for'' and inserting ``The center 
     established under subsection (a) shall conduct activities for 
     the purpose of'';
       (C) by striking ``youth suicide'' each place such term 
     appears and inserting ``suicide'';
       (D) in paragraph (1)--
       (i) by striking ``the development or continuation of'' and 
     inserting ``developing and continuing''; and
       (ii) by inserting ``for all ages, particularly among groups 
     that are at high risk for suicide'' before the semicolon at 
     the end;
       (E) in paragraph (2), by inserting ``for all ages, 
     particularly among groups that are at high risk for suicide'' 
     before the semicolon at the end;
       (F) in paragraph (3), by inserting ``and tribal'' after 
     ``statewide'';
       (G) in paragraph (5), by inserting ``and prevention'' after 
     ``intervention'';
       (H) in paragraph (8), by striking ``in youth'';
       (I) in paragraph (9), by striking ``and behavioral health'' 
     and inserting ``health and substance use disorder''; and
       (J) in paragraph (10), by inserting ``conducting'' before 
     ``other''; and
       (6) by striking subsection (e) and inserting the following:
       ``(c) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there are authorized to be 
     appropriated $5,988,000 for each of fiscal years 2017 through 
     2021.
       ``(d) Report.--Not later than 2 years after the date of 
     enactment of the Helping Families in Mental Health Crisis Act 
     of 2016, the Secretary shall submit to Congress a report on 
     the activities carried out by the center established under 
     subsection (a) during the year involved, including the 
     potential effects of such activities, and the States, 
     organizations, and institutions that have worked with the 
     center.''.

     SEC. 702. YOUTH SUICIDE EARLY INTERVENTION AND PREVENTION 
                   STRATEGIES.

       Section 520E of the Public Health Service Act (42 U.S.C. 
     290bb-36) is amended--
       (1) in paragraph (1) of subsection (a) and in subsection 
     (c), by striking ``substance abuse'' each place such term 
     appears and inserting ``substance use disorder'';
       (2) in subsection (b)(2)--
       (A) by striking ``each State is awarded only 1 grant or 
     cooperative agreement under this section'' and inserting ``a 
     State does not receive more than 1 grant or cooperative 
     agreement under this section at any 1 time''; and
       (B) by striking ``been awarded'' and inserting 
     ``received''; and
       (3) by striking subsection (m) and inserting the following:
       ``(m) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there are authorized to be 
     appropriated $35,427,000 for each of fiscal years 2017 
     through 2021.''.

     SEC. 703. MENTAL HEALTH AND SUBSTANCE USE DISORDER SERVICES 
                   ON CAMPUS.

       Section 520E-2 of the Public Health Service Act (42 U.S.C. 
     290bb-36b) is amended--
       (1) in the section heading, by striking ``and behavioral 
     health'' and inserting ``health and substance use disorder'';
       (2) in subsection (a)--
       (A) by striking ``Services,'' and inserting ``Services 
     and'';
       (B) by striking ``and behavioral health problems'' and 
     inserting ``health or substance use disorders''; and
       (C) by striking ``substance abuse'' and inserting 
     ``substance use disorders'';
       (3) in subsection (b)--
       (A) in the matter preceding paragraph (1), by striking 
     ``for--'' and inserting ``for one or more of the 
     following:''; and
       (B) by striking paragraphs (1) through (6) and inserting 
     the following:
       ``(1) Educating students, families, faculty, and staff to 
     increase awareness of mental health and substance use 
     disorders.
       ``(2) The operation of hotlines.
       ``(3) Preparing informational material.
       ``(4) Providing outreach services to notify students about 
     available mental health and substance use disorder services.
       ``(5) Administering voluntary mental health and substance 
     use disorder screenings and assessments.
       ``(6) Supporting the training of students, faculty, and 
     staff to respond effectively to students with mental health 
     and substance use disorders.
       ``(7) Creating a network infrastructure to link colleges 
     and universities with health care providers who treat mental 
     health and substance use disorders.'';
       (4) in subsection (c)(5), by striking ``substance abuse'' 
     and inserting ``substance use disorder'';
       (5) in subsection (d)--
       (A) in the matter preceding paragraph (1), by striking ``An 
     institution of higher education desiring a grant under this 
     section'' and inserting ``To be eligible to receive a grant 
     under this section, an institution of higher education'';
       (B) in paragraph (1)--
       (i) by striking ``and behavioral health'' and inserting 
     ``health and substance use disorder''; and
       (ii) by inserting ``, including veterans whenever possible 
     and appropriate,'' after ``students''; and
       (C) in paragraph (2), by inserting ``, which may include, 
     as appropriate and in accordance with subsection (b)(7), a 
     plan to seek input from relevant stakeholders in the 
     community, including appropriate public and private entities, 
     in order to carry out the program under the grant'' before 
     the period at the end;
       (6) in subsection (e)(1), by striking ``and behavioral 
     health problems'' and inserting ``health and substance use 
     disorders'';
       (7) in subsection (f)(2)--
       (A) by striking ``and behavioral health'' and inserting 
     ``health and substance use disorder''; and
       (B) by striking ``suicide and substance abuse'' and 
     inserting ``suicide and substance use disorders''; and
       (8) in subsection (h), by striking ``$5,000,000 for fiscal 
     year 2005'' and all that follows through the period at the 
     end and inserting ``$6,488,000 for each of fiscal years 2017 
     through 2021.''.

[[Page H4314]]

  


                      Subtitle B--Other Provisions

     SEC. 711. NATIONAL SUICIDE PREVENTION LIFELINE PROGRAM.

       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 520E-2 (42 U.S.C. 290bb-36b) the following:

     ``SEC. 520E-3. NATIONAL SUICIDE PREVENTION LIFELINE PROGRAM.

       ``(a) In General.--The Secretary, acting through the 
     Assistant Secretary, shall maintain the National Suicide 
     Prevention Lifeline Program (referred to in this section as 
     the `Program'), authorized under section 520A and in effect 
     prior to the date of enactment of the Helping Families in 
     Mental Health Crisis Act of 2016.
       ``(b) Activities.--In maintaining the Program, the 
     activities of the Secretary shall include--
       ``(1) coordinating a network of crisis centers across the 
     United States for providing suicide prevention and crisis 
     intervention services to individuals seeking help at any 
     time, day or night;
       ``(2) maintaining a suicide prevention hotline to link 
     callers to local emergency, mental health, and social 
     services resources; and
       ``(3) consulting with the Secretary of Veterans Affairs to 
     ensure that veterans calling the suicide prevention hotline 
     have access to a specialized veterans' suicide prevention 
     hotline.
       ``(c) Authorization of Appropriations.--To carry out this 
     section, there are authorized to be appropriated $7,198,000 
     for each of fiscal years 2017 through 2021.''.

     SEC. 712. WORKFORCE DEVELOPMENT STUDIES AND REPORTS.

       (a) In General.--Not later than 2 years after the date of 
     enactment of this Act, the Assistant Secretary for Mental 
     Health and Substance Use, in consultation with the 
     Administrator of the Health Resources and Services 
     Administration, shall conduct a study, and publicly post on 
     the appropriate Internet website of the Department of Health 
     and Human Services a report, on the mental health and 
     substance use disorder workforce in order to inform Federal, 
     State, and local efforts related to workforce enhancement.
       (b) Contents.--The report under this section shall 
     contain--
       (1) national and State-level projections of the supply and 
     demand of mental health and substance use disorder health 
     workers, including the number of individuals practicing in 
     fields deemed relevant by the Secretary;
       (2) an assessment of the mental health and substance use 
     disorder workforce capacity, strengths, and weaknesses as of 
     the date of the report, including the capacity of primary 
     care to prevent, screen, treat, or refer for mental health 
     and substance use disorders;
       (3) information on trends within the mental health and 
     substance use disorder provider workforce, including the 
     number of individuals entering the mental health workforce 
     over the next five years;
       (4) information on the gaps in workforce development for 
     mental health providers and professionals, including those 
     who serve pediatric, adult, and geriatric patients; and
       (5) any additional information determined by the Assistant 
     Secretary for Mental Health and Substance Use, in 
     consultation with the Administrator of the Health Resources 
     and Services Administration, to be relevant to the mental 
     health and substance use disorder provider workforce.

     SEC. 713. MINORITY FELLOWSHIP PROGRAM.

       Title V of the Public Health Service Act (42 U.S.C. 290aa 
     et seq.) is amended by adding at the end the following:

                 ``PART K--MINORITY FELLOWSHIP PROGRAM

     ``SEC. 597. FELLOWSHIPS.

       ``(a) In General.--The Secretary shall maintain a program, 
     to be known as the Minority Fellowship Program, under which 
     the Secretary awards fellowships, which may include stipends, 
     for the purposes of--
       ``(1) increasing behavioral health practitioners' knowledge 
     of issues related to prevention, treatment, and recovery 
     support for mental illness and substance use disorders among 
     racial and ethnic minority populations;
       ``(2) improving the quality of mental illness and substance 
     use disorder prevention and treatment delivered to racial and 
     ethnic minorities; and
       ``(3) increasing the number of culturally competent 
     behavioral health professionals and school personnel who 
     teach, administer, conduct services research, and provide 
     direct mental health or substance use services to racial and 
     ethnic minority populations.
       ``(b) Training Covered.--The fellowships under subsection 
     (a) shall be for postbaccalaureate training (including for 
     master's and doctoral degrees) for mental health 
     professionals, including in the fields of psychiatry, 
     nursing, social work, psychology, marriage and family 
     therapy, mental health counseling, and substance use and 
     addiction counseling.
       ``(c) Authorization of Appropriations.--To carry out this 
     section, there are authorized to be appropriated $12,669,000 
     for each of fiscal years 2017, 2018, and 2019 and $13,669,000 
     for each of fiscal years 2020 and 2021.''.

     SEC. 714. CENTER AND PROGRAM REPEALS.

       Part B of title V of the Public Health Service Act (42 
     U.S.C. 290bb et seq.) is amended by striking the second 
     section 514 (42 U.S.C. 290bb-9), relating to methamphetamine 
     and amphetamine treatment initiatives, and sections 514A, 
     517, 519A, 519C, 519E, 520D, and 520H (42 U.S.C. 290bb-8, 
     290bb-23, 290bb-25a, 290bb-25c, 290bb-25e, 290bb-35, and 
     290bb-39).

     SEC. 715. NATIONAL VIOLENT DEATH REPORTING SYSTEM.

       The Secretary of Health and Human Services, acting through 
     the Director of the Centers for Disease Control and 
     Prevention, is encouraged to improve, particularly through 
     the inclusion of additional States, the National Violent 
     Death Reporting System as authorized by title III of the 
     Public Health Service Act (42 U.S.C. 241 et seq.). 
     Participation in the system by the States shall be voluntary.

     SEC. 716. SENSE OF CONGRESS ON PRIORITIZING NATIVE AMERICAN 
                   YOUTH AND SUICIDE PREVENTION PROGRAMS.

       (a) Findings.--The Congress finds as follows:
       (1) Suicide is the eighth leading cause of death among 
     American Indians and Alaska Natives across all ages.
       (2) Among American Indians and Alaska Natives who are 10 to 
     34 years of age, suicide is the second leading cause of 
     death.
       (3) The suicide rate among American Indian and Alaska 
     Native adolescents and young adults ages 15 to 34 (19.5 per 
     100,000) is 1.5 times higher than the national average for 
     that age group (12.9 per 100,000).
       (b) Sense of Congress.--It is the sense of Congress that 
     the Secretary of Health and Human Services, in carrying out 
     programs for Native American youth and suicide prevention 
     programs for youth suicide intervention, should prioritize 
     programs and activities for individuals who have a high risk 
     or disproportional burden of suicide, such as Native 
     Americans.

     SEC. 717. PEER PROFESSIONAL WORKFORCE DEVELOPMENT GRANT 
                   PROGRAM.

       (a) In General.--For the purposes described in subsection 
     (b), the Secretary of Health and Human Services shall award 
     grants to develop and sustain behavioral health 
     paraprofessional training and education programs, including 
     through tuition support.
       (b) Purposes.--The purposes of grants under this section 
     are--
       (1) to increase the number of behavioral health 
     paraprofessionals, including trained peers, recovery coaches, 
     mental health and addiction specialists, prevention 
     specialists, and pre-masters-level addiction counselors; and
       (2) to help communities develop the infrastructure to train 
     and certify peers as behavioral health paraprofessionals.
       (c) Eligible Entities.--To be eligible to receive a grant 
     under this section, an entity shall be a community college or 
     other entity the Secretary deems appropriate.
       (d) Geographic Distribution.--In awarding grants under this 
     section, the Secretary shall seek to achieve an appropriate 
     national balance in the geographic distribution of such 
     awards.
       (e) Special Consideration.--In awarding grants under this 
     section, the Secretary may give special consideration to 
     proposed and existing programs targeting peer professionals 
     serving youth ages 16 to 25.
       (f) Authorization of Appropriations.--To carry out this 
     section, there is authorized to be appropriated $10,000,000 
     for the period of fiscal years 2018 through 2022.

     SEC. 718. NATIONAL HEALTH SERVICE CORPS.

       (a) Definitions.--
       (1) Primary health services.--Section 331(a)(3)(D) of the 
     Public Health Service Act (42 U.S.C. 254d(a)(3)) is amended 
     by inserting ``(including pediatric mental health 
     subspecialty services)'' after ``pediatrics''.
       (2) Behavioral and mental health professionals.--Clause (i) 
     of section 331(a)(3)(E) of the Public Health Service Act (42 
     U.S.C. 254d(a)(3)(E)) is amended by inserting ``(and 
     pediatric subspecialists thereof)'' before the period at the 
     end.
       (b) Eligibility To Participate in Loan Repayment Program.--
     Section 338B(b)(1)(B) of the Public Health Service Act (42 
     U.S.C. 254l-1(b)(1)(B)) is amended by inserting ``, including 
     any physician child and adolescent psychiatry residency or 
     fellowship training program'' after ``be enrolled in an 
     approved graduate training program in medicine, osteopathic 
     medicine, dentistry, behavioral and mental health, or other 
     health profession''.

     SEC. 719. ADULT SUICIDE PREVENTION.

       (a) Grants.--
       (1) Authority.--The Assistant Secretary for Mental Health 
     and Substance Use (referred to in this section as the 
     ``Assistant Secretary'') may award grants to eligible 
     entities in order to implement suicide prevention efforts 
     amongst adults 25 and older.
       (2) Purpose.--The grant program under this section shall be 
     designed to raise suicide awareness, establish referral 
     processes, and improve clinical care practice standards for 
     treating suicide ideation, plans, and attempts among adults.
       (3) Recipients.--To be eligible to receive a grant under 
     this section, an entity shall be a community-based primary 
     care or behavioral health care setting, an emergency 
     department, a State mental health agency, an Indian tribe, a 
     tribal organization, or any other entity the Assistant 
     Secretary deems appropriate.
       (4) Nature of activities.--The grants awarded under 
     paragraph (1) shall be used to implement programs that--
       (A) screen for suicide risk in adults and provide 
     intervention and referral to treatment;
       (B) implement evidence-based practices to treat individuals 
     who are at suicide risk, including appropriate followup 
     services; and

[[Page H4315]]

       (C) raise awareness, reduce stigma, and foster open 
     dialogue about suicide prevention.
       (b) Additional Activities.--The Assistant Secretary shall--
       (1) evaluate the activities supported by grants awarded 
     under subsection (a) in order to further the Nation's 
     understanding of effective interventions to prevent suicide 
     in adults;
       (2) disseminate the findings from the evaluation as the 
     Assistant Secretary considers appropriate; and
       (3) provide appropriate information, training, and 
     technical assistance to eligible entities that receive a 
     grant under this section, in order to help such entities to 
     meet the requirements of this section, including assistance 
     with--
       (A) selection and implementation of evidence-based 
     interventions and frameworks to prevent suicide, such as the 
     Zero Suicide framework; and
       (B) other activities as the Assistant Secretary determines 
     appropriate.
       (c) Duration.--A grant under this section shall be for a 
     period of not more than 5 years.
       (d) Authorization of Appropriations.--
       (1) In general.--There is authorized to be appropriated to 
     carry out this section $30,000,000 for the period of fiscal 
     years 2018 through 2022.
       (2) Use of certain funds.--Of the funds appropriated to 
     carry out this section in any fiscal year, the lesser of 5 
     percent of such funds or $500,000 shall be available to the 
     Assistant Secretary for purposes of carrying out subsection 
     (b).

     SEC. 720. CRISIS INTERVENTION GRANTS FOR POLICE OFFICERS AND 
                   FIRST RESPONDERS.

       (a) In General.--The Assistant Secretary for Mental Health 
     and Substance Use may award grants to entities such as law 
     enforcement agencies and first responders--
       (1) to provide specialized training to law enforcement 
     officers, corrections officers, paramedics, emergency medical 
     services workers, and other first responders (including 
     village public safety officers (as defined in section 247 of 
     the Indian Arts and Crafts Amendments Act of 2010 (42 U.S.C. 
     3796dd note)))--
       (A) to recognize individuals who have mental illness and 
     how to properly intervene with individuals with mental 
     illness; and
       (B) to establish programs that enhance the ability of law 
     enforcement agencies to address the mental health, 
     behavioral, and substance use problems of individuals 
     encountered in the line of duty; and
       (2) to establish collaborative law enforcement and mental 
     health programs, including behavioral health response teams 
     and mental health crisis intervention teams comprised of 
     mental health professionals, law enforcement officers, and 
     other first responders, as appropriate, to provide on-site, 
     face-to-face, mental and behavioral health care services 
     during a mental health crisis, and to connect the individual 
     in crisis to appropriate community-based treatment services 
     in lieu of unnecessary hospitalization or further involvement 
     with the criminal justice system.
       (b) Authorization of Appropriations.--There are authorized 
     to be appropriated to carry out this section $9,000,000 for 
     the period of fiscal years 2018 through 2020.

     SEC. 721. DEMONSTRATION GRANT PROGRAM TO TRAIN HEALTH SERVICE 
                   PSYCHOLOGISTS IN COMMUNITY-BASED MENTAL HEALTH.

       (a) Establishment.--The Secretary of Health and Human 
     Services shall establish a grant program under which the 
     Assistant Secretary of Mental Health and Substance Use 
     Disorders may award grants to eligible institutions to 
     support the recruitment, education, and clinical training 
     experiences of health services psychology students, interns, 
     and postdoctoral residents for education and clinical 
     experience in community mental health settings.
       (b) Eligible Institutions.--For purposes of this section, 
     the term ``eligible institutions'' includes American 
     Psychological Association-accredited doctoral, internship, 
     and postdoctoral residency schools or programs in health 
     service psychology that--
       (1) are focused on the development and implementation of 
     interdisciplinary training of psychology graduate students 
     and postdoctoral fellows in providing mental and behavioral 
     health services to address substance use disorders, serious 
     emotional disturbance, and serious illness, as well as 
     developing faculty and implementing curriculum to prepare 
     psychologists to work with underserved populations; and
       (2) demonstrate an ability to train health service 
     psychologists in psychiatric hospitals, forensic hospitals, 
     community mental health centers, community health centers, 
     federally qualified health centers, or adult and juvenile 
     correctional facilities.
       (c) Priorities.--In selecting grant recipients under this 
     section, the Secretary shall give priority to eligible 
     institutions in which training focuses on the needs of 
     individuals with serious mental illness, serious emotional 
     disturbance, justice-involved youth, and individuals with or 
     at high risk for substance use disorders.
       (d) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section $12,000,000 for 
     the period of fiscal years 2018 through 2022.

     SEC. 722. INVESTMENT IN TOMORROW'S PEDIATRIC HEALTH CARE 
                   WORKFORCE.

       Section 775(e) of the Public Health Service Act (42 U.S.C. 
     295f(e)) is amended to read as follows:
       ``(e) Authorization of Appropriations.--To carry out this 
     section, there is authorized to be appropriated $12,000,000 
     for the period of fiscal years 2018 through 2022.''.

     SEC. 723. CUTGO COMPLIANCE.

       Section 319D(f) of the Public Health Service Act (42 U.S.C. 
     247d-4(f)) is amended by striking ``$138,300,000 for each of 
     fiscal years 2014 through 2018'' and inserting ``$138,300,000 
     for each of fiscal years 2014 through 2016 and $58,000,000 
     for each of fiscal years 2017 and 2018''.

                    TITLE VIII--MENTAL HEALTH PARITY

     SEC. 801. ENHANCED COMPLIANCE WITH MENTAL HEALTH AND 
                   SUBSTANCE USE DISORDER COVERAGE REQUIREMENTS.

       (a) Compliance Program Guidance Document.--Section 2726(a) 
     of the Public Health Service Act (42 U.S.C. 300gg-26(a)) is 
     amended by adding at the end the following:
       ``(6) Compliance program guidance document.--
       ``(A) In general.--Not later than 12 months after the date 
     of enactment of the Helping Families in Mental Health Crisis 
     Act of 2016, the Secretary, the Secretary of Labor, and the 
     Secretary of the Treasury, in consultation with the Inspector 
     General of the Department of Health and Human Services, shall 
     issue a compliance program guidance document to help improve 
     compliance with this section, section 712 of the Employee 
     Retirement Income Security Act of 1974, and section 9812 of 
     the Internal Revenue Code of 1986, as applicable.
       ``(B) Examples illustrating compliance and noncompliance.--
       ``(i) In general.--The compliance program guidance document 
     required under this paragraph shall provide illustrative, de-
     identified examples (that do not disclose any protected 
     health information or individually identifiable information) 
     of previous findings of compliance and noncompliance with 
     this section, section 712 of the Employee Retirement Income 
     Security Act of 1974, or section 9812 of the Internal Revenue 
     Code of 1986, as applicable, based on investigations of 
     violations of such sections, including--

       ``(I) examples illustrating requirements for information 
     disclosures and nonquantitative treatment limitations; and
       ``(II) descriptions of the violations uncovered during the 
     course of such investigations.

       ``(ii) Nonquantitative treatment limitations.--To the 
     extent that any example described in clause (i) involves a 
     finding of compliance or noncompliance with regard to any 
     requirement for nonquantitative treatment limitations, the 
     example shall provide sufficient detail to fully explain such 
     finding, including a full description of the criteria 
     involved for medical and surgical benefits and the criteria 
     involved for mental health and substance use disorder 
     benefits.
       ``(iii) Access to additional information regarding 
     compliance.--In developing and issuing the compliance program 
     guidance document required under this paragraph, the 
     Secretaries specified in subparagraph (A)--

       ``(I) shall enter into interagency agreements with the 
     Inspector General of the Department of Health and Human 
     Services, the Inspector General of the Department of Labor, 
     and the Inspector General of the Department of the Treasury 
     to share findings of compliance and noncompliance with this 
     section, section 712 of the Employee Retirement Income 
     Security Act of 1974, or section 9812 of the Internal Revenue 
     Code of 1986, as applicable; and
       ``(II) shall seek to enter into an agreement with a State 
     to share information on findings of compliance and 
     noncompliance with this section, section 712 of the Employee 
     Retirement Income Security Act of 1974, or section 9812 of 
     the Internal Revenue Code of 1986, as applicable.

       ``(C) Recommendations.--The compliance program guidance 
     document shall include recommendations to comply with this 
     section, section 712 of the Employee Retirement Income 
     Security Act of 1974, or section 9812 of the Internal Revenue 
     Code of 1986, as applicable, and encourage the development 
     and use of internal controls to monitor adherence to 
     applicable statutes, regulations, and program requirements. 
     Such internal controls may include a compliance checklist 
     with illustrative examples of nonquantitative treatment 
     limitations on mental health and substance use disorder 
     benefits, which may fail to comply with this section, section 
     712 of the Employee Retirement Income Security Act of 1974, 
     or section 9812 of the Internal Revenue Code of 1986, as 
     applicable, in relation to nonquantitative treatment 
     limitations on medical and surgical benefits.
       ``(D) Updating the compliance program guidance document.--
     The compliance program guidance document shall be updated 
     every 2 years to include illustrative, de-identified examples 
     (that do not disclose any protected health information or 
     individually identifiable information) of previous findings 
     of compliance and noncompliance with this section, section 
     712 of the Employee Retirement Income Security Act of 1974, 
     or section 9812 of the Internal Revenue Code of 1986, as 
     applicable.''.
       (b) Additional Guidance.--Section 2726(a) of the Public 
     Health Service Act (42 U.S.C. 300gg-26(a)), as amended by 
     subsection (a), is further amended by adding at the end the 
     following:
       ``(7) Additional guidance.--
       ``(A) In general.--Not later than 1 year after the date of 
     enactment of the Helping Families in Mental Health Crisis Act 
     of 2016,

[[Page H4316]]

     the Secretary, in coordination with the Secretary of Labor 
     and the Secretary of the Treasury, shall issue guidance to 
     group health plans and health insurance issuers offering 
     group or individual health insurance coverage to assist such 
     plans and issuers in satisfying the requirements of this 
     section, section 712 of the Employee Retirement Income 
     Security Act of 1974, or section 9812 of the Internal Revenue 
     Code of 1986, as applicable,.
       ``(B) Disclosure.--
       ``(i) Guidance for plans and issuers.--The guidance issued 
     under this paragraph shall include clarifying information and 
     illustrative examples of methods that group health plans and 
     health insurance issuers offering group or individual health 
     insurance coverage may use for disclosing information to 
     ensure compliance with the requirements under this section, 
     section 712 of the Employee Retirement Income Security Act of 
     1974, or section 9812 of the Internal Revenue Code of 1986, 
     as applicable, (and any regulations promulgated pursuant to 
     such sections, as applicable).
       ``(ii) Documents for participants, beneficiaries, 
     contracting providers, or authorized representatives.--The 
     guidance issued under this paragraph shall include clarifying 
     information and illustrative examples of methods that group 
     health plans and health insurance issuers offering group or 
     individual health insurance coverage may use to provide any 
     participant, beneficiary, contracting provider, or authorized 
     representative, as applicable, with documents containing 
     information that the health plans or issuers are required to 
     disclose to participants, beneficiaries, contracting 
     providers, or authorized representatives to ensure compliance 
     with this section, section 712 of the Employee Retirement 
     Income Security Act of 1974, or section 9812 of the Internal 
     Revenue Code of 1986, as applicable; any regulation issued 
     pursuant to such respective section, or any other applicable 
     law or regulation, including information that is comparative 
     in nature with respect to--

       ``(I) nonquantitative treatment limitations for both 
     medical and surgical benefits and mental health and substance 
     use disorder benefits;
       ``(II) the processes, strategies, evidentiary standards, 
     and other factors used to apply the limitations described in 
     subclause (I); and
       ``(III) the application of the limitations described in 
     subclause (I) to ensure that such limitations are applied in 
     parity with respect to both medical and surgical benefits and 
     mental health and substance use disorder benefits.

       ``(C) Nonquantitative treatment limitations.--The guidance 
     issued under this paragraph shall include clarifying 
     information and illustrative examples of methods, processes, 
     strategies, evidentiary standards, and other factors that 
     group health plans and health insurance issuers offering 
     group or individual health insurance coverage may use 
     regarding the development and application of nonquantitative 
     treatment limitations to ensure compliance with this section, 
     section 712 of the Employee Retirement Income Security Act of 
     1974, or section 9812 of the Internal Revenue Code of 1986, 
     as applicable, (and any regulations promulgated pursuant to 
     such respective section), including--
       ``(i) examples of methods of determining appropriate types 
     of nonquantitative treatment limitations with respect to both 
     medical and surgical benefits and mental health and substance 
     use disorder benefits, including nonquantitative treatment 
     limitations pertaining to--

       ``(I) medical management standards based on medical 
     necessity or appropriateness, or whether a treatment is 
     experimental or investigative;
       ``(II) limitations with respect to prescription drug 
     formulary design; and
       ``(III) use of fail-first or step therapy protocols;

       ``(ii) examples of methods of determining--

       ``(I) network admission standards (such as credentialing); 
     and
       ``(II) factors used in provider reimbursement methodologies 
     (such as service type, geographic market, demand for 
     services, and provider supply, practice size, training, 
     experience, and licensure) as such factors apply to network 
     adequacy;

       ``(iii) examples of sources of information that may serve 
     as evidentiary standards for the purposes of making 
     determinations regarding the development and application of 
     nonquantitative treatment limitations;
       ``(iv) examples of specific factors, and the evidentiary 
     standards used to evaluate such factors, used by such plans 
     or issuers in performing a nonquantitative treatment 
     limitation analysis;
       ``(v) examples of how specific evidentiary standards may be 
     used to determine whether treatments are considered 
     experimental or investigative;
       ``(vi) examples of how specific evidentiary standards may 
     be applied to each service category or classification of 
     benefits;
       ``(vii) examples of methods of reaching appropriate 
     coverage determinations for new mental health or substance 
     use disorder treatments, such as evidence-based early 
     intervention programs for individuals with a serious mental 
     illness and types of medical management techniques;
       ``(viii) examples of methods of reaching appropriate 
     coverage determinations for which there is an indirect 
     relationship between the covered mental health or substance 
     use disorder benefit and a traditional covered medical and 
     surgical benefit, such as residential treatment or 
     hospitalizations involving voluntary or involuntary 
     commitment; and
       ``(ix) additional illustrative examples of methods, 
     processes, strategies, evidentiary standards, and other 
     factors for which the Secretary determines that additional 
     guidance is necessary to improve compliance with this 
     section, section 712 of the Employee Retirement Income 
     Security Act of 1974, or section 9812 of the Internal Revenue 
     Code of 1986, as applicable.
       ``(D) Public comment.--Prior to issuing any final guidance 
     under this paragraph, the Secretary shall provide a public 
     comment period of not less than 60 days during which any 
     member of the public may provide comments on a draft of the 
     guidance.''.
       (c) Availability of Plan Information.--
       (1) PHSA amendment.--Paragraph (4) of section 2726(a) of 
     the Public Health Service Act (42 U.S.C. 300gg-26(a)) is 
     amended to read as follows:
       ``(4) Availability of plan information.--The criteria for 
     medical necessity determinations made under the plan or 
     health insurance coverage with respect to mental health or 
     substance use disorder benefits or medical or surgical 
     benefits, the reason for denial of any such benefits, and any 
     other information appropriate to demonstrate compliance under 
     this section (including any such medical and surgical 
     information) shall be made available by the plan 
     administrator (or the health insurance issuer offering such 
     coverage) in accordance with applicable regulations to the 
     current or potential participant, beneficiary, or contracting 
     provider involved upon request. The Secretary may promulgate 
     any such regulations, including interim final regulations or 
     temporary regulations, as may be appropriate to carry out 
     this paragraph.''.
       (2) ERISA amendment.--Paragraph (4) of section 712(a) of 
     the Employee Retirement Income Security Act of 1974 (29 
     U.S.C. 1185a(a)) is amended to read as follows:
       ``(4) Availability of plan information.--The criteria for 
     medical necessity determinations made under the plan with 
     respect to mental health or substance use disorder benefits 
     or medical or surgical benefits (or the health insurance 
     coverage offered in connection with the plan with respect to 
     such benefits), the reason for denial of any such benefits, 
     and any other information appropriate to demonstrate 
     compliance under this section (including any such medical and 
     surgical information) shall be made available by the plan 
     administrator (or the health insurance issuer offering such 
     coverage) in accordance with applicable regulations to the 
     current or potential participant, beneficiary, or contracting 
     provider involved upon request. The Secretary may promulgate 
     any such regulations, including interim final regulations or 
     temporary regulations, as may be appropriate to carry out 
     this paragraph.''.
       (3) IRC amendment.--Paragraph (4) of section 9812(a) of the 
     Internal Revenue Code of 1986 is amended to read as follows:
       ``(4) Availability of plan information.--The criteria for 
     medical necessity determinations made under the plan with 
     respect to mental health or substance use disorder benefits 
     or medical or surgical benefits, the reason for denial of any 
     such benefits, and any other information appropriate to 
     demonstrate compliance under this section (including any such 
     medical and surgical information) shall be made available by 
     the plan administrator in accordance with applicable 
     regulations to the current or potential participant, 
     beneficiary, or contracting provider involved upon request. 
     The Secretary may promulgate any such regulations, including 
     interim final regulations or temporary regulations, as may be 
     appropriate to carry out this paragraph.''.
       (d) Improving Compliance.--
       (1) In general.--In the case that the Secretary of Health 
     and Human Services, the Secretary of Labor, or the Secretary 
     of the Treasury determines that a group health plan or health 
     insurance issuer offering group or individual health 
     insurance coverage has violated, at least 5 times, section 
     2726 of the Public Health Service Act (42 U.S.C. 300gg-26), 
     section 712 of the Employee Retirement Income Security Act of 
     1974 (29 U.S.C. 1185a), or section 9812 of the Internal 
     Revenue Code of 1986, respectively, the appropriate Secretary 
     shall audit plan documents for such health plan or issuer in 
     the plan year following the Secretary's determination in 
     order to help improve compliance with such section.
       (2) Rule of construction.--Nothing in this subsection shall 
     be construed to limit the authority, as in effect on the day 
     before the date of enactment of this Act, of the Secretary of 
     Health and Human Services, the Secretary of Labor, or the 
     Secretary of the Treasury to audit documents of health plans 
     or health insurance issuers.

     SEC. 802. ACTION PLAN FOR ENHANCED ENFORCEMENT OF MENTAL 
                   HEALTH AND SUBSTANCE USE DISORDER COVERAGE.

       (a) Public Meeting.--
       (1) In general.--Not later than 6 months after the date of 
     enactment of this Act, the Secretary of Health and Human 
     Services shall convene a public meeting of stakeholders 
     described in paragraph (2) to produce an action plan for 
     improved Federal and State coordination related to the 
     enforcement of section 2726 of the Public Health Service Act 
     (42 U.S.C. 300gg-26), section 712 of the Employee Retirement 
     Income Security Act of 1974 (29 U.S.C. 1185a), and section

[[Page H4317]]

     9812 of the Internal Revenue Code of 1986, and any comparable 
     provisions of State law (in this section collectively 
     referred to as ``mental health parity and addiction equity 
     requirements'').
       (2) Stakeholders.--The stakeholders described in this 
     paragraph shall include each of the following:
       (A) The Federal Government, including representatives 
     from--
       (i) the Department of Health and Human Services;
       (ii) the Department of the Treasury;
       (iii) the Department of Labor; and
       (iv) the Department of Justice.
       (B) State governments, including--
       (i) State health insurance commissioners;
       (ii) appropriate State agencies, including agencies on 
     public health or mental health; and
       (iii) State attorneys general or other representatives of 
     State entities involved in the enforcement of mental health 
     parity and addiction equity requirements.
       (C) Representatives from key stakeholder groups, 
     including--
       (i) the National Association of Insurance Commissioners;
       (ii) health insurance providers;
       (iii) providers of mental health and substance use disorder 
     treatment;
       (iv) employers; and
       (v) patients or their advocates.
       (b) Action Plan.--Not later than 6 months after the 
     conclusion of the public meeting under subsection (a), the 
     Secretary of Health and Human Services shall finalize the 
     action plan described in such subsection and make it plainly 
     available on the Internet website of the Department of Health 
     and Human Services.
       (c) Content.--The action plan under this section shall--
       (1) reflect the input of the stakeholders participating in 
     the public meeting under subsection (a);
       (2) identify specific strategic objectives regarding how 
     the various Federal and State agencies charged with 
     enforcement of mental health parity and addiction equity 
     requirements will collaborate to improve enforcement of such 
     requirements;
       (3) provide a timeline for implementing the action plan; 
     and
       (4) provide specific examples of how such objectives may be 
     met, which may include--
       (A) providing common educational information and documents 
     to patients about their rights under mental health parity and 
     addiction equity requirements;
       (B) facilitating the centralized collection of, monitoring 
     of, and response to patient complaints or inquiries relating 
     to mental health parity and addiction equity requirements, 
     which may be through the development and administration of a 
     single, toll-free telephone number and an Internet website 
     portal;
       (C) Federal and State law enforcement agencies entering 
     into memoranda of understanding to better coordinate 
     enforcement responsibilities and information sharing, 
     including whether such agencies should make the results of 
     enforcement actions related to mental health parity and 
     addiction equity requirements publicly available; and
       (D) recommendations to the Congress regarding the need for 
     additional legal authority to improve enforcement of mental 
     health parity and addiction equity requirements, including 
     the need for additional legal authority to ensure that 
     nonquantitative treatment limitations are applied, and the 
     extent and frequency of the applications of such limitations, 
     both to medical and surgical benefits and to mental health 
     and substance use disorder benefits in a comparable manner.

     SEC. 803. REPORT ON INVESTIGATIONS REGARDING PARITY IN MENTAL 
                   HEALTH AND SUBSTANCE USE DISORDER BENEFITS.

       (a) In General.--Not later than 1 year after the date of 
     enactment of this Act, and annually thereafter for the 
     subsequent 5 years, the Administrator of the Centers for 
     Medicare & Medicaid Services, in collaboration with the 
     Assistant Secretary of Labor of the Employee Benefits 
     Security Administration and the Secretary of the Treasury, 
     shall submit to the Committee on Energy and Commerce of the 
     House of Representatives and the Committee on Health, 
     Education, Labor, and Pensions of the Senate a report 
     summarizing the results of all closed Federal investigations 
     completed during the preceding 12-month period with findings 
     of any serious violation regarding compliance with mental 
     health and substance use disorder coverage requirements under 
     section 2726 of the Public Health Service Act (42 U.S.C. 
     300gg-26), section 712 of the Employee Retirement Income 
     Security Act of 1974 (29 U.S.C. 1185a), and section 9812 of 
     the Internal Revenue Code of 1986.
       (b) Contents.--Subject to subsection (c), a report under 
     subsection (a) shall, with respect to investigations 
     described in such subsection, include each of the following:
       (1) The number of closed Federal investigations conducted 
     during the covered reporting period.
       (2) Each benefit classification examined by any such 
     investigation conducted during the covered reporting period.
       (3) Each subject matter, including compliance with 
     requirements for quantitative and nonquantitative treatment 
     limitations, of any such investigation conducted during the 
     covered reporting period.
       (4) A summary of the basis of the final decision rendered 
     for each closed investigation conducted during the covered 
     reporting period that resulted in a finding of a serious 
     violation.
       (c) Limitation.--Any individually identifiable information 
     shall be excluded from reports under subsection (a) 
     consistent with protections under the health privacy and 
     security rules promulgated under section 264(c) of the Health 
     Insurance Portability and Accountability Act of 1996 (42 
     U.S.C. 1320d-2 note).

     SEC. 804. GAO STUDY ON PARITY IN MENTAL HEALTH AND SUBSTANCE 
                   USE DISORDER BENEFITS.

       Not later than 3 years after the date of enactment of this 
     Act, the Comptroller General of the United States, in 
     consultation with the Secretary of Health and Human Services, 
     the Secretary of Labor, and the Secretary of the Treasury, 
     shall submit to the Committee on Energy and Commerce of the 
     House of Representatives and the Committee on Health, 
     Education, Labor, and Pensions of the Senate a report 
     detailing the extent to which group health plans or health 
     insurance issuers offering group or individual health 
     insurance coverage that provides both medical and surgical 
     benefits and mental health or substance use disorder 
     benefits, medicaid managed care organizations with a contract 
     under section 1903(m) of the Social Security Act (42 U.S.C. 
     1396b(m)), and health plans provided under the State 
     Children's Health Insurance Program under title XXI of the 
     Social Security Act (42 U.S.C. 1397aa et seq.) comply with 
     section 2726 of the Public Health Service Act (42 U.S.C. 
     300gg-26), section 712 of the Employee Retirement Income 
     Security Act of 1974 (29 U.S.C. 1185a), and section 9812 of 
     the Internal Revenue Code of 1986, including--
       (1) how nonquantitative treatment limitations, including 
     medical necessity criteria, of such plans or issuers comply 
     with such sections;
       (2) how the responsible Federal departments and agencies 
     ensure that such plans or issuers comply with such sections, 
     including an assessment of how the Secretary of Health and 
     Human Services has used its authority to conduct audits of 
     such plans to ensure compliance;
       (3) a review of how the various Federal and State agencies 
     responsible for enforcing mental health parity requirements 
     have improved enforcement of such requirements in accordance 
     with the objectives and timeline described in the action plan 
     under section 802; and
       (4) recommendations for how additional enforcement, 
     education, and coordination activities by responsible Federal 
     and State departments and agencies could better ensure 
     compliance with such sections, including recommendations 
     regarding the need for additional legal authority.

     SEC. 805. INFORMATION AND AWARENESS ON EATING DISORDERS.

       (a) Information.--The Secretary of Health and Human 
     Services (in this section referred to as the ``Secretary'') 
     may--
       (1) update information, related fact sheets, and resource 
     lists related to eating disorders that are available on the 
     public Internet website of the National Women's Health 
     Information Center sponsored by the Office on Women's Health, 
     to include--
       (A) updated findings and current research related to eating 
     disorders, as appropriate; and
       (B) information about eating disorders, including 
     information related to males and females;
       (2) incorporate, as appropriate, and in coordination with 
     the Secretary of Education, information from publicly 
     available resources into appropriate obesity prevention 
     programs developed by the Office on Women's Health; and
       (3) make publicly available (through a public Internet 
     website or other method) information, related fact sheets and 
     resource lists, as updated under paragraph (1), and the 
     information incorporated into appropriate obesity prevention 
     programs, as updated under paragraph (2).
       (b) Awareness.--The Secretary may advance public awareness 
     on--
       (1) the types of eating disorders;
       (2) the seriousness of eating disorders, including 
     prevalence, comorbidities, and physical and mental health 
     consequences;
       (3) methods to identify, intervene, refer for treatment, 
     and prevent behaviors that may lead to the development of 
     eating disorders;
       (4) discrimination and bullying based on body size;
       (5) the effects of media on self-esteem and body image; and
       (6) the signs and symptoms of eating disorders.

     SEC. 806. EDUCATION AND TRAINING ON EATING DISORDERS.

       The Secretary of Health and Human Services may facilitate 
     the identification of programs to educate and train health 
     professionals and school personnel in effective strategies 
     to--
       (1) identify individuals with eating disorders;
       (2) provide early intervention services for individuals 
     with eating disorders;
       (3) refer patients with eating disorders for appropriate 
     treatment;
       (4) prevent the development of eating disorders; or
       (5) provide appropriate treatment services for individuals 
     with eating disorders.

[[Page H4318]]

  


     SEC. 807. GAO STUDY ON PREVENTING DISCRIMINATORY COVERAGE 
                   LIMITATIONS FOR INDIVIDUALS WITH SERIOUS MENTAL 
                   ILLNESS AND SUBSTANCE USE DISORDERS.

       Not later than 2 years after the date of the enactment of 
     this Act, the Comptroller General of the United States shall 
     submit to Congress and make publicly available a report 
     detailing Federal oversight of group health plans and health 
     insurance coverage offered in the individual or group market 
     (as such terms are defined in section 2791 of the Public 
     Health Service Act (42 U.S.C. 300gg-91)), including Medicaid 
     managed care plans under section 1903 of the Social Security 
     Act (42 U.S.C. 1396b), to ensure compliance of such plans and 
     coverage with sections 2726 of the Public Health Service Act 
     (42 U.S.C. 300gg-26), 712 of the Employee Retirement Income 
     Security Act of 1974 (29 U.S.C. 1185a), and 9812 of the 
     Internal Revenue Code of 1986 (in this section collectively 
     referred to as the ``parity law''), including--
       (1) a description of how Federal regulations and guidance 
     consider nonquantitative treatment limitations, including 
     medical necessity criteria and application of such criteria 
     to medical, surgical, and primary care, of such plans and 
     coverage in ensuring compliance by such plans and coverage 
     with the parity law;
       (2) a description of actions that Federal departments and 
     agencies are taking to ensure that such plans and coverage 
     comply with the parity law; and
       (3) the identification of enforcement, education, and 
     coordination activities within Federal departments and 
     agencies, including educational activities directed to State 
     insurance commissioners, and a description of how such proper 
     activities can be used to ensure full compliance with the 
     parity law.

     SEC. 808. CLARIFICATION OF EXISTING PARITY RULES.

        If a group health plan or a health insurance issuer 
     offering group or individual health insurance coverage 
     provides coverage for eating disorder benefits, including 
     residential treatment, such group health plan or health 
     insurance issuer shall provide such benefits consistent with 
     the requirements of section 2726 of the Public Health Service 
     Act (42 U.S.C. 300gg-26), section 712 of the Employee 
     Retirement Income Security Act of 1974 (29 U.S.C. 1185a), and 
     section 9812 of the Internal Revenue Code of 1986.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Pennsylvania (Mr. Murphy) and the gentleman from New Jersey (Mr. 
Pallone) each will control 20 minutes.
  The Chair recognizes the gentleman from Pennsylvania.


                             General Leave

  Mr. MURPHY of Pennsylvania. Mr. Speaker, I ask unanimous consent that 
all Members have 5 legislative days in which to revise and extend their 
remarks and insert extraneous materials in the Record on the bill.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Pennsylvania?
  There was no objection.
  Mr. MURPHY of Pennsylvania. Mr. Speaker, I yield myself such time as 
I may consume.
  Mr. Speaker, our mental health system in this country is a failure. 
This is one of those times where we are not gathered for a moment of 
silence, but a time of action. We are here finally to speak up for the 
last, the lost, the least, and the lonely, that is those who suffer 
from mental illness which is untreated.
  Mental illness affects one in five Americans. About 10 million 
Americans have serious mental illness. About 4 million of those go 
without any treatment. There are 100,000 new cases each year. Half of 
psychosis cases emerge by age 14, 75 percent by age 24. We have a need 
for 30,000 child psychiatrists. We only have 9,000. We have great 
shortages of psychologists.
  The time between the emergence of the first symptoms of serious 
mental illness and the first appointment is about 80 weeks. We need 
about 100,000 hospital beds in this country, but we only have 40,000 
for psychiatric crises. A person is 10 times more likely, therefore, to 
be in jail than in a hospital if they are mentally ill.
  And these statistics, too: 43,000 suicides last year, 47,000 drug 
overdose deaths, 1,000 homicides, 250 mentally ill violently killed in 
a police encounter where they attacked a policeman. We have hundreds of 
thousands of homeless and mentally ill who die the slow-motion death of 
chronic illness, and that comes to more than the number who die of 
breast cancer, perhaps 350,000 or more a year.
  The Helping Families in Mental Health Crisis Act, a bipartisan bill 
with over 205 cosponsors, which came out of the Committee on Energy and 
Commerce with a unanimous vote, fixes this. It allows parents and 
caregivers to help with care. It increases the number of crisis mental 
health beds. It drives evidence-based care. It builds on existing 
mental health and substance abuse parity laws. It brings accountability 
to Federal grant programs, which two GAO reports say were disastrous. 
It focuses on innovation and reaches underserved and rural populations, 
expands the mental health workforce, advances early intervention and 
prevention programs, develops alternatives to institutionalization, 
focuses on suicide prevention, increases program coordination across 
the 112 Federal programs and agencies, reforms protection and advocacy, 
provides training grants to train police officers and first responders, 
and saves the Federal Government money. It is wide ranging, it is 
impactful, and it is something that we are going to have to pass today 
if we really, truly want to make a difference.
  Mr. Speaker, I reserve the balance of my time.
  Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume.
  I rise in support of H.R. 2646, the Helping Families in Mental Health 
Crisis Act.
  Today's mental health system can hardly be described as a system at 
all. While some States are undertaking promising improvements, the 
system is fragmented, overwhelmed, and underresourced. Far too many 
people with mental illnesses can't get the treatment they need to live 
long, healthy, and productive lives, so I am pleased that this bill 
takes an important step toward improving mental health care in this 
country.
  The bill under consideration today, Mr. Speaker, is a significant 
improvement over the original version introduced a year ago. It is no 
secret that many of us had substantial concerns with some of the 
provisions in the original text of the bill, and I am sure that my 
fellow Members of the Committee on Energy and Commerce remember the 
extensive debate we had on this bill during our subcommittee markup 
last November.
  Since that time, we have found common ground. We removed many 
provisions that would have done more harm than good, in my opinion, and 
replaced them with policies that strengthen the bill. I am proud that 
H.R. 2646 now includes several policies championed by Democrats.
  The bill requires that States provide the full range of early and 
periodic screening, diagnostic, and treatment--EPSDT--services to 
children in the Medicaid program who receive inpatient psychiatric care 
at so-called institutions of mental disease. It creates a new assertive 
community treatment grant program and a peer professional workforce 
grant program. The legislation also creates new grant programs to 
address adult suicide, expands access to community crisis response 
services, and creates and disseminates model HIPAA training programs.
  A great deal of work went into crafting this agreement, and I want to 
thank my Republican colleagues for continuing to meet with us 
throughout this process so that we could bring a bipartisan product to 
the floor.
  That said, the bill before us today is not transformative reform nor 
is it a panacea to the many problems now facing our mental health 
system. I encourage my colleagues to see this legislation as a 
necessary step rather than a solution, and I want to be very clear on 
this point. If we are truly serious about fixing our broken mental 
health system, we have to expand access and make sustained investment, 
and that means we must work to encourage all States to expand Medicaid 
and provide more Federal resources to support the growth of community-
based prevention, treatment, and recovery services.
  This legislation is not comprehensive. It by no means contains enough 
funding to make the mental health system whole. I hope that, in the 
near future, we can work together again on additional legislation to 
increase treatment options and further strengthen mental health parity 
enforcement.
  I once again want to thank my colleagues who stood with me throughout 
this long process, fiercely voicing their concerns and advocating for 
major improvements to the bill. I want to thank Chairman Upton for his 
leadership, and the bill's sponsors, Representatives Tim Murphy and 
Eddie Bernice Johnson, for championing this issue for so many years.

[[Page H4319]]

  I urge my colleagues to support this important bipartisan bill, and I 
look forward to the Senate's action on this issue.
  Mr. Speaker, I reserve the balance of my time.
  Mr. MURPHY of Pennsylvania. Mr. Speaker, I yield 1 minute to the 
gentleman from New Jersey (Mr. Lance), a member of the Committee on 
Energy and Commerce, who has been supporting this from the onset.
  Mr. LANCE. Mr. Speaker, today marks a very important moment in the 
long and tortuous road to reform a mental health system that is broken 
and must be fixed.
  I joined the gentleman from Pennsylvania (Mr. Murphy), a psychologist 
and my friend and colleague, and our former colleague, now U.S. Senator 
from Louisiana, Dr. Bill Cassidy, in a conference room in the basement 
of the U.S. Capitol in December 2013, where the three of us stood 
together and called on Congress to address a mental healthcare system 
in crisis, a system where millions of Americans suffer every year and 
are all too often pushed into the shadows by archaic regulations and an 
outdated Federal bureaucracy. 2\1/2\ years later, I am proud that the 
House stands poised today to pass the most significant reform to our 
Nation's mental health programs in decades.
  This bill includes provisions I have championed to help provide early 
detection of eating disorders and improve access to treatment coverage. 
This is an historic achievement, as it marks the first time Congress 
has addressed eating disorders specifically through legislation.
  I thank Subcommittee Chairman Murphy, Chairman Upton, and the entire 
Committee on Energy and Commerce for working together to pass this 
landmark mental healthcare reform bill and move us one step closer to 
providing millions of Americans and their families a chance at 
treatment before tragedy strikes.
  Mr. PALLONE. Mr. Speaker, I yield 1\1/2\ minutes to the gentleman 
from Texas (Mr. Gene Green), the ranking member of the Health 
Subcommittee.

                              {time}  1400

  Mr. GENE GREEN of Texas. Mr. Speaker, I rise in support of H.R. 2646, 
legislation to improve our mental health system.
  This bill is a positive step forward. I want to thank my colleagues 
on both sides of the aisle for their work to improve access, 
prevention, and treatment for those with mental and behavioral 
conditions. We worked extensively and collaboratively to craft the 
legislation.
  I want to particularly thank Energy and Commerce Committee Chairman 
Upton; Ranking Member Pallone; Representatives Kennedy, Matsui, 
Loebsack, Tonko, and DeGette for their contributions; and Congressman 
Tim Murphy for elevating the conversation about mental health.
  H.R. 2646 includes new grant programs that expand access to critical 
mental health services, such as community crisis response systems and 
adult suicide prevention. It provides new tools to improve compliance 
with mental health parity, HIPAA training programs for patients and 
providers to better understand their protections and rights, and a peer 
professional workforce development grant.
  I am pleased that this legislation extends the Federal Tort Claims 
Act to help professional volunteers at community health centers. It 
also affords the full range of Early and Periodic Screening, 
Diagnostic, and Treatment services to Medicaid children who receive 
care in Institutes of Mental Diseases.
  While not comprehensive and lacking key resources, today's vote marks 
a significant step forward to strengthening our Nation's mental health 
system.
  Again, I want to thank my colleagues on the Energy and Commerce 
Committee and their staffs, and I urge Members to vote in favor of this 
legislation.
  Mr. MURPHY of Pennsylvania. Mr. Speaker, I yield 1 minute to the 
gentleman from Louisiana (Mr. Scalise) the majority whip.
  Mr. SCALISE. Mr. Speaker, I thank my colleague from Pennsylvania for 
yielding, but especially for taking the lead on this issue.
  Mr. Speaker, it has been decades since Congress has reformed our 
mental health laws. Unfortunately, we have seen so many negative 
aspects since then. Suicide rates are through the roof. There are so 
many other problems throughout our country. It has touched every 
community in this Nation. We see a growing problem with mental health.
  This bill really refocuses efforts, but it also puts a different 
priority on Federal grants and Federal agencies to force them to do a 
better job of addressing these problems. It also helps families to get 
more involved in the mental health problems that their own children 
face. Right now, some Federal laws make it harder for parents to help 
their own children. These kinds of serious problems have been 
complicated to work through.
  Mr. Speaker, when you look at the fact that it has been decades, 
there is a reason why. This is hard work. It is complicated work. This 
bill has been at least 3 years in the making, and so it is very 
important that we bring this bill to the floor today and pass it over 
to the Senate. This is not only reform that can pass the House, but 
reform that actually get signed by the President and make a real 
difference and impact in improving people's lives.
  Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentlewoman from 
California (Ms. Matsui).
  Ms. MATSUI. Mr. Speaker, I thank the gentleman for yielding.
  For far too long, those with mental illness have been left in the 
shadows, and mental health prevention and treatment have been left out 
of our health systems.
  The mental health crisis in this country is very personal to me, and 
I have been fighting for patients and their loved ones for many years. 
I believe there is a lot we can do better to stop or slow down the hurt 
and pain that patients and families feel when mental health is left 
unaddressed.
  The bill before us today is a good bill. It is a first step toward 
mental health reform, offering policies that help move us in the 
direction of better parity between mental and physical illness, a 
stronger workforce trained to address mental illness, and promotion of 
evidence-based services and supports.
  Especially important to me are the provisions that will help clarify 
when and how providers are able to share information with families and 
caregivers in order to better serve the patients in times of need.
  There is more left to be done, more to do, and our reform efforts 
will not be complete or comprehensive until we make real investments in 
our mental health system. I will continue working for the comprehensive 
mental health reforms that our families need and deserve.
  Mr. MURPHY of Pennsylvania. Mr. Speaker, I yield 1 minute to the 
gentleman from Michigan (Mr. Upton), chairman of the full committee and 
who we owe a great debt of gratitude for moving forward this bill.
  Mr. UPTON. Mr. Speaker, today marks an important milestone in the 
multiyear, multi-Congress effort to deliver meaningful reforms to the 
Nation's mental health system.
  Last month, the Energy and Commerce Committee passed this bill 53-0 
in committee. It has been bipartisan. We know that this is an issue 
that impacts every community and so many families in one way or 
another. We continue to hear tales of great loss where intervention was 
lacking or nonexistent. So we got to work. We spent hundreds and 
hundreds of hours--I am not kidding--in staff work and work by Members.
  For way too long, mental health was a subject that was left in the 
shadows. Thankfully, that is no longer the case. Today we have 
developed a thoughtful solution. Throughout the process, we have 
achieved many important reforms. Today we build upon that momentum.
  Our current system of siloed grants, prevention, and treatment simply 
doesn't work the way it should. This bill changes that with real 
reforms to provide SAMHSA new tools, under the leadership of a new 
Assistant Secretary, and we have done it the way that we should.
  This bipartisan bill will save lives, aid families, and provide 
comfort and relief to those who are struggling.
  Mr. Speaker, today marks an important milestone in the multi-year, 
multi-Congress effort to deliver meaningful reforms to the nation's 
mental health system. Last month, the

[[Page H4320]]

Energy and Commerce Committee unanimously approved H.R. 2646 by a vote 
of 53 to zero to help families in mental health crisis.
  This is an issue that impacts every community, and so many families, 
in one way or another. We continue to hear tales of great loss where 
intervention was lacking or nonexistent.
  But you know what? Congressman Tim Murphy got to work. For way too 
long, mental health was a subject left for the shadows. Thankfully, 
that's no longer the case. Today, we have developed a thoughtful 
legislative solution. Throughout this process, we have achieved 
important reforms and today we build upon that momentum.
  Our current system of siloed grants, prevention, and treatment simply 
does not work as well as it should. The ``Helping Families in Mental 
Health Crisis Act'' includes new reforms to make sure the federal 
government is leveraging their dollars with investments in evidence-
based programs. The bill includes reforms to provide SAMHSA new tools, 
under the leadership of an Assistant Secretary for Mental Health and 
Substance Use, to do its job better.
  Thoughtful legislating takes time and dedication. This Congress we 
have seen multi-year landmark committee efforts finally make it across 
the finish line in SGR reform, pipeline safety and chemical safety 
reforms, which were both signed into law late last month. 21st Century 
Cures has taken years, and we continue to make progress. And I am 
hopeful these mental health reforms that we have long pursued are on 
the same path to being signed into law, building upon our proud 
bipartisan record of success.
  This bipartisan bill will save lives, aid families, and provide 
comfort and relief to those struggling. This strong bill is something 
that both Republicans and Democrats can be proud of. I thank Dr. 
Murphy, Health Subcommittee Chairman Pitts, full committee Ranking 
Member Frank Pallone and the staff, who worked hundreds of hours to 
bring us to where we are today.
  This bill will truly make a real difference and deliver meaningful 
reforms to families in mental health crisis all across America.
  Mr. PALLONE. Mr. Speaker, I yield 1\1/2\ minutes to the gentleman 
from New York (Mr. Tonko).
  Mr. TONKO. Mr. Speaker, I thank the gentleman from New Jersey for 
yielding.
  Mr. Speaker, I rise today in support of H.R. 2646, the Helping 
Families in Mental Health Crisis Act. While this bill is not perfect 
and necessarily represents a compromise from all sides, it is a good 
first step in making the improvement to our Nation's mental health 
system. It has been a long road to get here, and the passionate debate 
we have had has only served to strengthen the bill and produce 
legislation that we can all support.
  In particular, I would like to highlight section 502, which is based 
on my Coordinating Crisis Care Act, which I sponsored. This provision 
would authorize a new grant program at SAMHSA to fund the development 
of real-time bed registry systems that will help get individuals in 
crisis the appropriate care they need in a timely fashion. By ensuring 
better coordination of crisis care systems, we can save lives and 
support individuals and families in their time of need.
  Looking forward, Congress needs to do more to heal a broken mental 
health system. We should pass additional legislation that would ensure 
vigorous enforcement of our mental health parity laws and to strengthen 
mental health and substance use coverage for Medicaid and Medicare 
beneficiaries. That is ultimately the key to quality performance here 
for the mental health community.
  Finally, we have to acknowledge that the current dysfunction in our 
mental health systems stems, in part, from decades of broken promises 
and a chronic underinvestment in community-based mental health services 
that simply cannot be solved by one single bill like this.
  We must do better, and I stand ready to help in that fight.
  Mr. MURPHY of Pennsylvania. Mr. Speaker, I yield 1 minute to the 
gentleman from Oregon (Mr. Walden).
  Mr. WALDEN. Mr. Speaker, today I rise in support of Representative 
Murphy's Helping Families in Mental Health Crisis Act.
  Ten million Americans suffer from serious mental illness, Mr. 
Speaker. If they get care, they are 16 times less likely to harm 
themselves or others. Right now, too many patients fall through the 
cracks.
  At a recent roundtable in Medford, Oregon, and on a tele-townhall I 
just completed, I heard from parents about their children who 
experienced homelessness and violence due to their illness, from 
caregivers about the difficulty of getting timely care, and from law 
enforcement about how the default place for the mentally ill is often a 
jail.
  The consensus among all of them was that the healthcare system, the 
government, and society are failing those who need help the most. They 
overwhelmingly support the provisions in this legislation.
  We can improve treatment, we can and do boost resources, and we will 
get care to people in need, especially in our rural communities.
  Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentleman from 
Massachusetts (Mr. Kennedy).
  Mr. KENNEDY. Mr. Speaker, I want to thank Ranking Member Pallone, 
Chairman Upton, and Congressman Murphy for, once again, the bipartisan 
leadership that has guided this bill through our committee and onto the 
floor.
  Mr. Speaker, you cannot listen to the constant stories from patients 
and families who have been denied access to mental health care and 
believe that there are not tragic gaps in our mental health system. 
This bill is a bipartisan, incremental step forward in our efforts to 
address those gaps.
  I am especially pleased by the inclusion of my bill to remove the 
discriminatory barrier to care for children in certain inpatient 
psychiatric facilities, yet we have to acknowledge that, unless this is 
just the first step, we have failed to fix a broken system. Unless we 
increase Medicaid reimbursements rates, providers will still be forced 
to turn away our most vulnerable patient populations. Unless we inspire 
and encourage a new generation to pursue careers as psychologists, 
psychiatrists, and social workers, there will still be a shortage of 
professionals to care for our patients. Unless we can guarantee parity, 
insurance companies will continue to construct barriers to care, 
leaving patients without access to the mental health system no matter 
how strong that system may be.
  And that is where our eyes should be focused tomorrow after this bill 
is passed.
  Whether in conference or in our future committee hearings, we cannot 
accept this bill as a full, comprehensive fix to a fully broken system. 
If we do, patients suffering from mental illness will continue to fall 
through the same gaps that exist today.
  Mr. MURPHY of Pennsylvania. Mr. Speaker, I yield 2 minutes to the 
gentleman from Florida (Mr. Bilirakis), a member of the Energy and 
Commerce Committee.
  Mr. BILIRAKIS. Mr. Speaker, I rise today in support of H.R. 2646, the 
Helping Families in Mental Health Crisis Act, of which I am a 
cosponsor.
  I want to thank Chairman Murphy for the extensive amount of time and 
attention he has put into addressing mental health and substance abuse 
disorders. He even joined me in my district to hear directly from my 
constituents about this particular bill. I thank Chairman Murphy again 
for that.
  We discussed the struggles that individuals with mental illness face 
and how Congress can best address the need of those we serve. With 
their input, we worked to address every aspect of this overall problem.
  This legislation will help countless individuals and families in my 
district in Florida and in communities across our country. I urge my 
colleagues to support this great piece of legislation.
  Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentlewoman from 
Texas (Ms. Eddie Bernice Johnson), the Democratic sponsor of the bill.
  Ms. EDDIE BERNICE JOHNSON of Texas. Mr. Speaker, I rise today in 
support of H.R. 2646, the Helping Families in Mental Health Crisis Act. 
As the original Democratic cosponsor of this piece of legislation and 
the one that preceded it, I am proud to see it come to the floor today.
  H.R. 2646 is a demonstration of more than 3 years of collaboration 
between not only myself and Congressman Tim Murphy, but the many other 
Members and organizations that came to the table to offer feedback, 
suggestions, and, at times, criticism. At no time did Congressman 
Murphy turn anyone's input down.

[[Page H4321]]

  The end result is a bill that remains focused on enabling the most 
severely and mentally ill to access the treatment they desperately 
deserve, while allowing their families and caregivers to help them 
along the way.
  This piece of legislation contains several necessary provisions, 
including the establishment of an Assistant Secretary for Mental Health 
and Substance Use Disorder, easing our Nation's chronic shortage of 
psychiatric beds, requiring the Secretary of Health and Human Services 
to clarify confusing HIPAA rules surrounding mental health patients, 
and increasing grant programs with results proven to help individuals 
with serious mental health illness gain access to treatment like 
Assisted Outpatient Treatment and Assertive Community Treatment.
  As two of the few mental health providers serving in Congress--
another over here to my left, Dr. McDermott, a psychiatrist--
Congressman Murphy and I have always been focused on the needs of the 
severely mentally ill. Many that we read about daily in our many cities 
across the Nation end up in jail or prison.

                              {time}  1415

  While the homeless and prison population are particularly vulnerable 
to mental illness, these are the individuals that get the least amount 
of attention and access to mental health services. Through our work, we 
have a deep understanding of patient need, and this need is not being 
met.
  The SPEAKER pro tempore. The time of the gentlewoman has expired.
  Mr. PALLONE. Mr. Speaker, I yield the gentlewoman an additional 1 
minute.
  Ms. EDDIE BERNICE JOHNSON of Texas. Unfortunately, we have found that 
many of our fellow Members lack the understanding of patients in 
crisis, making this process more difficult.
  I am hopeful, however, that this bill will be a framework to help us 
move the needle forward on mental health treatment in America.
  I would like to thank Congressman Murphy for his steadfast commitment 
to mental health. I would also like to thank the chairman, Fred Upton, 
and our ranking member, Mr. Pallone, for their hard work on this 
measure. While we still have a long ways to go, this is certainly a 
step forward.
  Mr. MURPHY of Pennsylvania. Mr. Speaker, how much time do I have 
remaining?
  The SPEAKER pro tempore (Mr. Loudermilk). The gentleman from 
Pennsylvania has 12\1/2\ minutes remaining.
  Mr. MURPHY of Pennsylvania. Mr. Speaker, I yield such time as she may 
consume to the gentlewoman from Indiana (Mrs. Brooks), who has been a 
real champion of this bill.
  Mrs. BROOKS of Indiana. Mr. Speaker, 1 in 4 adults, a total of 61.5 
million Americans, will experience mental illness within a given year. 
The numbers alone don't tell the stories behind the deeply personal 
pain that this disease inflicts on our friends, neighbors, and, most 
importantly, their families.
  Today, I am proud to stand with the gentleman from Pennsylvania in 
support of this strong bipartisan bill. He has truly championed the 
first major mental health reform in this country in 50 years.
  Right now, our healthcare system does not allow families of those 
suffering from mental illness to become partners in their health care, 
and this bill ensures that adult patients struggling with mental 
illness will receive the healthcare treatment they need, while allowing 
their families to become close partners in their care. It expands the 
mental health workforce and increases the number of psychiatric 
hospital beds for those experiencing an acute mental health crisis.
  This legislation is a significant, important step toward 
comprehensive, community-based care that will work better for people 
and, most importantly, their families. I urge my colleagues to vote 
``yes'' on this bill.
  Mr. PALLONE. Mr. Speaker, how much time do I have remaining?
  The SPEAKER pro tempore. The gentleman from New Jersey has 8\1/2\ 
minutes remaining.
  Mr. PALLONE. Mr. Speaker, I yield 1\1/2\ minutes to the gentlewoman 
from Ohio (Ms. Kaptur).
  Ms. KAPTUR. Mr. Speaker, I rise today in support of the Helping 
Families in Mental Health Crisis Act, H.R. 2646, and wish to thank 
Chairman Upton, Ranking Member Pallone, and the two driving sponsors of 
this measure, Congressman Tim Murphy and Congresswoman Eddie Bernice 
Johnson, who have adeptly navigated this bill through very choppy 
legislative waters.
  The bill takes head-on one of the most compelling and unaddressed 
health challenges of our society: the suffering, the anguish, the 
travails, the plight of the seriously mentally ill. The bill will 
empower parents and caregivers, drive innovation, advance early-
intervention and prevention programs, and offer alternatives to 
institutionalization, and provide the first step in a long time to show 
respect and real treatment alternatives to Americans living with mental 
illness.
  It is no secret our prisons have become the domiciles for the 
mentally ill. This bill rings out: ``No more, no more.''
  Sadly, psychiatric care has become the responsibility of our prison 
system. Three of the largest mental health ``hospitals'' in our country 
are incarceration facilities. Speak to any local sheriff. They will 
tell you their jails are overcrowded with the mentally ill.
  What too often happens is that the ill person in an adult 
incarceration facility actually began their journey in a child 
correction facility, and as they matured, essentially, graduated to the 
adult facility without their underlying mental illness being properly 
diagnosed, much less treated. What an indictment of our Nation, not 
just our health and corrections system, this is, but our entire 
country.
  Today's bill calls for a complete overhaul of the current mental 
health system. It has been needed since the de-institutionalization 
that sent millions, some to their death when they were sent to the 
streets.
  I want to congratulate, as I conclude, Representatives Murphy and 
Johnson for bringing this bill to the floor and addressing a crying 
human need for too long ignored in our country. They are doing 
something noble for the Nation. The severely mentally ill must be 
humanely treated.
  Mr. MURPHY of Pennsylvania. Mr. Speaker, I yield 1 minute to the 
gentleman from Pennsylvania (Mr. Pitts), the chairman of the Health 
Subcommittee of the Committee on Energy and Commerce.
  Mr. PITTS. Mr. Speaker, I thank Mr. Murphy for his leadership and his 
persistence in getting this historic legislation to the floor.
  When a person struggles with mental illness, he or she may lose her 
job, her friends, even her family, which can make the mental illness 
worse. And help for this person may be available, but she may not be 
able to navigate available resources alone or drive to her doctor's 
appointments regularly without help.
  Therefore, organizations providing mental health assistance must not 
only provide resources, they must make sure they actually connect 
people with people in need.
  When the Federal Government distributes mental health funding, it 
needs to go to programs that are doing this, and Congressman Murphy's 
bill is a step in the right direction. His bill will increase 
accountability so that we can better understand how Federal mental 
health and substance abuse treatment funds are used in each State. It 
would summarize best practice models in the States and do many other 
things, and this way we can highlight mental health programs that are 
most effective.
  I urge my colleagues to support the bill.
  Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentleman from 
Washington (Mr. McDermott), the chairman of the Ways and Means Health 
Subcommittee.
  Mr. McDERMOTT. Mr. Speaker, first of all, I want to say 
congratulations to Congressman Murphy. His persistence brought this 
bill to the floor, and it is important that this issue be discussed.
  We are all going to vote for this bill. It will go out of here 
unanimously. We are all going to vote for it. But it is a hollow 
promise if there is not some money in it.
  Now, I was in my training in Chicago, in 1964, when the first mental 
health money came from the Federal Government to Chicago, and it went 
all

[[Page H4322]]

over the country. And if the Federal Government doesn't put money into 
this program that we are outlining in this very carefully constructed 
bill, we will be sending out a blank check. There will be nothing. It 
won't be worth anything. To think that State legislatures or somebody 
is going to find the money somewhere is simply not real.
  Now, this morning, Mr. Pallone and I sat on a conference committee on 
opioids. We are doing the same thing there. We know there is addiction, 
we know there are all kinds of problems all over the place, and we are 
passing a wonderful bill out with some nice words in it, but no money. 
And if you are not willing to put some money into a program like this, 
you are simply consigning the mental health people to the jail.
  I was the King County Jail psychiatrist in 1979 and I ran the second-
largest mental hospital in the State of Washington. I had more patients 
every night in that jail than anybody except the guy running the State 
mental hospital down in Tacoma. And that is where the mentally ill are 
today.
  If you want to get them out of that situation and get them into 
treatment, you are going to have to put some money out into the 
community in a variety of these programs. Good programs. I like what is 
in them. But you have got to put some money where your mouth is.
  I will support the bill, and I want to hear the appropriations 
process next.
  Mr. MURPHY of Pennsylvania. Mr. Speaker, I yield 1 minute to the 
gentleman from Texas (Mr. Burgess).
  Mr. BURGESS. I thank the gentleman for the recognition.
  Mr. Speaker, passage of this bill represents a major milestone for 
individuals affected by mental illness across the country, and, of 
course, I want to congratulate Chairman and Congressman Tim Murphy and 
Congresswoman Eddie Bernice Johnson on the progress they have made on 
this front. Many of us have worked in committee for a long time to 
achieve this day.
  And while we are in the business of congratulating ourselves as a 
routine matter, I also want to take a moment to acknowledge the 
participation of staff, both in our personal offices, as well as the 
professional committee staff that helped bring this bill to the point 
we are today. In particular, an alumnus of my office, Adrianna 
Simonelli, worked hard to get this bill to a place where both sides 
could expect and accept the results that we are achieving today.
  Thank you, Mr. Chairman, for the recognition. Thanks for bringing 
this bill to the floor of the House.
  Mr. PALLONE. Mr. Speaker, could I inquire again about the time 
remaining on each side, and ask whether Mr. Murphy, how many additional 
speakers he has?
  The SPEAKER pro tempore. The gentleman from New Jersey has 5 minutes 
remaining.
  Mr. PALLONE. Does the gentleman have a number of additional speakers?
  Mr. MURPHY of Pennsylvania. I have about 10 more speakers who would 
like to speak.
  Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentlewoman from 
Colorado (Ms. DeGette), who is the ranking member of the Oversight and 
Investigations Subcommittee.
  Ms. DeGETTE. Mr. Speaker, today's vote on this wonderful bill is the 
result of longstanding efforts in the Energy and Commerce Committee to 
come to a bipartisan compromise on mental health legislation. I 
particularly want to thank my compadre, my chairman, Mr. Murphy, for 
his hard work on this. I have spent many, many hours talking to him 
about this bill over the last few years, and I am happy to have it come 
together.
  This bill really incorporates a number of our positive changes that 
included key provisions from the Comprehensive Behavioral Health Reform 
and Recovery Act, which I am an original cosponsor, and other bills.
  But as Mr. McDermott and others on this side of the aisle have said, 
we still have a lot more work to do. This bill is really just the first 
step towards true reform. And if we want to make a difference, Congress 
really does need to provide the resources needed.
  We have heard people talking about overfilled jails. We have heard 
people talking about parents who can't find beds for their tremendously 
mentally ill children. We have heard about the lack of truly educated 
professionals.
  These things can only be achieved with resources and money. And so I 
truly see this bill as the first step towards a very robust mental 
health system in this country.
  The last thing I want to say is, action on mental health legislation 
does not excuse inaction on gun violence prevention legislation. We 
must do something as well as passing comprehensive mental health 
legislation to respond to the gun violence epidemic.
  Americans, my constituents, want us to take these steps. They have 
made this abundantly clear in the last few weeks, and I am urging that 
we have a vote separately on those issues.
  But for today, let's all vote ``yes'' on this piece of legislation, 
and then let's move forward for the important steps we need to take.
  Mr. MURPHY of Pennsylvania. Mr. Speaker, I yield 45 seconds to the 
gentleman from Michigan (Mr. Benishek).
  Mr. BENISHEK. Mr. Speaker, we are here today to vote on long overdue 
bipartisan mental health legislation. This bill will finally take 
concrete steps toward improving the quality of care available to those 
suffering from mental illness.
  For too long, the most desperate among us have not had access to 
proper mental health care. Patients, along with their families and 
loved ones, have had nowhere to turn.
  As a doctor taking care of patients in northern Michigan for 30 
years, I am all too familiar with the lack of resources and attention 
devoted to providing quality mental health care for our Nation. There 
are many communities in my district there are no psychiatric beds 
available. Local agencies don't have the staff or the resources to 
provide answers for those seeking help, let alone treatment. This bill 
represents a major step forward in turning all that around.
  I hope all my colleagues will join me in supporting this commonsense 
step to help deliver better mental health care.
  Mr. PALLONE. Mr. Speaker, I reserve the balance of my time.
  Mr. MURPHY of Pennsylvania. Mr. Speaker, I yield 45 seconds to the 
gentleman from New York (Mr. Gibson).
  Mr. GIBSON. Mr. Speaker, I want to congratulate Dr. Murphy and Ms. 
Johnson for this landmark mental health legislation. I believe it 
builds on earlier legislation we enacted in this Congress, like the 
Clay Hunt suicide awareness and prevention bill, improving the mental 
health for our veterans. And it fills a void that has existed for 
decades now since we de-institutionalized in the 1970s, a decision I 
support, but we never put Federal policy in behind it until today, Mr. 
Speaker, resources for the local level for inpatient care for Americans 
and families in mental health crisis.

                              {time}  1430

  It improves coordination across the agencies to deliver better 
suicide awareness and prevention in mental health.
  I want to thank my wife, Mary Jo, a licensed clinical social worker, 
for her advice and inspiration.
  Mr. Speaker, I urge my colleagues to support this legislation.
  Mr. PALLONE. I continue to reserve the balance of my time, Mr. 
Speaker.
  Mr. MURPHY of Pennsylvania. Mr. Speaker, I yield 45 seconds to the 
gentleman from Pennsylvania (Mr. Rothfus), my friend and colleague.
  Mr. ROTHFUS. Mr. Speaker, I want to thank my colleague and neighbor 
from Pennsylvania, Congressman Murphy, for his unrelenting leadership 
on this legislation and for calling attention to a problem that affects 
millions of families across the country.
  Nearly 10 million Americans have serious mental illness, including 
schizophrenia, substance abuse disorder, and major depression. I think 
today of the many families in my district who tell me about the 
heartbreak they have had after losing loved ones to drug addiction or 
suicide.
  This legislation will improve the oversight of mental health and 
substance abuse programs by ensuring we are using the most relevant 
data and most effective, evidence-based programs to address our mental 
health crisis.
  I urge my colleagues to support this legislation, and I thank the 
gentleman for his leadership.

[[Page H4323]]

  

  Mr. PALLONE. Mr. Speaker, I will continue to reserve the balance of 
my time until we get to closing remarks.
  Mr. MURPHY of Pennsylvania. Mr. Speaker, I yield 45 seconds to the 
gentleman from Georgia (Mr. Allen).
  Mr. ALLEN. Mr. Speaker, I thank Chairman Murphy for this great piece 
of legislation.
  I rise today in support of H.R. 2646, the Helping Families in Mental 
Health Crisis Act. Too many families across America have experienced a 
loved one who is living with or has been diagnosed with a mental 
illness. Sadly, one in five children ages 13 to 18 have or will battle 
a mental illness.
  As a proud member of the House Education and the Workforce Committee, 
I had the privilege of visiting schools across Georgia's 12th 
Congressional District and visiting with educators and staff members. 
School leaders from elementary school to college all say that mental 
health is one of their top concerns for the students.
  These heartbreaking statistics are more than data and numbers on a 
spreadsheet. They are mothers, fathers, sisters, brothers, students, 
friends, and children.
  Mr. Speaker, I urge my colleagues to vote in favor of H.R. 2646.
  Mr. MURPHY of Pennsylvania. Mr. Speaker, I yield 45 seconds to the 
gentlewoman from Virginia (Mrs. Comstock).
  Mrs. COMSTOCK. Mr. Speaker, I thank the gentleman for yielding and 
for his tireless work on this important bipartisan legislation which I 
was proud to cosponsor.
  I rise in support of H.R. 2646, the Helping Families in Mental Health 
Crisis Act.
  Every week we hear from constituents concerned about this issue, and, 
of course, we all no doubt know somebody battling with this issue. I 
appreciate the input from all stakeholders that has been taken into 
account here--doctors, healthcare providers, academics, and law 
enforcement--but, most importantly, the input from the families, the 
caregivers, and those dealing with the mental health conditions that 
are in so much need for more care.
  So I urge my colleagues to support this bipartisan bill that will 
allow for more efficient use of the resource allocation, improved 
responsiveness, and reduced time and energy that is now lost spent 
navigating a very difficult system that will be improved by this. So I 
thank the gentleman.
  Mr. MURPHY of Pennsylvania. Mr. Speaker, I include in the Record this 
list of over 50 professional organizations in support of this bill and 
also a list of 65-plus editorials in support of this bill.

 Helping Families in Mental Health Crisis Editorial Board Endorsements 
                              (H.R. 2646)


                    2015-2016 Editorial Endorsements

       1. The Florida Times Union, Congress begins to tackle 
     mental illness (April 21, 2015).
       2. Observer-Reporter, Reforms to mental-health system 
     neede, (July 21, 2015).
       3. The Sacramento Bee, Perhaps Congress will address mental 
     health care (August 1, 2015).
       4. The National Review, Congress is Waking Up To Mental 
     health, (August 4, 2015).
       5. Reading Record Searchlight, Perhaps Congress will 
     address mental health care (August 9, 2015).
       6. U.S. News and World Report, America Wakes Up to Mental 
     Health (August 11, 2015).
       7. The Florida Times-Union, Florida's inept system for 
     mental health leads to tragedies (August 20, 2015).
       8. The Washington Times, Stopping the shooters (August 27, 
     2015).
       9. KDKA-News, KDKA Urges Congress To Pass Murphy's Helping 
     Families in Mental Health Crisis Act (August 31, 2015).
       10. The Connecticut Post, Congress can finally make a 
     difference for mental-health reform (September 17, 2015).
       11. The Winona Daily News, Congress can finally make a 
     difference for mental-health reform (September 17, 2015).
       12. Dubuque Telegraph Herald, Congress can finally make a 
     difference for mental-health reform (September 17, 2015).
       13. Boulder Daily Camera, Congress can finally make a 
     difference for mental-health reform (September 17, 2015).
       14. The Rome News-Tribune, Congress can finally make a 
     difference for mental-health reform (September 17, 2015).
       15. Carlsbad Current Argus, Congress can finally make a 
     difference for mental-health reform (September 17, 2015).
       16. Cecil Whig, Congress can finally make a difference for 
     mental-health reform (September 17, 2015).
       17. The Seattle Times, Congress can finally make a 
     difference for mental-health reform (September 17, 2015).
       18. Vero Beach Press Journal, Another View: Mental health 
     reform effort deserves support (September 22, 2015).
       19. Alamogordo Daily News, Mental health reform effort 
     deserves support (September 25, 2015).
       20. Grand Rapids Business Journal, Behavioral Health Care: 
     We Can Do Better Than This (October 2, 2015).
       21. The Roanoke Times, Our view: Murphy's (would-be) law 
     (October 7, 2015).
       22. The Dallas Morning News, Congress can rewrite mental 
     illness stories by doing this (October 21, 2015).
       23. The San Francisco Chronicle, Crime, punishment and 
     mental health (October 22, 2015).
       24. The National Review, Editorial: The Week (October 26, 
     2015).
       25. North Dallas Gazette, Dealing with Mental Illness in a 
     Dysfunctional Society (October 28, 2015).
       26. The Daily Courier, Seeking to help people before they 
     pull the trigger (October 29, 2015).
       27. The Sacramento Bee, We've come to accept the 
     unacceptable (October 30, 2015).
       28. The Washington Post, Movement on mental-health care 
     (November 1, 2015).
       29. The National Review, Editorial: The Week (November 2, 
     2015).
       30. Kane County Chronicle, Another view: Movement on Mental 
     Health Care (November 2, 2015).
       31. Northwest Arkansas Democrat Gazette, Others say: 
     Movement on mental-health care (November 3, 2015).
       32. Grand Forks Herald, OUR OPINION: Support US. House's 
     mental health care reform (November 4, 2015).
       33. The Oklahoman, A review of state, federal mental health 
     laws is justified (November 9, 2015).
       34. Sarasota Herald Tribune, Bill targets mental health 
     crisis (November 22, 2015).
       35. The Wall Street Journal, The Next Mad Gunman (November 
     29, 2015).
       36. The Tampa Bay Tribune, Confront Our Mental Health 
     Crisis (December 1, 2015).
       37. PennLive, Full U.S. house should get a vote on Rep. Tim 
     Murphy's mental health bill (December 14, 2015).
       38. The Scranton Times-Tribune, Retool mental health system 
     (December 16, 2015).
       39. The Citizens Voice, Improve access to mental health 
     care (December 16, 2015).
       40. New York Daily News, Sane law promises mental health 
     treatment for the dangerously insane (January 28, 2016).
       41. Washington Post, A glimmer of hope for reforming mental 
     health care in America (June 25, 2016).


                    2013-2014 Editorial Endorsements

       42. The Express-Times, Don't give up on background checks, 
     mental health reform (December 15, 2013).
       43. Washington Observer-Reporter, Murphy's bill a step 
     toward mental health reform (December 21, 2013).
       44. The Wall Street Journal, A Mental Health Overhaul 
     (December 25, 2013).
       45. Houston Chronicle, Dealing with it (January 15, 2014).
       46. The Wall Street Journal, The Definition of Insanity 
     (March 31, 2014).
       47. Pittsburgh Post-Gazette, Worthy of Support: Murphy's 
     Mental Health Bill Faces the Critics (April 6, 2014).
       48. The Toledo Blade, Worth of support (April 9, 2014).
       49. Pittsburgh Post-Gazette, Better Care for the Mentally 
     Ill is Crucial for Our Society (April 13, 2014).
       50. The Washington Post Mental health care in the U.S. 
     needs a check-up (April 16, 2014).
       51. The Orange County Register, A Mental Health Fix That 
     Merits A Chance (April 21, 2014).
       52. Mansfield News Journal, How Congress can solve our 
     mental-health crisis (May 19, 2014).
       53. The Sacramento Bee, Efforts underway to prevent all-
     too-often tragic results of untreated severe mental illness 
     (May 20, 2014).
       54. The Fresno Bee, Orange County sets example with passage 
     of Laura's Law (May 21, 2014).
       55. The Seattle Times, Mental-health reform to consider in 
     light of Santa Barbara shootings (May 28, 2014).
       56. Cecil Whig, Rampage spurring new approaches (June 2, 
     2014).
       57. The Arizona Republic, Reforms shouldn't protect `Big 
     Mental Health' (June 6, 2014).
       58. National Review, Don't Go Wobbly on Mental Illness 
     (June 9, 2014).
       59. The Sacramento Bee, San Francisco Casts Vote for 
     Compassion for People with Severe Mental Illness (July 9, 
     2014).
       60. San Mateo Journal, A vote for compassion (July 10, 
     2014).
       61. Ocala Star Banner, Mental health issue (August 18, 
     2014).
       62. Bradenton Herald, Bill in Congress a solid overhaul of 
     America's broken mental health system (August 21, 2014).
       63. Raleigh News & Observer, Pennsylvania Congressman has 
     Ideas to Address Mental Health Care (August 28, 2014).
       64. The Fayetteville Observer, Mental health-care Overhaul 
     Bill Worth Attention (August 29, 2014).
       65. The Tampa Tribune, Nation needs to treat mental illness 
     as a crisis (December 21, 2014).


                             Organizations

       Adventist Health Care, American Academy of Child & 
     Adolescent Psychiatry, American Academy of Emergency 
     Medicine, American Academy of Forensic Sciences, American 
     Foundation For Suicide Prevention, American College of 
     Emergency Physicians,

[[Page H4324]]

     American Occupational Therapy Association, Inc., American 
     Psychiatric Association, American Psychological Association, 
     Behavioral Health IT Coalition, California Psychiatric 
     Association, Center for Substance Abuse Research.
       College of Psychiatric and Neurologic Pharmacists, 
     Developmental Disabilities Area Board 10 Los Angeles, Federal 
     Law Enforcement Association of America, International Bipolar 
     Foundation, Mental Health America, Mental Health Association 
     of Essex County, NJ.
       Mental Illness FACTS, Mental Illness Policy Organization, 
     National Alliance on Mental Illness (NAMI), National 
     Association of Psychiatric Health Systems, NAMI Harlem, NAMI 
     Kentucky.
       NAMI Los Angeles County, NAMI New York State, NAMI Ohio, 
     NAMI San Francisco, NAMI West Side Los Angeles, National 
     Association for the Advancement of Psychoanalysis, National 
     Association of Psychiatric Health Systems, National Council 
     for Behavioral Health, National Sheriffs' Association, No 
     Health Without Mental Health, Pennsylvania Medical Society, 
     Pine Rest Christian Mental Health Services.
       Saint Paulus Lutheran Church (San Francisco), Schizophrenia 
     and Related Disorders Alliance of America, Sheppard Pratt 
     Hospital, Society of Hospital Medicine, Sunovian, Treatment 
     Advocacy Cater, Treatment Before Tragedy, University of 
     Pittsburgh, Department of Psychiatry, Washington Psychiatric 
     Society, New York State Association of Chiefs of Police.

  Mr. MURPHY of Pennsylvania. Mr. Speaker, I yield 45 seconds to the 
gentleman from Georgia (Mr. Carter).
  Mr. CARTER of Georgia. Mr. Speaker, I thank the gentleman for 
yielding.


 =========================== NOTE =========================== 

  
  July 6, 2016, on page H4324, the following appeared: Mr. 
Speaker, I yield 45 seconds to the gentleman from Georgia (Mr. 
Carter). . . . Mr. CARTER of Georgia. Mr. Speaker
  
  The online version has been corrected to read: Mr. MURPHY of 
Pennsylvania. Mr. Speaker, I yield 45 seconds to the gentleman 
from Georgia (Mr. Carter). Mr. CARTER of Georgia. Mr. Speaker


 ========================= END NOTE ========================= 

  Mr. Speaker, I rise today in support of H.R. 2646, the Helping 
Families in Mental Health Crisis Act of 2015.
  Mental health has become a crisis in our country. There is a 
nationwide shortage of nearly 100,000 psychiatric beds. Three of the 
largest mental health hospitals are, in fact, criminal incarceration 
facilities. Only one child psychologist is available for every 2,000 
children with a mental disorder.
  Our Nation's mental health system is broken. Yet through the hard 
work of my friend from Pennsylvania (Mr. Murphy), this bill fixes the 
deficit that currently exists in our mental health system through 
refocusing programs, reforming grants, and removing Federal barriers 
for care. It provides for additional psychiatric hospital beds. It 
advances telepsychiatry to allow for better coordination. It also 
incentivizes States to provide community-based alternatives to 
institutionalization.
  This bill takes numerous steps to addressing the deficiencies that 
our mental health community faces.
  I commend Representative Tim Murphy for his work on this bill, and I 
encourage my colleagues to support this bill.
  Mr. MURPHY of Pennsylvania. Mr. Speaker, I yield 45 seconds to the 
gentlewoman from California (Mrs. Mimi Walters).
  Mrs. MIMI WALTERS of California. Mr. Speaker, I rise today in strong 
support of the Helping Families in Mental Health Crisis Act.
  Across this country, our mental health system is broken. Nearly 10 
million Americans suffer from serious mental illness, and for far too 
many of those individuals the Federal Government stands between them 
and the care that they so desperately need.
  The laws on the books are complicated and outdated, but with this 
legislation, we have the opportunity to reform our national mental 
health system. This bipartisan bill will refocus programs, reform 
grants, and remove the Federal Government as a barrier to lifesaving 
health care.
  I urge my colleagues to support this critical legislation to improve 
the quality and access to mental health care treatment.
  Mr. MURPHY of Pennsylvania. Mr. Speaker, I yield 1 minute to the 
gentleman from California (Mr. McCarthy), the majority leader of the 
House of Representatives.
  Mr. McCARTHY. Mr. Speaker, I thank the gentleman for yielding.
  Mr. Speaker, it is a testament to Representative Tim Murphy's 
expertise, persuasion, and sheer force of will that something so many 
thought would be impossible is now inevitable.
  The House will soon vote to pass Mr. Murphy's Helping Families in 
Mental Health Crisis Act under suspension. Though this bill is the most 
significant reform to our Nation's mental health program in decades, it 
has such a breadth of bipartisan support that we know it will pass with 
far more than a majority of votes in this House.
  This is a work that Mr. Murphy of Pennsylvania has done not just for 
1 month, not 2, not even 1 year, but I would say a lifetime of his 
work. You see, each year, the Federal Government has responded with 
money--$130 billion to be exact. But we cannot and should never 
conflate the amount we spend with the effectiveness of the spending.
  The Federal Government has 112 programs to address mental illness. 
But coordination is limited and gaps are common. Children with mental 
health disorders can't get psychiatrists. Criminal facilities are 
commonly used to house mental health patients. Funding isn't going to 
support evidence-based breakthroughs that improve people's lives.
  We need simplification, coordination, and effectiveness. We need 
reforms that help those who suffer from mental illness while also 
making our Nation safer.
  This bill is thorough and will deliver. From top to bottom it will 
improve our fragmented mental health systems, giving new hope to those 
too often forgotten and support to those truly in need.
  It is an honor to be on this floor with Representative Tim Murphy. He 
had the passion, but he had the servant's heart to never forget those 
that he wanted to serve. Many of those did not have a voice, and many 
of those felt left out, with no one there to speak for them.
  Mr. Murphy of Pennsylvania has never given up, and he has shown that 
the entire body of this House, and in essence willed it together, that 
it came out of the Committee on Energy and Commerce unanimously, and I 
hope on this floor we follow that direction.
  Mr. MURPHY of Pennsylvania. Mr. Speaker, I yield 45 seconds to the 
gentleman from Illinois (Mr. LaHood.)
  Mr. LaHOOD. Mr. Speaker, I rise in support of H.R. 2646 and commend 
Dr. Murphy for introducing it.
  Across the country, over 10 million Americans suffer from severe 
mental illness. Unfortunately, many are not receiving their proper 
treatment, including access to inpatient facilities or trained mental 
health professionals.
  In my prior life, I spent about 10 years as a State and Federal 
prosecutor. In that role, I saw the negative effects of a broken mental 
health system. It is a system in much need of reform in Illinois and 
all across this country. I have litigated many cases in which mental 
health played a significant role in the case, and I can assure you that 
when it comes to mental illness, incarceration in prison is not the 
solution.
  This bill is a step in the right direction. It is comprehensive, and 
it will help change the direction of our mental health system. I 
strongly support it and urge my colleagues to support it.
  Mr. PALLONE. Mr. Speaker, I yield myself the balance of my time.
  Mr. Speaker, this bill is an important and positive step towards 
expanding and improving mental health care services in this country, 
but it is only a first step. If we are serious about strengthening our 
national mental health care system, we must expand access and dedicate 
more resources.
  Comprehensive legislation should include dedicating robust resources 
to ensure access to community-based prevention, treatment, and recovery 
services in every community across the country. It must provide 
additional tools to strengthen mental health parity enforcement.
  Democrats will stay focused on continuing to expand and improve the 
continuum care for mental health care services.
  That said, I do want my colleagues, and I urge my colleagues, to 
support this bipartisan legislation, and let us also work together to 
get the Senate to pass their bipartisan bill, and they need to go to 
conference or somehow get a bill that would pass both Houses and get to 
the President. I do pledge to my colleagues on the Republican side that 
we need to do that between now and the end of year.
  I wanted to take a moment to thank the Democratic committee staff who 
worked so hard on this bill--most of them are on the floor--Tiffany 
Guarascio, Waverly Gordon to my right, Rachel Pryor, Arielle Woronoff, 
Una Lee, and, finally, our fellow, Kyle Fischer.

  Again, I urge my colleagues to support this bill.

[[Page H4325]]

  Mr. Speaker, I yield back the balance of my time.
  Mr. MURPHY of Pennsylvania. Mr. Speaker, may I inquire how much time 
I have remaining?
  The SPEAKER pro tempore. The gentleman has 2\1/2\ minutes remaining.
  Mr. MURPHY of Pennsylvania. Mr. Speaker, I yield myself the balance 
of my time.
  I want to add my thanks also to the ranking member, Mr. Pallone, for 
his steadfast work in this and to his staff. I have learned a lot from 
them. We have had a lot of conversations and hopefully we have learned 
from each other.
  Particularly, I want to thank Eddie Bernice Johnson of Texas. Her 
persistence and her role as a psychiatric nurse has been invaluable in 
this whole process.
  In addition, other Members on the other side of the aisle, Mr. Gene 
Green of Texas and Ms. DeGette, Marcy Kaptur and Jim McDermott, who 
have been incredible allies in this process, and, of course, the 
chairman of the full committee, Mr. Upton.
  The staff I want to thank are Gary Andres, Karen Christian, Sam 
Spector, Paul Edattel, Adrianna Simonelli; my staff, Susan Mosychuk, 
Scott Dziengelski; my former staff, Brad Grantz; and also Michelle 
Rosenberg from the committee, for their help.
  Publicly, I want to also thank those families who spoke up. Many 
families came out of their pain--Senator Creigh Deeds, Cathy Costello 
of Oklahoma, Anthony Hernandez of California and Jennifer Hoff of 
California, Liza Long from up in Idaho, and Doris Fuller from nearby--
all talking about the suffering of their families.
  Thousands of other families spoke up, but there are still millions 
who suffer silently in the shadows trying to deal with mental illness 
and a Federal Government that has failed them, States that have 
underfunded it.
  I appreciate the comments from my colleagues. Indeed, if we do not 
fund some of these things we are authorizing here, it is a far cry from 
what we need to do. But this bill comes a long way in reforming a 
system.
  I ask my colleagues also now, this is one of those moments to put 
aside any political differences. In the 40 years that I have worked as 
a psychologist, I have never once asked any of my patients what party 
they belonged to. We were there to help them. This is our opportunity 
to speak up for those who have no voice, as I said at the onset, the 
last, the lost, the least, and the lonely. They depend on us.
  I know that Members from both sides of the aisle have told me many 
times of the stories that they have suffered themselves of their own 
families and friends.
  But now let me take a moment to set aside my title as Congressman or 
as doctor but to talk as a family member.
  I think I was in college at the time when I heard a soft voice call 
in my house just saying ``help.'' It was my father. I went into the 
bathroom where he was. He had cut the arteries in his arms and he was 
bleeding out. I called an ambulance and asked them to come get help for 
him. He eventually recovered and made peace. But it was that soft voice 
calling for help that I responded to.
  It is decades later and he is long gone. But it is that soft voice 
that millions of Americans are also calling out for help.
  We have a chance here with this bill to make a huge difference. 
Unlike any other bills we may pass in Congress, this is one where I 
think Members can really go back and say: Today I voted to save lives.
  Let's have treatment before tragedy, because where there is help, 
there is hope.
  Mr. Speaker, I yield back the balance of my time.
  Mr. LEVIN. Mr. Speaker, reforming our mental health system has been 
an active priority of mine. That's why I supported legislation 
increasing access to the mental health care, including the Mental 
Health Parity Act of 1996, the Paul Wellstone and Pete Domenici Mental 
Health Parity and Addiction Equity Act of 2008, the Excellence in 
Mental Health Act, and the Affordable Care Act.
  Among its provisions, the Affordable Care Act expanded mental health 
parity protections by including mental health coverage as one of ten 
Essential Health Benefit categories. The ACA also ended insurers' 
ability to refuse to cover someone due to a pre-existing condition. 
Prior to the ACA, insurers often declined to cover someone who had 
diagnoses of mental health conditions such as bipolar disorder, 
schizophrenia, and anorexia. This was no accident, and these important 
mental health reforms were yet another reason I supported the ACA.
  The amended version of H.R. 2646, the Helping Families in Mental 
Health Crisis Act as reported out of Committee on the Energy and 
Commerce, takes another meaningful step towards reforming our mental 
health system by strengthening enforcement of mental health parity 
requirements, increasing access to community-based treatment, and 
growing the mental health workforce. I am pleased to support this 
bipartisan legislation, and I look forward to working with my 
colleagues in Congress to continue to improve the nation's mental 
health system.

                              {time}  1445

  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Pennsylvania (Mr. Murphy) that the House suspend the 
rules and pass the bill, H.R. 2646, as amended.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds 
being in the affirmative, the ayes have it.
  Mr. MURPHY of Pennsylvania. Mr. Speaker, on that I demand the yeas 
and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, further 
proceedings on this motion will be postponed.

                          ____________________