114 HR 2646 IH: Helping Families in Mental Health Crisis Act of 2015
U.S. House of Representatives
2015-06-04
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EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.
1.Short title; table of contents
(a)This Act may be cited as the Helping Families in Mental Health Crisis Act of 2015
. (b)The table of contents for this Act is as follows:
Sec. 1. Short title; table of contents.
Sec. 2. Definitions.
Title I—Assistant Secretary for Mental Health and Substance Use Disorders
Sec. 101. Assistant Secretary for Mental Health and Substance Use Disorders.
Sec. 102. Transfer of SAMHSA authorities.
Sec. 103. Reports.
Sec. 104. Advisory Council on Graduate Medical Education.
Title II—Grant reform and restructuring
Sec. 201. National mental health policy laboratory.
Sec. 202. Innovation grants.
Sec. 203. Demonstration grants.
Sec. 204. Early childhood intervention and treatment.
Sec. 205. Extension of assisted outpatient treatment grant program for individuals with serious
mental illness.
Sec. 206. Block grants.
Sec. 207. Workforce development.
Sec. 208. Authorized grants and programs.
Title III—Interagency Serious Mental Illness Coordinating Committee
Sec. 301. Interagency Serious Mental Illness Coordinating Committee.
Title IV—HIPAA and FERPA caregivers
Sec. 401. Promoting appropriate treatment for mentally ill individuals by treating their caregivers
as personal representatives for purposes of HIPAA privacy regulations.
Sec. 402. Caregivers permitted access to certain education records under FERPA.
Sec. 403. Confidentiality of records.
Title V—Medicare and Medicaid reforms
Sec. 501. Enhanced Medicaid coverage relating to certain mental health services.
Sec. 502. Access to mental health prescription drugs under Medicare and Medicaid.
Sec. 503. Elimination of 190-day lifetime limit on coverage of inpatient psychiatric hospital
services under Medicare.
Sec. 504. Modifications to Medicare discharge planning requirements.
Sec. 505. Demonstration programs to improve community mental health services.
Title VI—Research by National Institute of Mental Health
Sec. 601. Increase in funding for certain research.
Title VII—Behavioral health information technology
Sec. 701. Extension of health information technology assistance for behavioral and mental health
and substance abuse.
Sec. 702. Extension of eligibility for Medicare and Medicaid health information technology
implementation assistance.
Title VIII—SAMHSA Reauthorization and Reforms
Subtitle A—Organization and general authorities
Sec. 801. In general.
Sec. 802. Advisory councils.
Sec. 803. Peer review.
Subtitle B—Protection and advocacy for individuals with mental illness
Sec. 811. Prohibition against lobbying by systems accepting Federal funds to protect and advocate
the rights of individuals with mental illness.
Sec. 812. Ensuring that caregivers of individuals with serious mental illness have access to the
protected health information of such individuals.
Sec. 813. Protection and advocacy activities to focus exclusively on safeguarding rights to be free
from abuse and neglect.
Sec. 814. Reporting.
Sec. 815. Grievance procedure.
Sec. 816. Evidence-based treatment for individuals with serious mental illness.
Title IX—Reporting
Sec. 901. GAO study on preventing discriminatory coverage limitations for individuals with serious
mental illness and substance use disorders.
2.In this Act: (1)Except as inconsistent with the provisions of this Act, the term Assistant Secretary means the Assistant Secretary for Mental Health and Substance Use Disorders.
(2)The term evidence-based means the conscientious, systematic, explicit, and judicious appraisal and use of external, current, reliable, and valid research findings as the basis for making decisions about the effectiveness and efficacy of a program, intervention, or treatment.
<enum>I</enum><header>Assistant Secretary for Mental Health and Substance Use Disorders</header>
<section id="H0BDC504BC6C8413ABBDD5C97371006FB"><enum>101.</enum><header>Assistant Secretary for Mental Health and Substance Use Disorders</header>
<subsection id="H8537376071634E70B33503F63D75128B"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">There shall be in the Department of Health and Human Services an official to be known as the Assistant Secretary for Mental Health and Substance Use Disorders, who shall—</text>
<paragraph id="H8A3358F8D955492289B1FB3C004D4577"><enum>(1)</enum><text>report directly to the Secretary;</text> </paragraph><paragraph id="H49B63DDFFC824F66BBB613FBA0DBF1FC"><enum>(2)</enum><text>be appointed by the Secretary of Health and Human Services, by and with the advice and consent of the Senate; and</text>
</paragraph><paragraph id="HDE43FC46E19144B5B9D354BE6DA53149"><enum>(3)</enum><text>be selected from among individuals who—</text> <subparagraph id="H7080CF9BC3464DE5BC231C186F764249"><enum>(A)</enum> <clause commented="no" display-inline="yes-display-inline" id="HBF22698A48164757A244A4DAFAA24DCB"><enum>(i)</enum><text>have a doctoral degree in medicine or osteopathic medicine and clinical and research experience in psychiatry;</text>
</clause><clause id="H7C2AACC6B78249578FAE303E027309D3" indent="up1"><enum>(ii)</enum><text display-inline="yes-display-inline">graduated from an Accreditation Council for Graduate Medical Education-accredited psychiatric residency program; and</text>
</clause><clause id="H0EFFC11F97F84D94B2E41A6D365C4A07" indent="up1"><enum>(iii)</enum><text display-inline="yes-display-inline">have an understanding of biological, psychosocial, and pharmaceutical treatments of mental illness and substance use disorders; or</text>
</clause></subparagraph><subparagraph id="HAA147ACF5DC740A6BD7A8EDD58E8E223"><enum>(B)</enum><text display-inline="yes-display-inline">have a doctoral degree in psychology with—</text> <clause id="HEDAC24A21222456ABA2A04BA3D0BAB1F"><enum>(i)</enum><text>clinical and research experience regarding mental illness and substance use disorders; and</text>
</clause><clause id="HB1B0C4DAC29A4690B876082D7AA42649"><enum>(ii)</enum><text display-inline="yes-display-inline">an understanding of biological, psychosocial, and pharmaceutical treatments of mental illness and substance use disorders.</text>
</clause></subparagraph></paragraph></subsection><subsection id="H9DCFE5A44203429EB5B8614F778A68AD"><enum>(b)</enum><header>Duties</header><text display-inline="yes-display-inline">The Assistant Secretary shall—</text> <paragraph id="HB06943601CCC4B8A92B14C267255241E"><enum>(1)</enum><text display-inline="yes-display-inline">promote, evaluate, organize, integrate, and coordinate research, treatment, and services across departments, agencies, organizations, and individuals with respect to the problems of individuals suffering from substance use disorders or mental illness;</text>
</paragraph><paragraph id="H864EE507DB4F43149E28A21CEC135633"><enum>(2)</enum><text>carry out any functions within the Department of Health and Human Services—</text> <subparagraph id="H8F9342813C52433FAD98F1449B1EF96A"><enum>(A)</enum><text>to improve the treatment of, and related services to, individuals with respect to substance use disorders or mental illness;</text>
</subparagraph><subparagraph commented="no" id="HDF9908FA206D404E8B5230FCF0CEC185"><enum>(B)</enum><text display-inline="yes-display-inline">to improve secondary prevention or tertiary prevention services for such individuals;</text> </subparagraph><subparagraph commented="no" id="HFB7E109B160D46399FDE92941BF87187"><enum>(C)</enum><text>to ensure access to effective, evidence-based treatment for individuals with mental illnesses and individuals with a substance use disorder;</text>
</subparagraph><subparagraph commented="no" id="H24B637EA79624469A7BB5EAC6AFFC6C7"><enum>(D)</enum><text>to ensure that grant programs of the Department adhere to scientific standards with an emphasis on secondary prevention and tertiary prevention for individuals with serious mental illness or substance use disorders; and</text>
</subparagraph><subparagraph commented="no" id="HE12389A03C564064B93B95BC13D27B0D"><enum>(E)</enum><text>to develop and implement initiatives to encourage individuals to pursue careers (especially in underserved areas and populations) as psychiatrists, psychologists, psychiatric nurse practitioners, clinical social workers, and other licensed mental health professionals specializing in the diagnosis, evaluation, and treatment of individuals with severe mental illness, including individuals—</text>
<clause commented="no" id="H14D5B8C24A724BFAAB9212ECA8738011"><enum>(i)</enum><text>who are vulnerable to crises, psychotic episodes, or suicidal rumination;</text> </clause><clause commented="no" id="H85875BA10E28453A840893199CD677E5"><enum>(ii)</enum><text>whose deterioration can be rapid; or</text>
</clause><clause commented="no" id="H6E3EF52026784593A76872B468FFFDEC"><enum>(iii)</enum><text>who require more frequent contact or integration of a variety of services by the treating mental health professional;</text>
</clause></subparagraph></paragraph><paragraph id="H69E36F6F17804503B261B4D295B94A5C"><enum>(3)</enum><text display-inline="yes-display-inline">carry out the administrative and financial management, policy development and planning, evaluation, knowledge dissemination, and public information functions that are required for the implementation of mental health programs, including block grants, treatments, and data collection;</text>
</paragraph><paragraph id="H49C0D3290F2C49069BDDBECC2BD88B12"><enum>(4)</enum><text display-inline="yes-display-inline">conduct and coordinate demonstration projects, evaluations, and service system assessments and other activities necessary to improve the availability and quality of treatment, prevention, and related services related to substance use disorders and mental illness;</text>
</paragraph><paragraph id="H0F74E5F8B68E4AE0819F755FB6A7159B"><enum>(5)</enum><text display-inline="yes-display-inline">within the Department of Health and Human Services, oversee and coordinate all programs and activities relating to—</text>
<subparagraph id="HAE0F3CC8D910426F8DFF06743EBC7BCB"><enum>(A)</enum><text>the prevention of, or treatment or rehabilitation for, mental health or substance use disorders;</text> </subparagraph><subparagraph id="H5FAF415AB8AE43FD8006EE274CA33874"><enum>(B)</enum><text display-inline="yes-display-inline">parity in health insurance benefits and conditions relating to mental health and substance use disorder; or</text>
</subparagraph><subparagraph id="H2FEE71D6265E4844BF2EED310618FC8D"><enum>(C)</enum><text>the reduction of homelessness among individuals with mental illness;</text> </subparagraph></paragraph><paragraph id="H467B4E6D5FE34C2A9715C9415A6D8613"><enum>(6)</enum><text>across the Federal Government, in conjunction with the Interagency Serious Mental Illness Coordinating Committee under section 501A—</text>
<subparagraph id="HE1EED3AAA807400D9F2C9E1974B5DDA9"><enum>(A)</enum><text>review all programs and activities relating to the prevention of, or treatment or rehabilitation for, mental illness or substance use disorders;</text>
</subparagraph><subparagraph id="HFEF4264D245C4BD5BCA0A8E72835617E"><enum>(B)</enum><text>identify any such programs and activities that are duplicative;</text> </subparagraph><subparagraph id="H6AFCE4EEE97340DBA042BB73C872D305"><enum>(C)</enum><text>identify any such programs and activities that are not evidence-based, effective, or efficient; and</text>
</subparagraph><subparagraph id="H4E7DD90FF22E48AD9A307FE325EC7CF8"><enum>(D)</enum><text>formulate recommendations for expanding, coordinating, eliminating, and improving programs and activities identified pursuant to subparagraph (B) or (C) and merging such programs and activities into other, successful programs and activities;</text>
</subparagraph></paragraph><paragraph id="HBA2CBBF13B654F3AB87F865335992438"><enum>(7)</enum><text display-inline="yes-display-inline">identify evidence-based best practices across the Federal Government for treatment and services for those with mental health and substance use disorders by reviewing practices for efficiency, effectiveness, quality, coordination, and cost effectiveness;</text>
</paragraph><paragraph id="H8833707293064D9AA331DBA3AFB763DD"><enum>(8)</enum><text display-inline="yes-display-inline">be the head of and supervise the National Mental Health Policy Laboratory; and</text> </paragraph><paragraph commented="no" id="H8617083DD4AA4126986921045344E173"><enum>(9)</enum><text>not later than one year after the date of enactment of the Helping Families in Mental Health Crisis Act of 2015, submit to the Congress a report containing a nationwide strategy to increase the psychiatric workforce and recruit medical professionals for the treatment of individuals with serious mental illness and substance use disorders.</text>
</paragraph></subsection><subsection commented="no" id="HCFA334DC40EC4900902743780D50A998"><enum>(c)</enum><header>Nationwide strategy</header><text>The Assistant Secretary shall ensure that the nationwide strategy in the report under subsection (b)(9) is designed—</text>
<paragraph commented="no" id="H613F0BC4CFA84C48BDB5E6AB283815BB"><enum>(1)</enum><text>to encourage and incentivize students enrolled in an accredited medical or osteopathic medical school to enter the specialty of psychiatry;</text>
</paragraph><paragraph commented="no" id="H5DC04B16F52C4D5094DB5E132CE857BD"><enum>(2)</enum><text>to promote greater research-oriented psychiatrist residency training on evidence-based service delivery models for individuals with serious mental illness or substance use disorders;</text>
</paragraph><paragraph commented="no" id="H46E850062C6C4C37B6E20AF6BCBEE0BB"><enum>(3)</enum><text>to promote appropriate Federal administrative and fiscal mechanisms that support—</text> <subparagraph id="H6F0B11FCB2054EEFAF551093623F6A96"><enum>(A)</enum><text>evidence-based collaborative care models; and</text>
</subparagraph><subparagraph id="HD631255F43CB41E0A093A636A1A33179"><enum>(B)</enum><text display-inline="yes-display-inline">the necessary psychiatric workforce capacity for these models, including psychiatrists (including child and adolescent psychiatrists), psychologists, psychiatric nurse practitioners, clinical social workers, and mental health, peer-support specialists;</text>
</subparagraph></paragraph><paragraph commented="no" id="HCDC828DBA4034CADAAF6CE6FC7BFE3EE"><enum>(4)</enum><text>to increase access to child and adolescent psychiatric services in order to promote early intervention for prevention and mitigation of mental illness; and</text>
</paragraph><paragraph id="H007496C402054BF897C0B1BCD6148442"><enum>(5)</enum><text display-inline="yes-display-inline">to identify populations and locations that are the most underserved by mental health professionals and the most in need of psychiatrists (including child and adolescent psychiatrists), psychologists, psychiatric nurse practitioners, clinical social workers, and mental health, peer-support specialists.</text>
</paragraph></subsection><subsection commented="no" id="H30698DF7067049DF802A85C200C33655"><enum>(d)</enum><header>Prioritization of integration of services, early diagnosis, intervention, and workforce development</header><text display-inline="yes-display-inline">In carrying out the duties described in subsection (b), the Assistant Secretary shall prioritize—</text> <paragraph id="H09F002842E4D4A0EA4B1153D22D16A58"><enum>(1)</enum><text>the integration of mental health, substance use, and physical health services for the purpose of diagnosing, preventing, treating, or providing rehabilitation for mental illness or substance use disorders, including any such services provided through the justice system (including departments of correction) or other entities other than the Department of Health and Human Services;</text>
</paragraph><paragraph id="H8EB1398DDDA54694AB7A73D7CBA315FF"><enum>(2)</enum><text>crisis intervention for, early diagnosis and intervention services for the prevention of, and treatment and rehabilitation for, serious mental illness or substance use disorders; and</text>
</paragraph><paragraph id="H9AF6A04893E74088995699D95D14FF8E"><enum>(3)</enum><text>workforce development for—</text> <subparagraph id="HEF3049E98FCA4C7CA85E1CAB7A936897"><enum>(A)</enum><text>appropriate treatment of serious mental illness or substance use disorders; and</text>
</subparagraph><subparagraph id="HED286912AE9E46ADA12139BD2773E0C3"><enum>(B)</enum><text display-inline="yes-display-inline">research activities that advance scientific and clinical understandings of these disorders, including the development and implementation of a continuing nationwide strategy to increase the psychiatric workforce with psychiatrists, child and adolescent psychiatrists, psychologists, psychiatric nurse practitioners, clinical social workers, and mental health peer support specialists.</text>
</subparagraph></paragraph></subsection><subsection commented="no" id="HE41D024B82024E29A4902B4333AC8A89"><enum>(e)</enum><header>Requirements and restrictions on authority To award grants</header><text>In awarding any grant or financial assistance, the Assistant Secretary, and any agency or official within the Office of the Assistant Secretary, shall comply with the following:</text>
<paragraph commented="no" id="HE61362D7786E418E969D76B5A0BD5548"><enum>(1)</enum><text>The grant or financial assistance shall be for activities consisting of, or based upon, applied scientific research.</text>
</paragraph><paragraph commented="no" id="H663F03C92BEC46738ECD81340716973C"><enum>(2)</enum><text>Any program to be funded shall be demonstrated—</text> <subparagraph commented="no" id="H709E5D6EAE66444AA68EF4B0A291D770"><enum>(A)</enum><text>in the case of an ongoing program, to be effective; and</text>
</subparagraph><subparagraph commented="no" id="H37F120707F36419A90148874536A1897"><enum>(B)</enum><text>in the case of a new program, to have the prospect of being effective.</text> </subparagraph></paragraph><paragraph commented="no" id="H6B9CD65003254C699355AEC18F86E949"><enum>(3)</enum><text>The programs and activities to be funded shall use evidence-based best practices or emerging evidence-based best practices that are translational and can be expanded or replicated to other States, local communities, agencies, or through the Medicaid program under title XIX of the Social Security Act.</text>
</paragraph><paragraph commented="no" id="HD7EDB876466A46B792AE1EAB716147EE"><enum>(4)</enum><text>An application for the grant or financial assistance shall include, as applicable, a scientific justification based on previously demonstrated models, the number of individuals to be served, the population to be targeted, what objective outcomes measures will be used, and details on how the program or activity to be funded can be replicated and by whom.</text>
</paragraph><paragraph commented="no" id="H2D6AACBE05C9424DBD5AB80FE7862895"><enum>(5)</enum><text>Applicants shall be evaluated and selected through a blind, peer-review process by expert mental health care providers with professional experience in mental health research or treatment and where appropriate or necessary professional experience related to substance abuse and other areas of expertise appropriate to the grant or other financial assistance.</text>
</paragraph><paragraph commented="no" id="H80906F925CA24357BC3CE166C0EFA77D"><enum>(6)</enum><text>No member of a peer-review group conducting a blind, peer-review process, as required by paragraph (5), may be related to anyone who may be applying for the type of award being reviewed, may be a current grant applicant, or may have a financial or employment interested in selecting whom to receive the award.</text>
</paragraph><paragraph commented="no" id="H6545708693234C45B176C9A3BAC1DF0F"><enum>(7)</enum><text>Award recipients may be periodically reviewed and audited at the discretion of the Inspector General of the Department of Health and Human Services or the Comptroller General of the United States to ensure that—</text>
<subparagraph id="H7087B5C2959944DBAB518F3E3141F42E"><enum>(A)</enum><text>the best scientific method for both services and data collection is being followed; and</text> </subparagraph><subparagraph id="H51A13F587766454199F7355BE97CFE31"><enum>(B)</enum><text>Federal funds are being used as required by the conditions of the award and by applicable guidelines of the NMHPL.</text>
</subparagraph></paragraph><paragraph commented="no" id="H033B08DE6206472790FF68D4B55E0F64"><enum>(8)</enum><text>Award recipients that fail an audit or fail to provide information pursuant to an audit shall have their awards terminated.</text>
</paragraph></subsection><subsection commented="no" id="H650BF53935684D33BEC086504198258A"><enum>(f)</enum><header>Definitions</header><text display-inline="yes-display-inline">In this section:</text> <paragraph commented="no" id="HBFF531326E1A4326B1B067E45CF4E7E7"><enum>(1)</enum><text>The term <term>secondary prevention</term> means prevention that is designed to prevent a disease or condition from occurring among individuals or a subpopulation determined to be at risk for the disease or condition.</text>
</paragraph><paragraph commented="no" id="HAD3E17CCF0C846F48ACFBEFDC32848B3"><enum>(2)</enum><text>The term <term>tertiary prevention</term> means prevention that is designed to reduce or minimize the consequences of a disease or condition among individuals showing symptoms of the disease or condition.</text>
</paragraph></subsection></section><section id="HF32D3A9CDEE74368A8C247793F4B2C74"><enum>102.</enum><header>Transfer of SAMHSA authorities</header>
<subsection id="HE260C254475D4801B0A6AAEE6C2D0942"><enum>(a)</enum><header>In general</header><text>The Secretary of Health and Human Services shall delegate to the Assistant Secretary all duties and authorities that—</text>
<paragraph id="H618384D4D8B045509E53F9AB85BF8A25"><enum>(1)</enum><text>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</text>
</paragraph><paragraph id="H4F43263DBDCE4BC7B5CAFD06C24B0DB4"><enum>(2)</enum><text>are not terminated by this Act.</text> </paragraph></subsection><subsection commented="no" id="HB030CB1722E345099CE0CCCAFBD44662"><enum>(b)</enum><header>Transition</header><text display-inline="yes-display-inline">This section and the amendments made by this section apply beginning on the day that is 6 months after the date of enactment of this Act. As of such day, the Secretary of Health and Human Services shall provide for the transfer of the personnel, assets, and obligations of the Substance Abuse and Mental Health Services Administration to the Office of the Assistant Secretary.</text>
</subsection><subsection id="H63E3FA92588A4DBE9EB883C370DC5495"><enum>(c)</enum><header>Conforming amendments</header><text>Title V of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290aa">42 U.S.C. 290aa et seq.</external-xref>) is amended—</text> <paragraph id="H126ADEBB690047148F13EDB9B113A05B"><enum>(1)</enum><text>in the title heading, by striking <quote><header-in-text level="title" style="OLC">Substance Abuse and Mental Health Services Administration</header-in-text></quote> and inserting <quote><header-in-text level="title" style="OLC">Mental Health and Substance Use Disorders</header-in-text></quote>;</text>
</paragraph><paragraph id="H75FDBA4A6098439CB04BC369DF97CB1B"><enum>(2)</enum><text>by amending section 501(a) to read as follows:</text> <quoted-block display-inline="no-display-inline" id="H7A7BA6F3D8F640C5BFD6E47EE1C2BE40" style="OLC"> <subsection id="H6235D51746474EB58C60B44E501E8FF4"><enum>(a)</enum><header>Assistant Secretary</header><text display-inline="yes-display-inline">The Assistant Secretary for Mental Health and Substance Use Disorders shall have the duties and authorities vested in the Assistant Secretary by this title in addition to the duties and authorities vested in the Assistant Secretary by section 501 of the <short-title>Helping Families in Mental Health Crisis Act of 2015</short-title> and other provisions of law.</text></subsection><after-quoted-block>;</after-quoted-block></quoted-block>
</paragraph><paragraph id="H8B68F8162EC04BAF9EB08EA14DCCC294"><enum>(3)</enum><text>by amending section 501(c) to read as follows:</text> <quoted-block display-inline="no-display-inline" id="H07775253E5054E3980887D3C5FAD2191" style="OLC"> <subsection id="H156A30F381E24255BE9A87E0CA711E15"><enum>(c)</enum><header>Deputy Assistant Secretary</header><text display-inline="yes-display-inline">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 under this title.</text></subsection><after-quoted-block>;</after-quoted-block></quoted-block>
</paragraph><paragraph id="HA86775443932482BB63DA1877F7F4D70"><enum>(4)</enum><text>by striking subsection (o) (relating to authorization of appropriations);</text> </paragraph><paragraph id="HB624FB8E343D4E029B5DBC812F8015BF"><enum>(5)</enum><text>by striking <quote>Administrator of the Substance Abuse and Mental Health Services Administration</quote> each place it appears and inserting <quote>Assistant Secretary for Mental Health and Substance Use Disorders</quote>;</text>
</paragraph><paragraph id="H065E43DBD18642B2B5E796834834084A"><enum>(6)</enum><text display-inline="yes-display-inline">by striking <term>Administrator</term> each place it appears and inserting <quote>Assistant Secretary</quote>, except where the term <term>Administrator</term> appears within the term—</text> <subparagraph id="H314C0376B4C1492F9AD1087BF9D2F8E4"><enum>(A)</enum><text>Associate Administrator;</text>
</subparagraph><subparagraph id="H4EADE335B8FD4A5D86BBD690B4496BC2"><enum>(B)</enum><text>Administrator of the Health Resources and Services Administration;</text> </subparagraph><subparagraph id="H1BDE33DC319C40A6A8AB908314A5D798"><enum>(C)</enum><text>Administrator of the Centers for Medicare & Medicaid Services; or</text>
</subparagraph><subparagraph id="H8715B697E662403295DCD1633559DE9E"><enum>(D)</enum><text display-inline="yes-display-inline">Administrator of the Office of Juvenile Justice and Delinquency Prevention;</text> </subparagraph></paragraph><paragraph id="H82EECA006E1343C4871B7578F25A37AE"><enum>(7)</enum><text>by striking <quote>Substance Abuse and Mental Health Services Administration</quote> each place it appears and inserting <quote>Office of the Assistant Secretary</quote>;</text>
</paragraph><paragraph id="H913698665DCC42E693DFAF6D7B927756"><enum>(8)</enum><text>in section 502, by striking <quote>Administration or Center</quote> each place it appears and inserting <quote>Office or Center</quote>;</text> </paragraph><paragraph id="H448A74510F2D40FCBBF58121B97ACE4E"><enum>(9)</enum><text>in section 502, by striking <quote>Administration's</quote> and inserting <quote>Office of the Assistant Secretary’s</quote>; and</text>
</paragraph><paragraph id="H90F8C8DF692A4988946C5CC664D4180E"><enum>(10)</enum><text>by striking the term <term>Administration</term> each place it appears and inserting <quote>Office of the Assistant Secretary</quote>, except in the heading of section 520G(b) and where the term <term>Administration</term> appears with the term—</text> <subparagraph id="H23C30ECC35A54E758E86DB49AEE95414"><enum>(A)</enum><text>Health Resources and Services Administration; or</text>
</subparagraph><subparagraph id="HF7EE1753E40547F8BA194FD18778D4B3"><enum>(B)</enum><text display-inline="yes-display-inline">National Highway Traffic Safety Administration.</text> </subparagraph></paragraph></subsection><subsection id="H4CB4571A09DC4D70BB2A6DFDD8909045"><enum>(d)</enum><header>References</header><text>After executing subsection (a), subsection (b), and the amendments made by subsection (c)—</text>
<paragraph id="HCE86BFEC54D94E12BF673768ED4E1A4C"><enum>(1)</enum><text>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 Disorders; and</text>
</paragraph><paragraph id="H8A629F912E764A7BAA47AD9E3FEF220D"><enum>(2)</enum><text>any reference in statute, regulation, or guidance to the Substance Abuse and Mental Health Services Administration shall be construed to be a reference to the Office of the Assistant Secretary.</text>
</paragraph></subsection></section><section id="HC830597359174A7D9F2514805AF28A8B"><enum>103.</enum><header>Reports</header>
<subsection display-inline="no-display-inline" id="H5DFC8D51414B46B99D93B038742B293D"><enum>(a)</enum><header>Report on investigations regarding parity in mental health and substance use disorder benefits</header>
<paragraph id="HE0FEF27318A04661B4D5C972871D3C18"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Not later than 180 days after the enactment of this Act, and annually thereafter, 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, and in consultation with the Assistant Secretary for Mental Health and Substance Use Disorders, shall submit to the Congress a report—</text>
<subparagraph id="HC7DB629D27324201ABADE3136A23FFC5"><enum>(A)</enum><text>identifying Federal investigations conducted or completed during the preceding 12-month period regarding compliance with parity in mental health and substance use disorder benefits, including benefits provided to persons with serious mental illness and substance use disorders, under the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (subtitle B of title V of division C of <external-xref legal-doc="public-law" parsable-cite="pl/110/343">Public Law 110–343</external-xref>); and</text>
</subparagraph><subparagraph id="HC7A9D046B4954444B6383AD46190375D"><enum>(B)</enum><text>summarizing the results of such investigations.</text> </subparagraph></paragraph><paragraph id="H537E3757A578405692D8D9F756832F55"><enum>(2)</enum><header>Contents</header><text>Subject to paragraph (3), each report under paragraph (1) shall include the following information:</text>
<subparagraph id="HAA3292E8361E40C79A31C07757810DCA"><enum>(A)</enum><text>The number of investigations opened and closed during the covered reporting period.</text> </subparagraph><subparagraph id="HB80A0C9C48B3451CAB3491AC384FA0BB"><enum>(B)</enum><text>The benefit classification or classifications examined by each investigation.</text>
</subparagraph><subparagraph id="H4F7A96F160C44E3DA0E16AE87CC5EDF4"><enum>(C)</enum><text>The subject matter or subject matters of each investigation, including quantitative and nonquantitative treatment limitations.</text>
</subparagraph><subparagraph id="H63837BAE83364154BF5ACF45C498A63F"><enum>(D)</enum><text>A summary of the basis of the final decision rendered for each investigation.</text> </subparagraph></paragraph><paragraph id="HACBB3FE776B742FE8AC9D0C328A90A95"><enum>(3)</enum><header>Limitation</header><text>Individually identifiable information shall be excluded from reports under paragraph (1) consistent with Federal privacy protections.</text>
</paragraph></subsection><subsection commented="no" id="H4474E9572D904B788168FD1D00775948"><enum>(b)</enum><header>Report on best practices for peer-Support specialist programs, training, and certification</header>
<paragraph commented="no" id="H0CE3B5745A93425CB2DF8BFF727EC38A"><enum>(1)</enum><header>In general</header><text>Not later than 1 year after the date of enactment of this Act, and biannually thereafter, the Assistant Secretary shall submit to the Congress and make publicly available a report on best practices and professional standards in States for—</text>
<subparagraph id="H49B9ABA10360457AACED2C83F3F0BA51"><enum>(A)</enum><text>establishing and operating health care programs using peer-support specialists; and</text> </subparagraph><subparagraph id="HE80820A90B3F4670AC1F7DFB51CF23CE"><enum>(B)</enum><text>training and certifying peer-support specialists.</text>
</subparagraph></paragraph><paragraph commented="no" id="HF2975207377340D9B67C72B2F0AFF68A"><enum>(2)</enum><header>Peer-support specialist defined</header><text>In this subsection, the term <term>peer-support specialist</term> means an individual who—</text> <subparagraph commented="no" id="HB7BDCC6D608E4D399AA5EF2453962F4C"><enum>(A)</enum><text>uses his or her lived experience of recovery from mental illness or substance abuse, plus skills learned in formal training, to facilitate support groups, and to work on a one-on-one basis, with individuals with a serious mental illness or a substance use disorder, in consultation with and under the supervision of a licensed mental health or substance use treatment professional;</text>
</subparagraph><subparagraph commented="no" id="H878DAD7F5EAC4BD6A83B627F6EC2290C"><enum>(B)</enum><text>has been an active participant in mental health or substance use treatment for at least the preceding 2 years;</text>
</subparagraph><subparagraph commented="no" id="H3145CFA75A3B4CCEADE08DC2FF75F3FB"><enum>(C)</enum><text>does not provide direct medical services; and</text> </subparagraph><subparagraph commented="no" id="HEFF781B46A4349959B556C59AA7959EA"><enum>(D)</enum><text>does not perform services outside of his or her area of training, expertise, competence, or scope of practice.</text>
</subparagraph></paragraph><paragraph commented="no" id="H4AA9BAC96C764F60B3675F68D3FE59DD"><enum>(3)</enum><header>Contents</header><text>Each report under this subsection shall include information on best practices and standards with regard to the following:</text>
<subparagraph commented="no" id="H9E1BF4871F98473F9B22D2B63746BDEE"><enum>(A)</enum><text>Hours of formal work or volunteer experience related to mental health and substance use issues.</text> </subparagraph><subparagraph commented="no" id="H1EA1A891AF7649D586C02FAC60078349"><enum>(B)</enum><text>Types of peer specialist exams required.</text>
</subparagraph><subparagraph commented="no" id="H15C91EE63B9447E1A4DEC5C2F0F86752"><enum>(C)</enum><text>Code of ethics.</text> </subparagraph><subparagraph commented="no" id="HF37B28779C394CA08CFC809810133DA8"><enum>(D)</enum><text>Additional training required prior to certification, including in areas such as—</text>
<clause commented="no" id="HB876ABDCABC04923A24AFD3CA4129434"><enum>(i)</enum><text>psychopharmacology;</text> </clause><clause commented="no" id="HA29079FEB1F74512B0B02CF8B2C4ED45"><enum>(ii)</enum><text>integrating physical medicine and mental health supportive services;</text>
</clause><clause commented="no" id="H9A12EEA878DB40D4A4782636146F1AA1"><enum>(iii)</enum><text>ethics;</text> </clause><clause commented="no" id="HD9A122A17B474D17BA9EC93A2151A7EE"><enum>(iv)</enum><text>scope of practice;</text>
</clause><clause commented="no" id="HA938AC3DAAD34C7C8DCA3476D3985BA0"><enum>(v)</enum><text>crisis intervention;</text> </clause><clause commented="no" id="HE7B12DC76D67476D9D2FD14FA4E6A93A"><enum>(vi)</enum><text>identification and treatment of mental health disorders;</text>
</clause><clause commented="no" id="HD842FDD75E8D4FE5BEEA41E4F00E1743"><enum>(vii)</enum><text>State confidentiality laws;</text> </clause><clause commented="no" id="HCFA5A7F6E3354BF3952272E65659F7F6"><enum>(viii)</enum><text>Federal privacy protections, including under the Health Insurance Portability and Accountability Act of 1996; and</text>
</clause><clause commented="no" id="H3CC4FB1671EE473BB119227C10E47562"><enum>(ix)</enum><text>other areas as determined by the Assistant Secretary.</text> </clause></subparagraph><subparagraph commented="no" id="H6AA3F4E1928B4807A57CF3E05E25CD0C"><enum>(E)</enum><text>Requirements to explain what, where, when, and how to accurately complete all required documentation activities.</text>
</subparagraph><subparagraph commented="no" id="H437589F8D4C84873A5B69E682560D5C0"><enum>(F)</enum><text>Required or recommended skill sets, including—</text> <clause commented="no" id="HF8B1283FA4094ACBBFACF12064844E9C"><enum>(i)</enum><text>identifying consumer risk indicators, including individual stressors, triggers, and indicators of escalating symptoms;</text>
</clause><clause commented="no" id="H353C002B25454A9B93CB8384C8C74214"><enum>(ii)</enum><text>explaining basic de-escalation techniques;</text> </clause><clause commented="no" id="HB2AD902E2C6C4D9F8D6607D04156055E"><enum>(iii)</enum><text>explaining basic suicide prevention concepts and techniques;</text>
</clause><clause commented="no" id="H3B955343F771430B8D422C01F26A0697"><enum>(iv)</enum><text>identifying indicators that the consumer may be experiencing abuse or neglect;</text> </clause><clause commented="no" id="H3676FEC66BF24493AFD535B35D1BB89A"><enum>(v)</enum><text>identifying and responding appropriately to personal stressors, triggers, and indicators;</text>
</clause><clause commented="no" id="H0EE288954393442BAB8E15BA5DE01380"><enum>(vi)</enum><text>identifying the consumer’s current stage of change or recovery;</text> </clause><clause commented="no" id="H0718046CC61841389FF50F37E405C35C"><enum>(vii)</enum><text>explaining the typical process that should be followed to access or participate in community mental health and related services; and</text>
</clause><clause commented="no" id="HD7B5DD0231694CC1B41DD68E83A280B4"><enum>(viii)</enum><text>identifying circumstances when it is appropriate to request assistance from other professionals to help meet the consumer’s recovery goals.</text>
</clause></subparagraph><subparagraph commented="no" id="H7FB3E6C57FF94D6DA023746C812C6835"><enum>(G)</enum><text>Requirements for continuing education credits annually.</text> </subparagraph></paragraph></subsection><subsection commented="no" id="H12C1AAC9FA8645369D0F92FF3E3C60FE"><enum>(c)</enum><header>Report on the state of the States in mental health and substance use treatment</header> <paragraph commented="no" id="H993879731AAE4D9689B1182C059AC572"><enum>(1)</enum><header>In general</header><text>Not later than 1 year after the date of enactment of this Act, and not less than every 2 years thereafter, the Assistant Secretary shall submit to the Congress and make available to the public a report on the state of the States in mental health and substance use treatment, including the following:</text>
<subparagraph id="H17BDE96EC8D94647BC272BF0C6867748"><enum>(A)</enum><text>A detailed report on how Federal mental health and substance use treatment funds are used in each State including:</text>
<clause commented="no" id="H49E874AFC4C041A3B3870EAF70054269"><enum>(i)</enum><text>The numbers of individuals with serious mental illness or substance use disorders who are served with Federal funds.</text>
</clause><clause commented="no" id="H2B00357D6B9F4CE195535CDC3E956673"><enum>(ii)</enum><text>The types of programs made available to individuals with serious mental illness or substance use disorders.</text>
</clause></subparagraph><subparagraph commented="no" id="H04BA6905E99041E485DB6D9DC0C7EE8B"><enum>(B)</enum><text>A summary of best practice models in the States highlighting programs that are cost effective, provide evidence-based care, increase access to care, integrate physical, psychiatric, psychological, and behavioral medicine, and improve outcomes for individuals with mental illness or substance use disorders.</text>
</subparagraph><subparagraph commented="no" id="H703F4304B1B341658C223EE01A9020B2"><enum>(C)</enum><text>A statistical report of outcome measures in each State, including—</text> <clause commented="no" id="HE4B519A267C147709370D18EB2446724"><enum>(i)</enum><text>rates of suicide, suicide attempts, substance abuse, overdose, overdose deaths, emergency psychiatric hospitalizations, and emergency room boarding; and</text>
</clause><clause commented="no" id="HEF12B2CADF774E138C3FC3303FE31386"><enum>(ii)</enum><text>for those with mental illness, arrests, incarcerations, victimization, homelessness, joblessness, employment, and enrollment in educational or vocational programs.</text>
</clause></subparagraph><subparagraph commented="no" id="H32F02428A4C3491AB9583CF5A239C170"><enum>(D)</enum><text>Outcome measures on State-assisted outpatient treatment programs, including—</text> <clause commented="no" id="HAF3A79083D95487FB2F770043A2F73D3"><enum>(i)</enum><text>rates of keeping treatment appointments and compliance with prescribed medications;</text>
</clause><clause commented="no" id="HA52301F30E024908826E0E0A1F00BCDF"><enum>(ii)</enum><text>participants’ perceived effectiveness of the program;</text> </clause><clause commented="no" id="HDA28D625E9D549B7B8034B637F70BDBE"><enum>(iii)</enum><text>rates of the programs helping those with serious mental illness gain control over their lives;</text>
</clause><clause commented="no" id="H051A782220A64607AEA71B940522F83F"><enum>(iv)</enum><text>alcohol and drug abuse rates;</text> </clause><clause commented="no" id="H54CB5ADC19C0455A8B8818C51ED28921"><enum>(v)</enum><text>incarceration and arrest rates;</text>
</clause><clause commented="no" id="HF71DFC7BDDD14864B29D480A8DE63734"><enum>(vi)</enum><text>violence against persons or property;</text> </clause><clause commented="no" id="HA462974B88EC4F5FB4C143796B2BB9BB"><enum>(vii)</enum><text>homelessness; and</text>
</clause><clause commented="no" id="HCCEC7FD456684283A0CBBFE6DA0D9E93"><enum>(viii)</enum><text>total treatment costs for compliance with the program.</text> </clause></subparagraph><subparagraph commented="no" id="HC9117A3299694E6CBE5A0656099A6846"><enum>(E)</enum><header>State and counties with assisted outpatient treatment programs</header><text>For States and counties with assisted outpatient treatment programs, the information reported under this subsection shall include a comparison of the outcomes of individuals with serious mental illness who participated in the programs versus the outcomes of individuals who did not participate but were eligible to do so by nature of their history.</text>
</subparagraph><subparagraph commented="no" id="HEFE1C3DE35A34FECAD6464191FF5CA07"><enum>(F)</enum><header>States and counties without AOT programs</header><text>For States and counties without assisted outpatient treatment programs, the information reported under this subsection shall include data on individuals with mental illness who—</text>
<clause commented="no" id="H26E3118579FF4D2C8A767E6731E50BE7"><enum>(i)</enum><text>have a history of violence, incarceration, and arrests;</text> </clause><clause commented="no" id="H288EF85E943741E48C1BB00ACF867349"><enum>(ii)</enum><text>have a history of emergency psychiatric hospitalizations;</text>
</clause><clause commented="no" id="HFCF0492B94B14CADACCC44F162B7B4F3"><enum>(iii)</enum><text>are substantially unlikely to participate in treatment on their own;</text> </clause><clause commented="no" id="H590649699A204DB1AFD42423EB8AF842"><enum>(iv)</enum><text>may be unable for reasons other than indigence, to provide for any of their basic needs such as food, clothing, shelter, health or safety;</text>
</clause><clause commented="no" id="H063F88C16D324129B44FE4038C56A53F"><enum>(v)</enum><text>have a history of mental illness or condition that is likely to substantially deteriorate if the individual is not provided with timely treatment; and</text>
</clause><clause commented="no" id="H64DC3D77C9314AB085FEA445EE0D3C95"><enum>(vi)</enum><text>due to their mental illness, have a lack of capacity to fully understand or lack judgment, or diminished capacity to make informed decisions, regarding their need for treatment, care, or supervision.</text>
</clause></subparagraph></paragraph><paragraph commented="no" id="H088A5A1B9D4846CB9C307ED340D1FDCB"><enum>(2)</enum><header>Definition</header><text display-inline="yes-display-inline">In this subsection, the term <term>emergency room boarding</term> means the practice of admitting patients to an emergency department and holding them in the department until inpatient psychiatric beds become available.</text>
</paragraph></subsection><subsection commented="no" id="H880A585901D641159F62E10A27365DB3"><enum>(d)</enum><header>Reporting compliance study</header>
<paragraph commented="no" id="H76D1CF948C9F4F91901C1D83005662E4"><enum>(1)</enum><header>In general</header><text>The Assistant Secretary for Mental Health and Substance Use Disorders shall enter into an arrangement with the Institute of Medicine of the National Academies (or, if the Institute declines, another appropriate entity) under which, not later than 12 months after the date of enactment of this Act, the Institute will submit to the appropriate committees of Congress a report that evaluates the combined paperwork burden of—</text>
<subparagraph commented="no" id="H3735C0EACCE94566AABE1130E67208C4"><enum>(A)</enum><text>community mental health centers meeting the criteria specified in section 1913(c) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300x-2">42 U.S.C. 300x–2</external-xref>), including such centers meeting such criteria as in effect on the day before the date of enactment of this Act; and</text>
</subparagraph><subparagraph commented="no" id="H34B2A8FDE60241838EAD7EF5DF5BAFC5"><enum>(B)</enum><text>federally qualified community mental health clinics certified pursuant to section 223 of the Protecting Access to Medicare Act of 2014 (<external-xref legal-doc="public-law" parsable-cite="pl/113/93">Public Law 113–93</external-xref>), as amended by section 505.</text>
</subparagraph></paragraph><paragraph commented="no" id="HF8A523996AC144F2BA499FC1633EE9A0"><enum>(2)</enum><header>Scope</header><text>In preparing the report under subsection (a), the Institute of Medicine (or, if applicable, other appropriate entity) shall examine licensing, certification, service definitions, claims payment, billing codes, and financial auditing requirements used by the Office of Management and Budget, the Centers for Medicare & Medicaid Services, the Health Resources and Services Administration, the Substance Abuse and Mental Health Services Administration, the Office of the Inspector General of the Department of Health and Human Services, State Medicaid agencies, State departments of health, State departments of education, and State and local juvenile justice and social service agencies to—</text>
<subparagraph commented="no" id="H0FDDBC138E3E481E8B9B41940CDA5DB4"><enum>(A)</enum><text>establish an estimate of the combined nationwide cost of complying with such requirements, in terms of both administrative funding and staff time;</text>
</subparagraph><subparagraph commented="no" id="H4B7860D110E54ADA865354FC92A84A42"><enum>(B)</enum><text>establish an estimate of the per capita cost to each center or clinic described in subparagraph (A) or (B) of paragraph (1) to comply with such requirements, in terms of both administrative funding and staff time; and</text>
</subparagraph><subparagraph commented="no" id="HBBC38A3A38804B629B9AC3005FD142DC"><enum>(C)</enum><text>make administrative and statutory recommendations to Congress (which recommendations may include a uniform methodology) to reduce the paperwork burden experienced by centers and clinics described in subparagraph (A) or (B) of paragraph (1).</text>
</subparagraph></paragraph></subsection></section><section id="HD2A036C3E513424BADD3649B91039407"><enum>104.</enum><header>Advisory Council on Graduate Medical Education</header><text display-inline="no-display-inline">Section 762(b) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/294o">42 U.S.C. 294o(b)</external-xref>) is amended—</text> <paragraph id="H1A5F9429860D4BB58C2FFFEED9A45333"><enum>(1)</enum><text>by redesignating paragraphs (4) through (6) as paragraphs (5) through (7), respectively; and</text>
</paragraph><paragraph id="HBC9D7699BD0148CB9D6946C4A3F4B89D"><enum>(2)</enum><text>by inserting after paragraph (3) the following:</text> <quoted-block display-inline="no-display-inline" id="H85150EB22C214B689A1BBF9A5A2D2272" style="OLC"> <paragraph id="H30925EA1E57642948AA7DF18C2F74EA6"><enum>(4)</enum><text display-inline="yes-display-inline">the Assistant Secretary for Mental Health and Substance Use Disorders;</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section><enum>II</enum><header>Grant reform and restructuring</header>
<section id="H489EA14A16C14CCE9AA59C29E61BBE3F"><enum>201.</enum><header>National mental health policy laboratory</header>
<subsection commented="no" id="H8E7AA1AE6D104551A79D55D59B6A8703"><enum>(a)</enum><header>In general</header>
<paragraph commented="no" id="H4C2DF2CF17F24FCD98EF794173D233D5"><enum>(1)</enum><header>Establishment</header><text>The Assistant Secretary for Mental Health and Substance Use Disorders shall establish, within the Office of the Assistant Secretary, the National Mental Health Policy Laboratory (in this section referred to as the <quote>NMHPL</quote>), to be headed by a Director.</text>
</paragraph><paragraph commented="no" id="H5F13BB6E6F72496F97AF78FFD2147606"><enum>(2)</enum><header>Duties</header><text>The Director of the NMHPL shall—</text> <subparagraph commented="no" id="H135045F4C3D141DA86853066D9C9ACE8"><enum>(A)</enum><text>identify, coordinate, and implement policy changes and other trends likely to have the most significant impact on mental health services and monitor their impact;</text>
</subparagraph><subparagraph commented="no" id="H3388481BFE7E4196967973C84CD93826"><enum>(B)</enum><text display-inline="yes-display-inline">collect information from grantees under programs established or amended by this Act and under other mental health programs under the Public Health Service Act, including grantees that are States receiving funds under a block grant under part B of title XIX of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300x">42 U.S.C. 300x et seq.</external-xref>);</text>
</subparagraph><subparagraph commented="no" id="HAEDEE0C3B29641B8AB1B570D29E7B3ED"><enum>(C)</enum><text display-inline="yes-display-inline">evaluate and disseminate to such grantees evidence-based practices and services delivery models using the best available science shown to be cost-effective while enhancing the quality of care furnished to individuals;</text>
</subparagraph><subparagraph commented="no" id="HAA67618FBA6A4578BE009B68E9216AA1"><enum>(D)</enum><text>establish standards for the appointment of scientific peer-review panels to evaluate grant applications; and</text>
</subparagraph><subparagraph id="H2BB65D71CE89457894E18EEDFAFB270E"><enum>(E)</enum><text>establish standards for grant programs under subsection (b).</text> </subparagraph></paragraph><paragraph commented="no" id="H60004347449741F0AF63B9510375AFA6"><enum>(3)</enum><header>Evidence-based practices and service delivery models</header><text>In selecting evidence-based best practices and service delivery models for evaluation and dissemination under paragraph (2)(C), the Director of the NMHPL—</text>
<subparagraph commented="no" id="H0546382B617D476E8D94077142ABDF44"><enum>(A)</enum><text display-inline="yes-display-inline">shall give preference to models that improve—</text> <clause commented="no" id="HA0664F4C12A149EDB960F84B2FC6669E"><enum>(i)</enum><text>the coordination between mental health and physical health providers;</text>
</clause><clause commented="no" id="H450F2551495C47FB8AC5CB7C1197834F"><enum>(ii)</enum><text>the coordination among such providers and the justice and corrections system; and</text> </clause><clause commented="no" id="HEA3D9C6273FD41B49AF53418D08A3F6B"><enum>(iii)</enum><text>the cost effectiveness, quality, effectiveness, and efficiency of health care services furnished to individuals with serious mental illness, in mental health crisis, or at risk to themselves, their families, and the general public; and</text>
</clause></subparagraph><subparagraph commented="no" id="H0B8D99FBA215436BACA7971A2F7B3DDB"><enum>(B)</enum><text>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.</text>
</subparagraph></paragraph><paragraph commented="no" id="H34C5DD6B722D49EC822EA8D7F46BCE4E"><enum>(4)</enum><header>Deadline for beginning implementation</header><text>The Director of the NMHPL shall begin implementation of the duties described in this subsection not later than January 1, 2018.</text>
</paragraph><paragraph commented="no" id="H4465EFC129544CA0B9A9ED0AFB9D8110"><enum>(5)</enum><header>Consultation</header><text>In carrying out the duties under this subsection, the Director of the NMHPL shall consult with—</text> <subparagraph commented="no" id="H3DA1F4AA67014033A77E959A75210E23"><enum>(A)</enum><text>representatives of the National Institute of Mental Health on organization, hiring decisions, and operations, initially and on an ongoing basis;</text>
</subparagraph><subparagraph commented="no" id="HBC19230AB29B464A9E44CEB8265D81BE"><enum>(B)</enum><text>other appropriate Federal agencies;</text> </subparagraph><subparagraph commented="no" id="H6CAC7F30AA1A4DB895E8E221A07E04C1"><enum>(C)</enum><text display-inline="yes-display-inline">clinical and analytical experts with expertise in medicine, psychiatric and clinical psychological care, health care management, education, corrections health care, and mental health court systems; and</text>
</subparagraph><subparagraph commented="no" id="HDF3323BDCE0F4ADA8E965830F15DF234"><enum>(D)</enum><text>other individuals and agencies as determined appropriate by the Assistant Secretary.</text> </subparagraph></paragraph></subsection><subsection commented="no" id="H8E396085C1854BEA8418AC874B6D8D80"><enum>(b)</enum><header>Standards for grant programs</header> <paragraph commented="no" id="H9E9A26A425E4441F96153A53B4356204"><enum>(1)</enum><header>In general</header><text>The Director of the NMHPL shall set standards for grant programs administered by the Assistant Secretary, and the Assistant Secretary shall comply with such standards, including standards for—</text>
<subparagraph commented="no" id="HF4D735499248436EBF5975BBA0DD8ECF"><enum>(A)</enum><text>the extent to which the grantee must have the capacity to implement the award;</text> </subparagraph><subparagraph commented="no" id="HAB9F04E76A594C2386B3D7BCBD8437C2"><enum>(B)</enum><text>the extent to which the grant plan submitted by the grantee as part of its application must explain how the grantee will help to provide comprehensive community mental health or substance use services to adults with serious mental illness and children with serious emotional disturbances;</text>
</subparagraph><subparagraph commented="no" id="H9ABB420FF5544F13BE92A49C28476BA0"><enum>(C)</enum><text>the extent to which the grantee must identify priorities, as well as strategies and performance indicators to address those priorities for the duration of the grant;</text>
</subparagraph><subparagraph commented="no" id="H425CC2A760654746AA775FE0F72B7C04"><enum>(D)</enum><text>the extent to which the grantee must submit statements on the extent to which the grantee is meeting annual program priorities with quantifiable, objective, and scientific targets, measures, and outcomes;</text>
</subparagraph><subparagraph commented="no" id="HF829ECE173B543B5B21FEB165AEFC2B8"><enum>(E)</enum><text>the extent to which grantees are expected to collaborate with other child-serving systems such as child welfare, education, juvenile justice, and primary care systems;</text>
</subparagraph><subparagraph commented="no" id="HD384D24BA13940FC8EDD9ECA08CACACB"><enum>(F)</enum><text>the extent to which the grantee must collect and report data;</text> </subparagraph><subparagraph commented="no" id="HE6E06943F576404FB9F349A121E1B642"><enum>(G)</enum><text>the extent to which the grantee must use evidence-based practices and the extent to which 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; and</text>
</subparagraph><subparagraph commented="no" id="HF018EE5E564A43E6A59B36DCD2FE15BC"><enum>(H)</enum><text>the extent to which a grantee, when possible, must have a control group.</text> </subparagraph></paragraph><paragraph commented="no" id="HF0EAC9D4ABD6463FB7C43F76C885DA61"><enum>(2)</enum><header>Public disclosure of results</header><text>The Director of the NMHPL—</text>
<subparagraph id="HDC13A3CF984148D9AC4AC70BFD1B4084"><enum>(A)</enum><text>shall make the standards under paragraph (1), and the Director’s findings on compliance by the Assistant Secretary and grantees with such standards, available to the public in a timely fashion; and</text>
</subparagraph><subparagraph id="H0A2C399532BD42439C27D9CC637F8A4C"><enum>(B)</enum><text display-inline="yes-display-inline">may establish requirements for States and other entities receiving funds through grants under programs established or amended by this Act and under other mental health programs under the Public Health Service Act, including under a block grant under part B of title XIX of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300x">42 U.S.C. 300x et seq.</external-xref>), to collect information on evidence-based best practices and services delivery models selected under section 101(c)(2), as the Assistant Secretary determines necessary to monitor and evaluate such models.</text>
</subparagraph></paragraph></subsection><subsection commented="no" id="H45794589BAB5443387916378163794FE"><enum>(c)</enum><header>Staffing</header>
<paragraph commented="no" id="H8124E92D036C4FA7BCE980C52DE69AF6"><enum>(1)</enum><header>Composition</header><text>In selecting the staff of the NMHPL, the Director of the NMHPL, in consultation with the Director of the National Institute of Mental Health, shall ensure the following:</text>
<subparagraph commented="no" id="H7162C18AA3444408B1DC6887F8D980D7"><enum>(A)</enum><text>At least 20 percent of the staff shall—</text> <clause commented="no" id="HCBC6B9F44E66485A8EC7196B7F4B97DB"><enum>(i)</enum><text>have a doctoral degree in medicine or osteopathic medicine and clinical and research experience in psychiatry;</text>
</clause><clause commented="no" id="H40C565B9BFE9468F80A4D81693EAE5A8"><enum>(ii)</enum><text>have graduated from an Accreditation Council for Graduate Medical Education-accredited psychiatric residency program; and</text>
</clause><clause commented="no" id="H588FD7A8845642B7A1D461E0C43E4E22"><enum>(iii)</enum><text>have an understanding of biological, psychosocial, and pharmaceutical treatments of mental illness and substance use disorders.</text>
</clause></subparagraph><subparagraph commented="no" id="H7D678AD440E549B18F804AF03ABB345B"><enum>(B)</enum><text>At least 20 percent of the staff shall have a doctoral degree in psychology with—</text> <clause commented="no" id="H374BA43FD0BA4F4690CDBDB517F84BE1"><enum>(i)</enum><text>clinical and research experience regarding mental illness and substance use disorders; and</text>
</clause><clause commented="no" id="H2EE8C23D3FE643EA8237904FA8174785"><enum>(ii)</enum><text>an understanding of biological, psychosocial, and pharmaceutical treatments of mental illness and substance use disorders.</text>
</clause></subparagraph><subparagraph commented="no" id="H45E2754288AC47D9A91BFCE0EC42DD97"><enum>(C)</enum><text>At least 20 percent of the staff shall be professionals or academics with clinical or research expertise in substance use disorders and treatment.</text>
</subparagraph><subparagraph commented="no" id="HD681125D83CD43A8BB7E239F8EA8D7C5"><enum>(D)</enum><text>At least 20 percent of the staff shall be professionals or academics with expertise in research design and methodologies.</text>
</subparagraph></paragraph><paragraph commented="no" id="H5D43C0B4733946369FF5632027C2B1F0"><enum>(2)</enum><header>Congressional appointments</header><text>At least 20 percent, or two, whichever is greater, of the members of the staff of the NMHPL shall be appointed by Congress.</text>
</paragraph></subsection><subsection commented="no" id="HFADA69576B0245BCAAA114F09695659E"><enum>(d)</enum><header>Report on quality of care</header><text>Not later than 1 year after the date of enactment of this Act, and every 2 years thereafter, the Director of the NMHPL shall submit to the Congress a report on the quality of care furnished through grant programs administered by the Assistant Secretary under the respective services delivery models, including measurement of patient-level outcomes and public health outcomes such as—</text>
<paragraph commented="no" id="HEFF642BE89C24A80BB7B0A1832C8D88D"><enum>(1)</enum><text>reduced rates of suicide, suicide attempts, substance abuse, overdose, overdose deaths, emergency psychiatric hospitalizations, emergency room boarding, incarceration, crime, arrest, victimization, homelessness, and joblessness;</text>
</paragraph><paragraph commented="no" id="HC48306B68B2643F4B375B673A4963B19"><enum>(2)</enum><text>rates of employment and enrollment in educational and vocational programs; and</text> </paragraph><paragraph commented="no" id="H6F5197008B8A491FA26E27D0B3B2B4BF"><enum>(3)</enum><text>such other criteria as the Director may determine.</text>
</paragraph></subsection><subsection id="HE7187F76BE284303891AD0EFAD4C9408"><enum>(e)</enum><header>Definition</header><text display-inline="yes-display-inline">In this section, the term <term>emergency room boarding</term> means the practice of admitting patients to an emergency department and holding them in the department until inpatient psychiatric beds become available.</text>
</subsection></section><section commented="no" id="HB4BF469E3BE049F383101A479D18F24A"><enum>202.</enum><header>Innovation grants</header>
<subsection commented="no" id="H1AD9180B23FE466B9EDCA54114273F2A"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Assistant Secretary shall award grants to State and local governments, educational institutions, and nonprofit organizations for expanding a model that has been scientifically demonstrated to show promise, but would benefit from further applied research, for—</text>
<paragraph commented="no" id="HBDE6EFD4630343EC8E7A129CAA124EAC"><enum>(1)</enum><text>enhancing the screening, diagnosis, and treatment of mental illness and serious mental illness; or</text> </paragraph><paragraph commented="no" id="HA4022CD974024A519B30A43822305E7C"><enum>(2)</enum><text>integrating or coordinating physical, mental health, and substance use services.</text>
</paragraph></subsection><subsection commented="no" id="H4394DD95AE51436D9D2A4579B700B470"><enum>(b)</enum><header>Duration</header><text>A grant under this section shall be for a period of not more than 2 years.</text> </subsection><subsection commented="no" id="HDDFE7B30C55242D3A52EEC55C481CB8C"><enum>(c)</enum><header>Limitations</header><text display-inline="yes-display-inline">Of the amounts made available for carrying out this section for a fiscal year—</text>
<paragraph commented="no" id="H8947CEF00EDE441FAC67313DC52D30DC"><enum>(1)</enum><text>not more than one-third shall be awarded for use for primary prevention; and</text> </paragraph><paragraph commented="no" id="H2771AF3FAAF94C91A701A009E04FF8A7"><enum>(2)</enum><text>not less than one-third shall be awarded for screening, diagnosis, treatment, or services, as described in subsection (a), for individuals (or subpopulations of individuals) who are below the age of 18 when activities funded through the grant award are initiated.</text>
</paragraph></subsection><subsection commented="no" id="HE5728A9CA9F2427A8B5D2E880DA2855F"><enum>(d)</enum><header>Guidelines</header><text display-inline="yes-display-inline">As a condition on receipt of an award under this section, an applicant shall agree to adhere to guidelines issued by the National Mental Health Policy Laboratory on research designs and data collection.</text>
</subsection><subsection commented="no" id="HE1C4B3258D72447FBD2AB939F080C61A"><enum>(e)</enum><header>Termination</header><text>The Assistant Secretary may terminate any award under this section upon a determination that—</text> <paragraph commented="no" id="HCB3CAE046A3541938A226FB00DC023FA"><enum>(1)</enum><text display-inline="yes-display-inline">the recipient is not providing information requested by the National Mental Health Policy Laboratory or the Assistant Secretary in connection with the award; or</text>
</paragraph><paragraph commented="no" id="H1AA5147C07A14692A758CF50B3093A84"><enum>(2)</enum><text display-inline="yes-display-inline">there is a clear failure in the effectiveness of the recipient’s programs or activities funded through the award.</text>
</paragraph></subsection><subsection commented="no" id="H3BC162189EA8461B8D9E67471CBC09C8"><enum>(f)</enum><header>Reporting</header><text display-inline="yes-display-inline">As a condition on receipt of an award under this section, an applicant shall agree—</text> <paragraph id="H24380B81092E40E996AA9F5C394E7704"><enum>(1)</enum><text>to report to the National Mental Health Policy Laboratory and the Assistant Secretary the results of programs and activities funded through the award; and</text>
</paragraph><paragraph id="HFF4CCB30D9D94E2F8D5EE70E3585FBFB"><enum>(2)</enum><text display-inline="yes-display-inline">to include in such reporting any relevant data requested by the National Mental Health Policy Laboratory and the Assistant Secretary.</text>
</paragraph></subsection><subsection commented="no" id="H2E645CABDC044489B4436EAB55EE8459"><enum>(g)</enum><header>Definition</header><text>In this section, the term <term>primary prevention</term> means prevention that is designed to prevent a disease or condition from occurring among the general population without regard to identifying the presence of risk factors or symptoms in the population.</text>
</subsection><subsection commented="no" id="H4BC6C0E827F2499DA6283549C6C6501A"><enum>(h)</enum><header>Funding</header><text>Of the amounts made available to carry out sections 501, 509, 516, and 520A of the Public Health Service Act for a fiscal year, 5 percent of such amounts are authorized to be used to carry out this section.</text>
</subsection></section><section commented="no" id="HE5F4F30B27744DA49409800A1B3EFB34"><enum>203.</enum><header>Demonstration grants</header>
<subsection id="H39E4A8E9C7B744DB933DD8EFF38CAAF4"><enum>(a)</enum><header>Grants</header><text display-inline="yes-display-inline">The Assistant Secretary shall award grants to States, counties, local governments, educational institutions, and private nonprofit organizations for the expansion, replication, or scaling of evidence-based programs across a wider area to enhance effective screening, early diagnosis, intervention, and treatment with respect to mental illness and serious mental illness, primarily by—</text>
<paragraph commented="no" id="H7522A15E2A6548178C109E4A88AA5101"><enum>(1)</enum><text>applied delivery of care, including training staff in effective evidence-based treatment; and</text> </paragraph><paragraph id="H7A39B015EF434010B39C8F91C8BD9FB9"><enum>(2)</enum><text>integrating models of care across specialties and jurisdictions.</text>
</paragraph></subsection><subsection commented="no" id="H610C620E2F784C25BFD609CA5F793E8F"><enum>(b)</enum><header>Duration</header><text>A grant under this section shall be for a period of not less than 2 years and not more than 5 years.</text>
</subsection><subsection commented="no" id="H10784D90B96043C3BC104F73B0B3991C"><enum>(c)</enum><header>Limitations</header><text display-inline="yes-display-inline">Of the amounts made available for carrying out this section for a fiscal year—</text> <paragraph id="HBB331C05FDAF487DB0B08D9EF86C5426"><enum>(1)</enum><text display-inline="yes-display-inline">not less than half shall be awarded for screening, diagnosis, intervention, and treatment, as described in subsection (a), for individuals (or subpopulations of individuals) who are below the age of 26 when activities funded through the grant award are initiated;</text>
</paragraph><paragraph commented="no" id="H8CB79E551622413C9B1F335BDA50F554"><enum>(2)</enum><text>no amounts shall be made available for any program or project that is not evidence-based;</text> </paragraph><paragraph id="H911A41AE84A84CFBBC700805877FC716"><enum>(3)</enum><text>no amounts shall be made available for primary prevention; and</text>
</paragraph><paragraph commented="no" id="H774732CE40F34B3CAEDF6A38F5D6B100"><enum>(4)</enum><text>no amounts shall be made available solely for the purpose of expanding facilities or increasing staff at an existing program.</text>
</paragraph></subsection><subsection commented="no" id="HC9A4C68919894594A72D1880294B9314"><enum>(d)</enum><header>Guidelines</header><text display-inline="yes-display-inline">As a condition on receipt of an award under this section, an applicant shall agree to adhere to guidelines issued by the National Mental Health Policy Laboratory on research designs and data collection.</text>
</subsection><subsection commented="no" id="H053CCABF488A4859A23879BBAB365E32"><enum>(e)</enum><header>Termination</header><text>The Assistant Secretary may terminate any award under this section upon a determination that—</text> <paragraph commented="no" id="H6E9EF9452FD3484EA345EADA8FC27B4C"><enum>(1)</enum><text display-inline="yes-display-inline">the recipient is not providing information requested by the National Mental Health Policy Laboratory or the Assistant Secretary in connection with the award; or</text>
</paragraph><paragraph commented="no" id="HD45C383490624EBFB220E345401B11BD"><enum>(2)</enum><text display-inline="yes-display-inline">there is a clear failure in the effectiveness of the recipient’s programs or activities funded through the award.</text>
</paragraph></subsection><subsection commented="no" id="HD9CC9615B4314A9297BFB12E807036BD"><enum>(f)</enum><header>Reporting</header><text display-inline="yes-display-inline">As a condition on receipt of an award under this section, an applicant shall agree—</text> <paragraph id="H614385ADE7FD4EBB8B375FD204A42C2D"><enum>(1)</enum><text>to report to the National Mental Health Policy Laboratory and the Assistant Secretary the results of programs and activities funded through the award; and</text>
</paragraph><paragraph id="HA002D178ECA349F69FE7E466876AC09C"><enum>(2)</enum><text display-inline="yes-display-inline">to include in such reporting any relevant data requested by the National Mental Health Policy Laboratory and the Assistant Secretary.</text>
</paragraph></subsection><subsection commented="no" id="HDD2B7E35999549888BD2982DF0E23639"><enum>(g)</enum><header>Funding</header><text display-inline="yes-display-inline">Of the amounts made available to carry out sections 501, 509, 516, and 520A of the Public Health Service Act for a fiscal year, 10 percent of such amounts are authorized to be used to carry out this section.</text>
</subsection></section><section commented="no" id="HC0C709B5BE5044B88370BA4063A8C8F2"><enum>204.</enum><header>Early childhood intervention and treatment</header>
<subsection commented="no" id="H30BA180207834D879367AE409DAA6A8B"><enum>(a)</enum><header>Grants</header><text>The Director of the National Mental Health Policy Laboratory (in this section referred to as the <quote>NMHPL</quote>) shall award—</text> <paragraph commented="no" id="H5448B93B27384FB392000AFEE2B2CC66"><enum>(1)</enum><text>grants to eligible entities to initiate and undertake, for eligible children, early childhood intervention and treatment programs, and specialized preschool and elementary school programs, with the goal of preventing chronic and serious mental illness;</text>
</paragraph><paragraph commented="no" id="HF26973517A3A4C4994D33163680F62A8"><enum>(2)</enum><text>grants to not more than 3 eligible entities for studying the longitudinal outcomes of programs funded under paragraph (1) on eligible children who were treated 5 or more years prior to the enactment of this Act; and</text>
</paragraph><paragraph commented="no" id="H62FF1716F311433C97E4DFD9D949EE8C"><enum>(3)</enum><text display-inline="yes-display-inline">ensure that programs and activities funded through grants under this subsection are based on a sound scientific model that shows evidence and promise and can be replicated in other settings.</text>
</paragraph></subsection><subsection commented="no" id="H28D762A1C01C4530BD23DCF8CC97F9DB"><enum>(b)</enum><header>Eligible entities and children</header><text>In this section:</text> <paragraph commented="no" id="HC7E09A66EAB847AF94300C77948B5010"><enum>(1)</enum><header>Eligible entity</header><text>The term <term>eligible entity</term> means a nonprofit institution that—</text>
<subparagraph commented="no" id="H227FF3357B664C10BBB69041E082DCE3"><enum>(A)</enum><text display-inline="yes-display-inline">is duly accredited by State mental health and education agencies, as applicable, for the treatment and education of children from 1 to 10 years of age; and</text>
</subparagraph><subparagraph commented="no" id="H6A250545FF184FAF8C4260AB7B28DFAF"><enum>(B)</enum><text>provides services that include early childhood intervention and specialized preschool and elementary school programs focused on children whose primary need is a social or emotional disability (in addition to any learning disability).</text>
</subparagraph></paragraph><paragraph commented="no" id="HB64E15281AFD4F71AAEDFDF470D534B3"><enum>(2)</enum><header>Eligible child</header><text>The term <term>eligible child</term> means a child who is at least 0 years old and not more than 12 years old—</text> <subparagraph commented="no" id="H3FB94F0549DB42A89A6BCFC3F02AC12D"><enum>(A)</enum><text>whose primary need is a social and emotional disability (in addition to any learning disability);</text>
</subparagraph><subparagraph commented="no" id="HE4EBB1F03F584A88B4144FE318E36CB3"><enum>(B)</enum><text display-inline="yes-display-inline">who is at risk of developing serious mental illness and/or may show early signs of mental illness; and</text>
</subparagraph><subparagraph commented="no" id="H933AA4F8CBF249F3B02FC2AEE6A7B4F5"><enum>(C)</enum><text>who could benefit from early childhood intervention and specialized preschool or elementary school programs with the goal of preventing or treating chronic and serious mental illness.</text>
</subparagraph></paragraph></subsection><subsection commented="no" id="HA8B604FC018543F29369FC6824EAA0F4"><enum>(c)</enum><header>Application</header><text>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.</text>
</subsection><subsection commented="no" id="H02BA67272F9246CFAED9FB8E0ACEF678"><enum>(d)</enum><header>Use of funds for early childhood intervention and treatment programs</header><text>An eligible entity shall use amounts awarded under a grant under subsection (a)(1) to carry out the following activities:</text>
<paragraph commented="no" id="H75870F1759F14A2DB382E4D39765F97B"><enum>(1)</enum><text>Deliver (or facilitate) for eligible children treatment and education, early childhood intervention, and specialized preschool and elementary school programs, including the provision of medically based child care and early education services.</text>
</paragraph><paragraph commented="no" id="H136DF357B92E4B7F8E78121B57ABDCB9"><enum>(2)</enum><text>Treat and educate eligible children, including startup, curricula development, operating and capital needs, staff and equipment, assessment and intervention services, administration and medication requirements, enrollment costs, collaboration with primary care physicians and psychiatrists, other related services to meet emergency needs of children, and communication with families and medical professionals concerning the children.</text>
</paragraph><paragraph commented="no" id="HC4DFC4100D4E417CA45086B2E6AED866"><enum>(3)</enum><text display-inline="yes-display-inline">Develop and implement other strategies to address identified treatment and educational needs of eligible children that have reliable and valid evaluation modalities built into assess outcomes based on sound scientific metrics as determined by the NMHPL.</text>
</paragraph></subsection><subsection commented="no" id="H8B3C311EB59B44A29C318E2A17FBC0EE"><enum>(e)</enum><header>Use of funds for longitudinal study</header><text display-inline="yes-display-inline">In conducting a study on longitudinal outcomes through a grant under subsection (a)(2), an eligible entity shall include an analysis of—</text>
<paragraph commented="no" id="H70008F7E0FC4470FB5D5F0C53EDF7094"><enum>(1)</enum><text>the individuals treated and educated;</text> </paragraph><paragraph commented="no" id="H2D0575FEE0D44CDEB6887749763FEDCF"><enum>(2)</enum><text>the success of such treatment and education in avoiding the onset of serious mental illness or the preparation of such children for the care and management of serious mental illness;</text>
</paragraph><paragraph commented="no" id="HEF0ACB35C9A746D08C3BA7C08D4FCC62"><enum>(3)</enum><text>any evidence-based best practices generally applicable as a result of such treatment and educational techniques used with such children; and</text>
</paragraph><paragraph commented="no" id="HCBC2EFCCD0D74B739F290D253A331260"><enum>(4)</enum><text display-inline="yes-display-inline">the ability of programs to be replicated as a best practice model of intervention.</text> </paragraph></subsection><subsection commented="no" id="H467F4FC1F1A04F7681A1E5902B72C9AA"><enum>(f)</enum><header>Requirements</header><text>In carrying out this section, the Secretary shall ensure that each entity receiving a grant under subsection (a) maintains a written agreement with the Secretary, and provides regular written reports, as required by the Secretary, regarding the quality, efficiency, and effectiveness of intervention and treatment for eligible children preventing or treating the development and onset of serious mental illness.</text>
</subsection><subsection commented="no" id="H6F76C75B005F40129771694E4426BF08"><enum>(g)</enum><header>Amount of awards</header>
<paragraph commented="no" id="H2A4DF700D47649208DD792E778B263E1"><enum>(1)</enum><header>Amounts for early childhood intervention and treatment programs</header><text>The amount of an award to an eligible entity under subsection (a)(1) shall be not more than $600,000 per fiscal year.</text>
</paragraph><paragraph commented="no" id="H591CF2BE6050419BB931987DC49A1C9A"><enum>(2)</enum><header>Amounts for longitudinal study</header><text>The total amount of an award to an eligible entity under subsection (a)(2) (for one or more fiscal years) shall be not less than $1,000,000 and not greater than $2,000,000.</text>
</paragraph></subsection><subsection commented="no" id="H915BBE728B6E41B7A062DAF667BDB354"><enum>(h)</enum><header>Project terms</header><text>The period of a grant—</text> <paragraph commented="no" id="H589F8B873B404F42AD2FCC6FD4276E21"><enum>(1)</enum><text>for awards under subsection (a)(1), shall be not less than 3 fiscal years and not more than 10 fiscal years; and</text>
</paragraph><paragraph commented="no" id="HBEA8BBBA22314B70B1A81F37DC6BA478"><enum>(2)</enum><text>for awards under subsection (a)(2), shall be not more than 5 fiscal years.</text> </paragraph></subsection><subsection commented="no" id="HC6DF5CABB0954E1C83816D7FDF8E0F5E"><enum>(i)</enum><header>Matching funds</header><text>The Director of the NMHPL 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 subparagraph (D), to make available non-Federal contributions (in cash or in kind) toward such costs in an amount equal to not less than 10 percent of Federal funds provided in the grant.</text>
</subsection><subsection commented="no" id="H1EB0A092E6144F5AB3F185669268937C"><enum>(j)</enum><header>Definitions</header><text display-inline="yes-display-inline">In this section:</text> <paragraph commented="no" id="HD4A2EDE3E91C41B0865574276E1A4B98"><enum>(1)</enum><text>The term <term>emergency room boarding</term> means the practice of admitting patients to an emergency department and holding them in the department until inpatient psychiatric beds become available.</text>
</paragraph><paragraph commented="no" id="HF4C7416EEFF14E2E9FD863170F17A3FF"><enum>(2)</enum><text>The term <term>primary prevention</term> means prevention that is designed to prevent a disease or condition from occurring among the general population without regard to identifying the presence of risk factors or symptoms in the population.</text>
</paragraph></subsection><subsection commented="no" id="H56D487F8EFD24F68A26CB451CC96DA42"><enum>(k)</enum><header>Funding</header><text>Of the amounts made available to carry out part E of title V of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290ff">42 U.S.C. 290ff et seq.</external-xref>) for each of fiscal years 2016 through 2021, not more than 5 percent of such amounts are authorized to be appropriated to carry out this section.</text>
</subsection></section><section commented="no" id="HAC35CCE18B7D45379FEB7B92E424DFF5"><enum>205.</enum><header>Extension of assisted outpatient treatment grant program for individuals with serious mental
illness</header><text display-inline="no-display-inline">Section 224 of the Protecting Access to Medicare Act of 2014 (<external-xref legal-doc="usc" parsable-cite="usc/42/290aa">42 U.S.C. 290aa</external-xref> note) is amended—</text> <paragraph commented="no" id="HB67110AD00EE443381F4071D88BC1D53"><enum>(1)</enum><text>in subsection (e), by striking <quote>and 2018</quote> and inserting <quote>2018, 2019, and 2020</quote>; and</text>
</paragraph><paragraph commented="no" id="HC363B9CEE3B34873AC97027F7594A16D"><enum>(2)</enum><text>in subsection (g)—</text> <subparagraph commented="no" id="H9A9BB9AFD75B44C08CE9C7BCF87AB57A"><enum>(A)</enum><text>in paragraph (1), by striking <quote>2018</quote> and inserting <quote>2020</quote>;</text>
</subparagraph><subparagraph commented="no" id="HF117FF17213247128E6D8DE935A9385F"><enum>(B)</enum><text>in paragraph (2)—</text> <clause commented="no" id="HE2C6108117C9472EA59CC670931A7D90"><enum>(i)</enum><text>by striking <quote>$15,000,000</quote> and inserting <quote>$20,000,000</quote>; and</text>
</clause><clause commented="no" id="H4AC5011DDC834D3E9457D4602989EB4A"><enum>(ii)</enum><text>by striking <quote>2018</quote> and inserting <quote>2020</quote>; and</text> </clause></subparagraph><subparagraph commented="no" id="H0DE9F629A9DF479F9C810C4B75D79B60"><enum>(C)</enum><text>by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H631B60D566014E9EBF477301DD19B8EB" style="OLC">
<paragraph commented="no" id="H798AB627DAE34FDF836F7206BEC551D2"><enum>(3)</enum><header>Allocation</header><text display-inline="yes-display-inline">Of the funds made available to carry out this section for a fiscal year, the Secretary shall allocate—</text>
<subparagraph commented="no" id="H183A38BDDEA74404B3D595471F42B9F6"><enum>(A)</enum><text>20 percent of such funds for existing assisted outpatient treatment programs; and</text> </subparagraph><subparagraph commented="no" id="H4CFBE75FED964BD6839250E565E23F24"><enum>(B)</enum><text>80 percent of such funds for new assisted outpatient treatment programs.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph></section><section id="HA52455E2AF0E4B75BE8DB544B04A4D88"><enum>206.</enum><header>Block grants</header>
<subsection id="H77B5EA5F504B44FC9C4D9BCE3DC57BC9"><enum>(a)</enum><header>Best practices in clinical care models</header><text display-inline="yes-display-inline">Section 1920 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300x-9">42 U.S.C. 300x–9</external-xref>) is amended by adding at the end the following:</text>
<quoted-block id="HACB4294B2A58468CB037F375023A066E" style="OLC">
<subsection id="H6DF2644364774EC3A1F957D1F9A19C5E"><enum>(c)</enum><header>Best practices in clinical care models</header><text>The Secretary, acting through the Director of the National Institute of Mental Health, shall obligate 5 percent of the amounts appropriated for a fiscal year under subsection (a) for translating evidence-based (as defined in section 2 of the <short-title>Helping Families in Mental Health Crisis Act of 2015</short-title>) interventions and best available science into systems of care, such as through models including—</text>
<paragraph id="HD05355345C884E6EA28A139E85C2D387"><enum>(1)</enum><text>the Recovery After an Initial Schizophrenia Episode research project of the National Institute of Mental Health; and</text>
</paragraph><paragraph id="H8FC3066B56CC48928AB14D827CFA2834"><enum>(2)</enum><text>the North American Prodrome Longitudinal Study.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block> </subsection><subsection id="HD07F053B70C5424DB6BCFE86140F2F68"><enum>(b)</enum><header>Administration of block grants by Assistant Secretary</header><text>Section 1911(a) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300x">42 U.S.C. 300x</external-xref>) is amended by striking <quote>acting through the Director of the Center for Mental Health Services</quote> and inserting <quote>acting through the Assistant Secretary for Mental Health and Substance Use Disorders</quote>.</text>
</subsection><subsection id="H8E4B289E10214B969A82075CCD150151"><enum>(c)</enum><header>Additional program requirements</header>
<paragraph id="H2184C1C7AB7040F0AA79336862692F93"><enum>(1)</enum><header>Integrated services</header><text display-inline="yes-display-inline">Subsection (b)(1) of section 1912 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300x-1">42 U.S.C. 300x–1(b)(1)</external-xref>) is amended—</text>
<subparagraph id="H60F1E0A002624DEC82993F479C5842A0"><enum>(A)</enum><text>by striking <quote>The plan provides</quote> and inserting:</text> <quoted-block display-inline="no-display-inline" id="H40E3EF43385248E4999EAF2796A55FB2" style="OLC"> <subparagraph id="HE37B74D61C394C5F9F27DFF0F8F7A0FA"><enum>(A)</enum><text display-inline="yes-display-inline">The plan provides</text></subparagraph><after-quoted-block>; </after-quoted-block></quoted-block>
</subparagraph><subparagraph commented="no" id="H5A621794BA6F41929048E96D7F4EBCBB"><enum>(B)</enum><text>in the subparagraph (A) inserted by paragraph (1), in the second sentence, by striking <quote>health and mental health services</quote> and inserting <quote>integrated physical and mental health services</quote>;</text> </subparagraph><subparagraph commented="no" id="HB14497B72E8D4BDC92DFC7B80C083B0C"><enum>(C)</enum><text>in such subparagraph (A), by striking <quote>The plan shall include</quote> through the period at the end and inserting <quote>The plan shall integrate and coordinate services to maximize the efficiency, effectiveness, quality, coordination, and cost effectiveness of those services and programs to produce the best possible outcomes for those with serious mental illness.</quote>; and</text>
</subparagraph><subparagraph commented="no" id="HBF4904D914D443AB8A0218B62EF52728"><enum>(D)</enum><text>by adding at the end the following new subparagraph:</text> <quoted-block display-inline="no-display-inline" id="H3EAA5640B2F5474CA2DA8953717D1CBB" style="OLC"> <subparagraph commented="no" id="H42C7D23E225F48DD8E4B3C3F44041F3D"><enum>(B)</enum><text display-inline="yes-display-inline">The plan shall include a separate description of case management services and provide for activities leading to reduction of rates of suicides, suicide attempts, substance abuse, overdose deaths, emergency hospitalizations, incarceration, crimes, arrest, victimization, homelessness, joblessness, medication nonadherence, and education and vocational programs drop outs. The plan must also include a detailed list of services available for eligible patients (as defined in subsection (d)(3)) in each county or county equivalent, including assisted outpatient treatment.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H1A10AB7423264B468DA4B5CC011DA932"><enum>(2)</enum><header>Data collection system</header><text>Subsection (b)(2) of section 1912 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300x-1">42 U.S.C. 300x–1(b)(2)</external-xref>) is amended—</text>
<subparagraph display-inline="no-display-inline" id="H499028FB73FC442C856B2F34FD0F1309"><enum>(A)</enum><text>by striking <quote>The plan contains an estimate of</quote> and inserting the following:</text> <quoted-block display-inline="yes-display-inline" id="H0C7F89A5A6E04E95B41AD365D30F3F13" style="OLC"> <text>The plan contains—</text><subparagraph id="H254897D142FA49718139BC412CB6505B"><enum>(A)</enum><text display-inline="yes-display-inline">an estimate of</text></subparagraph><after-quoted-block>;</after-quoted-block></quoted-block> </subparagraph><subparagraph id="HFAB56E6314394C80A203D237D8439D55"><enum>(B)</enum><text>in subparagraph (A), as inserted by paragraph (1), by inserting <quote>, including reductions in homelessness, emergency hospitalization, incarceration, and unemployment for eligible patients (as defined in subsection (d)(3)),</quote> after <quote>targets</quote>;</text>
</subparagraph><subparagraph id="HFB84BF9125D749FAA523E2054F4ECC21"><enum>(C)</enum><text>in such subparagraph, by striking the period at the end and inserting <quote>; and</quote>; and</text> </subparagraph><subparagraph id="HD6A74C8B4188489CAA111137C77F92A4"><enum>(D)</enum><text>by adding at the end the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="H477EE59639604D09B37F5A9A6E316551" style="OLC">
<subparagraph id="H4396AA18DE1B4E8CBAE2A69F87CEEDB1"><enum>(B)</enum><text display-inline="yes-display-inline">an agreement by the State to report to the National Mental Health Policy Laboratory such data as may be required by the Secretary concerning—</text>
<clause id="H197B45CC46F44C39878D892A41040103"><enum>(i)</enum><text>comprehensive community mental health services in the State; and</text> </clause><clause id="HA08BF5D470BA47FDA03BD32DE17BF359"><enum>(ii)</enum><text display-inline="yes-display-inline">public health outcomes for persons with serious mental illness in the State, including rates of suicides, suicide attempts, substance abuse, overdose deaths, emergency hospitalizations, incarceration, crimes, arrest, victimization, homelessness, joblessness, medication non-adherence, and education and vocational programs drop outs.</text></clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph commented="no" id="H3979A911D51A4DD691C1DC32286B9022"><enum>(3)</enum><header>Implementation of plan</header><text display-inline="yes-display-inline">Subsection (d) of section 1912 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300x-1">42 U.S.C. 300x–1(d)</external-xref>) is amended—</text> <subparagraph commented="no" id="H4F32BA8E7B8F41CD898577D423FFFEE5"><enum>(A)</enum><text>in paragraph (1)—</text>
<clause commented="no" id="HFB49A705C12E40EBBB2618AB334D87A1"><enum>(i)</enum><text>by striking <quote>Except as provided</quote> and inserting:</text> <quoted-block display-inline="no-display-inline" id="H89430F1B9C3244B2ADB94FE4ACD639DD" style="OLC"> <subparagraph commented="no" id="H75A0F64A480943FD81F73AA4F55BA9A3"><enum>(A)</enum><text display-inline="yes-display-inline">Except as provided</text></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block>
</clause><clause commented="no" id="HFF789DB0960D4EF2B27C4055DBD915C4"><enum>(ii)</enum><text>by adding at the end the following new subparagraph:</text> <quoted-block display-inline="no-display-inline" id="H458F77584AE645579CD4B2E1FCD19F15" style="OLC"> <subparagraph commented="no" id="H401485C4E10A409FA5C59154C3437ECD"><enum>(B)</enum><text display-inline="yes-display-inline">For eligible patients receiving treatment through funds awarded under a grant under section 1911, a State shall include in the State plan for the first year beginning after the date of the enactment of this subparagraph and each subsequent year, a de-individualized report, containing information that is open source and de-identified, on the services provided to those individuals, including—</text>
<clause commented="no" id="H13FA8214400F4E4DA2D437F53AE0EE35"><enum>(i)</enum><text>outcomes and the overall cost of such treatment provided; and</text> </clause><clause commented="no" id="HFF0BA68414B2438B801E32402755A491"><enum>(ii)</enum><text display-inline="yes-display-inline">county or county equivalent level data on such patient population, including overall costs and raw number data on rates of involuntary inpatient and outpatient commitment orders, suicides, suicide attempts, substance abuse, overdose deaths, emergency hospitalizations, incarceration, crimes, arrest, victimization, homelessness, joblessness, medication non-adherence, and education and vocational programs drop outs.</text></clause></subparagraph><after-quoted-block>; and </after-quoted-block></quoted-block>
</clause></subparagraph><subparagraph commented="no" id="H7EE64E43CDCF478A8DA07A1A3CF27802"><enum>(B)</enum><text>by adding at the end the following new paragraph:</text> <quoted-block id="H1D6EB54E591A430A842234F2F7877997" style="OLC"> <paragraph commented="no" id="H47849158084941EB9ECD03742F974344"><enum>(3)</enum><header>Definition</header><text>In this subsection, the term <term>eligible patient</term> means an adult mentally ill person who—</text>
<subparagraph commented="no" id="H4307E9DD8F964676A27C1578E035759A"><enum>(A)</enum><text>may have a history of violence, incarceration, or medically unnecessary hospitalizations;</text> </subparagraph><subparagraph commented="no" id="H1B3A0022D08F41F1A595887FFB2B60FE"><enum>(B)</enum><text>without supervision and treatment, may be a danger to self or others in the community;</text>
</subparagraph><subparagraph commented="no" id="H82FF2EF679F24BD7B10B8751FD604385"><enum>(C)</enum><text>is substantially unlikely to voluntarily participate in treatment;</text> </subparagraph><subparagraph commented="no" id="HF884D0C1A98441F58124F6C5006D33B3"><enum>(D)</enum><text>may be unable, for reasons other than indigence, to provide for any of the basic needs of such person, such as food, clothing, shelter, health, or safety;</text>
</subparagraph><subparagraph commented="no" id="HA1CFF291EF2F43B18514E207C48416F7"><enum>(E)</enum><text>with a history of mental illness or condition that is likely to substantially deteriorate if the person is not provided with timely treatment;</text>
</subparagraph><subparagraph commented="no" id="H631869BA79A44594887632F2724EACF1"><enum>(F)</enum><text>due to mental illness, lacks capacity to fully understand or lacks judgment to make informed decisions regarding his or her need for treatment, care, or supervision; and</text>
</subparagraph><subparagraph commented="no" id="H602B4B501BAD48FAA6B03882FC865184"><enum>(G)</enum><text display-inline="yes-display-inline">is likely to improve in mental health and reduce the symptoms of serious mental illness when in treatment.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph commented="no" id="H975D08BCD70D4F8A9061A76CE82C9F5E"><enum>(4)</enum><header>Treatment under State law</header>
<subparagraph commented="no" id="H9A31FD2AD6D344E48CD74723A3F752D7"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">Section 1912 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300x-1">42 U.S.C. 300x–1</external-xref>) is amended by adding at the end the following new subsections:</text>
<quoted-block display-inline="no-display-inline" id="HCD476E3883E24BC48762E3E64679B6E6" style="OLC">
<subsection commented="no" id="H31D3DEA549914B81B6CC89FD2E753CDA"><enum>(e)</enum><header>Assisted outpatient treatment under State law</header>
<paragraph commented="no" id="HA802B21E5F044CE3A4F9EE2E9B0BAAFF"><enum>(1)</enum><header>In general</header><text>A funding agreement for a grant under section 1911 is that the State involved has in effect a law under which a State court may order a treatment plan for an eligible patient that—</text>
<subparagraph commented="no" id="HA3A2D85E3F234CABBD50F6E6CBACA55D"><enum>(A)</enum><text>requires such patient to obtain outpatient mental health treatment while the patient is living in a community; and</text>
</subparagraph><subparagraph commented="no" id="H94D1544EA3C84A8DB25B429CF26AE648"><enum>(B)</enum><text>is designed to improve access and adherence by such patient to intensive behavioral health services in order to—</text>
<clause commented="no" id="HBAC65D8E7A604AD8A4F53E5BA0FB5E3B"><enum>(i)</enum><text>avert relapse, repeated hospitalizations, arrest, incarceration, suicide, property destruction, and violent behavior; and</text>
</clause><clause commented="no" id="H1E77B4D2EC5E40B1B23853565EE8D42D"><enum>(ii)</enum><text>provide such patient with the opportunity to live in a less restrictive alternative to incarceration or involuntary hospitalization.</text>
</clause></subparagraph></paragraph><paragraph commented="no" id="H3E9F85CDCBAA469ABB1F49B7196DE07B"><enum>(2)</enum><header>Certification of State compliance</header><text>A funding agreement described in paragraph (1) is effective only if the Assistant Secretary for Mental Health and Substance Use Disorders reviews the State law and certifies that it satisfies the criteria specified in such paragraph.</text>
</paragraph></subsection><subsection commented="no" id="H4C524EAE3B0E4D8B8126FB2352FCADE3"><enum>(f)</enum><header>Treatment standard under State law</header>
<paragraph commented="no" id="H69CC6502CF264B538DB0E952F88451BE"><enum>(1)</enum><header>In general</header><text>A funding agreement for a grant under section 1911 is that—</text> <subparagraph commented="no" id="HFD65CA1B8C554927B3FD0EBC304FA91E"><enum>(A)</enum><text>the State involved has in effect a law under which, if a State court finds by clear and convincing evidence that an individual, as a result of mental illness, is a danger to self, is a danger to others, is persistently or acutely disabled, or is gravely disabled and in need of treatment, and is either unwilling or unable to accept voluntary treatment, the court must order the individual to undergo inpatient or outpatient treatment; or</text>
</subparagraph><subparagraph commented="no" id="HFF6EE34CB82A4F3485DB0576A1673601"><enum>(B)</enum><text>the State involved has in effect a law under which a State court must order an individual with a mental illness to undergo inpatient or outpatient treatment, the law was in effect on the date of enactment of the <short-title>Helping Families in Mental Health Crisis Act of 2015</short-title>, and the Secretary finds that the law requires a State court to order such treatment across all or a sufficient range of the type of circumstances described in subparagraph (A).</text>
</subparagraph></paragraph><paragraph commented="no" id="H15FF094B2C9F49EE8EBD25B53EF273FC"><enum>(2)</enum><header>Definition</header><text>For purposes of paragraph (1), the term <term>persistently or acutely disabled</term> refers to a serious mental illness that meets all the following criteria:</text> <subparagraph commented="no" id="H15E25AFE97704385A498EFDA437FEA4F"><enum>(A)</enum><text>If not treated, the illness has a substantial probability of causing the individual to suffer or continue to suffer severe and abnormal mental, emotional, or physical harm that significantly impairs judgment, reason, behavior, or capacity to recognize reality.</text>
</subparagraph><subparagraph commented="no" id="HEBC54ED4F9444C6CB674EFC9BFDDA61B"><enum>(B)</enum><text>The illness substantially impairs the individual’s capacity to make an informed decision regarding treatment, and this impairment causes the individual to be incapable of understanding and expressing an understanding of the advantages and disadvantages of accepting treatment and understanding and expressing an understanding of the alternatives to the particular treatment offered after the advantages, disadvantages, and alternatives are explained to that individual.</text>
</subparagraph><subparagraph commented="no" id="H5339E9D4A1C0464B8340B46B0B294F43"><enum>(C)</enum><text>The illness has a reasonable prospect of being treatable by outpatient, inpatient, or combined inpatient and outpatient treatment.</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph><subparagraph commented="no" id="H3868A89002204B60A356F9FC31666DF8"><enum>(B)</enum><header>Funding increase</header><text>Section 1918 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300x-7">42 U.S.C. 300x–7</external-xref>) is amended—</text> <clause commented="no" id="HAD9B91041A1747009B8D668EC3485533"><enum>(i)</enum><text>in subsection (a)(1), by striking <quote>subsection (b)</quote> and inserting <quote>subsections (b) and (d)</quote>; and</text>
</clause><clause commented="no" id="HF5FBEF10DFAC4A89909BDE5B6EDA8130"><enum>(ii)</enum><text>by adding at the end the following new subsection:</text> <quoted-block display-inline="no-display-inline" id="H6603A07563B7424F96F940D52BBD14BA" style="OLC"> <subsection commented="no" id="H12742482E05F4F8AAC673CADA96F63F0"><enum>(d)</enum><header>Increase for certain States</header><text display-inline="yes-display-inline">With respect to fiscal year 2016 and each subsequent fiscal year, in the case of a State that has in effect a law described in subsection (e)(1) or subparagraph (A) or (B) of subsection (f)(1), the amount of the allotment of a State under section 1911 shall be for such fiscal year the amount that would otherwise be determined, without application of this subsection, for such State for such fiscal year, increased by 2 percent.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</clause></subparagraph></paragraph><paragraph commented="no" id="H4E6AF1BC2F7441C2A57807882A28F5CF"><enum>(5)</enum><header>Evidence-based services delivery models</header><text display-inline="yes-display-inline">Section 1912 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300x-1">42 U.S.C. 300x–1</external-xref>), as amended by paragraph (4), is further amended by adding at the end the following new subsection:</text>
<quoted-block display-inline="no-display-inline" id="H3DEF051EC4B4477AAF6DFEEF30FEF91D" style="OLC">
<subsection commented="no" id="H6BF9FFCC98364AF5A435E4EBEE244AB2"><enum>(g)</enum><header>Expansion of models</header>
<paragraph commented="no" id="HC2E8FA002DBD46EC81D3811307F416A3"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Taking into account the results of evaluations under section 201(a)(2)(C) of the Helping Families in Mental Health Crisis Act of 2015, the Assistant Secretary may, by rule, as part of the program of block grants under this subpart, provide for expanded use across the Nation of evidence-based service delivery models by providers funded under such block grants, so long as—</text>
<subparagraph commented="no" id="HC9AC2839B31746119CBD136526738CA6"><enum>(A)</enum><text display-inline="yes-display-inline">the Assistant Secretary for Mental Health and Substance Use Disorders (in this subsection referred to as the <quote>Assistant Secretary</quote>) determines that such expansion will—</text>
<clause commented="no" id="HEFF80062AB064753B516AD13B2AFBAA1"><enum>(i)</enum><text>result in more effective use of funds under such block grants without reducing the quality of care; or</text>
</clause><clause commented="no" id="HBC7B35CBEBC84FCDAF4D6887AAEAC757"><enum>(ii)</enum><text>improve the quality of patient care without significantly increasing spending;</text> </clause></subparagraph><subparagraph commented="no" id="HB2C678D117E5473E9918DA86C89A23E5"><enum>(B)</enum><text>the Director of the National Institute of Mental Health determines that such expansion would improve the quality of patient care; and</text>
</subparagraph><subparagraph commented="no" id="H5C72ACA157B7495DAEE964CD82589ED9"><enum>(C)</enum><text>the Assistant Secretary determines that the change will—</text> <clause commented="no" id="H47FD1A5CCE71497EA5721FE716A71486"><enum>(i)</enum><text>significantly reduce severity and duration of symptoms of mental illness;</text>
</clause><clause commented="no" id="H6E0D840CF10B4FA1A89C8914D3C3E6AE"><enum>(ii)</enum><text>reduce rates of suicide, suicide attempts, substance abuse, overdose, emergency hospitalizations, emergency room boarding, incarceration, crime, arrest, victimization, homelessness, or joblessness; or</text>
</clause><clause commented="no" id="HC77D23056C5849E6A2B5D38023613917"><enum>(iii)</enum><text>significantly improve the quality of patient care and mental health crisis outcomes without significantly increasing spending.</text>
</clause></subparagraph></paragraph><paragraph commented="no" id="HCCB54C9373064D74ADE102E42739ABA3"><enum>(2)</enum><header>Congressional review</header><text>Any rule promulgated pursuant to paragraph (1) is deemed to be a major rule subject to congressional review and disapproval under <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/5/8">chapter 8</external-xref> of title 5, United States Code.</text>
</paragraph><paragraph id="H279442F0006F48A7B8ADF4503A927584"><enum>(3)</enum><header>Definition</header><text display-inline="yes-display-inline">In this subsection, the term <term>emergency room boarding</term> means the practice of admitting patients to an emergency department and holding them in the department until inpatient psychiatric beds become available.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H00365BB725E44F39BC7982278EEAC1DD"><enum>(d)</enum><header>Period for expenditure of grant funds</header><text>Section 1913 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300x-2">42 U.S.C. 300x–2</external-xref>), as amended, is further amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H39127CE8D86B40B3BF1610A8F62DE397" style="OLC">
<subsection id="HEA4F697653FF4AA1A2CEEC057FBEB610"><enum>(d)</enum><header>Period for expenditure of grant funds</header><text display-inline="yes-display-inline">In implementing a plan submitted under section 1912(a), a State receiving grant funds under section 1911 may make such funds available to providers of services described in subsection (b) for the provision of services without fiscal year limitation.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection commented="no" id="H4CE7E367EACF48878494FE0039779EB9"><enum>(e)</enum><header>Active outreach and engagement</header><text>Section 1915 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300x-4">42 U.S.C. 300x–4</external-xref>) is amended by adding at the end of the following:</text>
<quoted-block display-inline="no-display-inline" id="H7E1EBF96FEBD4D8EB3B4F1CA15E6AF3B" style="OLC">
<subsection commented="no" id="H106F1D70B6524D2FA64DC078E2EE5320"><enum>(c)</enum><header>Active Outreach and Engagement to Persons with Serious Mental Illness</header><text>A funding agreement for a grant under section 1911 is that the State involved has in effect active programs, including assisted outpatient treatment, to engage persons with serious mental illness who are substantially unlikely to voluntarily seek treatment, in comprehensive services in order to avert relapse, repeated hospitalizations, arrest, incarceration, and suicide to provide the patient with the opportunity to live in the community through evidence-based (as defined in section 2 of the <short-title>Helping Families in Mental Health Crisis Act of 2015</short-title>) assertive outreach and engagement services targeting individuals that are homeless, have co-occurring disorders, or have a history of treatment failure. The Assistant Secretary for Mental Health and Substance Use Disorders shall work with the Director of the National Institute of Mental Health to develop a list of such evidence-based (as defined in section 2 of the <short-title>Helping Families in Mental Health Crisis Act of 2015</short-title>) assertive outreach and engagement services, as well as criteria to be used to assess the scope and effectiveness of such approaches. These programs may include assistant outpatient treatment programs under State law where State courts may order a treatment plan for an eligible patient that requires—</text>
<paragraph commented="no" id="H210D63CD783C4091A537BBBD99C859E4"><enum>(1)</enum><text>such patient to obtain outpatient mental health treatment while the patient is living in the community; and</text>
</paragraph><paragraph commented="no" id="HD9C9FE7F7B2846A88CADAFB237FF6F99"><enum>(2)</enum><text>a design to improve access and adherence by such patient to intensive mental health services.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block> </subsection></section><section commented="no" id="HB0AEB692EAB146FDB86EC876655850F6"><enum>207.</enum><header>Workforce development</header> <subsection commented="no" id="HFB7C328689814CB194A52395E30F845C"><enum>(a)</enum><header>Telepsychiatry and primary care physician training grant program</header> <paragraph commented="no" id="HE84CD6DC222F4697AEA3238263CFBDBD"><enum>(1)</enum><header>In general</header><text>The Assistant Secretary of Mental Health and Substance Use Disorders (in this subsection referred to as the <quote>Assistant Secretary</quote>) shall establish a grant program (in this subsection referred to as the <quote>grant program</quote>) under which the Assistant Secretary shall award to 10 eligible States (as described in paragraph (5)) grants for carrying out all of the purposes described in paragraphs (2), (3), and (4).</text>
</paragraph><paragraph commented="no" id="H7BFFB24B11414E36A26AF8030579727B"><enum>(2)</enum><header>Training program for certain primary care physicians</header><text>For purposes of paragraph (1), the purpose described in this paragraph, with respect to a grant awarded to a State under the grant program, is for the State to establish a training program to train primary care physicians in—</text>
<subparagraph commented="no" id="H7179E87622704C88842AF6A29B5F08EC"><enum>(A)</enum><text display-inline="yes-display-inline">valid and reliable behavioral-health screening tools for violence and suicide risk, early signs of serious mental illness, and untreated substance abuse, including any standardized behavioral-health screening tools that are determined appropriate by the Assistant Secretary;</text>
</subparagraph><subparagraph commented="no" id="HAF4AB06E771A41438F632A0D2FBB696B"><enum>(B)</enum><text>implementing the use of behavioral-health screening tools in their practices;</text> </subparagraph><subparagraph commented="no" id="HC46886C89C224959965ECF0D417CCFFF"><enum>(C)</enum><text display-inline="yes-display-inline">establishment of recommended intervention and treatment protocols for individuals in mental health crisis, especially for individuals whose illness makes them less receptive to mental health services; and</text>
</subparagraph><subparagraph commented="no" id="H65C733E111424CE0A54D8DD8BBB2DAD5"><enum>(D)</enum><text display-inline="yes-display-inline">implementing the evidence-based collaborative care model of integrated medical-behavioral health care in their practices.</text>
</subparagraph></paragraph><paragraph commented="no" id="H78F5D99727F24301A7A28A45F8FB9266"><enum>(3)</enum><header>Payments for mental health services provided by certain primary care physicians</header>
<subparagraph commented="no" id="H4D82645B088746BDBE2F1B123675C255"><enum>(A)</enum><header>In general</header><text>For purposes of paragraph (1), the purpose described in this paragraph, with respect to a grant awarded to a State under the grant program, is for the State to provide, in accordance with this paragraph, in the case of a primary care physician who participates in the training program of the State establish pursuant to paragraph (2), payments to the primary care physician for services furnished by the primary care physician.</text>
</subparagraph><subparagraph commented="no" id="HB9B69F94D66344EEAC35C891952E27A0"><enum>(B)</enum><header>Considerations</header><text>The Assistant Secretary, in determining the structure, quality, and form of payment under subparagraph (A) shall seek to find innovative payment systems which may take into account—</text>
<clause commented="no" id="H9365C74850AB4731863FD0CE9E07BD50"><enum>(i)</enum><text display-inline="yes-display-inline">the nature and quality of services rendered;</text> </clause><clause commented="no" id="H959C7FE20559449784893A99A95A6C8A"><enum>(ii)</enum><text>the patients’ health outcome;</text>
</clause><clause commented="no" id="H9DF7303B8BB24CE8AC9ABE497F7C0EC9"><enum>(iii)</enum><text>the geographical location where services were provided;</text> </clause><clause commented="no" id="H2147FD70032E404CB7BF1209B78F8BF2"><enum>(iv)</enum><text display-inline="yes-display-inline">the acuteness of the patient’s medical condition;</text>
</clause><clause commented="no" id="H79667EBBAACF46058F1DE359B6AB98B0"><enum>(v)</enum><text>the duration of services provided;</text> </clause><clause commented="no" id="H8758B52BEDD842DB84788F605112A828"><enum>(vi)</enum><text>the feasibility of replicating the payment model in other locations nationwide; and</text>
</clause><clause commented="no" id="HC638F2DC8CC7432DA9E8B2D0FDDDC695"><enum>(vii)</enum><text display-inline="yes-display-inline">proper triage and enduring linkage to appropriate treatment provider for subspecialty care in child or forensic issues; family crisis intervention; drug or alcohol rehabilitation; management of suicidal or violent behavior risk, and treatment for serious mental illness.</text>
</clause></subparagraph></paragraph><paragraph commented="no" id="H201D38BC788141BEA52EF68346701942"><enum>(4)</enum><header>Telehealth services for mental health disorders</header>
<subparagraph commented="no" id="HE7508C62622744D3925E496BABC278B5"><enum>(A)</enum><header>In general</header><text>For purposes of paragraph (1), the purpose described in this paragraph, with respect to a grant awarded to a State under the grant program, is for the State to provide, in the case of an individual furnished items and services by a primary care physician during an office visit, for payment for a consultation provided by a psychiatrist or psychologist to such physician with respect to such individual through the use of qualified telehealth technology for the identification, diagnosis, mitigation, or treatment of a mental health disorder if such consultation occurs not later than the first business day that follows such visit.</text>
</subparagraph><subparagraph commented="no" id="H3E39920FB5B242708E6D27094A0C650F"><enum>(B)</enum><header>Qualified telehealth technology</header><text>For purposes of subparagraph (A), the term <term>qualified telehealth technology</term>, with respect to the provision of items and services to a patient by a health care provider, includes the use of interactive audio, audio-only telephone conversation, video, or other telecommunications technology by a health care provider to deliver health care services within the scope of the provider’s practice at a site other than the site where the patient is located, including the use of electronic media for consultation relating to the health care diagnosis or treatment of the patient.</text>
</subparagraph></paragraph><paragraph commented="no" id="HEB8E9215BC554D169D13E3BFABB83169"><enum>(5)</enum><header>Eligible State</header>
<subparagraph commented="no" id="H6AF832E28BA648C3989C078E4BF60A80"><enum>(A)</enum><header>In general</header><text>For purposes of this subsection, an eligible State is a State that has submitted to the Assistant Secretary an application under subparagraph (B) and has been selected under subparagraph (D).</text>
</subparagraph><subparagraph commented="no" id="H8AF9D2A8FA494744A6C80A816BF0B5A9"><enum>(B)</enum><header>Application</header><text>A State seeking to participate in the grant program under this subsection shall submit to the Assistant Secretary, at such time and in such format as the Assistant Secretary requires, an application that includes such information, provisions, and assurances as the Assistant Secretary may require.</text>
</subparagraph><subparagraph commented="no" id="HEDBB1449387C4A129C9C9158EE0DAE5E"><enum>(C)</enum><header>Matching requirement</header><text>The Assistant Secretary may not make a grant under the grant program unless the State involved agrees, with respect to the costs to be incurred by the State in carrying out the purposes described in this subsection, to make available non-Federal contributions (in cash or in kind) toward such costs in an amount equal to not less than 20 percent of Federal funds provided in the grant.</text>
</subparagraph><subparagraph commented="no" id="H62E36ACC691341C3AA7715539367C8AC"><enum>(D)</enum><header>Selection</header><text>A State shall be determined eligible for the grant program by the Assistant Secretary on a competitive basis among States with applications meeting the requirements of subparagraphs (B) and (C). In selecting State applications for the grant program, the Secretary shall seek to achieve an appropriate national balance in the geographic distribution of grants awarded under the grant program.</text>
</subparagraph></paragraph><paragraph commented="no" id="HC45B4BFE23364F44AC3B8D46D27210EA"><enum>(6)</enum><header>Target population</header><text>In seeking a grant under this subsection, a State shall demonstrate how the grant will improve care for individuals with co-occurring behavioral health and physical health conditions, vulnerable populations, socially isolated populations, rural populations, and other populations who have limited access to qualified mental health providers.</text>
</paragraph><paragraph commented="no" id="H31DB9882E053420899017FCAB45DDE90"><enum>(7)</enum><header>Length of grant program</header><text>The grant program under this subsection shall be conducted for a period of 3 consecutive years.</text> </paragraph><paragraph commented="no" id="H871B0D6A5E0E40C6BA410E1A5CB40FBB"><enum>(8)</enum><header>Public availability of findings and conclusions</header><text display-inline="yes-display-inline">Subject to Federal privacy protections with respect to individually identifiable information, the Assistant Secretary shall make the findings and conclusions resulting from the grant program under this subsection available to the public.</text>
</paragraph><paragraph commented="no" id="HC56F765FADC34A5D84A369E913203B66"><enum>(9)</enum><header>Authorization of appropriations</header><text>Out of any funds in the Treasury not otherwise appropriated, there is authorized to be appropriated to carry out this subsection, $3,000,000 for each of the fiscal years 2016 through 2020.</text>
</paragraph><paragraph commented="no" id="H5B0AA9E0416942FDA88D74D4D95C9A4B"><enum>(10)</enum><header>Reports</header>
<subparagraph commented="no" id="H88B8E9AE7BB945CAB58236D5A63887FA"><enum>(A)</enum><header>Reports</header><text>For each fiscal year that grants are awarded under this subsection, the Assistant Secretary and the National Mental Health Policy Laboratory shall conduct a study on the results of the grants and submit to the Congress a report on such results that includes the following:</text>
<clause commented="no" id="H7CAB042D30F54921BD196E859535EFFD"><enum>(i)</enum><text>An evaluation of the grant program outcomes, including a summary of activities carried out with the grant and the results achieved through those activities.</text>
</clause><clause commented="no" id="HE74D1E2F3E1A49739B0CB60CAE7E5457"><enum>(ii)</enum><text>Recommendations on how to improve access to mental health services at grantee locations.</text> </clause><clause commented="no" id="HB53F8AF7E0A9498BB51D3DD6E7481371"><enum>(iii)</enum><text>An assessment of access to mental health services under the program.</text>
</clause><clause commented="no" id="H7A8CB825A2054906B38F872211DFF4CE"><enum>(iv)</enum><text>An assessment of the impact of the demonstration project on the costs of the full range of mental health services (including inpatient, emergency and ambulatory care).</text>
</clause><clause commented="no" id="H9FC5413C85D94AFCB804B1EA9F4FD234"><enum>(v)</enum><text>Recommendations on congressional action to improve the grant.</text> </clause><clause commented="no" id="H09643794C0CC46189106DAE66A41073E"><enum>(vi)</enum><text display-inline="yes-display-inline">Recommendations to improve training of primary care physicians.</text>
</clause></subparagraph><subparagraph commented="no" id="H028C3E979ED746C982D202D0A07B3461"><enum>(B)</enum><header>Report</header><text>Not later than December 31, 2018, the Assistant Secretary and the National Mental Health Policy Laboratory shall submit to Congress and make available to the public a report on the findings of the evaluation under subparagraph (A) and also a policy outline on how Congress can expand the grant program to the national level.</text>
</subparagraph></paragraph></subsection><subsection commented="no" id="H99BD375C9E2D474F92627E381F89140B"><enum>(b)</enum><header>Liability protections for health care professional volunteers at community health centers and
federally qualified community behavioral health clinics</header><text>Section 224 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/233">42 U.S.C. 233</external-xref>) is amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H951D2B8523D243759F5E1CE74BDD53BD" style="OLC">
<subsection commented="no" id="H5794A8442BE14FEB8CDD30F33D6B200B"><enum>(q)</enum>
<paragraph commented="no" display-inline="yes-display-inline" id="HD8125835DFC944EBA7E68CBD2D27E2FB"><enum>(1)</enum><text display-inline="yes-display-inline">In this subsection, the term <term>federally qualified community behavioral health clinic</term> means—</text> <subparagraph commented="no" id="H09A2F40DB1144172B8F267AD62489A84" indent="up1"><enum>(A)</enum><text display-inline="yes-display-inline">a federally qualified community behavioral health clinic with a certification in effect under section 223 of the Protecting Access to Medicare Act of 2014; or</text>
</subparagraph><subparagraph commented="no" id="H3C352F746DFF46E196D2CF24B40D1072" indent="up1"><enum>(B)</enum><text>a community mental health center meeting the criteria specified in section 1913(c) of this Act.</text> </subparagraph></paragraph><paragraph commented="no" id="H9B7053CFCFC940FEA4AB8A153161BBAF" indent="up1"><enum>(2)</enum><text display-inline="yes-display-inline">For purposes of this section, a health care professional volunteer at an entity described in subsection (g)(4) or a federally qualified community behavioral health clinic shall, in providing health care services eligible for funding under section 330 or subpart I of part B of title XIX 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 (5)(C). The preceding sentence is subject to the provisions of this subsection.</text>
</paragraph><paragraph commented="no" id="H11FA97C9203746B1AF630538B4E9F862" indent="up1"><enum>(3)</enum><text display-inline="yes-display-inline">In providing a health care service to an individual, a health care professional shall for purposes of this subsection be considered to be a health professional volunteer at an entity described in subsection (g)(4) or at a federally qualified community behavioral health clinic if the following conditions are met:</text>
<subparagraph commented="no" id="H3E739A2544D64402B2E2A9CE6603163A"><enum>(A)</enum><text display-inline="yes-display-inline">The service is provided to the individual at the facilities of an entity described in subsection (g)(4), at a federally qualified community behavioral health clinic, or through offsite programs or events carried out by the center.</text>
</subparagraph><subparagraph commented="no" id="H8A385EB0B83648D0A3D4CE23EA787070"><enum>(B)</enum><text display-inline="yes-display-inline">The center or entity is sponsoring the health care professional volunteer pursuant to paragraph (4)(B).</text>
</subparagraph><subparagraph commented="no" id="HBF1E35A63F8C46099A778E589939D221"><enum>(C)</enum><text display-inline="yes-display-inline">The health care professional 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 professional may receive repayment from the entity described in subsection (g)(4) or the center for reasonable expenses incurred by the health care professional in the provision of the service to the individual.</text>
</subparagraph><subparagraph commented="no" id="H9FAB529C1B5F41FEBA6EF03FC59F118A"><enum>(D)</enum><text display-inline="yes-display-inline">Before the service is provided, the health care professional or the center or 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 professional is limited pursuant to this subsection.</text>
</subparagraph><subparagraph commented="no" id="H3FFEDE2613E54FD4A27E8ABC0CE5D61F"><enum>(E)</enum><text display-inline="yes-display-inline">At the time the service is provided, the health care professional is licensed or certified in accordance with applicable law regarding the provision of the service.</text>
</subparagraph></paragraph><paragraph commented="no" id="H641E76E4E6634D338D224279FBB3B10C" indent="up1"><enum>(4)</enum><text display-inline="yes-display-inline">Subsection (g) (other than paragraphs (3) and (5)) and subsections (h), (i), and (l) apply to a health care professional 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 (5) and subject to the following:</text>
<subparagraph commented="no" id="H9F12FEBB81A6465498C6DF0FD94D71E6"><enum>(A)</enum><text>The first sentence of paragraph (2) applies in lieu of the first sentence of subsection (g)(1)(A).</text> </subparagraph><subparagraph commented="no" id="H4AD2AE0814684B26ACA6A8899F75F813"><enum>(B)</enum><text display-inline="yes-display-inline">With respect to an entity described in subsection (g)(4) or a federally qualified community behavioral health clinic, a health care professional is not a health professional volunteer at such center unless the center sponsors the health care professional. For purposes of this subsection, the center shall be considered to be sponsoring the health care professional if—</text>
<clause commented="no" id="H4BF580A25DC24B0E8F667E960951B311"><enum>(i)</enum><text display-inline="yes-display-inline">with respect to the health care professional, the center submits to the Secretary an application meeting the requirements of subsection (g)(1)(D); and</text>
</clause><clause commented="no" id="H5EA6C0C015E64E7898F80298047DC862"><enum>(ii)</enum><text display-inline="yes-display-inline">the Secretary, pursuant to subsection (g)(1)(E), determines that the health care professional is deemed to be an employee of the Public Health Service.</text>
</clause></subparagraph><subparagraph commented="no" id="H16DB7C8B333A4DCD98609C4D9F3FD35A"><enum>(C)</enum><text display-inline="yes-display-inline">In the case of a health care professional who is determined by the Secretary pursuant to subsection (g)(1)(E) to be a health professional volunteer at such center, this subsection applies to the health care professional (with respect to services described in paragraph (2)) for any cause of action arising from an act or omission of the health care professional occurring on or after the date on which the Secretary makes such determination.</text>
</subparagraph><subparagraph commented="no" id="H4A94173EEBF0475D961AAF477B992C10"><enum>(D)</enum><text display-inline="yes-display-inline">Subsection (g)(1)(F) applies to a health professional volunteer for purposes of this subsection only to the extent that, in providing health services to an individual, each of the conditions specified in paragraph (3) is met.</text>
</subparagraph></paragraph><paragraph commented="no" id="H86F5AB47D4854754A07EA0C8014CFAC9" indent="up1"><enum>(5)</enum>
<subparagraph commented="no" display-inline="yes-display-inline" id="H536D1D9BB85C46E98AD404D2ADBF48A7"><enum>(A)</enum><text display-inline="yes-display-inline">Amounts in the fund established under subsection (k)(2) shall be available for transfer under subparagraph (C) for purposes of carrying out this subsection for health professional volunteers at entities described in subsection (g)(4).</text>
</subparagraph><subparagraph commented="no" id="H3FB320870E6B4B4CA5E620949BD6CE2E" indent="up1"><enum>(B)</enum><text>Not later than 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 care professional volunteers, will be paid pursuant to this subsection 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 care 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).</text>
</subparagraph><subparagraph commented="no" id="HE6D04D36C43C4D52995E5CDDC6E0A479" indent="up1"><enum>(C)</enum><text>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.</text>
</subparagraph></paragraph><paragraph commented="no" id="H33F26430B26A470DBE03D80EFBAD5DAD" indent="up1"><enum>(6)</enum>
<subparagraph commented="no" display-inline="yes-display-inline" id="HD416B856764846A39537B383210DFEB1"><enum>(A)</enum><text>This subsection takes effect on October 1, 2017, except as provided in subparagraph (B).</text> </subparagraph><subparagraph commented="no" id="HA349DD53056142C58C55CC68A066163D" indent="up1"><enum>(B)</enum><text display-inline="yes-display-inline">Effective on the date of the enactment of this subsection—</text>
<clause commented="no" id="H69278C13374240678FE39C58D0D56EA7"><enum>(i)</enum><text display-inline="yes-display-inline">the Secretary may issue regulations for carrying out this subsection, and the Secretary may accept and consider applications submitted pursuant to paragraph (4)(B); and</text>
</clause><clause commented="no" id="HE0D4D4B579944A1EA70934EF276A1B8D"><enum>(ii)</enum><text display-inline="yes-display-inline">reports under paragraph (5)(B) may be submitted to the Congress.</text></clause></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block> </subsection><subsection commented="no" id="H31C0529C8D794B4EA4DDCFADF7FC8CD1"><enum>(c)</enum><header>Minority Fellowship Program</header><text>Title V of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290aa">42 U.S.C. 290aa et seq.</external-xref>), as amended, is further amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="HD8F37A978D1B47B39189FB4744B792C0" style="OLC">
<part commented="no" id="H2E8D12CB9EB24823922EDD26D6845D67"><enum>K</enum><header>Minority Fellowship Program</header>
<section commented="no" id="H100602B5595B4AE4B0480DBFB41E7B2F"><enum>597.</enum><header>Fellowships</header>
<subsection commented="no" id="H51A67D510C224540A8F19D0E24EADBD9"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">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—</text>
<paragraph commented="no" id="HC1ABCC6C61DE462E96518C26B9796493"><enum>(1)</enum><text>increasing behavioral health practitioners’ knowledge of issues related to prevention, treatment, and recovery support for mental and substance use disorders among racial and ethnic minority populations;</text>
</paragraph><paragraph commented="no" id="H75C64AC6E2E5429F81570AD33EB52D79"><enum>(2)</enum><text>improving the quality of mental and substance use disorder prevention and treatment delivered to ethnic minorities; and</text>
</paragraph><paragraph commented="no" id="H8AD28D02ABE04070B52017FFE7AA0A02"><enum>(3)</enum><text>increasing the number of culturally competent behavioral health professionals who teach, administer, conduct services research, and provide direct mental health or substance use services to underserved minority populations.</text>
</paragraph></subsection><subsection commented="no" id="H94493CA8B50942BFA2AAF74EE28587A9"><enum>(b)</enum><header>Training covered</header><text display-inline="yes-display-inline">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, and substance use and addiction counseling.</text>
</subsection><subsection commented="no" id="H95727CD6B15F4F49A0CD6390642F26FA"><enum>(c)</enum><header>Authorization of appropriations</header><text display-inline="yes-display-inline">To carry out this section, there are authorized to be appropriated $6,000,000 for each of fiscal years 2016 through 2020.</text></subsection></section></part><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection commented="no" id="H506C872984C74084931ACD76AEAC5D74"><enum>(d)</enum><header>National Health Service Corps</header>
<paragraph commented="no" id="H44995C1913654F86AEA5BFAB5CFC9DEE"><enum>(1)</enum><header>Definitions</header>
<subparagraph commented="no" id="H0E78FB2E091241A289846FE36748AD53"><enum>(A)</enum><header>Primary health services</header><text>Section 331(a)(3)(D) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/254d">42 U.S.C. 254d(a)(3)</external-xref>) is amended by inserting <quote>(including pediatric mental health subspecialty services)</quote> after <quote>pediatrics</quote>.</text>
</subparagraph><subparagraph commented="no" id="H9F0009E2D46E4B94B9D44594D95B3979"><enum>(B)</enum><header>Behavioral and mental health professionals</header><text display-inline="yes-display-inline">Clause (i) of section 331(a)(3)(E)(i) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/254d">42 U.S.C. 254d(a)(3)(E)(i)</external-xref>) is amended by inserting <quote>(and pediatric subspecialists thereof)</quote> before the period at the end.</text>
</subparagraph><subparagraph commented="no" id="H06F9CCE0610E4E0A8BD0BBF0FF4543A1"><enum>(C)</enum><header>Health professional shortage area</header><text>Section 332(a)(1) of the Public Health Service Act is amended by inserting <quote>(including children and adolescents)</quote> after <quote>population group</quote>.</text> </subparagraph><subparagraph commented="no" id="HF7A6D2369F9145F4A53294E8E54E09D1"><enum>(D)</enum><header>Medical facility</header><text>Section 332(a)(2)(A) of the Public Health Service Act is amended by inserting <quote>medical residency or fellowship training site for training in child and adolescent psychiatry,</quote> before <quote>facility operated by a city or county health department,</quote>.</text>
</subparagraph></paragraph><paragraph commented="no" id="H5761BC5A3DE949B2B5AAA2AD298BA63E"><enum>(2)</enum><header>Eligibility To participate in loan repayment program</header><text display-inline="yes-display-inline">Section 338A(b)(1)(B) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/254l-1">42 U.S.C. 254l–1(b)(1)(B)</external-xref>) is amended by inserting <quote>, including any physician child and adolescent psychiatry residency or fellowship training program</quote> after <quote>be enrolled in an approved graduate training program in medicine, osteopathic medicine, dentistry, behavioral and mental health, or other health profession</quote>.</text>
</paragraph></subsection><subsection commented="no" id="H2EF0A77E76F84D46824A6F113814D7C7"><enum>(e)</enum><header>Crisis Intervention Grants for Police Officers and First Responders</header>
<paragraph id="H06C81B093DE548E584EFB9B6C98EE0D7"><enum>(1)</enum><header>Grants</header><text>The Assistant Secretary may award grants 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 (<external-xref legal-doc="usc" parsable-cite="usc/42/3796dd">42 U.S.C. 3796dd</external-xref> note)))—</text>
<subparagraph id="H4850ACD9F2EC4156832B5B57CD0E21A7"><enum>(A)</enum><text>to recognize individuals who have mental illness and how to properly intervene with individuals with mental illness; and</text>
</subparagraph><subparagraph id="H7F0504D1A08741FB8B4A4379F28DE3E9"><enum>(B)</enum><text>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.</text>
</subparagraph></paragraph><paragraph id="H013ECDB5B0764AA68168F0872A7BFBDE"><enum>(2)</enum><header>Funding</header><text>Of the amounts made available to carry out sections 501, 509, 516, and 520A of the Public Health Service Act for a fiscal year, 5 percent of such amounts are authorized to be used to carry out this subsection.</text>
</paragraph></subsection></section><section id="H4E49DCDEB5F542E1A6BC6B1B934DCBFA"><enum>208.</enum><header>Authorized grants and programs</header>
<subsection id="H837D5D0164E44B24BD734D38852C614D"><enum>(a)</enum><header>Children’s recovery from trauma</header><text>Section 582 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290hh-1">42 U.S.C. 290hh–1</external-xref>) is amended—</text> <paragraph id="H08EC0006B3314677A2D1BD98C0477A7B"><enum>(1)</enum><text>in subsection (a), by striking <quote>developing programs</quote> and all that follows and inserting the following:</text>
<quoted-block display-inline="yes-display-inline" id="H0743A898416A413DA285FBC3EEBDC8F8" style="OLC">
<text>developing and maintaining programs that provide for—</text><paragraph id="HE93BC08AF3CE46C7BD07F18A703BB1BC"><enum>(1)</enum><text>the continued operation of the National Child Traumatic Stress Initiative (referred to in this section as the <quote>NCTSI</quote>), which includes a coordinating center, that focuses on the mental, behavioral, and biological aspects of psychological trauma response; and</text>
</paragraph><paragraph id="H171C7257A2D84C9389762910CA50E482"><enum>(2)</enum><text>the development of knowledge with regard to evidence-based (as defined in section 2 of the <short-title>Helping Families in Mental Health Crisis Act of 2015</short-title>) practices for identifying and treating mental, behavioral, and biological disorders of children and youth resulting from witnessing or experiencing a traumatic event.</text></paragraph><after-quoted-block>;</after-quoted-block></quoted-block>
</paragraph><paragraph id="HE0CDA95183A04D21ADF75037C6CC51C2"><enum>(2)</enum><text>in subsection (b)—</text> <subparagraph id="HDAFC345A633647DBB4E4B842067DFAA0"><enum>(A)</enum><text>by striking <quote>subsection (a) related</quote> and inserting <quote>subsection (a)(2) (related</quote>;</text>
</subparagraph><subparagraph id="H68F48642BC764724B25854A1D218A5A9"><enum>(B)</enum><text>by striking <quote>treating disorders associated with psychological trauma</quote> and inserting <quote>treating mental, behavioral, and biological disorders associated with psychological trauma)</quote>; and</text> </subparagraph><subparagraph id="HC7424492B32E4A9FA41EB6E39C79CAC4"><enum>(C)</enum><text>by striking <quote>mental health agencies and programs that have established clinical and basic research</quote> and inserting <quote>universities, hospitals, mental health agencies, and other programs that have established clinical expertise and research</quote>;</text>
</subparagraph></paragraph><paragraph id="HE59092A9F69D48B8BED50DBA2282D3C3"><enum>(3)</enum><text>by redesignating subsections (c) through (g) as subsections (g) through (k), respectively;</text> </paragraph><paragraph id="HCE6BED37F89743BFAF7D25C80C24F055"><enum>(4)</enum><text>by inserting after subsection (b), the following:</text>
<quoted-block id="H053A313B0FE94751959754C7D5FB460A" style="OLC">
<subsection id="HA36C0897B98A4C04BBD3ED768F0F079D"><enum>(c)</enum><header>Child outcome data</header><text>The NCTSI coordinating center shall collect, analyze, and report NCTSI-wide child treatment process and outcome data regarding the early identification and delivery of evidence-based (as defined in section 2 of the <short-title>Helping Families in Mental Health Crisis Act of 2015</short-title>) treatment and services for children and families served by the NCTSI grantees.</text>
</subsection><subsection id="HE60638D20FAD4E54BF0838CF25D2DD30"><enum>(d)</enum><header>Training</header><text>The NCTSI coordinating center shall facilitate the coordination of training initiatives in evidence-based (as defined in section 2 of the <short-title>Helping Families in Mental Health Crisis Act of 2015</short-title>) and trauma-informed treatments, interventions, and practices offered to NCTSI grantees, providers, and partners.</text>
</subsection><subsection id="H8594273DD06D4BD098858EB2CCB6F36E"><enum>(e)</enum><header>Dissemination</header><text>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.</text>
</subsection><subsection id="HAC65A696B5344DE09F8B11E01AF314B0"><enum>(f)</enum><header>Review</header><text>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 (as defined in section 2 of the <short-title>Helping Families in Mental Health Crisis Act of 2015</short-title>) practices.</text></subsection><after-quoted-block>;</after-quoted-block></quoted-block>
</paragraph><paragraph id="H4FB78AF7480A463DB6B4984FB0AF1B65"><enum>(5)</enum><text>in subsection (g) (as so redesignated), by striking <quote>with respect to centers of excellence are distributed equitably among the regions of the country</quote> and inserting <quote>are distributed equitably among the regions of the United States</quote>;</text> </paragraph><paragraph id="H9EEEC312E34F4CDD9249A45E68F443BB"><enum>(6)</enum><text>in subsection (i) (as so redesignated), by striking <quote>recipient may not exceed 5 years</quote> and inserting <quote>recipient shall not be less than 4 years, but shall not exceed 5 years</quote>; and</text>
</paragraph><paragraph id="H5BD232742933481586A1FD5D3F0F8B07"><enum>(7)</enum><text>in subsection (j) (as so redesignated), by striking <quote>$50,000,000</quote> and all that follows through <quote>2006</quote> and inserting <quote>$45,713,000 for each of fiscal years 2014 through 2018</quote>.</text> </paragraph></subsection><subsection id="H1480937C991B4D35A3BC061A1674173D"><enum>(b)</enum><header>Reducing the stigma of serious mental illness</header> <paragraph id="H5A400E1FBA2943EABEEAE0E0C7F33995"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary of Education, along with the Assistant Secretary for Mental Health and Substance Use Disorders, shall organize a national awareness campaign involving public health organizations, advocacy groups for persons with serious mental illness, and social media companies to assist secondary school students and postsecondary students in—</text>
<subparagraph id="H328DF4E743F34DE7869852DC558CE101"><enum>(A)</enum><text>reducing the stigma associated with serious mental illness;</text> </subparagraph><subparagraph id="H364FD9AEBA514E699CC4D2EDB0559F24"><enum>(B)</enum><text display-inline="yes-display-inline">understanding how to assist an individual who is demonstrating signs of a serious mental illness; and</text>
</subparagraph><subparagraph id="HAAA0403F66424F349986EEDE1066B42A"><enum>(C)</enum><text>understanding the importance of seeking treatment from a physician, clinical psychologist, or licensed mental health professional when a student believes the student may be suffering from a serious mental illness or behavioral health disorder.</text>
</subparagraph></paragraph><paragraph id="H224840D578464857ABE4CD4DC90CA59B"><enum>(2)</enum><header>Data collection</header><text>The Secretary of Education shall—</text> <subparagraph id="H37D4CA738BBE4665A9447A75E1AB09AC"><enum>(A)</enum><text>evaluate the program under subsection (a) on public health to determine whether the program has made an impact on public health, including mortality rates of persons with serious mental illness, prevalence of serious mental illness, physician and clinical psychological visits, emergency room visits; and</text>
</subparagraph><subparagraph id="H462A2AA6285F4EBCA6755C7B971BA13F"><enum>(B)</enum><text display-inline="yes-display-inline">submit a report on the evaluation to the National Mental Health Policy Laboratory created by title I of this Act.</text>
</subparagraph></paragraph><paragraph id="H457B339EA1784AC9BE02F9A726BC6AA0"><enum>(3)</enum><header>Secondary school defined</header><text>For purposes of this section, the term <term>secondary school</term> has the meaning given the term in section 9101 of the Elementary and Secondary Education Act of 1965 (<external-xref legal-doc="usc" parsable-cite="usc/20/7801">20 U.S.C. 7801</external-xref>).</text>
</paragraph></subsection><subsection id="H4CE7B3ADE85348A7A07DD887330C1335"><enum>(c)</enum><header>Garrett Lee Smith Reauthorization</header>
<paragraph id="H528D20350D3B4BB18B45EC60D1061734"><enum>(1)</enum><header>Suicide prevention technical assistance center</header><text>Section 520C of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290bb-34">42 U.S.C. 290bb–34</external-xref>) is amended to read as follows:</text> <quoted-block display-inline="no-display-inline" id="H0AFB3AD976F3432B90EF4FF0954215CD" style="OLC"> <section id="H8DE0F1BBBCEA4B29BC19BA881E288F0F"><enum>520C.</enum><header>Suicide prevention technical assistance center</header> <subsection id="H1A05C7325FE843CF953CD990F8FE6659"><enum>(a)</enum><header>Program authorized</header><text display-inline="yes-display-inline">The Assistant Secretary for Mental Health and Substance Use Disorders shall award a grant for the operation and maintenance of 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 concerning the prevention of suicide among all ages, particularly among groups that are at high risk for suicide.</text>
</subsection><subsection id="H3ABA529C24F047AEBA5CA458C04815E7"><enum>(b)</enum><header>Responsibilities of the center</header><text display-inline="yes-display-inline">The center operated and maintained under subsection (a) shall—</text> <paragraph id="HA001AD9532E64B488718FA50E13FA276"><enum>(1)</enum><text>assist in the development or continuation of statewide and tribal suicide early intervention and prevention strategies for all ages, particularly among groups that are at high risk for suicide;</text>
</paragraph><paragraph id="HD7724DC48D834FCDADFE50F3E4FA3B5B"><enum>(2)</enum><text>ensure the surveillance of suicide early intervention and prevention strategies for all ages, particularly among groups that are at high risk for suicide;</text>
</paragraph><paragraph id="HC8FE8E0A6F474282A280B774228056AA"><enum>(3)</enum><text>study the costs and effectiveness of statewide and tribal suicide early intervention and prevention strategies in order to provide information concerning relevant issues of importance to State, tribal, and national policymakers;</text>
</paragraph><paragraph id="H2353EF94BF6B4292BFBDF26959CEEA74"><enum>(4)</enum><text>further identify and understand causes and associated risk factors for suicide for all ages, particularly among groups that are at high risk for suicide;</text>
</paragraph><paragraph id="H71DB80BCA2B3417AB243EA2163A2710A"><enum>(5)</enum><text>analyze the efficacy of new and existing suicide early intervention and prevention techniques and technology for all ages, particularly among groups that are at high risk for suicide;</text>
</paragraph><paragraph id="H43DF24F4B2BB4A3D8423AED0D5C05770"><enum>(6)</enum><text>ensure the surveillance of suicidal behaviors and nonfatal suicidal attempts;</text> </paragraph><paragraph id="H2DFC93FB34794F8BBF86381E5D5B5EFA"><enum>(7)</enum><text>study the effectiveness of State-sponsored statewide and tribal suicide early intervention and prevention strategies for all ages particularly among groups that are at high risk for suicide on the overall wellness and health promotion strategies related to suicide attempts;</text>
</paragraph><paragraph id="HDA94F66D983F4314A72DC64F6242A797"><enum>(8)</enum><text>promote the sharing of data regarding suicide with Federal agencies involved with suicide early intervention and prevention, and State-sponsored statewide and tribal suicide early intervention and prevention strategies for the purpose of identifying previously unknown mental health causes and associated risk factors for suicide among all ages particularly among groups that are at high risk for suicide;</text>
</paragraph><paragraph id="HE45CE3B4A56B4F3AAC1F8E2C195B03D3"><enum>(9)</enum><text>evaluate and disseminate outcomes and best practices of mental health and substance use disorder services at institutions of higher education; and</text>
</paragraph><paragraph id="HC5B8D16733C8495E8FB0E577BD3EFC0A"><enum>(10)</enum><text>conduct other activities determined appropriate by the Secretary.</text> </paragraph></subsection><subsection id="HBFFA49B1781A48EA8839B16083D374B8"><enum>(c)</enum><header>Authorization of appropriations</header><text>For the purpose of carrying out this section, there are authorized to be appropriated $4,957,000 for each of the fiscal years 2016 through 2020.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="H45CBAEFFA23445089CE15EC7B74B1DF1"><enum>(2)</enum><header>Youth suicide intervention and prevention strategies</header><text>Section 520E of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290bb-36">42 U.S.C. 290bb–36</external-xref>) is amended to read as follows:</text> <quoted-block display-inline="no-display-inline" id="H166C0AEB94C04BCFA49289868F5F8540" style="OLC"> <section id="H8058F01A9A6840608B7EBE36B53B6345"><enum>520E.</enum><header>Youth suicide early intervention and prevention strategies</header> <subsection id="HE8AD510D4C1242619D1C5B1C8FAFA25B"><enum>(a)</enum><header>In general</header><text>The Secretary, acting through the Assistant Secretary, shall award grants or cooperative agreements to eligible entities to—</text>
<paragraph id="H07A5CAE622314C2F982FD7AE0A9364D8"><enum>(1)</enum><text>develop and implement State-sponsored statewide or tribal youth suicide early intervention and prevention strategies in schools, educational institutions, juvenile justice systems, substance use disorder programs, mental health programs, foster care systems, and other child and youth support organizations;</text>
</paragraph><paragraph id="H35DAE95FDC404FDCB78DBC2D11871926"><enum>(2)</enum><text>support public organizations and private nonprofit organizations actively involved in State-sponsored statewide or tribal youth suicide early intervention and prevention strategies and in the development and continuation of State-sponsored statewide youth suicide early intervention and prevention strategies;</text>
</paragraph><paragraph id="HDA03B257E0FD4A6E839C2DE91A5D736F"><enum>(3)</enum><text>provide grants to institutions of higher education to coordinate the implementation of State-sponsored or tribal youth suicide early intervention and prevention strategies;</text>
</paragraph><paragraph id="H7185060375784C43851C864168E81E86"><enum>(4)</enum><text>collect and analyze data on State-sponsored statewide or tribal youth suicide early intervention and prevention services that can be used to monitor the effectiveness of such services and for research, technical assistance, and policy development; and</text>
</paragraph><paragraph id="HFAE32781C90C4998895829ECEB08C342"><enum>(5)</enum><text>assist eligible entities, through State-sponsored statewide or tribal youth suicide early intervention and prevention strategies, in achieving targets for youth suicide reductions under title V of the <act-name parsable-cite="SSA">Social Security Act</act-name>.</text>
</paragraph></subsection><subsection id="H03A8730C82754CBA8A2184586F1FA95F"><enum>(b)</enum><header>Eligible entity</header>
<paragraph id="H950C01EB70B14F49851FA4B6BDB17A8A"><enum>(1)</enum><header>Definition</header><text>In this section, the term <term>eligible entity</term> means—</text> <subparagraph id="HFEC488803C144C958A9791385F25423F"><enum>(A)</enum><text>a State;</text>
</subparagraph><subparagraph id="H2B152080FC7A47FB8B49A61E2E445B99"><enum>(B)</enum><text>a public organization or private nonprofit organization designated by a State to develop or direct the State-sponsored statewide youth suicide early intervention and prevention strategy; or</text>
</subparagraph><subparagraph id="H6DE41FF567424119A38E5AFBBB62AE09"><enum>(C)</enum><text>a federally recognized Indian tribe or tribal organization (as defined in the <act-name parsable-cite="ISDA">Indian Self-Determination and Education Assistance Act</act-name>) or an urban Indian organization (as defined in the <act-name parsable-cite="IHCIA">Indian Health Care Improvement Act</act-name>) that is actively involved in the development and continuation of a tribal youth suicide early intervention and prevention strategy.</text>
</subparagraph></paragraph><paragraph id="H92E965D89EC54CD38205FF6172D39E0F"><enum>(2)</enum><header>Limitation</header><text>In carrying out this section, the Secretary shall ensure that a State does not receive more than one grant or cooperative agreement under this section at any one time. For purposes of the preceding sentence, a State shall be considered to have received a grant or cooperative agreement if the eligible entity involved is the State or an entity designated by the State under paragraph (1)(B). Nothing in this paragraph shall be construed to apply to entities described in paragraph (1)(C).</text>
</paragraph></subsection><subsection id="HD66BEA33A1E94A10AB9EE05AC5B21068"><enum>(c)</enum><header>Preference</header><text>In providing assistance under a grant or cooperative agreement under this section, an eligible entity shall give preference to public organizations, private nonprofit organizations, political subdivisions, institutions of higher education, and tribal organizations actively involved with the State-sponsored statewide or tribal youth suicide early intervention and prevention strategy that—</text>
<paragraph id="H760B8A0C8E484B40945AC9F37E3795C8"><enum>(1)</enum><text>provide early intervention and assessment services, including screening programs, to youth who are at risk for mental or emotional disorders that may lead to a suicide attempt, and that are integrated with school systems, educational institutions, juvenile justice systems, substance use disorder programs, mental health programs, foster care systems, and other child and youth support organizations;</text>
</paragraph><paragraph id="H5E986038843647F9B6C1DAC0B57098E4"><enum>(2)</enum><text>demonstrate collaboration among early intervention and prevention services or certify that entities will engage in future collaboration;</text>
</paragraph><paragraph id="H714A1CD18D224F40B757EDA207EFC3C6"><enum>(3)</enum><text>employ or include in their applications a commitment to evaluate youth suicide early intervention and prevention practices and strategies adapted to the local community;</text>
</paragraph><paragraph id="H8D1B6C9DB2F04788AD84C8E55DB2AD5B"><enum>(4)</enum><text>provide timely referrals for appropriate community-based mental health care and treatment of youth who are at risk for suicide in child-serving settings and agencies;</text>
</paragraph><paragraph id="H9D1A1008BCE84E5AB749668313FC57C3"><enum>(5)</enum><text>provide immediate support and information resources to families of youth who are at risk for suicide;</text>
</paragraph><paragraph id="H23E442A98CDD4F9898D7C49BD9A5FC97"><enum>(6)</enum><text>offer access to services and care to youth with diverse linguistic and cultural backgrounds;</text> </paragraph><paragraph id="H848E72CB6AAF410AA55632AEB82E4D5B"><enum>(7)</enum><text>offer appropriate postsuicide intervention services, care, and information to families, friends, schools, educational institutions, juvenile justice systems, substance use disorder programs, mental health programs, foster care systems, and other child and youth support organizations of youth who recently completed suicide;</text>
</paragraph><paragraph id="HDEB715F7EF85400C8417E96EF81B4ED4"><enum>(8)</enum><text>offer continuous and up-to-date information and awareness campaigns that target parents, family members, child care professionals, community care providers, and the general public and highlight the risk factors associated with youth suicide and the life-saving help and care available from early intervention and prevention services;</text>
</paragraph><paragraph id="HBC9D21E20E9D4E548521CEDEBC8D44AD"><enum>(9)</enum><text>ensure that information and awareness campaigns on youth suicide risk factors, and early intervention and prevention services, use effective communication mechanisms that are targeted to and reach youth, families, schools, educational institutions, and youth organizations;</text>
</paragraph><paragraph id="H12C868E695E34632A0849DE1987C1CED"><enum>(10)</enum><text>provide a timely response system to ensure that child-serving professionals and providers are properly trained in youth suicide early intervention and prevention strategies and that child-serving professionals and providers involved in early intervention and prevention services are properly trained in effectively identifying youth who are at risk for suicide;</text>
</paragraph><paragraph id="H06B05F7BEC8741CF888E59FA4CC3ED98"><enum>(11)</enum><text>provide continuous training activities for child care professionals and community care providers on the latest youth suicide early intervention and prevention services practices and strategies;</text>
</paragraph><paragraph id="H13003015B73F49CB8C77277251DAE77B"><enum>(12)</enum><text>conduct annual self-evaluations of outcomes and activities, including consulting with interested families and advocacy organizations;</text>
</paragraph><paragraph id="H96D5545CC92042DEA74545F3C78174E3"><enum>(13)</enum><text>provide services in areas or regions with rates of youth suicide that exceed the national average as determined by the Centers for Disease Control and Prevention; and</text>
</paragraph><paragraph id="H0A49CA0CD39442BDB9B5A93B66B2C506"><enum>(14)</enum><text>obtain informed written consent from a parent or legal guardian of an at-risk child before involving the child in a youth suicide early intervention and prevention program.</text>
</paragraph></subsection><subsection id="H05FBDCBB0E5348E3A8842786F7F2BC1E"><enum>(d)</enum><header>Requirement for direct services</header><text>Not less than 85 percent of grant funds received under this section shall be used to provide direct services, of which not less than 5 percent shall be used for activities authorized under subsection (a)(3).</text>
</subsection><subsection id="H0BA4AA08005049F7913599F0F136F40E"><enum>(e)</enum><header>Consultation and policy development</header>
<paragraph id="H7BEA684F6FB44B61B3E675FAF5508B88"><enum>(1)</enum><header>In general</header><text>In carrying out this section, the Secretary shall collaborate with the Secretary of Education and relevant Federal agencies and suicide working groups responsible for early intervention and prevention services relating to youth suicide.</text>
</paragraph><paragraph id="HFB662C32B600486381D64965B5803B59"><enum>(2)</enum><header>Consultation</header><text>In carrying out this section, the Secretary shall consult with—</text> <subparagraph id="H638AA993A9C5461E85CD01526833990C"><enum>(A)</enum><text>State and local agencies, including agencies responsible for early intervention and prevention services under title XIX of the <act-name parsable-cite="SSA">Social Security Act</act-name>, the State Children's Health Insurance Program under title XXI of the <act-name parsable-cite="SSA">Social Security Act</act-name>, and programs funded by grants under title V of the <act-name parsable-cite="SSA">Social Security Act</act-name>;</text>
</subparagraph><subparagraph id="H894DF8AC5B424F618D170299AD953BD8"><enum>(B)</enum><text>local and national organizations that serve youth at risk for suicide and their families;</text> </subparagraph><subparagraph id="H389667E81D384E95B8897C2A1A3C9682"><enum>(C)</enum><text>relevant national medical and other health and education specialty organizations;</text>
</subparagraph><subparagraph id="H4D6212917C9A47499997DCE732EA022D"><enum>(D)</enum><text>youth who are at risk for suicide, who have survived suicide attempts, or who are currently receiving care from early intervention services;</text>
</subparagraph><subparagraph id="H27A499178167469FA75B3699F7A64949"><enum>(E)</enum><text>families and friends of youth who are at risk for suicide, who have survived suicide attempts, who are currently receiving care from early intervention and prevention services, or who have completed suicide;</text>
</subparagraph><subparagraph id="HCC8744801AF743CC8E99BF8665D2FF99"><enum>(F)</enum><text>qualified professionals who possess the specialized knowledge, skills, experience, and relevant attributes needed to serve youth at risk for suicide and their families; and</text>
</subparagraph><subparagraph id="H97AAA41B0F8944EA90BCA06D5DAF7412"><enum>(G)</enum><text>third-party payers, managed care organizations, and related commercial industries.</text> </subparagraph></paragraph><paragraph id="H88FBFCB31423465F8101BDE842FFDBCD"><enum>(3)</enum><header>Policy development</header><text>In carrying out this section, the Secretary shall—</text>
<subparagraph id="HC744E1CAC3E54654881B26F7F23AB707"><enum>(A)</enum><text>coordinate and collaborate on policy development at the Federal level with the relevant Department of Health and Human Services agencies and suicide working groups; and</text>
</subparagraph><subparagraph id="HE5AB6057565C44F7B45B8AC1828F7F6F"><enum>(B)</enum><text>consult on policy development at the Federal level with the private sector, including consumer, medical, suicide prevention advocacy groups, and other health and education professional-based organizations, with respect to State-sponsored statewide or tribal youth suicide early intervention and prevention strategies.</text>
</subparagraph></paragraph></subsection><subsection id="H01F11C00B9CC46279585CF4DCAB4E16A"><enum>(f)</enum><header>Rule of construction; religious and moral accommodation</header><text>Nothing in this section shall be construed to require suicide assessment, early intervention, or treatment services for youth whose parents or legal guardians object based on the parents' or legal guardians' religious beliefs or moral objections.</text>
</subsection><subsection id="HFA54A2A01D0A4E4598D627D78D49AF48"><enum>(g)</enum><header>Evaluations and report</header>
<paragraph id="H8211A4B82D554DB7B23EDA83032FAFE9"><enum>(1)</enum><header>Evaluations by eligible entities</header><text>Not later than 18 months after receiving a grant or cooperative agreement under this section, an eligible entity shall submit to the Secretary the results of an evaluation to be conducted by the entity concerning the effectiveness of the activities carried out under the grant or agreement.</text>
</paragraph><paragraph id="H329527C1BCE84FF78343DF8012252C53"><enum>(2)</enum><header>Report</header><text>Not later than 2 years after the date of enactment of this section, the Secretary shall submit to the appropriate committees of Congress a report concerning the results of—</text>
<subparagraph id="H1E74A9E75AFE4A239C4DF2C18FA3F808"><enum>(A)</enum><text>the evaluations conducted under paragraph (1); and</text> </subparagraph><subparagraph id="H4FE0F766127542589C063D271BF2BFD7"><enum>(B)</enum><text>an evaluation conducted by the Secretary to analyze the effectiveness and efficacy of the activities conducted with grants, collaborations, and consultations under this section.</text>
</subparagraph></paragraph></subsection><subsection id="H3D5E11D9C18647C0A04AEC415A1C3B9B"><enum>(h)</enum><header>Rule of construction; student medication</header><text>Nothing in this section shall be construed to allow school personnel to require that a student obtain any medication as a condition of attending school or receiving services.</text>
</subsection><subsection id="HBF8E3926285D4035B6F8C0D6B8075BA2"><enum>(i)</enum><header>Prohibition</header><text>Funds appropriated to carry out this section, section 527, or section 529 shall not be used to pay for or refer for abortion.</text>
</subsection><subsection id="H650C0246E7E74D1A9033D74708BAA8AB"><enum>(j)</enum><header>Parental consent</header><text>States and entities receiving funding under this section shall obtain prior written, informed consent from the child's parent or legal guardian for assessment services, school-sponsored programs, and treatment involving medication related to youth suicide conducted in elementary and secondary schools. The requirement of the preceding sentence does not apply in the following cases:</text>
<paragraph id="H049AF676A1784084A041F0BF7DD8B748"><enum>(1)</enum><text>In an emergency, where it is necessary to protect the immediate health and safety of the student or other students.</text>
</paragraph><paragraph id="H8B2DF6CE238E4FD1B26B51E1DC00F552"><enum>(2)</enum><text>Other instances, as defined by the State, where parental consent cannot reasonably be obtained.</text> </paragraph></subsection><subsection id="H12E8AA8B14E3449E9117BDF9C82446A9"><enum>(k)</enum><header>Relation to education provisions</header><text>Nothing in this section shall be construed to supersede section 444 of the General Education Provisions Act, including the requirement of prior parental consent for the disclosure of any education records. Nothing in this section shall be construed to modify or affect parental notification requirements for programs authorized under the <act-name parsable-cite="ESEA">Elementary and Secondary Education Act of 1965</act-name> (as amended by the No Child Left Behind Act of 2001; <external-xref legal-doc="public-law" parsable-cite="pl/107/110">Public Law 107–110</external-xref>).</text>
</subsection><subsection id="H5A463AFC65364CB8BBF1A2F424847E17"><enum>(l)</enum><header>Definitions</header><text>In this section:</text> <paragraph id="H4B4C980215CB43699902FA63EA08FF3E"><enum>(1)</enum><header>Early intervention</header><text>The term <term>early intervention</term> means a strategy or approach that is intended to prevent an outcome or to alter the course of an existing condition.</text>
</paragraph><paragraph id="HCC6C7214D6E747B5A7F666F8D037543A"><enum>(2)</enum><header>Educational institution; institution of higher education; school</header><text>The term—</text> <subparagraph id="HF821DD9135D445378F1A4A6EDC926EAF"><enum>(A)</enum><text><quote>educational institution</quote> means a school or institution of higher education;</text>
</subparagraph><subparagraph id="HFE3F3F5DA82F436D9A650E3399C80635"><enum>(B)</enum><text><quote>institution of higher education</quote> has the meaning given such term in section 101 of the <act-name parsable-cite="HEA65">Higher Education Act of 1965</act-name>; and</text> </subparagraph><subparagraph id="H8F3972816FBD441EAF4C5B87A70C0F9D"><enum>(C)</enum><text><quote>school</quote> means an elementary or secondary school (as such terms are defined in section 9101 of the <act-name parsable-cite="ESEA">Elementary and Secondary Education Act of 1965</act-name>).</text>
</subparagraph></paragraph><paragraph id="HE5D48B6DF3DC4157B9707AB162DCD603"><enum>(3)</enum><header>Prevention</header><text>The term <term>prevention</term> means a strategy or approach that reduces the likelihood or risk of onset, or delays the onset, of adverse health problems that have been known to lead to suicide.</text>
</paragraph><paragraph id="H26B7B13A96BA4CBEBED0B48D225F8388"><enum>(4)</enum><header>Youth</header><text>The term <term>youth</term> means individuals who are between 10 and 26 years of age.</text> </paragraph></subsection><subsection id="H5E8514975407414B8F92E079A3F0F289"><enum>(m)</enum><header>Authorization of appropriations</header><text>For the purpose of carrying out this section, there are authorized to be appropriated $29,738,000 for each of the fiscal years 2016 through 2020.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="H27E89497E5C04DE4A22F630F467FD6CA"><enum>(3)</enum><header>Suicide prevention for youth</header><text>Section 520E–1 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290bb-36a">42 U.S.C. 290bb–36a</external-xref>) is amended—</text> <subparagraph id="H9462BFDE0F474962AF2C2388CA441191"><enum>(A)</enum><text>by amending the section heading to read as follows: <quote><header-in-text level="section" style="OLC">Suicide prevention for youth</header-in-text></quote>; and</text>
</subparagraph><subparagraph id="HB8F38CCF5FC84ADAB4FA18E74A591557"><enum>(B)</enum><text>by striking subsection (n) and inserting the following:</text> <quoted-block display-inline="no-display-inline" id="H96C4B5A3F78347F78ABC1936A5852AB7" style="OLC"> <subsection id="H7E3A9DBD136245FFB679ADBEA42B63DD"><enum>(n)</enum><header>Authorization of appropriations</header><text display-inline="yes-display-inline">For the purpose of carrying out this section, there is authorized to be appropriated such sums as may be necessary for each of fiscal years 2016 through 2020.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H0B8FB5E0101A47739A72324DED138B7C"><enum>(4)</enum><header>Mental health and substance use disorders services and outreach on campus</header><text>Section 520E–2 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290bb-36b">42 U.S.C. 290bb–36b</external-xref>) is amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H39C7398A651A4D33BE3FA40F32A07A45" style="OLC">
<section id="H3B266E5A0CAC49578C6F3E358B056189"><enum>520E–2.</enum><header>Mental health and substance use disorders services on campus</header>
<subsection id="H2B54AAA59C014376B95506C25752C0C0"><enum>(a)</enum><header>In general</header><text>The Secretary, acting through the Director of the Center for Mental Health Services and in consultation with the Secretary of Education, shall award grants on a competitive basis to institutions of higher education to enhance services for students with mental health or substance use disorders and to develop best practices for the delivery of such services.</text>
</subsection><subsection id="HACFE97ABE16E4D9F8376812E0DDE430E"><enum>(b)</enum><header>Uses of funds</header><text>Amounts received under a grant under this section shall be used for 1 or more of the following activities:</text>
<paragraph id="HF9E1F126F28C416CA967D28A54F78488"><enum>(1)</enum><text>The provision of mental health and substance use disorder services to students, including prevention, promotion of mental health, voluntary screening, early intervention, voluntary assessment, treatment, and management of mental health and substance use disorder issues.</text>
</paragraph><paragraph id="HD74927FAE3354BFEAAB54FABE88B1706"><enum>(2)</enum><text>The provision of outreach services to notify students about the existence of mental health and substance use disorder services.</text>
</paragraph><paragraph id="H75CB66EE9289423FB223A756F0B7C934"><enum>(3)</enum><text>Educating students, families, faculty, staff, and communities to increase awareness of mental health and substance use disorders.</text>
</paragraph><paragraph id="HE160A4516BE143B8B282F49F7EF77614"><enum>(4)</enum><text>The employment of appropriately trained staff, including administrative staff.</text> </paragraph><paragraph id="HF6850CF78C1C42ACB8EB0514A1C4C91B"><enum>(5)</enum><text>The provision of training to students, faculty, and staff to respond effectively to students with mental health and substance use disorders.</text>
</paragraph><paragraph id="H167DD066E13947F7BDAE933A30DA7470"><enum>(6)</enum><text>The creation of a networking infrastructure to link colleges and universities with providers who can treat mental health and substance use disorders.</text>
</paragraph><paragraph id="H4B25E5BFD609487A9FC61B6EADB4D8C1"><enum>(7)</enum><text>Developing, supporting, evaluating, and disseminating evidence-based and emerging best practices.</text> </paragraph></subsection><subsection id="HE633A2A78711437BA46CBA3DA7F2F4D9"><enum>(c)</enum><header>Implementation of activities using grant funds</header><text>An institution of higher education that receives a grant under this section may carry out activities under the grant through—</text>
<paragraph id="H6E97D1A5D8934D578C00EA5555A770B6"><enum>(1)</enum><text>college counseling centers;</text> </paragraph><paragraph id="H0A74CB7945F446DC8CC38B5A78DB9CD5"><enum>(2)</enum><text>college and university psychological service centers;</text>
</paragraph><paragraph id="HE87B59D698984F92A72D92F13EAB3EFF"><enum>(3)</enum><text>mental health centers;</text> </paragraph><paragraph id="H3FF1B6604B494C01B1C5624E9530523A"><enum>(4)</enum><text>psychology training clinics;</text>
</paragraph><paragraph id="H506E984451D8419E92A69118FB1EC38F"><enum>(5)</enum><text>institution of higher education supported, evidence-based, mental health and substance use disorder programs; or</text>
</paragraph><paragraph id="H2496B048364B44F9BE00FAA0C32EB4AF"><enum>(6)</enum><text>any other entity that provides mental health and substance use disorder services at an institution of higher education.</text>
</paragraph></subsection><subsection id="HB8099356CDF14408B7E0A170F8E26B58"><enum>(d)</enum><header>Application</header><text>To be eligible to receive a grant under this section, an institution of higher education shall prepare and submit to the Secretary an application at such time and in such manner as the Secretary may require. At a minimum, such application shall include the following:</text>
<paragraph id="H54B6D79C8B694084997247A3DEC2A893"><enum>(1)</enum><text>A description of identified mental health and substance use disorder needs of students at the institution of higher education.</text>
</paragraph><paragraph id="H7A3594B452134ED3AED3BB0C7397768E"><enum>(2)</enum><text>A description of Federal, State, local, private, and institutional resources currently available to address the needs described in paragraph (1) at the institution of higher education.</text>
</paragraph><paragraph id="H153B90A99E1F45BF97A89D023C657049"><enum>(3)</enum><text>A description of the outreach strategies of the institution of higher education for promoting access to services, including a proposed plan for reaching those students most in need of mental health services.</text>
</paragraph><paragraph id="HA836E159724842FAA686E3443C8420D6"><enum>(4)</enum><text>A plan, when applicable, to meet the specific mental health and substance use disorder needs of veterans attending institutions of higher education.</text>
</paragraph><paragraph id="H92572A68D56545BC93E303348B05E6F3"><enum>(5)</enum><text>A plan to seek input from community mental health providers, when available, community groups and other public and private entities in carrying out the program under the grant.</text>
</paragraph><paragraph id="HF613C4147B3E41F8A6EC575AE80BDE34"><enum>(6)</enum><text>A plan to evaluate program outcomes, including a description of the proposed use of funds, the program objectives, and how the objectives will be met.</text>
</paragraph><paragraph id="H68B6B239377C4395A565D852FE97775B"><enum>(7)</enum><text>An assurance that the institution will submit a report to the Secretary each fiscal year concerning the activities carried out with the grant and the results achieved through those activities.</text>
</paragraph></subsection><subsection id="H64D88738974A40459358FF696D166974"><enum>(e)</enum><header>Special considerations</header><text>In awarding grants under this section, the Secretary shall give special consideration to applications that describe programs to be carried out under the grant that—</text>
<paragraph id="H66725900FC8A4C0C856063CA8DF8EDA9"><enum>(1)</enum><text>demonstrate the greatest need for new or additional mental and substance use disorder services, in part by providing information on current ratios of students to mental health and substance use disorder health professionals; and</text>
</paragraph><paragraph id="H3974251A7AA6463D8787F9A64FE5D41E"><enum>(2)</enum><text>demonstrate the greatest potential for replication.</text> </paragraph></subsection><subsection id="H1B9BF1F5A615409DB1E7848C1A63131E"><enum>(f)</enum><header>Requirement of matching funds</header> <paragraph id="H0A1CB7CCC8AD4A119CDF52CFA3690C39"><enum>(1)</enum><header>In general</header><text>The Secretary may make a grant under this section to an institution of higher education only if the institution agrees to make available (directly or through donations from public or private entities) non-Federal contributions in an amount that is not less than $1 for each $1 of Federal funds provided under the grant, toward the costs of activities carried out with the grant (as described in subsection (b)) and other activities by the institution to reduce student mental health and substance use disorders.</text>
</paragraph><paragraph id="H5ED54061BF6947BDAE3715367ABB2A0A"><enum>(2)</enum><header>Determination of amount contributed</header><text>Non-Federal contributions required under paragraph (1) may be in cash or in kind. Amounts provided by the Federal Government, or services assisted or subsidized to any significant extent by the Federal Government, may not be included in determining the amount of such non-Federal contributions.</text>
</paragraph><paragraph id="HBADCD11B9D7E4D729BA2DCF6A69502CB"><enum>(3)</enum><header>Waiver</header><text>The Secretary may waive the application of paragraph (1) with respect to an institution of higher education if the Secretary determines that extraordinary need at the institution justifies the waiver.</text>
</paragraph></subsection><subsection id="H83E11761BFF64249886D61914FC78705"><enum>(g)</enum><header>Reports</header><text>For each fiscal year that grants are awarded under this section, the Secretary shall conduct a study on the results of the grants and submit to the Congress a report on such results that includes the following:</text>
<paragraph id="HCDBCD61B66C149E191750AB871978828"><enum>(1)</enum><text>An evaluation of the grant program outcomes, including a summary of activities carried out with the grant and the results achieved through those activities.</text>
</paragraph><paragraph id="HF88BB15EE9E74E01A77C3537AB342B3C"><enum>(2)</enum><text>Recommendations on how to improve access to mental health and substance use disorder services at institutions of higher education, including efforts to reduce the incidence of suicide and substance use disorders.</text>
</paragraph></subsection><subsection id="H411A526D930147BE9BD2A36D8061643E"><enum>(h)</enum><header>Definitions</header><text>In this section:</text> <paragraph commented="no" id="H410E47F33BE840EEB07F468A6112217C"><enum>(1)</enum><text>The term <term>evidence-based</term> has the meaning given to such term in section 2 of the <short-title>Helping Families in Mental Health Crisis Act of 2015</short-title>.</text>
</paragraph><paragraph id="H6768C71F53244559AEBC1E0A43AAF915"><enum>(2)</enum><text>The term <term>institution of higher education</term> has the meaning given such term in section 101 of the Higher Education Act of 1965.</text> </paragraph></subsection><subsection id="H99A668BF7CE5452BA9D5182014D5B59A"><enum>(i)</enum><header>Authorization of appropriations</header><text>For the purpose of carrying out this section, there are authorized to be appropriated $4,975,000 for each of fiscal years 2016 through 2020.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="HEC873A5608684B118700FF9797B9FCE2"><enum>(5)</enum><header>Suicide lifeline</header><text display-inline="yes-display-inline">Subpart 3 of part B of title V of the Public Health Service Act is amended by inserting after section 520E–2 of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290bb-36b">42 U.S.C. 290bb–36b</external-xref>), as amended, the following:</text>
<quoted-block display-inline="no-display-inline" id="H40636C09717A4EF88CF0864B4430C6CD" style="OLC">
<section id="H0355E31A9F2A4D8AA4EAAE95807EF5D4"><enum>520E–3.</enum><header>National Suicide Prevention Lifeline Program</header>
<subsection id="H539D46AEEB3D4655992DADA01E629E2E"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary shall maintain the National Suicide Prevention Lifeline program, including by—</text> <paragraph id="H0FB152AE9F8F446887CB8E768580E6F9"><enum>(1)</enum><text>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;</text>
</paragraph><paragraph id="H72DAF345E6F44DA29E5611B0B4F0CE7F"><enum>(2)</enum><text>maintaining a suicide prevention hotline to link callers to local emergency, mental health, and social services resources; and</text>
</paragraph><paragraph id="H2E9DD2C4CE604F019D458AEC156CC91E"><enum>(3)</enum><text>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.</text>
</paragraph></subsection><subsection id="H96AC765B06CA405FABB5BA2CC957824D"><enum>(b)</enum><header>Authorization of appropriations</header><text>To carry out this section, there are authorized to be appropriated $8,000,000 for each of fiscal years 2016 through 2020.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection></section><enum>III</enum><header>Interagency Serious Mental Illness Coordinating Committee</header>
<section id="HE4390BB5EAE64D0AB29D6B27064ABA6A"><enum>301.</enum><header>Interagency Serious Mental Illness Coordinating Committee</header><text display-inline="no-display-inline">Title V of the Public Health Service Act, as amended by section 101, is further amended by inserting after section 501 of such Act the following:</text>
<quoted-block display-inline="no-display-inline" id="H15BC1475BA5B4A729BC665E1DB522715" style="OLC">
<section id="H0B4EF01185A34DCAB84FF0FDE0C749AC"><enum>501A.</enum><header>Interagency Serious Mental Illness Coordinating Committee</header>
<subsection id="HC6D0DC03C5D74067BBF7D315B254C0E0"><enum>(a)</enum><header>Establishment</header><text display-inline="yes-display-inline">The Assistant Secretary for Mental Health and Substance Use Disorders (in this section referred to as the <quote>Assistant Secretary</quote>) shall establish a committee, to be known as the Interagency Serious Mental Illness Coordinating Committee (in this section referred to as the <quote>Committee</quote>), to assist the Assistant Secretary in carrying out the Assistant Secretary’s duties.</text>
</subsection><subsection id="H4DA9E6AECA6847CEA632B48B5129961F"><enum>(b)</enum><header>Responsibilities</header><text>The Committee shall—</text> <paragraph id="H670E7622573A4CBD8CFBE3FE8953146A"><enum>(1)</enum><text>develop and annually update a summary of advances in serious mental illness research related to causes, prevention, treatment, early screening, diagnosis or rule out, intervention, and access to services and supports for individuals with serious mental illness;</text>
</paragraph><paragraph id="H180E3777FE8741C98392847992BFC873"><enum>(2)</enum><text>monitor Federal activities with respect to serious mental illness;</text> </paragraph><paragraph id="H4C281E2F831B40388E7109D17A29593B"><enum>(3)</enum><text>make recommendations to the Assistant Secretary regarding any appropriate changes to such activities, including recommendations to the Director of NIH with respect to the strategic plan developed under paragraph (5);</text>
</paragraph><paragraph id="H63F3D231AB2D495DA3D14A5CE2F0B4DB"><enum>(4)</enum><text>make recommendations to the Assistant Secretary regarding public participation in decisions relating to serious mental illness;</text>
</paragraph><paragraph id="H89B7BD7A4BE9416CB915F8BE3EE0745B"><enum>(5)</enum><text display-inline="yes-display-inline">develop and annually update a strategic plan for advancing—</text> <subparagraph id="H83C9D30357954C019FCDFD7FC7545E82"><enum>(A)</enum><text>public utilization of effective mental health services; and</text>
</subparagraph><subparagraph id="HEF848AECC24E4085BB899F3EAB2F6A92"><enum>(B)</enum><text>compliance with treatment;</text> </subparagraph></paragraph><paragraph id="H3D99D8E57D424F7CA47A7E43CACC1D5D"><enum>(6)</enum><text>develop and annually update a strategic plan for the conduct of, and support for, serious mental illness research, including proposed budgetary requirements; and</text>
</paragraph><paragraph id="HEBD7D0BB3E614548BAEE41C6186857B9"><enum>(7)</enum><text>submit to the Congress such strategic plan and any updates to such plan.</text> </paragraph></subsection><subsection id="H75F3641C5C0248408669DD799F16A750"><enum>(c)</enum><header>Membership</header> <paragraph id="HDFCC619088E644F19A6F0E91F520F9FD"><enum>(1)</enum><header>In general</header><text>The Committee shall be composed of—</text>
<subparagraph id="H301E3E88497742988459BB581A794240"><enum>(A)</enum><text display-inline="yes-display-inline">the Assistant Secretary for Mental Health and Substance Use Disorders (or the Assistant Secretary’s designee), who shall serve as the Chair of the Committee;</text>
</subparagraph><subparagraph id="HB088434AA1A04E038A9CEDEABECCF2A0"><enum>(B)</enum><text>the Director of the National Institute of Mental Health (or the Director’s designee);</text> </subparagraph><subparagraph id="H0FAD4C677A6E4348B4861C664B0812E7"><enum>(C)</enum><text>the Attorney General of the United States (or the Attorney General’s designee);</text>
</subparagraph><subparagraph id="H333DD227ED1148579C36B42D3D66BC48"><enum>(D)</enum><text>the Director of the Centers for Disease Control and Prevention (or the Director’s designee);</text> </subparagraph><subparagraph id="HBA7CA1B410FC473BB25330A83917EBAC"><enum>(E)</enum><text>the Director of the National Institutes of Health (or the Director’s designee);</text>
</subparagraph><subparagraph id="H00877D39F9A7457DA0393ECB75E7CD9F"><enum>(F)</enum><text>the directors of such national research institutes of the National Institutes of Health as the Assistant Secretary for Mental Health and Substance Use Disorders determines appropriate (or their designees);</text>
</subparagraph><subparagraph id="HE59AF47F43EC479FBCF3632AA763514D"><enum>(G)</enum><text>a member of the United States Interagency Council on Homelessness;</text> </subparagraph><subparagraph id="H5B8D6EF3BB6C462D8E2F1268AF300B03"><enum>(H)</enum><text display-inline="yes-display-inline">representatives, appointed by the Assistant Secretary, of Federal agencies that are outside of the Department of Health and Human Services and serve individuals with serious mental illness, including representatives of the Bureau of Indian Affairs, the Department of Defense, the Department of Education, the Department of Housing and Urban Development, the Department of Labor, the Department of Veterans Affairs, and the Social Security Administration;</text>
</subparagraph><subparagraph id="HD69C33DD03064EA283FDD2E8B1AFF159"><enum>(I)</enum><text>4 members, of which—</text> <clause id="H214FB33224BC4806923C5E35053517D9"><enum>(i)</enum><text>1 shall be appointed by the Speaker of the House of Representatives;</text>
</clause><clause id="H43DDD7B116D7430EB1975D121B38BB42"><enum>(ii)</enum><text>1 shall be appointed by the minority leader of the House of Representatives;</text> </clause><clause id="HC524CC523C434D01BB16C86210110761"><enum>(iii)</enum><text>1 shall be appointed by the majority leader of the Senate; and</text>
</clause><clause id="HC754732135CE43C49820C822E96F709D"><enum>(iv)</enum><text>1 shall be appointed by the minority leader of the Senate; and</text> </clause></subparagraph><subparagraph id="HB38C322D6D5E4F6BAC475852CF280AA8"><enum>(J)</enum><text>the additional members appointed under paragraph (2).</text>
</subparagraph></paragraph><paragraph id="HB2756EB6C6474AD68E1BD66AA38E00F7"><enum>(2)</enum><header>Additional members</header><text>Not fewer than 14 members of the Committee, or <fraction>1/3</fraction> of the total membership of the Committee, whichever is greater, shall be composed of non-Federal public members to be appointed by the Assistant Secretary, of which—</text>
<subparagraph id="H5AE44FDEF63147549544B6465B423E87"><enum>(A)</enum><text display-inline="yes-display-inline">at least one such member shall be an individual in recovery from a diagnosis of serious mental illness who has benefitted from and is receiving medical treatment under the care of a licensed mental health professional;</text>
</subparagraph><subparagraph id="HA8CAA24DD50E477986FF2366E730BA71"><enum>(B)</enum><text display-inline="yes-display-inline">at least one such member shall be a parent or legal guardian of an individual with a history of serious mental illness who has either attempted suicide or is incarcerated for violence committed while experiencing a serious mental illness;</text>
</subparagraph><subparagraph id="H0226581302134BB2A9C9C4BF0F644889"><enum>(C)</enum><text>at least one such member shall be a representative of a leading research, advocacy, and service organization for individuals with serious mental illness;</text>
</subparagraph><subparagraph id="HF0A5AEBD4E104736B92E57A6D186915B"><enum>(D)</enum><text display-inline="yes-display-inline">at least one such member shall be—</text> <clause id="H12AFCC6ACDA646B4B337FCC37034A268"><enum>(i)</enum><text display-inline="yes-display-inline">a licensed psychiatrist with experience treating serious mental illness; or</text>
</clause><clause id="H0D01DA31F6014281A5D32CD3066ABF05"><enum>(ii)</enum><text display-inline="yes-display-inline">a licensed clinical psychologist with experience treating serious mental illness;</text> </clause></subparagraph><subparagraph id="H49FBD97E428F402D8AC22F7AE1783465"><enum>(E)</enum><text display-inline="yes-display-inline">at least one member shall be a licensed mental health counselor or psychotherapist;</text>
</subparagraph><subparagraph id="HDAD444C8A10B430DB5077A0ED040EAF1"><enum>(F)</enum><text display-inline="yes-display-inline">at least one member shall be a licensed clinical social worker;</text> </subparagraph><subparagraph id="HFF802F63FBD6474BA1B5694209185983"><enum>(G)</enum><text display-inline="yes-display-inline">at least one member shall be a licensed psychiatric nurse or nurse practitioner;</text>
</subparagraph><subparagraph id="H6DAC3AA39629419C8FD26FC92E7E456B"><enum>(H)</enum><text display-inline="yes-display-inline">at least one member shall be a mental health professional with a significant focus in his or her practice working with children and adolescents;</text>
</subparagraph><subparagraph id="HB33DBD548323449B8E209B62406C4F0A"><enum>(I)</enum><text display-inline="yes-display-inline">at least one member shall be a mental health professional who spends a significant concentration of his or her professional time or leadership practicing community mental health;</text>
</subparagraph><subparagraph id="H96D0185DB4D04869B1E116D25C715B01"><enum>(J)</enum><text display-inline="yes-display-inline">at least one member shall be a mental health professional with substantial experience working with mentally ill individuals who have a history of violence or suicide;</text>
</subparagraph><subparagraph id="H3594515B5B4D49C2B204680823582ABD"><enum>(K)</enum><text display-inline="yes-display-inline">at least one such member shall be a State certified mental health peer specialist;</text> </subparagraph><subparagraph id="H5B9BB5427BF24D30841AD57853A1349F"><enum>(L)</enum><text>at least one member shall be a judge with experiences applying assisted outpatient treatment;</text>
</subparagraph><subparagraph id="H145C332F6357492C9F03F7BAE4AC1EE6"><enum>(M)</enum><text display-inline="yes-display-inline">at least one member shall be a law enforcement officer with extensive experience in interfacing with psychiatric and psychological disorders or individuals in mental health crisis; and</text>
</subparagraph><subparagraph id="H74AA2A5443F0457DA1A9128109405DFF"><enum>(N)</enum><text>at least one member shall be a corrections officer.</text> </subparagraph></paragraph></subsection><subsection commented="no" id="H9787FBD11C2A473487A7F94C1E248D59"><enum>(d)</enum><header>Reports to Congress</header><text>Not later than 1 year after the date of enactment of this Act, and every 2 years thereafter, the Committee shall submit a report to the Congress—</text>
<paragraph commented="no" id="H3B223DABEC8E47F49E312D520D62D369"><enum>(1)</enum><text>analyzing the efficiency, effectiveness, quality, coordination, and cost effectiveness of Federal programs and activities relating to the prevention of, or treatment or rehabilitation for, mental health or substance use disorders, including an accounting of the costs of such programs and activities, with administrative costs disaggregated from the costs of services and care provided;</text>
</paragraph><paragraph commented="no" id="H0EFCBEB687704D4C8D4BAC67BD1EFAD5"><enum>(2)</enum><text>evaluating the impact on public health of projects addressing priority mental health needs of regional and national significance under sections 501, 509, 516, and 520A including measurement of public health outcomes such as—</text>
<subparagraph commented="no" id="H7A1C411B6599451687C47652FCA42DC7"><enum>(A)</enum><text>reduced rates of suicide, suicide attempts, substance abuse, overdose, overdose deaths, emergency hospitalizations, emergency room boarding, incarceration, crime, arrest, victimization, homelessness, and joblessness;</text>
</subparagraph><subparagraph commented="no" id="HC1D6C576EEA14B8B9E534E2BF8D7A71A"><enum>(B)</enum><text>increased rates of employment and enrollment in educational and vocational programs; and</text> </subparagraph><subparagraph commented="no" id="HD96C29877AFA4A70B8A280A635AA106B"><enum>(C)</enum><text>such other criteria as may be determined by the Assistant Secretary;</text>
</subparagraph></paragraph><paragraph commented="no" id="H5CCF706C097047E3B1903849D60ADC4A"><enum>(3)</enum><text>formulating recommendations for the coordination and improvement of Federal programs and activities described in paragraph (2);</text>
</paragraph><paragraph commented="no" id="H9D9667E7C03541BA9184E347922D2963"><enum>(4)</enum><text>identifying any such programs and activities that are duplicative; and</text> </paragraph><paragraph commented="no" id="HE096A5A890BB40279EB079504AE1DE3E"><enum>(5)</enum><text>summarizing all recommendations made, activities carried out, and results achieved pursuant to the workforce development strategy under section 501(b)(9) of the Public Health Service Act, as amended by section 101.</text>
</paragraph></subsection><subsection id="HCAD2F2A5720240D684F01C1D22D58B29"><enum>(e)</enum><header>Administrative support; terms of service; other provisions</header><text>The following provisions shall apply with respect to the Committee:</text> <paragraph id="H78B6218C65544314BD43ACC031E1F64B"><enum>(1)</enum><text display-inline="yes-display-inline">The Assistant Secretary shall provide such administrative support to the Committee as may be necessary for the Committee to carry out its responsibilities.</text>
</paragraph><paragraph id="H23CBEA9D84964D9D8FF185B689E94AA7"><enum>(2)</enum><text>Members of the Committee appointed under subsection (c)(2) shall serve for a term of 4 years, and may be reappointed for one or more additional 4-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 taken office.</text>
</paragraph><paragraph id="HFA529994455F45FCBBC3C8F4EA75E661"><enum>(3)</enum><text>The Committee shall meet at the call of the chair or upon the request of the Assistant Secretary. The Committee shall meet not fewer than 2 times each year.</text>
</paragraph><paragraph id="H51A314855EBC4D17A527556DFA179ABA"><enum>(4)</enum><text>All meetings of the Committee shall be public and shall include appropriate time periods for questions and presentations by the public.</text>
</paragraph></subsection><subsection id="H78998255FFA641D8B46B71C254D1AA35"><enum>(f)</enum><header>Subcommittees; establishment and membership</header><text>In carrying out its functions, the Committee may establish subcommittees and convene workshops and conferences. Such subcommittees shall be composed of Committee members and may hold such meetings as are necessary to enable the subcommittees to carry out their duties.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><enum>IV</enum><header>HIPAA and FERPA caregivers</header>
<section commented="no" id="H53DAE165B27046779E52CA0F4CD87F26"><enum>401.</enum><header>Promoting appropriate treatment for mentally ill individuals by treating their caregivers as
personal representatives for purposes of HIPAA privacy regulations</header>
<subsection commented="no" id="HC9EDCEAE169042E196B767FA20DD8196"><enum>(a)</enum><header>Caregiver access to information</header><text>In applying section 164.502(g) of title 45, Code of Federal Regulations, to an individual with serious mental illness an exception for disclosure of specific limited protected health information shall be provided if all of the following criteria are met for the disclosure by a physician (as defined in paragraphs (1) and (2) of section 1861(r) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(r)</external-xref>)) or other licensed mental health or health care professional to an identified responsible caregiver:</text>
<paragraph commented="no" id="HD9BDF41B2EAA4BF7B32DD8380DDBBB5C"><enum>(1)</enum><text>Such disclosure is for information limited to the diagnoses, treatment plans, appointment scheduling, medications, and medication-related instructions, but not including any personal psychotherapy notes.</text>
</paragraph><paragraph commented="no" id="H995764DB288544768FD2050C6AE89A84"><enum>(2)</enum><text>Such disclosure is necessary to protect the health, safety, or welfare of the individual or general public.</text>
</paragraph><paragraph commented="no" id="HA0BD6E2992D24A4D8688C70DA37FD137"><enum>(3)</enum><text>The information to be disclosed will be beneficial to the treatment of the individual if that individual has a co-occurring acute or chronic medical illness.</text>
</paragraph><paragraph commented="no" id="H4AD202C15BDC4FD780DBDAB8D0A27C08"><enum>(4)</enum><text>The information to be disclosed is necessary for the continuity of treatment of the medical condition or mental illness of the individual.</text>
</paragraph><paragraph commented="no" id="HA1D09D351D3343C482D7A048FADF4C04"><enum>(5)</enum><text>The absence of such information or treatment will contribute to a worsening prognosis or an acute medical condition.</text>
</paragraph><paragraph commented="no" id="HAB24FF4A94D440CBAB0087DD3D9A8BFB"><enum>(6)</enum><text>The individual by nature of the severe mental illness has or has had a diminished capacity to fully understand or follow a treatment plan for their medical condition or may become gravely disabled in absence of treatment.</text>
</paragraph></subsection><subsection commented="no" id="H33F93C5CCED840B2AE06B1EDBD757441"><enum>(b)</enum><header>Training</header><text>In applying section 164.530 of title 45, Code of Federal Regulations, the training described in paragraph (b)(1) of such section shall include training with respect to the disclosure of information to a caregiver of an individual pursuant to subsection (a).</text>
</subsection><subsection commented="no" id="H4489EE5D02E842D58EF0240F1809AEA0"><enum>(c)</enum><header>Age of majority</header><text>In applying section 164.502(g) of title 45, Code of Federal Regulations, notwithstanding any other provision of law, an unemancipated minor shall be an individual under the age of 18 years.</text>
</subsection><subsection commented="no" id="HA2142FEA92354689A20AB85FD274A064"><enum>(d)</enum><header>Provider access to information</header><text>Health care providers may listen to information or review medical history provided by family members or other caregivers who may have concerns about the health and well-being of the patient, so the health care provider can factor that information into the patient’s care.</text>
</subsection><subsection commented="no" id="H3F173F2765334903831F52A398B6216B"><enum>(e)</enum><header>Definitions</header><text>For purposes of this section:</text> <paragraph commented="no" id="H49C1E3DC55B6434DAE703F2FD43E393D"><enum>(1)</enum><header>Covered entity</header><text>The term <term>covered entity</term> has the meaning given such term in section 106.103 of title 45, Code of Federal Regulations.</text>
</paragraph><paragraph commented="no" id="HF6D2DDFA4C9842468BC0D9B64777976B"><enum>(2)</enum><header>Protected health information</header><text>The term <term>protected health information</term> has the meaning given such term in section 106.103 of title 45, Code of Federal Regulations.</text> </paragraph><paragraph commented="no" id="H39FC835945ED4A8999447EBF19E02BD3"><enum>(3)</enum><header>Caregiver</header><text>The term <term>caregiver</term> means, with respect to an individual with a serious mental illness—</text>
<subparagraph commented="no" id="H365EBB5520964A98A3AE1DE5667F9A0D"><enum>(A)</enum><text>an immediate family member of such individual;</text> </subparagraph><subparagraph commented="no" id="HBA3D6B779CB842CCB89706B8D69F1B4C"><enum>(B)</enum><text>an individual who assumes primary responsibility for providing a basic need of such individual;</text>
</subparagraph><subparagraph commented="no" id="H0E596EE3D66147B1B1EDC94845195283"><enum>(C)</enum><text>a personal representative of the individual as determined by the law of the State in which such individual resides;</text>
</subparagraph><subparagraph commented="no" id="HD1E3054C24A84B88949DBD1E11A36267"><enum>(D)</enum><text>can establish a longstanding involvement and is responsible with the individual with a serious mental illness and the health care of the individual; and</text>
</subparagraph><subparagraph commented="no" id="HE8831EF9F8184A18BC15A599233F0B94"><enum>(E)</enum><text>excludes an individual with a documented history of abuse.</text> </subparagraph></paragraph><paragraph commented="no" id="H461D645707BA4A07AE7B389FB86DDEBA"><enum>(4)</enum><header>Individual with a serious mental illness</header><text>The term <term>individual with a serious mental illness</term> means, with respect to the disclosure to a caregiver of protected health information of an individual, an individual who—</text>
<subparagraph commented="no" id="H166514092E31425EAC16B06414DBC68D"><enum>(A)</enum><text>is 18 years of age or older; and</text> </subparagraph><subparagraph commented="no" id="H3ECACFF036544C61A4D76BF397D398CC"><enum>(B)</enum><text>has, within one year before the date of the disclosure, been evaluated, diagnosed, or treated for a mental, behavioral, or emotional disorder that—</text>
<clause commented="no" id="HBA670144A57A415798D81362F9C4F7C0"><enum>(i)</enum><text>is determined by a physician to be of sufficient duration to meet diagnostic criteria specified within the Diagnostic and Statistical Manual of Mental Disorders; and</text>
</clause><clause commented="no" id="H99B2D41FE2F146608C11D2A1062B9D2D"><enum>(ii)</enum><text>results in functional impairment of the individual that substantially interferes with or limits one or more major life activities of the individual.</text>
</clause><continuation-text commented="no" continuation-text-level="subparagraph">Such term includes an individual with autism spectrum disorder or other developmental disability if
such individual has a co-occurring mental illness.</continuation-text></subparagraph></paragraph></subsection></section><section display-inline="no-display-inline" id="H9FF2EC5B50BB49A5ADE095CFD6682202" section-type="subsequent-section"><enum>402.</enum><header>Caregivers permitted access to certain education records under FERPA</header><text display-inline="no-display-inline">Section 444 of the General Education Provisions Act (<external-xref legal-doc="usc" parsable-cite="usc/20/1232g">20 U.S.C. 1232g</external-xref>) is amended by adding at the end the following new subsection:</text>
<quoted-block display-inline="no-display-inline" id="H9DAA857283064B5F9D473463BB4B4802" style="OLC">
<subsection id="H8A260E2333AB42FEA51E3EBD546523CD"><enum>(k)</enum><header>Disclosures to caregivers</header>
<paragraph id="H6A1117EF116644CC8716ECFC13D80781"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">With respect to a student who is 18 years of age or older, an educational agency or institution may disclose to the caregiver of the student, without regard to whether the student has explicitly provided consent to the agency or institution for the disclosure of the student’s education record, the education record of such student if a physician (as defined in paragraphs (1) and (2) of section 1861(r) of the Social Security Act), psychologist, or other recognized mental health professional or paraprofessional acting in his or her professional or paraprofessional capacity, or assisting in that capacity reasonably believes such disclosure to the caregiver is necessary to protect the health, safety, or welfare of such student or the safety of one or more other individuals.</text>
</paragraph><paragraph id="H523AACDD3D3249179B17D5DBBA0BA0AD"><enum>(2)</enum><header>Definitions</header><text display-inline="yes-display-inline">In this subsection:</text> <subparagraph id="HBB44AE59ADBE4602805E365D369D2B56"><enum>(A)</enum><header>Caregiver</header><text display-inline="yes-display-inline">The term <term>caregiver</term> means, with respect to a student, a family member or immediate past legal guardian who assumes a primary responsibility for providing a basic need of such student (such as a family member or past legal guardian of the student who has assumed the responsibility of co-signing a loan with the student).</text>
</subparagraph><subparagraph id="HEE54897A156545FFB7AA6F114056AB6A"><enum>(B)</enum><header>Education record</header><text>Notwithstanding subsection (a)(4)(B), the term <term>education record</term> shall include a record described in clause (iv) of such subsection.</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block> </section><section commented="no" id="H4ADB27F8ACD54165B301EBDB29ADFDBE"><enum>403.</enum><header>Confidentiality of records</header><text display-inline="no-display-inline">Section 543(e) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290dd-2">42 U.S.C. 290dd–2(e)</external-xref>) is amended—</text>
<paragraph commented="no" id="H5DE9E5618BBA4543AE3DAEF7B3C73650"><enum>(1)</enum><text>in paragraph (1), by striking <quote>; or</quote> and inserting a semicolon;</text> </paragraph><paragraph commented="no" id="HC79FBFE711A04C6CB379A8D4652755D4"><enum>(2)</enum><text>in paragraph (2), by striking the period and inserting <quote>; or</quote>; and</text>
</paragraph><paragraph commented="no" id="H716B2D6F0D174289A90BC1397F56D8F3"><enum>(3)</enum><text>after paragraph (2), by inserting the following:</text> <quoted-block display-inline="no-display-inline" id="H58821524AF5B4FFDBCA835319E19BD2A" style="OLC"> <paragraph commented="no" id="H3CF5C7B6221B48CE8FE6EE316F5C960F"><enum>(3)</enum><text>within accountable care organizations described in section 1899 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395jjj">42 U.S.C. 1395jjj</external-xref>), health information exchanges (as defined for purposes of section 3013), health homes (as defined in section 1945(h)(3) of such Act <external-xref legal-doc="usc" parsable-cite="usc/42/1396w-4">42 U.S.C. 1396w–4(h)(3)</external-xref>), or other integrated care arrangements (in existence before, on, or after the date of the enactment of this paragraph) involving the interchange of electronic health records (as defined in section 13400 of division A of <external-xref legal-doc="public-law" parsable-cite="pl/111/5">Public Law 111–5</external-xref>) (<external-xref legal-doc="usc" parsable-cite="usc/42/17921">42 U.S.C. 17921(5)</external-xref>) containing information described in subsection (a) for purposes of attaining interoperability, improving care coordination, reducing health care costs, and securing or providing patient safety.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section><enum>V</enum><header>Medicare and Medicaid reforms</header>
<section commented="no" id="HA4A5DDE91CAC478BA35895BA360CEA22" section-type="subsequent-section"><enum>501.</enum><header>Enhanced Medicaid coverage relating to certain mental health services</header>
<subsection commented="no" id="H14C28CEA8D2E4C9EB996A0102D22A479"><enum>(a)</enum><header>Medicaid coverage of mental health services and primary care services furnished on the same day</header>
<paragraph commented="no" id="H969912475F2042898D39F82AB1AFEA71"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Section 1902(a) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a(a)</external-xref>) is amended by inserting after paragraph (77) the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="H759ADD3AA4134E9AA9906A4130532E9E" style="traditional">
<paragraph commented="no" id="H4F728139FB3A42758D06BC7EACB6580B"><enum>(78)</enum><text display-inline="yes-display-inline">not prohibit payment under the plan for a mental health service or primary care service furnished to an individual at a community mental health center meeting the criteria specified in section 1913(c) of the Public Health Service Act or a federally qualified health center (as defined in section 1861(aa)(3)) for which payment would otherwise be payable under the plan, with respect to such individual, if such service were not a same-day qualifying service (as defined in subsection (ll));</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph commented="no" id="H5AE8084A50534B9C92B89E4BC1C39F9A"><enum>(2)</enum><header>Same-day qualifying services defined</header><text display-inline="yes-display-inline">Section 1902 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a</external-xref>) is amended by adding at the end the following new subsection:</text>
<quoted-block display-inline="no-display-inline" id="H22D316D269154B87A6C663F50DB778E7" style="OLC">
<subsection commented="no" id="H93EA69C7A19B4FABB97C4041EDD677E9"><enum>(ll)</enum><header>Same-Day qualifying services defined</header><text display-inline="yes-display-inline">For purposes of subsection (a)(78), the term <term>same-day qualifying service</term> means—</text> <paragraph commented="no" id="HC01AA027477D48DBB9598380E0926A88"><enum>(1)</enum><text>a primary care service furnished to an 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; and</text>
</paragraph><paragraph commented="no" id="H25378C259F8C447CA203037FE555A4EC"><enum>(2)</enum><text display-inline="yes-display-inline">a mental health service furnished to an 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.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H4A3E7D3A07184362B016F6A50911F6AF"><enum>(b)</enum><header>State option To provide medical assistance for certain inpatient psychiatric services to nonelderly
adults</header><text>Section 1905 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396d">42 U.S.C. 1396d</external-xref>) is amended—</text> <paragraph id="HEA7F275550934A7096EF69D235026C20"><enum>(1)</enum><text>in subsection (a)—</text>
<subparagraph id="HD191EEFBF2634D13AC637E974C6E0E1A"><enum>(A)</enum><text>in paragraph (16)—</text> <clause id="H4826E4410CB04C7083D9681E8CDC1883"><enum>(i)</enum><text>by striking <quote>effective</quote> and inserting <quote>(A) effective</quote>; and</text>
</clause><clause id="H2BCE90EB9E3B41E68521833FBA92DBFC"><enum>(ii)</enum><text>by inserting before the semicolon at the end the following: <quote>, (B) qualified inpatient psychiatric hospital services (as defined in subsection (h)(3)) for individuals over 21 years of age and under 65 years of age, and (C) psychiatric residential treatment facility services (as defined in subsection (h)(4)) for individuals over 21 years of age and under 65 years of age</quote>; and</text>
</clause></subparagraph><subparagraph id="H904B6E7DFF1344D4B105234F411F9310"><enum>(B)</enum><text>in the subdivision (B) that follows paragraph (29), by inserting <quote>(other than services described in subparagraphs (B) and (C) of paragraph (16) for individuals described in such subparagraphs)</quote> after <quote>patient in an institution for mental diseases</quote>; and</text>
</subparagraph></paragraph><paragraph id="H744E5B57265B44CD98B4F238CC7228A1"><enum>(2)</enum><text>in subsection (h), by adding at the end the following new paragraphs:</text> <quoted-block display-inline="no-display-inline" id="H216A24B269F744AD90761B551A8ED06A" style="traditional"> <paragraph id="HFF27CE60B4C14522ABEACBC050FF27FB" indent="up1"><enum>(3)</enum><text>For purposes of subsection (a)(16)(B), the term <term>qualified inpatient psychiatric hospital services</term> means, with respect to individuals described in such subsection, services described in subparagraphs (A) and (B) of paragraph (1) that are furnished in an acute care psychiatric unit in a State-operated psychiatric hospital or a psychiatric hospital (as defined section 1861(f)) if such unit or hospital, as applicable, has a facilitywide average (determined on an annual basis) length of stay of less than 30 days.</text>
</paragraph><paragraph id="H02BAF9972B1746949E081F2DDC5A9162" indent="up1"><enum>(4)</enum><text>For purposes of subsection (a)(16)(C), the term <term>psychiatric residential treatment facility services</term> means, with respect to individuals described in such subsection, services described in subparagraphs (A) and (B) of paragraph (1) that are furnished in a psychiatric residential treatment facility (as defined in section 484.353 of title 42, Code of Federal Regulations, as in effect on December 9, 2013).</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H6623A9586CA14D7E93D1449102F1045E"><enum>(c)</enum><header>Report</header>
<paragraph id="H904A279A29B04A629A0C6BC75B99B034"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">The Assistant Secretary for Mental Health and Substance Use Disorders shall report on the impact of the amendments made by subsection (b) on the funds made available by States for inpatient psychiatric hospital care and for community-based mental health services. Such study shall include an assessment of each of the following:</text>
<subparagraph id="H4D449013A71E4FDAA18860121EF4AC68"><enum>(A)</enum><text display-inline="yes-display-inline">The amount of funds expended annually by States on short-term, acute inpatient psychiatric hospital care.</text>
</subparagraph><subparagraph id="H1A4C45F16E154878AFB2DFD84E538C61"><enum>(B)</enum><text display-inline="yes-display-inline">The amount of funds expended annually on short-term, acute inpatient psychiatric hospital care through disproportionate share hospital payments under section 1923 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396r-4">42 U.S.C. 1396r–4</external-xref>).</text>
</subparagraph><subparagraph id="HE27E1BBDB3984AD28A035ECD458D8965"><enum>(C)</enum><text display-inline="yes-display-inline">The reduction in the amount of funds described in subparagraph (A) that is attributable to the amendments made by subsection (b).</text>
</subparagraph><subparagraph id="HC6234308902544C9A5E3FD5D29D80E99"><enum>(D)</enum><text display-inline="yes-display-inline">The reduction in the amount of funds described in subparagraph (B) that is attributable to the amendment made by such subsection.</text>
</subparagraph><subparagraph id="H7183CBC15E4948B88D8360EBFD08CF18"><enum>(E)</enum><text display-inline="yes-display-inline">The total amount of the reductions described in subparagraphs (C) and (D).</text> </subparagraph></paragraph><paragraph id="H3ABE9FB586B248759A3BE46840D4C1AD"><enum>(2)</enum><header>Definition of short-term, acute inpatient psychiatric hospital care</header><text>For purposes of paragraph (1), the term <term>short-term, acute inpatient psychiatric hospital care</term> means care that is provided in either—</text>
<subparagraph id="H0DB6542EF6BF43B29C9B5BCBC6425E82"><enum>(A)</enum><text display-inline="yes-display-inline">an acute-care psychiatric unit with an average annual length of stay of fewer than 30 days that is operated within a psychiatric hospital operated by a State; or</text>
</subparagraph><subparagraph id="H17BBC0B367554FF985B55FF29CC39CAF"><enum>(B)</enum><text>a psychiatric hospital with an average annual length of stay of fewer than 30 days.</text> </subparagraph></paragraph><paragraph commented="no" id="H23DDBBB5EEA24FEDB206FDD2818F7318"><enum>(3)</enum><header>Report</header><text display-inline="yes-display-inline">Not later than two years after the date of the enactment of this Act, such Assistant Secretary shall submit a report to Congress on the results of the study described in paragraph (1), including recommendations with respect to strategies that can be used to reinvest in community-based mental health services funds equal to the total amount of the reductions described in paragraph (1)(E).</text>
</paragraph></subsection><subsection commented="no" id="HC36ED1A95DCA45EE87669EE1C9BC3FA9"><enum>(d)</enum><header>Effective date</header>
<paragraph id="HC9D7102E518A4711996E4718D39C6A12"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Subject to paragraphs (2) and (3), the amendments made by this section shall apply to items and services furnished after the first day of the first calendar year that begins after the date of the enactment of this section.</text>
</paragraph><paragraph id="HE2DD6D236A61432A8F85D2E978EAC1A6"><enum>(2)</enum><header>Certification of no increased spending</header><text display-inline="yes-display-inline">The amendments made by this section shall not be effective unless the Chief Actuary of the Centers for Medicare & Medicaid Services certifies that the inclusion of qualified inpatient psychiatric hospital services and psychiatric residential treatment facility services (as those terms are defined in section 1905(h) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396d">42 U.S.C. 1396d(h)</external-xref>)) furnished to nonelderly adults as medical assistance under section 1905(a) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396d">42 U.S.C. 1396d(a)</external-xref>), as amended by subsection (a), would not result in any increase in net program spending under title XIX of such Act.</text>
</paragraph><paragraph id="H0DBE64580758454EAAD5B117BC9CDE25"><enum>(3)</enum><header>Exception for State legislation</header><text display-inline="yes-display-inline">In the case of a State plan under title XIX of the Social Security Act, which the Secretary of Health and Human Services determines requires State legislation in order for the respective plan to meet any requirement imposed by amendments made by this section, the respective plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet such an additional requirement before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of enactment of this section. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of the session shall be considered to be a separate regular session of the State legislature.</text>
</paragraph></subsection></section><section id="HBD787AC34ED747D6B75614A5D2D246F8" section-type="subsequent-section"><enum>502.</enum><header>Access to mental health prescription drugs under Medicare and Medicaid</header>
<subsection id="H8DAB4DBD033B4341AA10E69366EB9585"><enum>(a)</enum><header>Coverage of prescription drugs used To treat mental health disorders under Medicare</header><text display-inline="yes-display-inline">Section 1860D–4(b)(3)(G) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395w-104">42 U.S.C. 1395w–104(b)(3)(G)</external-xref>) is amended—</text> <paragraph id="H28CE51560ED545BF90C965C32E318840"><enum>(1)</enum><text display-inline="yes-display-inline">in clause (i)(I), by striking <quote>in the categories</quote> and inserting <quote>in the categories and classes of drugs specified in subclauses (II) and (IV) of clause (iv) and in other categories</quote>;</text>
</paragraph><paragraph id="H68DD6EE01BB74F08B6FB78B81476BC18"><enum>(2)</enum><text display-inline="yes-display-inline">in clause (i)(II), by inserting <quote>, for categories and classes of drugs other than the categories and classes of drugs specified in subclauses (II) and (IV) of clause (iv), </quote> before <quote>exceptions</quote>;</text>
</paragraph><paragraph id="HB03538386D1C465097F00CB9E3C966A3"><enum>(3)</enum><text display-inline="yes-display-inline">in clause (ii)(I), by inserting at the end the following new sentence: <quote>For purposes of the previous sentence, the categories and classes of drugs specified in subclauses (II) and (IV) of clause (iv) shall be deemed to be of clinical concern.</quote>; and</text>
</paragraph><paragraph id="H9179C49FD309404897B6E1F9CA0B72C9"><enum>(4)</enum><text>in clause (iv), in the matter preceding subclause (I), by inserting <quote>(and in the case of categories and classes of drugs specified in subclauses (II) and (IV), before, on, and after the Secretary establishes such criteria)</quote> after <quote>clause (ii)(II)</quote>.</text>
</paragraph></subsection><subsection id="HA789ED69EA06433DAD899C5CB7269883"><enum>(b)</enum><header>Coverage of prescription drugs used To treat mental health disorders under Medicaid</header>
<paragraph id="H17C5D30BDE0441998358D02294889819"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Section 1927(d) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396r-8">42 U.S.C. 1396r–8(d)</external-xref>) is amended by adding at the end the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="H18F8C01FFB094AE1812E4910DFA27165" style="OLC">
<paragraph id="HDC68969B74B348D39F0B397244F8D4B1"><enum>(8)</enum><header>Access to mental health drugs</header><text display-inline="yes-display-inline">With respect to covered outpatient drugs used for the treatment of a mental health disorder, including major depression, bipolar (manic-depressive) disorder, panic disorder, obsessive-compulsive disorder, schizophrenia, and schizoaffective disorder, a State shall not exclude from coverage or otherwise restrict access to such drugs other than pursuant to a prior authorization program that is consistent with paragraph (5).</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="HC8CD2F20B8BE4278B6ADF52500F59FBC"><enum>(2)</enum><header>Medicaid managed care organizations</header><text display-inline="yes-display-inline">Section 1932(b) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396u-2">42 U.S.C. 1396u–2(b)</external-xref>) is amended by adding at the end the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="HF8A01EE94EE14BA98D385588DE9C0BBD" style="OLC">
<paragraph id="HC299EE40642D4935ACF2B6D663F34A15"><enum>(9)</enum><header>Coverage of prescription drugs used to treat mental health disorders</header><text display-inline="yes-display-inline">Each contract with a managed care entity under section 1903(m) or under section 1905(t)(3) shall require coverage of all covered outpatient drugs used for the treatment of a mental health disorder, in accordance with section 1927(d)(8).</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection></section><section id="H7CFCC6C2B5C54746ABEBF3C17B84D79F"><enum>503.</enum><header>Elimination of 190-day lifetime limit on coverage of inpatient psychiatric hospital services under
Medicare</header>
<subsection id="HF86017AF579F490E9BB7866A0DB49974"><enum>(a)</enum><header>In general</header><text>Section 1812 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395d">42 U.S.C. 1395d</external-xref>) is amended—</text> <paragraph id="H701A61FCED6847F5B34549B5666FF493"><enum>(1)</enum><text>in subsection (b)—</text>
<subparagraph id="H42F5B170C882404189B3268C1EDDBE01"><enum>(A)</enum><text>in paragraph (1), by adding <quote>or</quote> at the end;</text> </subparagraph><subparagraph id="HFF262542623245BBA43B73394C85520C"><enum>(B)</enum><text>in paragraph (2), by striking <quote>; or</quote> at the end and inserting a period; and</text>
</subparagraph><subparagraph id="HE0B83D88D40D4248BC70CFE0D8B7BB07"><enum>(C)</enum><text>by striking paragraph (3); and</text> </subparagraph></paragraph><paragraph id="H679D554F853F4B0C9F92550E7E5F25F0"><enum>(2)</enum><text>in subsection (c), by striking <quote>or in determining the 190-day limit under subsection (b)(3)</quote>.</text>
</paragraph></subsection><subsection id="HAF01B35058E5480691029317E9561CF3"><enum>(b)</enum><header>Effective date; certification of no increased spending</header>
<paragraph id="H9525D12D52854D48B380E9598DCD1828"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Subject to paragraph (2), the amendments made by subsection (a) shall apply to items and services furnished on or after January 1, 2016.</text>
</paragraph><paragraph commented="no" id="H55453E6C70BA40C0AC36B48B3F64BE3B"><enum>(2)</enum><header>Certification of no increased spending</header><text display-inline="yes-display-inline">The amendments made by subsection (a) shall not be effective unless the Chief Actuary of the Centers for Medicare & Medicaid Services certifies that such amendments will not result in any increase in net Federal expenditures under title XVIII of the Social Security Act.</text>
</paragraph></subsection></section><section id="HAAB83190A9CA43D2AC2183553CEA3A01"><enum>504.</enum><header>Modifications to Medicare discharge planning requirements</header>
<text display-inline="no-display-inline">Section 1861(ee) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(ee)</external-xref>) is amended—</text> <paragraph id="HF5A459D9B0FC46C68474281715DBB59C"><enum>(1)</enum><text>in paragraph (1), by inserting <quote>and, in the case of a psychiatric hospital or a psychiatric unit (as described in the matter following clause (v) of section 1886(d)(1)(B)), if it also meets the guidelines and standards established by the Secretary under paragraph (3)</quote> before the period at the end; and</text>
</paragraph><paragraph id="H2AE82ACF6AE14458B23E4E1F1E7BE6A3"><enum>(2)</enum><text>by adding at the end the following new paragraph:</text> <quoted-block display-inline="no-display-inline" id="H2B885F1B2560485F9D2858BA29137E8F" style="OLC"> <paragraph id="H567DF11B53EA495BA9DA44C4BF200C65" indent="up1"><enum>(3)</enum><text display-inline="yes-display-inline">The Secretary shall develop guidelines and standards, in addition to those developed under paragraph (2), for the discharge planning process of a psychiatric hospital or a psychiatric unit (as described in the matter following clause (v) of section 1886(d)(1)(B)) in order to ensure a timely and smooth transition to the most appropriate type of and setting for posthospital or rehabilitative care. The Secretary shall issue final regulations implementing such guidelines and standards not later than 24 months after the date of the enactment of this paragraph. The guidelines and standards shall include the following:</text>
<subparagraph id="HDB2C36072B3C4D1D8436A26246047CEE"><enum>(A)</enum><text display-inline="yes-display-inline">The hospital or unit must identify the types of services needed upon discharge for the patients being treated by the hospital or unit.</text>
</subparagraph><subparagraph id="HEFDFC3C0BA2C402FB7EF4542D72F1AD9"><enum>(B)</enum><text display-inline="yes-display-inline">The hospital or unit must—</text> <clause id="H7F27A25D998D473BA3F811F655C33686"><enum>(i)</enum><text>identify organizations that offer community services to the community that is served by the hospital or unit and the types of services provided by the organizations; and</text>
</clause><clause id="H780B3987AFC44955AF6A136D2449AD68"><enum>(ii)</enum><text>must make demonstrated efforts to establish connections, relationships, and partnerships with such organizations.</text>
</clause></subparagraph><subparagraph id="H3AD9B02462CC4ECA83B9785DA4FEDE85"><enum>(C)</enum><text display-inline="yes-display-inline">The hospital or unit must arrange (with the participation of the patient and of any other individuals selected by the patient for such purpose) for the development and implementation of a discharge plan for the patient as part of the patient’s overall treatment plan from admission to discharge. Such discharge plan shall meet the requirements described in subparagraphs (G) and (H) of paragraph (2).</text>
</subparagraph><subparagraph id="H9AED8F0717414BCCB894BD971695E9CC"><enum>(D)</enum><text display-inline="yes-display-inline">The hospital or unit shall coordinate with the patient (or assist the patient with) the referral for posthospital or rehabilitative care and as part of that referral the hospital or unit shall include transmitting to the receiving organization, in a timely manner, appropriate information about the care furnished to the patient by the hospital or unit and recommendations for posthospital or rehabilitative care to be furnished to the patient by the organization.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section><section id="HDD94E351DF404AAD87318D1EB3D51438" section-type="subsequent-section"><enum>505.</enum><header>Demonstration programs to improve community mental health services</header><text display-inline="no-display-inline">Section 223 of the Protecting Access to Medicare Act of 2014 (<external-xref legal-doc="public-law" parsable-cite="pl/113/93">Public Law 113–93</external-xref>; 128 Stat. 1077) is amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H5AA20242FD754C06BA229D8C1E4AF426" style="OLC">
<section id="HB886DB91BC3847E4B5F1BEC766281C8B"><enum>223.</enum><header>Demonstration programs to improve community mental health services</header>
<subsection id="H24A74E84F4E24C2ABEC8D4D9AFC2C3D6"><enum>(a)</enum><header>Criteria for certified community behavioral health clinics To participate in demonstration programs</header>
<paragraph id="H4EBA49E5AD5E4D26B4AF43794FD7C1A4"><enum>(1)</enum><header>Publication</header><text>Not later than September 1, 2015, the Secretary shall publish criteria for a clinic to be certified by a State as a certified community behavioral health clinic for purposes of participating in a demonstration program conducted under subsection (d).</text>
</paragraph><paragraph id="HFB2BA1768E3C4FA69A29BB568D8BAD95"><enum>(2)</enum><header>Requirements</header><text>The criteria published under this subsection shall include criteria with respect to the following:</text> <subparagraph id="HF7E7986838A24618AC7DCA128D04AC6F"><enum>(A)</enum><header>Staffing</header><text>Staffing requirements, including criteria that staff have diverse disciplinary backgrounds, have necessary State-required license and accreditation, and are culturally and linguistically trained to serve the needs of the clinic's patient population.</text>
</subparagraph><subparagraph id="H7A71F81D82B0466481483A0048E792E4"><enum>(B)</enum><header>Availability and accessibility of services</header><text>Availability and accessibility of services, including crisis management services that are available and accessible 24 hours a day, the use of a sliding scale for payment, and no rejection for services or limiting of services on the basis of a patient's ability to pay or a place of residence.</text>
</subparagraph><subparagraph id="HBBB7F6118A834DE7A054FD3D2BB14AA6"><enum>(C)</enum><header>Care coordination</header><text>Care coordination, including requirements to coordinate care across settings and providers to ensure seamless transitions for patients across the full spectrum of health services including acute, chronic, and behavioral health needs. Care coordination requirements shall include partnerships or formal contracts with the following:</text>
<clause id="H9D719CA973374584863964550D078504"><enum>(i)</enum><text>Federally-qualified health centers (and as applicable, rural health clinics) to provide Federally-qualified health center services (and as applicable, rural health clinic services) to the extent such services are not provided directly through the certified community behavioral health clinic.</text>
</clause><clause id="HB858CF9AA283447CAC15F800E3715FE6"><enum>(ii)</enum><text>Inpatient psychiatric facilities and substance use detoxification, post-detoxification step-down services, and residential programs.</text>
</clause><clause id="HC939ADC4F3D045B5A4FB0580E1B6DBB2"><enum>(iii)</enum><text>Other community or regional services, supports, and providers, including schools, child welfare agencies, juvenile and criminal justice agencies and facilities, Indian Health Service youth regional treatment centers, State-licensed and nationally accredited child placing agencies for therapeutic foster care service, and other social and human services.</text>
</clause><clause id="HBDFBFA7216054C9597B3E82B69A8B05F"><enum>(iv)</enum><text>Department of Veterans Affairs medical centers, independent outpatient clinics, drop-in centers, and other facilities of the Department as defined in section 1801 of title 38, United States Code.</text>
</clause><clause id="H99398ADBF456430CA4591C89BDA19819"><enum>(v)</enum><text>Inpatient acute care hospitals and hospital outpatient clinics.</text> </clause></subparagraph><subparagraph id="H4C22295638E6472FAE9F7FBADD48A429"><enum>(D)</enum><header>Scope of services</header><text>Provision (in a manner reflecting person-centered care) of the following services which, if not available directly through the certified community behavioral health clinic, are provided or referred through formal relationships with other providers:</text>
<clause id="H2D43EDA5D765417E9977AC8C39530302"><enum>(i)</enum><text>Crisis mental health services, including 24-hour mobile crisis teams, emergency crisis intervention services, and crisis stabilization.</text>
</clause><clause id="HC03D785C776F4D5F992F4A4666C23FAC"><enum>(ii)</enum><text>Screening, assessment, and diagnosis, including risk assessment.</text> </clause><clause id="HA71DBEC3C0654BB69A88C41EB539E766"><enum>(iii)</enum><text>Patient-centered treatment planning or similar processes, including risk assessment and crisis planning.</text>
</clause><clause id="HE24724C828F04007B2AB02173BCDA9C3"><enum>(iv)</enum><text>Outpatient mental health and substance use services.</text> </clause><clause id="H3579E0754EA74874BA1D455844E60B29"><enum>(v)</enum><text>Outpatient clinic primary care screening and monitoring of key health indicators and health risk.</text>
</clause><clause id="HFC286C71DBE3457ABE760CBD2EACCD8F"><enum>(vi)</enum><text>Targeted case management.</text> </clause><clause id="HBBD3B0102128430CA64C986F0920A9CB"><enum>(vii)</enum><text>Psychiatric rehabilitation services.</text>
</clause><clause id="H87683125E1F04CF8909C49C6DA5FB2BF"><enum>(viii)</enum><text>Peer support and counselor services and family supports.</text> </clause><clause id="H6B24BB07F8DE4500B02BF7A717DC7C78"><enum>(ix)</enum><text>Intensive, community-based mental health care for members of the Armed Forces and veterans, particularly those members and veterans located in rural areas, provided the care is consistent with minimum clinical mental health guidelines promulgated by the Veterans Health Administration including clinical guidelines contained in the Uniform Mental Health Services Handbook of such Administration.</text>
</clause></subparagraph><subparagraph id="H00D2B84F003D473D9059093730A6B31B"><enum>(E)</enum><header>Quality and other reporting</header><text>Reporting of encounter data, clinical outcomes data, quality data, and such other data as the Secretary requires.</text>
</subparagraph><subparagraph id="H065731DE416E4806BCE618DCE2C4E761"><enum>(F)</enum><header>Organizational authority</header><text>Criteria that a clinic be a non-profit or part of a local government behavioral health authority or operated under the authority of the Indian Health Service, an Indian tribe or tribal organization pursuant to a contract, grant, cooperative agreement, or compact with the Indian Health Service pursuant to the Indian Self-Determination Act (<external-xref legal-doc="usc" parsable-cite="usc/25/450">25 U.S.C. 450 et seq.</external-xref>), or an urban Indian organization pursuant to a grant or contract with the Indian Health Service under title V of the Indian Health Care Improvement Act (<external-xref legal-doc="usc" parsable-cite="usc/25/1601">25 U.S.C. 1601 et seq.</external-xref>).</text>
</subparagraph></paragraph></subsection><subsection id="H1A4B4AC258C5456E9F4CBE9BD34C9228"><enum>(b)</enum><header>Guidance on development of prospective payment system for testing under demonstration programs</header>
<paragraph id="HE08C14A50B6C45D48AED9ACCCC4E0B70"><enum>(1)</enum><header>In general</header><text>Not later than September 1, 2015, the Secretary, through the Administrator of the Centers for Medicare & Medicaid Services, shall issue guidance for the establishment of a prospective payment system that shall only apply to medical assistance for mental health services furnished by a certified community behavioral health clinic participating in a demonstration program under subsection (d).</text>
</paragraph><paragraph id="H2FA15395457A47BFAA8ED404A930A780"><enum>(2)</enum><header>Requirements</header><text>The guidance issued by the Secretary under paragraph (1) shall provide that—</text> <subparagraph id="HE80F6AE352C44810A54E50B4D3ABDD95"><enum>(A)</enum><text>no payment shall be made for inpatient care, residential treatment, room and board expenses, or any other nonambulatory services, as determined by the Secretary; and</text>
</subparagraph><subparagraph id="HB80D969824C246DBA9D553A5E8C99121"><enum>(B)</enum><text>no payment shall be made to satellite facilities of certified community behavioral health clinics if such facilities are established after the date of enactment of this Act.</text>
</subparagraph></paragraph></subsection><subsection id="HC6781338EC7B426BB0206D04AAB4706A"><enum>(c)</enum><header>Planning grants</header>
<paragraph id="H7E0B7AD8F5614BA0BAAFE3D0068E62CC"><enum>(1)</enum><header>In general</header><text>Not later than January 1, 2016, the Secretary shall award planning grants to States for the purpose of developing proposals to participate in time-limited demonstration programs described in subsection (d).</text>
</paragraph><paragraph id="H49417EB22B30493C8141FDA49CAB6B05"><enum>(2)</enum><header>Use of funds</header><text>A State awarded a planning grant under this subsection shall—</text> <subparagraph id="HFE0C162178CD4217AB2DD03FF829BCC2"><enum>(A)</enum><text>solicit input with respect to the development of such a demonstration program from patients, providers, and other stakeholders;</text>
</subparagraph><subparagraph id="H145D86A9008248A7B761AAA77699EFE4"><enum>(B)</enum><text>certify clinics as certified community behavioral health clinics for purposes of participating in a demonstration program conducted under subsection (d); and</text>
</subparagraph><subparagraph id="HFCDD024E4CA24B98B850CD599AC190CD"><enum>(C)</enum><text>establish a prospective payment system for mental health services furnished by a certified community behavioral health clinic participating in a demonstration program under subsection (d) in accordance with the guidance issued under subsection (b).</text>
</subparagraph></paragraph></subsection><subsection id="HB8FFB02805E34D3992584883A20B7FC9"><enum>(d)</enum><header>Demonstration programs</header>
<paragraph id="H60EB2F7B4F0C4B858038B7902EB4AE36"><enum>(1)</enum><header>In general</header><text>Not later than September 1, 2017, the Secretary shall select States to participate in demonstration programs that are developed through planning grants awarded under subsection (c), meet the requirements of this subsection, and represent a diverse selection of geographic areas, including rural and underserved areas.</text>
</paragraph><paragraph id="H6672CA56E241412396FEAFE7C7AB7632"><enum>(2)</enum><header>Application requirements</header>
<subparagraph id="HAA181B14085C4B008334C47D323169DD"><enum>(A)</enum><header>In general</header><text>The Secretary shall solicit applications to participate in demonstration programs under this subsection solely from States awarded planning grants under subsection (c).</text>
</subparagraph><subparagraph id="H1E3771ABBB014C75BD1962B36BFB2171"><enum>(B)</enum><header>Required information</header><text>An application for a demonstration program under this subsection shall include the following:</text> <clause id="H5C55331AD7F641D98B59491806594116"><enum>(i)</enum><text>The target Medicaid population to be served under the demonstration program.</text>
</clause><clause id="HC7479126E9B6459F960A612080FCBE1E"><enum>(ii)</enum><text>A list of participating certified community behavioral health clinics.</text> </clause><clause id="H9389F1480E8147E2875519575E1EE3F0"><enum>(iii)</enum><text>Verification that the State has certified a participating clinic as a certified community behavioral health clinic in accordance with the requirements of subsection (b).</text>
</clause><clause id="HEAA1CFBCC73C42228B29744C65793977"><enum>(iv)</enum><text>A description of the scope of the mental health services available under the State Medicaid program that will be paid for under the prospective payment system tested in the demonstration program.</text>
</clause><clause id="H89D92CC041754F2489AD4660B3F16754"><enum>(v)</enum><text>Verification that the State has agreed to pay for such services at the rate established under the prospective payment system.</text>
</clause><clause id="HD0AFD9ECEB5249E6A237F7F5AF65577C"><enum>(vi)</enum><text>Such other information as the Secretary may require relating to the demonstration program including with respect to determining the soundness of the proposed prospective payment system.</text>
</clause></subparagraph></paragraph><paragraph id="HCB23337239BF4847ABF36316A8046148"><enum>(3)</enum><header>Number and length of demonstration programs</header><text>Not more than 10 States shall be selected for 4-year demonstration programs under this subsection.</text> </paragraph><paragraph commented="no" id="HB16FA2C8DD2940E1B78DFF252A9D8C94"><enum>(4)</enum><header>Requirements for selecting demonstration programs</header> <subparagraph id="HF80BE57A793649C3A85CC5C94BADC3B5"><enum>(A)</enum><header>In general</header><text>The Secretary shall give preference to selecting demonstration programs where participating certified community behavioral health clinics—</text>
<clause id="H1B47356E1639470EBC1BF5A633E15D60"><enum>(i)</enum><text>provide the most complete scope of services described in subsection (a)(2)(D) to individuals eligible for medical assistance under the State Medicaid program;</text>
</clause><clause id="HCB8562DADACB4CB19FC22D3DEF78CC3F"><enum>(ii)</enum><text>will improve availability of, access to, and participation in, services described in subsection (a)(2)(D) to individuals eligible for medical assistance under the State Medicaid program;</text>
</clause><clause id="HB144451517DA4CF596B989AD231845DB"><enum>(iii)</enum><text>will improve availability of, access to, and participation in assisted outpatient mental health treatment in the State; or</text>
</clause><clause id="H87AD8A9E25B548BE903AC303B1C501DA"><enum>(iv)</enum><text>demonstrate the potential to expand available mental health services in a demonstration area and increase the quality of such services without increasing net Federal spending.</text>
</clause></subparagraph></paragraph><paragraph id="H97BE012A730A46B88583D16F979D1773"><enum>(5)</enum><header>Payment for medical assistance for mental health services provided by certified community
behavioral health clinics</header>
<subparagraph id="HC49916B0A0754DE8BA3DB6DB89460927"><enum>(A)</enum><header>In general</header><text>The Secretary shall pay a State participating in a demonstration program under this subsection the Federal matching percentage specified in subparagraph (B) for amounts expended by the State to provide medical assistance for mental health services described in the demonstration program application in accordance with paragraph (2)(B)(iv) that are provided by certified community behavioral health clinics to individuals who are enrolled in the State Medicaid program. Payments to States made under this paragraph shall be considered to have been under, and are subject to the requirements of, section 1903 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396b">42 U.S.C. 1396b</external-xref>).</text>
</subparagraph><subparagraph id="H7229ECF0E2A1448EBEF04D43DC522FC6"><enum>(B)</enum><header>Federal matching percentage</header><text>The Federal matching percentage specified in this subparagraph is with respect to medical assistance described in subparagraph (A) that is furnished—</text>
<clause id="H196A53CC0CC4407FB807104E52B29DAA"><enum>(i)</enum><text>to a newly eligible individual described in paragraph (2) of section 1905(y) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396d">42 U.S.C. 1396d(y)</external-xref>), the matching rate applicable under paragraph (1) of that section; and</text>
</clause><clause id="H41BF6C8164BF482E9A34F4183EEDA06B"><enum>(ii)</enum><text>to an individual who is not a newly eligible individual (as so described) but who is eligible for medical assistance under the State Medicaid program, the enhanced FMAP applicable to the State.</text>
</clause></subparagraph><subparagraph id="H704EF0C1ACB1466B813353E01C51C1F4"><enum>(C)</enum><header>Limitations</header>
<clause id="HEC7A910F6D9D4B7E886079CE8108A811"><enum>(i)</enum><header>In general</header><text>Payments shall be made under this paragraph to a State only for mental health services—</text> <subclause id="H54BCA163B9E745F091060F45A7EEAE5B"><enum>(I)</enum><text>that are described in the demonstration program application in accordance with paragraph (2)(B)(iv);</text>
</subclause><subclause id="H9FC6C9FEF16D4A25BEA378CC67D6D20F"><enum>(II)</enum><text>for which payment is available under the State Medicaid program; and</text> </subclause><subclause id="H3B8919FEB9DA42FBAF464F90C20DDD26"><enum>(III)</enum><text>that are provided to an individual who is eligible for medical assistance under the State Medicaid program.</text>
</subclause></clause><clause id="H232A00C9EDA244EF90BFE665AA7D910A"><enum>(ii)</enum><header>Prohibited payments</header><text>No payment shall be made under this paragraph—</text> <subclause id="H71425D94607246059D4F0BD5DE0196E0"><enum>(I)</enum><text>for inpatient care, residential treatment, room and board expenses, or any other nonambulatory services, as determined by the Secretary; or</text>
</subclause><subclause id="HF637407E7189451DBFD933FD1CD94181"><enum>(II)</enum><text>with respect to payments made to satellite facilities of certified community behavioral health clinics if such facilities are established after the date of enactment of this Act.</text>
</subclause></clause></subparagraph></paragraph><paragraph id="H326860241D344FBC87A99383637BBE77"><enum>(6)</enum><header>Waiver of statewideness requirement</header><text>The Secretary shall waive section 1902(a)(1) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a(a)(1)</external-xref>) (relating to statewideness) as may be necessary to conduct demonstration programs in accordance with the requirements of this subsection.</text>
</paragraph><paragraph id="HFDA442B605254325934C7053512C6810"><enum>(7)</enum><header>Annual reports</header>
<subparagraph id="H97081511FC6940368AF6CD0390B280A7"><enum>(A)</enum><header>In general</header><text>Not later than 1 year after the date on which the first State is selected for a demonstration program under this subsection, and annually thereafter, the Secretary shall submit to Congress an annual report on the use of funds provided under all demonstration programs conducted under this subsection. Each such report shall include—</text>
<clause id="H5E9BE72523F841FA825E7C21CF88CFFA"><enum>(i)</enum><text>an assessment of access to community-based mental health services under the Medicaid program in the area or areas of a State targeted by a demonstration program compared to other areas of the State;</text>
</clause><clause id="H15E1110171784BF5AB95AAF73DBCEDCC"><enum>(ii)</enum><text>an assessment of the quality and scope of services provided by certified community behavioral health clinics compared to community-based mental health services provided in States not participating in a demonstration program under this subsection and in areas of a demonstration State that are not participating in the demonstration program; and</text>
</clause><clause id="HFF80447E544745AEAD976A9FC9E2106D"><enum>(iii)</enum><text>an assessment of the impact of the demonstration programs on the Federal and State costs of a full range of mental health services (including inpatient, emergency and ambulatory services).</text>
</clause></subparagraph><subparagraph id="HEF79FF2265294750B61EC7F8866BA570"><enum>(B)</enum><header>Recommendations</header><text>Not later than December 31, 2021, the Secretary shall submit to Congress recommendations concerning whether the demonstration programs under this section should be continued, expanded, modified, or terminated.</text>
</subparagraph></paragraph></subsection><subsection id="H8C1CEA6CFD3D4F2FB1F138AE3348E919"><enum>(e)</enum><header>Definitions</header><text>In this section:</text> <paragraph id="HE6855E06184F4F51850B74FEABE0C0C6"><enum>(1)</enum><header>Federally-qualified health center services; Federally-qualified health center; rural health clinic services; rural health clinic</header><text>The terms <term>Federally-qualified health center services</term>, <term>Federally-qualified health center</term>, <term>rural health clinic services</term>, and <term>rural health clinic</term> have the meanings given those terms in section 1905(l) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396d">42 U.S.C. 1396d(l)</external-xref>).</text>
</paragraph><paragraph id="HEA048D55D4464A16A0F2962747755022"><enum>(2)</enum><header>Enhanced FMAP</header><text>The term <term>enhanced FMAP</term> has the meaning given that term in section 2105(b) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397dd">42 U.S.C. 1397dd(b)</external-xref>) but without regard to the second and third sentences of that section.</text>
</paragraph><paragraph id="H3656A86CBFC2478282B29D053F7DEF3D"><enum>(3)</enum><header>Secretary</header><text>The term <term>Secretary</term> means the Secretary of Health and Human Services.</text> </paragraph><paragraph id="HB5B3A6A62C1441DBABE026D4C34CCE5C"><enum>(4)</enum><header>State</header><text>The term <term>State</term> has the meaning given such term for purposes of title XIX of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396 et seq.</external-xref>).</text>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HF7775011976B468E867A8496390D8AB8"><enum>(f)</enum><header>Funding</header>
<paragraph commented="no" display-inline="no-display-inline" id="HF3ED2CDF3311422F9649CC3AD0C36EC8"><enum>(1)</enum><header>In general</header><text>Out of any funds in the Treasury not otherwise appropriated, there is appropriated to the Secretary—</text>
<subparagraph id="HE742C3FB630C4A8595957CD10E0EA6AD"><enum>(A)</enum><text>for purposes of carrying out subsections (a), (b), and (d)(7), $2,000,000 for fiscal year 2014; and</text> </subparagraph><subparagraph id="H0B42BAB8B70A455B8B91A010AFA857B8"><enum>(B)</enum><text>for purposes of awarding planning grants under subsection (c), $25,000,000 for fiscal year 2016.</text>
</subparagraph></paragraph><paragraph commented="no" id="H07AAF77955024D02A6731EEF136FCA9E"><enum>(2)</enum><header>Availability</header><text>Funds appropriated under paragraph (1) shall remain available until expended.</text></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block> </section><enum>VI</enum><header>Research by National Institute of Mental Health</header> <section id="H60330D55925C40FEBC0E5B6747EEBC7F"><enum>601.</enum><header>Increase in funding for certain research</header><text display-inline="no-display-inline">Section 402A(a) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/282a">42 U.S.C. 282a(a)</external-xref>) is amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H4496E6AE48DF4444BB67711E859DF583" style="OLC">
<paragraph id="H4C9EB98C63854A7586F89937911A7406"><enum>(3)</enum><header>Funding for the brain initiative at the National Institute of Mental Health</header>
<subparagraph id="H31373109165B4A4491453F550E460208"><enum>(A)</enum><header>Funding</header><text display-inline="yes-display-inline">In addition to amounts made available pursuant to paragraphs (1) and (2), there are authorized to be appropriated to the National Institute of Mental Health for the purpose described in subparagraph (B)(ii) $40,000,000 for each of fiscal years 2016 through 2020.</text>
</subparagraph><subparagraph id="H546E5809141B4A3382FAFCE558943CD6"><enum>(B)</enum><header>Purposes</header><text>Amounts appropriated pursuant to subparagraph (A) shall be used exclusively for the purpose of conducting or supporting—</text>
<clause id="H796DC9AD1DD84CDB8C98AC560EDA5D3B"><enum>(i)</enum><text display-inline="yes-display-inline">research on the determinants of self- and other directed-violence in mental illness, including studies directed at reducing the risk of self harm, suicide, and interpersonal violence; or</text>
</clause><clause id="H03B0FB3C70D745DBA0B8649D6C6F96CA"><enum>(ii)</enum><text display-inline="yes-display-inline">brain research through the Brain Research through Advancing Innovative Neurotechnologies Initiative.</text></clause></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</section><enum>VII</enum><header>Behavioral health information technology</header>
<section id="H39B9DEC498CA47C8981A41CEFF08B123"><enum>701.</enum><header>Extension of health information technology assistance for behavioral and mental health and
substance abuse</header><text display-inline="no-display-inline">Section 3000(3) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300jj">42 U.S.C. 300jj(3)</external-xref>) is amended by inserting before <quote>and any other category</quote> the following: <quote>behavioral and mental health professionals (as defined in section 331(a)(3)(E)(i)), a substance abuse professional, a psychiatric hospital (as defined in section 1861(f) of the Social Security Act), a community mental health center meeting the criteria specified in section 1913(c), a residential or outpatient mental health or substance use treatment facility,</quote>.</text>
</section><section id="HD86EDCEDF2DD4E64AF23ACF8C315192D"><enum>702.</enum><header>Extension of eligibility for Medicare and Medicaid health information technology implementation
assistance</header>
<subsection id="HD23BC7723A984484BB7DD377878E919B"><enum>(a)</enum><header>Payment incentives for eligible professionals under Medicare</header><text>Section 1848 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395w-4">42 U.S.C. 1395w–4</external-xref>) is amended—</text> <paragraph id="H0C60B91586D54C90979D8BA8C01D59BE"><enum>(1)</enum><text>in subsection (a)(7)—</text>
<subparagraph id="H99E8F2D8B7B640618B50703FF130095E"><enum>(A)</enum><text>in subparagraph (E), by adding at the end the following new clause:</text> <quoted-block id="HD6DEB35AFB72483F90440D07FAF51FC0" style="OLC"> <clause id="H9B408BA7B90940469822870DE8AC32B9"><enum>(iv)</enum><header>Additional eligible professional</header><text display-inline="yes-display-inline">The term <term>additional eligible professional</term> means a clinical psychologist providing qualified psychologist services (as defined in section 1861(ii)).</text></clause><after-quoted-block>; and</after-quoted-block></quoted-block>
</subparagraph><subparagraph id="H21F9038923184D8688EABFC5665CEC47"><enum>(B)</enum><text>by adding at the end the following new subparagraph:</text> <quoted-block display-inline="no-display-inline" id="HFC83E79CF2FC4496AB33B18CEC73320F" style="OLC"> <subparagraph id="HB1DFB6FBCCE24441AF76F6B9BFDBD83D"><enum>(F)</enum><header>Application to additional eligible professionals</header><text display-inline="yes-display-inline">The Secretary shall apply the provisions of this paragraph with respect to an additional eligible professional in the same manner as such provisions apply to an eligible professional, except in applying subparagraph (A)—</text>
<clause id="H4B10345F6CBB4463B32C3A1DA2E3240B"><enum>(i)</enum><text>in clause (i), the reference to 2015 shall be deemed a reference to 2020;</text> </clause><clause id="HF073B975B2AA4A4A91F0BF111255A18E"><enum>(ii)</enum><text>in clause (ii), the references to 2015, 2016, and 2017 shall be deemed references to 2020, 2021, and 2022, respectively; and</text>
</clause><clause id="H1E176F67B8624E74868FD0D6DD8CBEE5"><enum>(iii)</enum><text>in clause (iii), the reference to 2018 shall be deemed a reference to 2023.</text></clause></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block> </subparagraph></paragraph><paragraph id="HF30313F123854DCA95AEFA22EC9E90F7"><enum>(2)</enum><text>in subsection (o)—</text>
<subparagraph id="HA2B8E5B2E92746679EBAFDDD3B58E71C"><enum>(A)</enum><text>in paragraph (5), by adding at the end the following new subparagraph:</text> <quoted-block id="HD9A3599A04534914912D62DD41C92BBE" style="OLC"> <subparagraph id="H33AAA93B8B504E1E8EA287E43F759873"><enum>(D)</enum><header>Additional eligible professional</header><text display-inline="yes-display-inline">The term <term>additional eligible professional</term> means a clinical psychologist providing qualified psychologist services (as defined in section 1861(ii)).</text></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block>
</subparagraph><subparagraph id="H5D739B65A444494DBE6645E6A5343F0F"><enum>(B)</enum><text>by adding at the end the following new paragraph:</text> <quoted-block display-inline="no-display-inline" id="HA1E013B85C214C588587025E73E1C87B" style="OLC"> <paragraph id="H487072A60FF642A3887356B9BF234073"><enum>(6)</enum><header>Application to additional eligible professionals</header><text display-inline="yes-display-inline">The Secretary shall apply the provisions of this subsection with respect to an additional eligible professional in the same manner as such provisions apply to an eligible professional, except in applying—</text>
<subparagraph id="H2271D656D41141028A6AAEB97EE6706E"><enum>(A)</enum><text display-inline="yes-display-inline">paragraph (1)(A)(ii), the reference to 2016 shall be deemed a reference to 2021;</text> </subparagraph><subparagraph id="H3638F02831AC4349A003A00F9867E1CC"><enum>(B)</enum><text>paragraph (1)(B)(ii), the references to 2011 and 2012 shall be deemed references to 2016 and 2017, respectively;</text>
</subparagraph><subparagraph id="HEA83ED4AA4594674B64ECDA245B15DFC"><enum>(C)</enum><text>paragraph (1)(B)(iii), the references to 2013 shall be deemed references to 2018;</text> </subparagraph><subparagraph id="H2DBB75A972A049BEB1653BED812D9276"><enum>(D)</enum><text>paragraph (1)(B)(v), the references to 2014 shall be deemed references to 2019; and</text>
</subparagraph><subparagraph id="H84E3B4980D2E4C6281FF5A57C5B5C3A1"><enum>(E)</enum><text>paragraph (1)(E), the reference to 2011 shall be deemed a reference to 2016.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block> </subparagraph></paragraph></subsection><subsection id="H4EC4F282E8B04E78B76B849D98E2635A"><enum>(b)</enum><header>Eligible hospitals</header><text>Section 1886 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395ww">42 U.S.C. 1395ww</external-xref>) is amended—</text>
<paragraph id="H9DCFCB61252C436CB9D671DFCA50DB56"><enum>(1)</enum><text display-inline="yes-display-inline">in subsection (b)(3)(B)(ix), by adding at the end the following new subclause:</text> <quoted-block display-inline="no-display-inline" id="H6B04E52BBEFF42AF9D08388357924F56" style="OLC"> <subclause id="HDA75C0CE1863407B8CD241496E537F2C"><enum>(V)</enum><text display-inline="yes-display-inline">The Secretary shall apply the provisions of this subsection with respect to an additional eligible hospital (as defined in subsection (n)(6)(C)) in the same manner as such provisions apply to an eligible hospital, except in applying—</text>
<item id="H7055FC41A33F43C082CE182697B2B285"><enum>(aa)</enum><text>subclause (I), the references to 2015, 2016, and 2017 shall be deemed references to 2020, 2021, and 2022, respectively; and</text>
</item><item id="HD0371B7C032F422CA70EED6935DDE5F2"><enum>(bb)</enum><text>subclause (III), the reference to 2015 shall be deemed a reference to 2020.</text></item></subclause><after-quoted-block>; and</after-quoted-block></quoted-block> </paragraph><paragraph id="H706191C8F4BA44BBBC5EB5F9D137562B"><enum>(2)</enum><text>in subsection (n)—</text>
<subparagraph id="H0914898D271040BB8E61BAC0BB877B52"><enum>(A)</enum><text>in paragraph (6), by adding at the end the following new subparagraph:</text> <quoted-block display-inline="no-display-inline" id="H25BE7AD5B48D4872A02CF4DE4E0B6F81" style="OLC"> <subparagraph id="HCC59DDB2E1C045E39F8A1045F3817CBF"><enum>(C)</enum><header>Additional eligible hospital</header><text display-inline="yes-display-inline">The term <term>additional eligible hospital</term> means an inpatient hospital that is a psychiatric hospital (as defined in section 1861(f)).</text></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block>
</subparagraph><subparagraph id="HAA1DA3CD23DE458890B60A713A835D07"><enum>(B)</enum><text>by adding at the end the following new paragraph:</text> <quoted-block display-inline="no-display-inline" id="HC1E4465D579C46B38EE179CD7F619075" style="OLC"> <paragraph id="H0BC0DF8EF277499BB7F0E3936AC93D2F"><enum>(7)</enum><header>Application to additional eligible hospitals</header><text display-inline="yes-display-inline">The Secretary shall apply the provisions of this subsection with respect to an additional eligible hospital in the same manner as such provisions apply to an eligible hospital, except in applying—</text>
<subparagraph id="HFCB3E8A6F974412785EFA67565E9D00D"><enum>(A)</enum><text>paragraph (2)(E)(ii), the references to 2013 and 2015 shall be deemed references to 2018 and 2020, respectively; and</text>
</subparagraph><subparagraph id="HF4704F80EC5F442DAFA40377EC290C68"><enum>(B)</enum><text>paragraph (2)(G)(i), the reference to 2011 shall be deemed a reference to 2016.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block> </subparagraph></paragraph></subsection><subsection id="H4997ABCB06B146F680F3FB8E7542AEDE"><enum>(c)</enum><header>Medicaid providers</header><text>Section 1903(t) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396b">42 U.S.C. 1396b(t)</external-xref>) is amended—</text>
<paragraph id="H166FAB95869740CB8F264F7561CCEF32"><enum>(1)</enum><text>in paragraph (2)(B)—</text> <subparagraph id="HA624B12C0B044AEC819A52499AE5AD63"><enum>(A)</enum><text>in clause (i), by striking <quote>, or</quote> at the end and inserting a semicolon;</text>
</subparagraph><subparagraph id="HA2A2B826CDB04BE59EAECD730E074B05"><enum>(B)</enum><text>in clause (ii), by striking the period at the end and inserting a semicolon; and</text> </subparagraph><subparagraph id="H7B426C106A574E74A8A6DB2EFD2C447E"><enum>(C)</enum><text display-inline="yes-display-inline">by inserting after clause (ii) the following new clauses:</text>
<quoted-block display-inline="no-display-inline" id="HF4BF2FDD04E04209822C173C62895FD1" style="traditional">
<clause id="H283C53EDDDDC4D5B954C57E87C71CE4B" indent="up1"><enum>(iii)</enum><text>a public hospital that is principally a psychiatric hospital (as defined in section 1861(f));</text> </clause><clause id="H8310B8BA30604B6CA782BDFD282928DA" indent="up1"><enum>(iv)</enum><text>a private hospital that is principally a psychiatric hospital (as defined in section 1861(f)) and that has at least 10 percent of its patient volume (as estimated in accordance with a methodology established by the Secretary) attributable to individuals receiving medical assistance under this title;</text>
</clause><clause id="H022C689C7DA34927B4E9507C6DD20A63" indent="up1"><enum>(v)</enum><text display-inline="yes-display-inline">a community mental health center meeting the criteria specified in section 1913(c) of the Public Health Service Act; or</text>
</clause><clause id="HC9813256563445FCA403358DE7C7BD02" indent="up1"><enum>(vi)</enum><text>a residential or outpatient mental health or substance use treatment facility that—</text> <subclause id="H91F84A1F46C149B6B7EF709DB43C14D6"><enum>(I)</enum><text display-inline="yes-display-inline">is accredited by the Joint Commission on Accreditation of Healthcare Organizations, the Commission on Accreditation of Rehabilitation Facilities, the Council on Accreditation, or any other national accrediting agency recognized by the Secretary; and</text>
</subclause><subclause id="H002C11279E024535BBC4642B00F60657"><enum>(II)</enum><text>has at least 10 percent of its patient volume (as estimated in accordance with a methodology established by the Secretary) attributable to individuals receiving medical assistance under this title.</text></subclause></clause><after-quoted-block>; and</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H16BD3FB5046A49AF9D675F2FDC0C9D47"><enum>(2)</enum><text>in paragraph (3)(B)—</text> <subparagraph id="HE3A3885AB41A4C9D9236C8651DA86F70"><enum>(A)</enum><text>in clause (iv), by striking <quote>; and</quote> at the end and inserting a semicolon;</text>
</subparagraph><subparagraph id="HAFE368FBB6624158AAF516DF45A0766F"><enum>(B)</enum><text>in clause (v), by striking the period at the end and inserting <quote>; and</quote>; and</text> </subparagraph><subparagraph id="H1B75E3E6C4044C118B3DBD43672B9142"><enum>(C)</enum><text>by adding at the end the following new clause:</text>
<quoted-block display-inline="no-display-inline" id="HAC84A9B0463D4085AFA6DF522B191740" style="traditional">
<clause id="HB00BE8E8D27349A4A1C41C9570724AE3" indent="up1"><enum>(vi)</enum><text>clinical psychologist providing qualified psychologist services (as defined in section 1861(ii)), if such clinical psychologist is practicing in an outpatient clinic that—</text>
<subclause id="H37F796AB70E042F1BC4E385AAAD25CE4"><enum>(I)</enum><text>is led by a clinical psychologist; and</text> </subclause><subclause id="H3179A17F5EEF488D877E7E259A4054CC"><enum>(II)</enum><text>is not otherwise receiving payment under paragraph (1) as a Medicaid provider described in paragraph (2)(B).</text></subclause></clause><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph></subsection><subsection id="H2FEBCD83FCF24AB78C5633F5F98F1823"><enum>(d)</enum><header>Medicare Advantage organizations</header><text>Section 1853 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395w-23">42 U.S.C. 1395w–23</external-xref>) is amended—</text> <paragraph id="H2EDA2AE3F5104AA3B9EF4A7E3F0226EC"><enum>(1)</enum><text>in subsection (l)—</text>
<subparagraph id="H7E3F5A997D7E413ABCB3E51DE2E10CB8"><enum>(A)</enum><text>in paragraph (1)—</text> <clause id="H7D2DBBD45EDA4DFBBD0B4EDE287FD356"><enum>(i)</enum><text>by inserting <quote>or additional eligible professionals (as described in paragraph (9))</quote> after <quote>paragraph (2)</quote>; and</text>
</clause><clause id="HD199DA7FD41440099CC9B8376B9659B7"><enum>(ii)</enum><text>by inserting <quote>and additional eligible professionals</quote> before <quote>under such sections</quote>;</text> </clause></subparagraph><subparagraph id="HE5D342D03E9B45BCB2D47F28C22E7BC6"><enum>(B)</enum><text>in paragraph (3)(B)—</text>
<clause id="H2B98F0231F9B4799BDBD5057562BB5AD"><enum>(i)</enum><text>in clause (i) in the matter preceding subclause (I), by inserting <quote>or an additional eligible professional described in paragraph (9)</quote> after <quote>paragraph (2)</quote>; and</text> </clause><clause id="HAE51DEA1E46044D78D2DECCC188EE93B"><enum>(ii)</enum><text display-inline="yes-display-inline">in clause (ii)—</text>
<subclause id="H9129882CE794459DAFA3B2CC04AD12E6"><enum>(I)</enum><text>in the matter preceding subclause (I), by inserting <quote>or an additional eligible professional described in paragraph (9)</quote> after <quote>paragraph (2)</quote>; and</text> </subclause><subclause id="HFE5D75942AC34E0AAE3AE117F3E715E1"><enum>(II)</enum><text display-inline="yes-display-inline">in subclause (I), by inserting <quote>or an additional eligible professional, respectively,</quote> after <quote>eligible professional</quote>;</text>
</subclause></clause></subparagraph><subparagraph id="HA8EF738077B6458990153825FBED0F7E"><enum>(C)</enum><text display-inline="yes-display-inline">in paragraph (3)(C), by inserting <quote>and additional eligible professionals</quote> after <quote>all eligible professionals</quote>;</text> </subparagraph><subparagraph id="H2AD6CF77B1954184B88114295FDFE986"><enum>(D)</enum><text>in paragraph (4)(D), by adding at the end the following new sentence: <quote>In the case that a qualifying MA organization attests that not all additional eligible professionals of the organization are meaningful EHR users with respect to an applicable year, the Secretary shall apply the payment adjustment under this paragraph based on the proportion of all such additional eligible professionals of the organization that are not meaningful EHR users for such year.</quote>;</text>
</subparagraph><subparagraph id="HD51952A19FE147DFB3E0E8B87D11317B"><enum>(E)</enum><text display-inline="yes-display-inline">in paragraph (6)(A), by inserting <quote>and, as applicable, each additional eligible professional described in paragraph (9)</quote> after <quote>paragraph (2)</quote>;</text> </subparagraph><subparagraph id="H93441969F1DA4346BADB2C1090AFC057"><enum>(F)</enum><text display-inline="yes-display-inline">in paragraph (6)(B), by inserting <quote>and, as applicable, each additional eligible hospital described in paragraph (9)</quote> after <quote>subsection (m)(1)</quote>;</text>
</subparagraph><subparagraph id="HD2D456FF54AC425AAC2C9AC9906ECC0C"><enum>(G)</enum><text display-inline="yes-display-inline">in paragraph (7)(A), by inserting <quote>and, as applicable, additional eligible professionals</quote> after <quote>eligible professionals</quote>;</text> </subparagraph><subparagraph id="HB65B35E52A9B443DB3AF797E32AD6A3F"><enum>(H)</enum><text display-inline="yes-display-inline">in paragraph (7)(B), by inserting <quote>and, as applicable, additional eligible professionals</quote> after <quote>eligible professionals</quote>;</text>
</subparagraph><subparagraph id="HF07FBC84C60D416995D51FB84111FF4A"><enum>(I)</enum><text display-inline="yes-display-inline">in paragraph (8)(B), by inserting <quote>and additional eligible professionals described in paragraph (9)</quote> after <quote>paragraph (2)</quote>; and</text> </subparagraph><subparagraph id="H8EC8FE4E39064FEE9ABAFC4F761E7B2A"><enum>(J)</enum><text>by adding at the end the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="H8CBADBBDDD9A41738A76C606E941B5E7" style="OLC">
<paragraph id="H2DF8EB470FE644FF98261604EECDD81A"><enum>(9)</enum><header>Additional eligible professional described</header><text display-inline="yes-display-inline">With respect to a qualifying MA organization, an additional eligible professional described in this paragraph is an additional eligible professional (as defined for purposes of section 1848(o)) who—</text>
<subparagraph id="HBF7652323E1B4265B7BFF3B6396745CC"><enum>(A)</enum>
<clause commented="no" display-inline="yes-display-inline" id="HBF9FB634385645C99396696FB04122C8"><enum>(i)</enum><text>is employed by the organization; or</text> </clause><clause id="HD2851CECA5C9401C9FAEF2B8898B971B" indent="up1"><enum>(ii)</enum> <subclause commented="no" display-inline="yes-display-inline" id="H26705F990C5D4A17903181F357AE96CC"><enum>(I)</enum><text>is employed by, or is a partner of, an entity that through contract with the organization furnishes at least 80 percent of the entity’s Medicare patient care services to enrollees of such organization; and</text>
</subclause><subclause id="H60B555850D924CEFB3B67146D870DF44" indent="up1"><enum>(II)</enum><text>furnishes at least 80 percent of the professional services of the additional eligible professional covered under this title to enrollees of the organization; and</text>
</subclause></clause></subparagraph><subparagraph id="H3FB8FE33D2B247249830D2C30DE833A9"><enum>(B)</enum><text>furnishes, on average, at least 20 hours per week of patient care services.</text></subparagraph></paragraph><after-quoted-block>; and</after-quoted-block></quoted-block> </subparagraph></paragraph><paragraph id="H3C14806981E348A2B929DE8D032BCC79"><enum>(2)</enum><text>in subsection (m)—</text>
<subparagraph id="HE04884B43E0942DE9EC62E2A562449D7"><enum>(A)</enum><text>in paragraph (1)—</text> <clause id="HB87E72B7AD7E4C7C958A2D7BFF0BC1E7"><enum>(i)</enum><text>by inserting <quote>or additional eligible hospitals (as described in paragraph (7))</quote> after <quote>paragraph (2)</quote>; and</text>
</clause><clause id="H36BF369EFABC40038FB7E6020007A382"><enum>(ii)</enum><text>by inserting <quote>and additional eligible hospitals</quote> before <quote>under such sections</quote>;</text> </clause></subparagraph><subparagraph id="H5CB27A3FF9F044068BAEE804196A89DE"><enum>(B)</enum><text>in paragraph (3)(A)(i), by inserting <quote>or additional eligible hospital</quote> after <quote>eligible hospital</quote>;</text>
</subparagraph><subparagraph id="HA2D6C7B23CFE42BDADDBC335E822FD81"><enum>(C)</enum><text>in paragraph (3)(A)(ii), by inserting <quote>or an additional eligible hospital</quote> after <quote>eligible hospital</quote> in each place it occurs;</text> </subparagraph><subparagraph id="H837C99C4EF4846EA9215D4B3B44BAD91"><enum>(D)</enum><text>in paragraph (3)(B)—</text>
<clause id="HEB517991873845FF8943C58032406BE7"><enum>(i)</enum><text>in clause (i), by inserting <quote>or an additional eligible hospital described in paragraph (7)</quote> after <quote>paragraph (2)</quote>; and</text> </clause><clause id="HFFF1E0EE81674E08B2C13BDCDAA8E555"><enum>(ii)</enum><text display-inline="yes-display-inline">in clause (ii)—</text>
<subclause id="H6C16EA5F55C840BD9EEB8B2ECF5B245B"><enum>(I)</enum><text>in the matter preceding subclause (I), by inserting <quote>or an additional eligible hospital described in paragraph (7)</quote> after <quote>paragraph (2)</quote>; and</text> </subclause><subclause id="H484DEE2FF0284E1AAC20E64A1D22C6CD"><enum>(II)</enum><text display-inline="yes-display-inline">in subclause (I), by inserting <quote>or an additional eligible hospital, respectively,</quote> after <quote>eligible hospital</quote>;</text>
</subclause></clause></subparagraph><subparagraph id="H568B99CE042C472E8129AC96936B3D4D"><enum>(E)</enum><text>in paragraph (4)(A), by inserting <quote>or one or more additional eligible hospitals (as defined in section 1886(n)), as appropriate,</quote> after <quote>section 1886(n)(6)(A))</quote>;</text> </subparagraph><subparagraph id="HBBDE22E105EA4FD3B4674867803ED811"><enum>(F)</enum><text>in paragraph (4)(D), by adding at the end the following new sentence: <quote>In the case that a qualifying MA organization attests that not all additional eligible hospitals of the organization are meaningful EHR users with respect to an applicable period, the Secretary shall apply the payment adjustment under this paragraph based on the methodology specified by the Secretary, taking into account the proportion of such additional eligible hospitals, or discharges from such hospitals, that are not meaningful EHR users for such period.</quote>;</text>
</subparagraph><subparagraph id="HC5DC7AB07B2D49A19782B51C7573FF91"><enum>(G)</enum><text display-inline="yes-display-inline">in paragraph (5)(A), by inserting <quote>and, as applicable, each additional eligible hospital described in paragraph (7)</quote> after <quote>paragraph (2)</quote>;</text> </subparagraph><subparagraph id="HD8B467FBEBFB460B991621FD36C1FBE3"><enum>(H)</enum><text display-inline="yes-display-inline">in paragraph (5)(B), by inserting <quote>and additional eligible hospitals, as applicable,</quote> after <quote>eligible hospitals</quote>;</text>
</subparagraph><subparagraph id="H25E9F3DD7E764FD5B01811FC13147F7B"><enum>(I)</enum><text display-inline="yes-display-inline">in paragraph (6)(B), by inserting <quote>and additional eligible hospitals described in paragraph (7)</quote> after <quote>paragraph (2)</quote>; and</text> </subparagraph><subparagraph id="HA249FEA086174255858E05FBFCDB39BE"><enum>(J)</enum><text>by adding at the end the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="HFC3E352D9B6141A8AFB8ABDCE8F8D0ED" style="OLC">
<paragraph id="HE5CF94DB857043AE8EC6650911549C23"><enum>(7)</enum><header>Additional eligible hospital described</header><text display-inline="yes-display-inline">With respect to a qualifying MA organization, an additional eligible hospital described in this paragraph is an additional eligible hospital (as defined in section 1886(n)(6)(C)) that is under common corporate governance with such organization and serves individuals enrolled under an MA plan offered by such organization.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph></subsection></section><enum>VIII</enum><header>SAMHSA Reauthorization and Reforms</header>
<subtitle id="HEECCDE2BC57C4A39AEF7C140DB49E56F"><enum>A</enum><header>Organization and general authorities</header>
<section id="H9E1F9389B92E4AD5AB4CC7BC4DE12AAF"><enum>801.</enum><header>In general</header><text display-inline="no-display-inline">Section 501 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290aa">42 U.S.C. 290aa</external-xref>) is amended—</text> <paragraph id="H1D084960DF0149EAAD49E3CD0EBFB6FD"><enum>(1)</enum><text>in subsection (h), by inserting at the end the following: <quote>For any such peer-review group reviewing a proposal or grant related to mental illness, no fewer than half of the members of the group shall have a medical degree, or a corresponding doctoral degree in psychology and clinical experience.</quote>; and</text>
</paragraph><paragraph id="HF6491A8AEA8046988ACAA050D4A7FC8C"><enum>(2)</enum><text>in subsection (l)—</text> <subparagraph id="HF104EFBE74174614A6AC37F272D1E6EA"><enum>(A)</enum><text>in paragraph (2), by striking <quote>and</quote> at the end;</text>
</subparagraph><subparagraph id="HF2A58746E5054EA3BBCE7D7646389B36"><enum>(B)</enum><text>in paragraph (3), by striking the period at the end and inserting <quote>; and</quote>; and</text> </subparagraph><subparagraph id="H93EECBD27B4A44398CE6D5E80DB9D13D"><enum>(C)</enum><text>by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="HFE4CCB0CF3DC4874B4F968E439B76E0E" style="OLC">
<paragraph id="HB3275236FE554BB3A3D08CE718F6F463"><enum>(4)</enum><text display-inline="yes-display-inline">At least 60 days before awarding a grant, cooperative agreement, or contract, the Assistant Secretary shall give written notice of the award to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph></section><section id="HA8C41862358D4180B2810E4CBB556810"><enum>802.</enum><header>Advisory councils</header><text display-inline="no-display-inline">Paragraph (3) of section 502(b) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290aa-1">42 U.S.C. 290aa–1(b)</external-xref>) is amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H60B982662DE04F20BDD1220EE9286F4F" style="OLC">
<subparagraph id="H874F395E132A459DB663C101FA89B378"><enum>(C)</enum><text display-inline="yes-display-inline">No fewer than half of the members of an advisory council shall be mental health care providers with—</text>
<clause id="HA655BF72ACAD4821A516278629189EA1"><enum>(i)</enum><text>experience in mental health research or treatment; and</text> </clause><clause id="HDD5316E14019450CBF62F20136B58C5A"><enum>(ii)</enum><text>expertise in the fields on which they are advising.</text>
</clause></subparagraph><subparagraph id="H1E564554C821487C95656A9FA422B4A9"><enum>(D)</enum><text display-inline="yes-display-inline">None of the appointed members may have at any point been a recipient of any grant, or participated in any program, about which the members are to advise.</text>
</subparagraph><subparagraph id="H3E0DE8E185E54F5299BB63958680B40F"><enum>(E)</enum><text>None of the appointed members may be related to anyone who has been a recipient of any grant, or participated in any program, about which the members are to advise.</text>
</subparagraph><subparagraph id="HDA45A9C308E344DD99A6084E01927958"><enum>(F)</enum><text>None of the appointed members may have a financial interest in any grant or program with respect to which they advise, or receive funding separately through the Office of Assistant Secretary.</text>
</subparagraph><subparagraph id="HDC8EE237E72E4203A13CB0218351AFFE"><enum>(G)</enum><text>Each advisory committee must include at least one member of the National Institute of Mental Health and one member from any Federal agency that has a program serving a similar population.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="H5F1C3DDF48DA48118271246A27527537"><enum>803.</enum><header>Peer review</header><text display-inline="no-display-inline">Section 504 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290aa-3">42 U.S.C. 290aa–3</external-xref>) is amended—</text> <paragraph id="H902AD11C3FFC4D94880F087D222B8F96"><enum>(1)</enum><text>by adding at the end of subsection (b) the following: <quote>At least half of the members of any peer-review group established under subsection (a) shall have a degree in medicine, or a corresponding doctoral degree in psychology, or be a licensed mental health professional. Before awarding a grant, cooperative agreement, or contract, the Secretary shall provide a list of the members of the peer-review group responsible for reviewing the award to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate.</quote>; and</text>
</paragraph><paragraph id="H21CD1645132440FCAC4AE64380395F21"><enum>(2)</enum><text>by adding at the end the following:</text> <quoted-block display-inline="no-display-inline" id="H227980A6890B41DA84D240104A82D734" style="OLC"> <subsection id="H852FD5540F7B4CEBB7CE1520036CC19E"><enum>(e)</enum><header>Scientific controls and standards</header><text display-inline="yes-display-inline">Peer review under this section shall ensure that any research concerning an intervention is based on scientific controls and standards indicating whether the intervention reduces symptoms, improves medical or behavioral outcomes, and improves social functioning.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section></subtitle><subtitle id="H9248EA57CA624443B771C2BC378554B6"><enum>B</enum><header>Protection and advocacy for individuals with mental illness</header>
<section id="H91248996E1904457B491631825455B91"><enum>811.</enum><header>Prohibition against lobbying by systems accepting Federal funds to protect and advocate the rights
of individuals with mental illness</header><text display-inline="no-display-inline">Section 105(a) of the Protection and Advocacy for Individuals with Mental Illness Act (<external-xref legal-doc="usc" parsable-cite="usc/42/10805">42 U.S.C. 10805(a)</external-xref>) is amended—</text>
<paragraph id="H432DF103BF1A41B89BC53762AEED6EA5"><enum>(1)</enum><text>in paragraph (9), by striking <quote>and</quote> at the end;</text> </paragraph><paragraph id="H4D47741B68A643538A1A1866CF9EFC6F"><enum>(2)</enum><text>in paragraph (10), by striking the period at the end and inserting a semicolon; and</text>
</paragraph><paragraph id="H64D0DAA5E5AA408F94838622D1050776"><enum>(3)</enum><text>by adding at the end the following:</text> <quoted-block display-inline="no-display-inline" id="HBE239264B9664DA69E11BBF87B07C07E" style="OLC"> <paragraph id="H2CC48CF5793746AB8630C6D5B6CBCDF3"><enum>(11)</enum><text display-inline="yes-display-inline">agree to refrain, during any period for which funding is provided to the system under this part, from—</text>
<subparagraph id="H2E9FA546FA044DFEA61BD27001B7AF8F"><enum>(A)</enum><text>lobbying or retaining a lobbyist for the purpose of influencing a Federal, State, or local governmental entity or officer; and</text>
</subparagraph><subparagraph id="H12F36875634749DCA94606425B782F10"><enum>(B)</enum><text>counseling an individual with a serious mental illness who lacks insight into their condition on refusing medical treatment or acting against the wishes of such individual’s caregiver;</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section><section id="HAD0E2E04B0204B50B5F0DB78902BEF2F"><enum>812.</enum><header>Ensuring that caregivers of individuals with serious mental illness have access to the protected
health information of such individuals</header><text display-inline="no-display-inline">Section 105(a) of the Protection and Advocacy for Individuals with Mental Illness Act (<external-xref legal-doc="usc" parsable-cite="usc/42/10805">42 U.S.C. 10805(a)</external-xref>), as amended by section 811, is further amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="HAAC83FB0FFA54108A045F37E0B654051" style="OLC">
<paragraph id="H2C722A4D91CD498C9481C9C0A5F84789"><enum>(12)</enum><text display-inline="yes-display-inline">ensure that caregivers (as defined in section 201 of the <short-title>Helping Families in Mental Health Crisis Act of 2015</short-title>) of individuals with serious mental illness (as defined in such section 201) have access to the protected health information of such individuals consistent with such section 201;</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="H7F3A9651E6E74D46A1296B872BE6E3D3"><enum>813.</enum><header>Protection and advocacy activities to focus exclusively on safeguarding rights to be free from
abuse and neglect</header>
<subsection id="H4642B93638EC45AB8A1F3B2F128F31EA"><enum>(a)</enum><header>Purposes</header><text display-inline="yes-display-inline">Section 101(b) of the Protection and Advocacy for Individuals with Mental Illness Act (<external-xref legal-doc="usc" parsable-cite="usc/42/10801">42 U.S.C. 10801(b)</external-xref>) is amended—</text>
<paragraph id="H08D43873DA2649F6A266E2DF8D585390"><enum>(1)</enum><text>in paragraph (1), by inserting <quote>to be free from abuse and neglect</quote> before <quote>are protected</quote>; and</text> </paragraph><paragraph id="H8F820BF3F06D451CBC4A141281D9CFCF"><enum>(2)</enum><text>in paragraph (2)(A), by inserting <quote>to be free from abuse and neglect</quote> before <quote>through activities to ensure</quote>.</text>
</paragraph></subsection><subsection id="H232FF42349C44CFE9C25AAC34477ACF9"><enum>(b)</enum><header>Allotments</header><text display-inline="yes-display-inline">Section 103(2)(A) of the Protection and Advocacy for Individuals with Mental Illness Act (<external-xref legal-doc="usc" parsable-cite="usc/42/10803">42 U.S.C. 10803(2)(A)</external-xref>) is amended by inserting <quote>to be free from abuse and neglect</quote> before the semicolon.</text>
</subsection><subsection id="H47AC4F28F753452494697CC51B963D8C"><enum>(c)</enum><header>Use of allotments</header><text display-inline="yes-display-inline">Section 104(a)(1) of the Protection and Advocacy for Individuals with Mental Illness Act (<external-xref legal-doc="usc" parsable-cite="usc/42/10804">42 U.S.C. 10804(a)(1)</external-xref>) is amended—</text>
<paragraph id="HFAF41988C9534FAAA1B8498C53ACB18F"><enum>(1)</enum><text>in subparagraph (A), by striking <quote>and</quote> at the end;</text> </paragraph><paragraph id="HF7CA9254F488421A84BFC7ED44988785"><enum>(2)</enum><text>in subparagraph (B), by striking the semicolon at the end and inserting <quote>to be free from abuse and neglect; and</quote>; and</text>
</paragraph><paragraph id="HA0CB2C2E13B44C09B6AE37FD2B2A15AB"><enum>(3)</enum><text>by adding at the end the following:</text> <quoted-block display-inline="no-display-inline" id="H94632ABB8BC24B0FA63E9AD2582A6641" style="OLC"> <subparagraph id="H7FA922B7CA1047218B5D0F2F66B3BBF8"><enum>(C)</enum><text display-inline="yes-display-inline">the protection and advocacy activities of such an agency or organization shall be exclusively focused on safeguarding the rights of individuals with mental illness to be free from abuse and neglect.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H1AF96D809F594A50AFF9C9857C51CCAA"><enum>(d)</enum><header>System requirements</header><text display-inline="yes-display-inline">Section 105 of the Protection and Advocacy for Individuals with Mental Illness Act (<external-xref legal-doc="usc" parsable-cite="usc/42/10805">42 U.S.C. 10805</external-xref>), as amended by sections 811 and 812, is further amended—</text>
<paragraph id="HDFA8AFE59017483DB1C6A6B03B3B2514"><enum>(1)</enum><text>in subsection (a)—</text> <subparagraph id="HC175689EF3C043A2861477515063F92C"><enum>(A)</enum><text>in the matter before paragraph (1), by inserting <quote>to be free from abuse and neglect</quote> before <quote>shall</quote>;</text>
</subparagraph><subparagraph id="HC51D7B0F7C664FBCA3EF7B1E9A0CFC13"><enum>(B)</enum><text>in paragraph (6)(A), by inserting <quote>to be free from abuse and neglect</quote> before the semicolon; and</text> </subparagraph><subparagraph id="H7FFBFCF8AB9647BFBD7C16A8BE3607CE"><enum>(C)</enum><text>by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="HB53167E5A22F48EBA48DC64789362DAB" style="OLC">
<paragraph id="HF294D9526A744342AD0E860B96BE515D"><enum>(13)</enum><text display-inline="yes-display-inline">be exclusively focused on safeguarding the rights of individuals with mental illness to be free from abuse and neglect; and</text></paragraph><after-quoted-block>; and</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="HA14BF730223E4E10A4653EFC3AF46B8A"><enum>(2)</enum><text>in subsection (c)(1)(A), by inserting <quote>to be free from abuse and neglect</quote> before <quote>shall have a governing authority</quote>.</text> </paragraph></subsection><subsection id="H50BCF4AC026547F8A622322F90A342B9"><enum>(e)</enum><header>Applications</header><text display-inline="yes-display-inline">Section 111(a) of the Protection and Advocacy for Individuals with Mental Illness Act (<external-xref legal-doc="usc" parsable-cite="usc/42/10821">42 U.S.C. 10821(a)</external-xref>) is amended—</text>
<paragraph id="H9710863628FB45EBB8B93D440FC0B990"><enum>(1)</enum><text>in paragraph (1), by inserting <quote>to be free from abuse and neglect</quote> before the semicolon;</text> </paragraph><paragraph id="HD4A09411E1C14EED8D452ED88660D466"><enum>(2)</enum><text>in paragraph (3), by striking <quote>and</quote> at the end;</text>
</paragraph><paragraph id="HA7BA95A359E74712B15C2CFC41C51D98"><enum>(3)</enum><text>by redesignating paragraph (4) as paragraph (5); and</text> </paragraph><paragraph id="H3F1413887A26480A93011D00FD1AF5AE"><enum>(4)</enum><text>by inserting after paragraph (3) the following:</text>
<quoted-block display-inline="no-display-inline" id="H0C59F9749B1E49EFA7332133F455983A" style="OLC">
<paragraph id="HC362BC80762B4A9AA3BE69AE0AEC0DC9"><enum>(4)</enum><text display-inline="yes-display-inline">assurances that such system, and any State agency or nonprofit organization with which such system may enter into a contract under section 10804(a), will be exclusively focused on safeguarding the rights of individuals with mental illness to be free from abuse and neglect; and</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H9B544E534FE64402A173FED983B7C0EA"><enum>(f)</enum><header>Reports by Secretary</header><text display-inline="yes-display-inline">Section 114(a) of the Protection and Advocacy for Individuals with Mental Illness Act (<external-xref legal-doc="usc" parsable-cite="usc/42/10824">42 U.S.C. 10824(a)</external-xref>) is amended—</text>
<paragraph id="H18BA2A6CEC864E0CB5F4FEA2558EB8DD"><enum>(1)</enum><text>in paragraph (1) in the matter before subparagraph (A), by inserting <quote>to be free from abuse and neglect</quote> before <quote>supported with payments</quote>;</text> </paragraph><paragraph id="H9EB5CCAA1E2545B08B31528747007A97"><enum>(2)</enum><text>in paragraph (2)(A), by inserting <quote>to be free from abuse and neglect</quote> before <quote>supported with payments</quote>; and</text>
</paragraph><paragraph id="H64F820D04B11404C9F94AFC880808336"><enum>(3)</enum><text>in paragraph (4), by inserting <quote>to be free from abuse and neglect</quote> before <quote>and a description</quote>.</text> </paragraph></subsection></section><section id="H58CB51D234E84926977E902C5E8675D3"><enum>814.</enum><header>Reporting</header> <subsection id="HAB6B2E5589D241F6B3B9665AE963E1B5"><enum>(a)</enum><header>Public availability of reports</header><text display-inline="yes-display-inline">Section 105(a)(7) of the Protection and Advocacy for Individuals with Mental Illness Act (<external-xref legal-doc="usc" parsable-cite="usc/42/10805">42 U.S.C. 10805(a)(7)</external-xref>) is amended by striking <quote>is located a report</quote> and inserting <quote>is located, and make publicly available, a report</quote>.</text>
</subsection><subsection id="HF24CE6F22D9F4A849BE35734523307D3"><enum>(b)</enum><header>Detailed accounting</header><text display-inline="yes-display-inline">Section 114(a) of the Protection and Advocacy for Individuals with Mental Illness Act (<external-xref legal-doc="usc" parsable-cite="usc/42/10824">42 U.S.C. 10824(a)</external-xref>), as amended, is further amended—</text>
<paragraph id="HBD51680C4FB24B208DB183BE090F1820"><enum>(1)</enum><text>in paragraph (3), by striking <quote>and</quote> at the end;</text> </paragraph><paragraph id="HF419C19124FB43DD9CFB9BC9327B313A"><enum>(2)</enum><text>in paragraph (4), by striking the period at the end and inserting <quote>; and</quote>; and</text>
</paragraph><paragraph id="H807E1EF102B242198627B4F9879355FD"><enum>(3)</enum><text>by adding at the end the following:</text> <quoted-block display-inline="no-display-inline" id="H092D777C8BF84B02B2C612E1F792C93F" style="OLC"> <paragraph id="HBE6AEAA88D4D4B1487154ADDBA0A0054"><enum>(5)</enum><text display-inline="yes-display-inline">a detailed accounting, for each system funded under this title, 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.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection></section><section id="H5181961F38F04FF58E699C6832C48C17"><enum>815.</enum><header>Grievance procedure</header><text display-inline="no-display-inline">Section 105 of the Protection and Advocacy for Individuals with Mental Illness Act (<external-xref legal-doc="usc" parsable-cite="usc/42/10805">42 U.S.C. 10805</external-xref>), as amended, is further amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H34E3E4E164C649B1BA63ED7720C8FB8A" style="OLC">
<subsection commented="no" id="H6E513AB2BB384334BEEFDF063A645F3D"><enum>(d)</enum><header>Grievance procedure</header><text display-inline="yes-display-inline">The Assistant Secretary shall establish an independent grievance procedure for the types of claims to be adjudicated, at the request of persons described in subsection (a)(9), through a system’s grievance procedure established under such subsection.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="HE6FF11451A8645DBB3D2FDD2737A301B"><enum>816.</enum><header>Evidence-based treatment for individuals with serious mental illness</header><text display-inline="no-display-inline">Section 105(a) of the Protection and Advocacy for Individuals with Mental Illness Act (<external-xref legal-doc="usc" parsable-cite="usc/42/10805">42 U.S.C. 10805(a)</external-xref>), as amended by sections 811, 812, and 813, is further amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H9687BB840B17459BA65D4D802B1B3234" style="OLC">
<paragraph id="H4D297264B974479DADFF51AE5A54D432"><enum>(14)</enum><text display-inline="yes-display-inline">ensure that individuals with serious mental illness have access to and can obtain evidence-based treatment for their serious mental illness.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</section></subtitle><enum>IX</enum><header>Reporting</header>
<section id="HB7F6E151731746BFAC27C0E4FD3B0483"><enum>901.</enum><header>GAO study on preventing discriminatory coverage limitations for individuals with serious mental
illness and substance use disorders</header><text display-inline="no-display-inline">Not later than 1 year after the date of the enactment of this Act, the Comptroller General of the United States, in consultation with the Assistant Secretary for Mental Health and Substance Use Disorders, the Secretary of Health and Human Services, the Secretary of Labor, and the Secretary of the Treasury, shall submit to Congress a report detailing the extent to which covered group health plans (or health insurance coverage offered in connection with such plans), including Medicaid managed care plans under section 1903 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396b">42 U.S.C. 1396b</external-xref>), comply with the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (subtitle B of title V of division C of <external-xref legal-doc="public-law" parsable-cite="pl/110/343">Public Law 110–343</external-xref>) (in this section referred to as the <quote>law</quote>), including—</text>
<paragraph id="HD8F620426D8C4F4498E508574FA32B9C"><enum>(1)</enum><text>how nonquantitative treatment limitations, including medical necessity criteria, of covered group health plans comply with the law;</text>
</paragraph><paragraph id="HEC20AC5F2C624C87BAEB8D57D1A8E34E"><enum>(2)</enum><text>how the responsible Federal departments and agencies ensure that plans comply with the law; and</text> </paragraph><paragraph id="HB606B3C64F9C4E238BFB3981EE96C09C"><enum>(3)</enum><text>how proper enforcement, education, and coordination activities within responsible Federal departments and agencies can be used to ensure full compliance with the law, including educational activities directed to State insurance commissioners.</text>
</paragraph></section>