[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7483 Introduced in House (IH)]
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117th CONGRESS
2d Session
H. R. 7483
To direct the Secretary of Health and Human Services to conduct a study
on the direct and indirect costs of serious mental illness for
nongovernmental entities, the Federal Government, and State, local, and
Tribal governments, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
April 7, 2022
Mr. Reschenthaler (for himself and Mr. Trone) introduced the following
bill; which was referred to the Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To direct the Secretary of Health and Human Services to conduct a study
on the direct and indirect costs of serious mental illness for
nongovernmental entities, the Federal Government, and State, local, and
Tribal governments, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as ``Cost of Mental Illness Act of 2022''.
SEC. 2. STUDY ON THE COSTS OF SERIOUS MENTAL ILLNESS.
(a) In General.--Not later than 180 days after the date of the
enactment of this Act, the Secretary of Health and Human Services, in
consultation with the Assistant Secretary for Planning and Evaluation,
the Attorney General of the United States, the Secretary of Labor, and
the Secretary of Housing and Urban Development, shall conduct a study
on the direct and indirect costs of serious mental illness with respect
to--
(1) nongovernmental entities; and
(2) the Federal Government and State, local, and Tribal
governments.
(b) Content.--The study under subsection (a) shall consider each of
the following:
(1) The costs of the health care system for all facilities
and health services, including--
(A) public and private inpatient hospitals,
outpatient health care, and home health care;
(B) office-based physician visits;
(C) prescription drugs and digital therapeutics;
(D) emergency room visits;
(E) substance use treatment;
(F) skilled nursing and long-term care facilities
for residential, custodial, and general health care;
(G) with respect to the costs described in
subparagraphs (A) through (F), out-of-pocket costs and
costs for different types of behavioral health and
psychiatric illness; and
(H) other professional health services.
(2) The costs of homelessness, including--
(A) homeless shelters;
(B) street outreach activities;
(C) crisis response center visits; and
(D) other supportive services.
(3) The costs of structured residential facilities and
other supportive housing for residential and custodial care
services.
(4) The costs of law enforcement encounters and encounters
with the criminal justice system, including--
(A) encounters that do and do not result in an
arrest;
(B) investigating a crime and judicial proceedings,
including the process of sentencing;
(C) services provided by police officers, sheriff
deputies, police departments and sheriff offices, and
judicial staff (including public defenders,
prosecutors, and private attorneys);
(D) services provided by public institutions
(including local and county jails, State prisons, and
paid legal guardians);
(E) public safety costs to transport an individual
with a serious mental illness to receive mental health
or substance use treatment services or be incarcerated
(including vehicle miles and personnel expenses);
(F) with respect to inmates with a serious mental
illness, incarceration costs in Federal prison, State
prison, and local jails (including residential,
custodial, and on-site and off-site health care); and
(G) solitary confinement, security, and other
similar costs.
(5) The costs of addressing serious mental illness as a
disability in the workplace, including--
(A) reduced wages for individuals with a serious
mental illness who are employed; and
(B) the estimated costs attributable to--
(i) the nationwide unemployment rate for
individuals with a serious mental illness;
(ii) benefits payable on the basis of
disability to individuals with a serious mental
illness--
(I) under title II or XVI of the
Social Security Act (42 U.S.C. 401 et
seq., 1381 et seq.); or
(II) from a State or other
governmental entity; or
(iii) to the extent feasible, lost lifetime
productivity due to disability.
(6) With respect to family members and caregivers, the
costs of caring for an individual with a serious mental
illness, including--
(A) the cost of unpaid labor;
(B) additional health care costs associated with
providing ongoing care for an individual with a serious
mental illness, including higher health care costs
resulting from stress and anxiety;
(C) taking leave from work; and
(D) out-of-pocket costs incurred while caring for
such individual.
(7) Costs with respect to funding for grants or cooperative
agreements for programs or services for basic, translational,
and applied research for individuals with a serious mental
illness.
(8) The costs of workforce development and training for
personnel that interact with individuals with a serious mental
illness, and insurance for such development and training,
including health care workers, social service employees, law
enforcement, and first responders.
(9) Other costs for programs and services administered by
the Federal Government or State, Tribal, or local governments.
(c) Data Disaggregation.--In conducting the study under subsection
(a), the Secretary shall (to the extent feasible)--
(1) disaggregate data by--
(A) costs to nongovernmental entities, the Federal
Government, and State, local, and Tribal governments;
(B) types of serious mental illnesses and medical
chronic diseases common in patients with a serious
mental illness; and
(C) demographic characteristics, including race,
ethnicity, sex, age (including pediatric subgroups),
and other characteristics determined by the Secretary;
and
(2) include an estimate of--
(A) the total number of individuals with a serious
mental illness in the United States, including in
traditional and nontraditional housing; and
(B) taking into account the information collected
pursuant to section 3(b)(3), the percentage of such
individuals in--
(i) homeless shelters;
(ii) penal facilities, including Federal
prisons, State prisons, and county and
municipal jails; and
(iii) nursing facilities.
(d) Report.--Not later than 2 years after the date of the enactment
of this Act, the Secretary shall--
(1) submit to the Congress a report containing the results
of the study conducted under this section; and
(2) make such report publicly available.
(e) Definitions.--In this section:
(1) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
(2) Serious mental illness.--The term ``serious mental
illness'' means a mental, behavioral, or emotional disorder
resulting in a serious functional impairment that substantially
interferes with or limits one or more major life activities,
including the following:
(A) Schizophrenia, including schizoaffective
disorder and other related psychosis.
(B) Schizoaffective disorder.
(C) Persistent mood disorder, including bipolar
disorder I and II.
(D) Major depressive disorder.
(E) Any other such mental, behavioral, or emotional
disorder, as determined by the Secretary.
(f) Authorization of Appropriations.--There is authorized to be
appropriated to the Secretary to carry out this section $3,500,000 for
each of fiscal years 2023 and 2024.
SEC. 3. SCHIZOPHRENIA SURVEILLANCE SURVEY.
(a) In General.--The Secretary of Health and Human Services (in
this section referred to as the ``Secretary''), acting through the
Assistant Secretary for Mental Health and Substance Use, and in
coordination with the Director of the Centers for Disease Control and
Prevention and the Director of the National Institute of Mental Health,
shall--
(1) conduct a surveillance survey to collect the
information described in subsection (b) about individuals with
schizophrenia in the United States; and
(2) not less than every 5 years, update such survey.
(b) Content.--In carrying out subsection (a), the Secretary shall
collect--
(1) to the extent practicable, information relating to
individuals with schizophrenia, such as--
(A) demographics, such as age, race, ethnicity,
sex, geographic location, family history, and other
information as appropriate;
(B) risk factors that may be associated with
schizophrenia such as environmental risk factors and
other information as appropriate; and
(C) average age at the time of initial diagnosis
and time lapses, if any, between the initial diagnosis
and the initiation of mental health care;
(2) to the extent practicable, information on the health
status of individuals with schizophrenia, including--
(A) mortality and morbidity rates;
(B) incidences of comorbid chronic diseases,
including diabetes, cardiac conditions, emphysema,
cirrhosis, HIV/AIDS, and hepatitis C; and
(C) the frequency of hospital emergency department
utilization; and
(3) the percentage of individuals with schizophrenia in--
(A) homeless shelters;
(B) penal facilities, including Federal prisons,
State prisons, and county and municipal jails;
(C) nursing facilities; and
(D) inpatient hospitals.
(c) Consultation.--In carrying out this section, the Secretary
shall consult with individuals with appropriate expertise, which may
include--
(1) epidemiologists with experience in mental health
conditions surveillance; and
(2) representatives of national voluntary health
association and nonprofit citizens organizations that--
(A) focus on schizophrenia and related psychotic
conditions; and
(B) have experience in research, care, and patient
services.
(d) Coordination.--In carrying out this section, the Secretary
shall--
(1) coordinate with the National Neurological Conditions
Surveillance System under section 399S-1 of the Public Health
Service Act (42 U.S.C. 280g-7a) to determine any overlap
between--
(A) individuals with schizophrenia counted for
purposes of the survey under this section; and
(B) individuals with neurological conditions
identified by the Director of the Centers for Disease
Control and Prevention for purposes of the National
Neurological Conditions Surveillance System; and
(2) coordinate with other Federal agencies, including the
Social Security Administration, the Department of the Treasury,
and the Department of Labor, to use administrative data, to the
extent feasible, to provide information for the survey
authorized by subsection (a).
(e) Grants.--The Secretary may award grants to, or enter into
contracts or cooperative agreements with, public or private nonprofit
entities to carry out activities in furtherance of the surveillance
survey under this section, including the convening of stakeholder
meetings.
(f) Reporting.--
(1) In general.--The Secretary shall submit to the
Committee on Energy and Commerce of the House of
Representatives and the Committee on Health, Education, Labor,
and Pensions of the Senate--
(A) not later than 2 years after the date of
enactment of this Act, a report containing findings of
the surveillance survey under this section, including
aggregate information collected and epidemiological
analyses, as appropriate; and
(B) not less than every 5 years when an updated
survey is conducted pursuant to subsection (a)(2), an
updated report.
(2) Posting.--The Secretary shall post the report under
paragraph (1) and each update under paragraph (2) on the public
website of the Department of Health and Human Services.
(g) Authorization of Appropriations.--To carry out this section,
there is authorized to be appropriated $50,000,000 for the period of
fiscal years 2023 through 2027.
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