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II
113th CONGRESS
1st Session
S. 1119
IN THE SENATE OF THE UNITED STATES
June 7, 2013
Ms. Collins (for herself
and Ms. Mikulski) introduced the
following bill; which was read twice and referred to the
Committee on Health, Education, Labor,
and Pensions
A BILL
To amend the Public Health Service Act to provide for
integration of mental health services and mental health treatment outreach
teams, and for other purposes.
1.
Short title
This Act may be cited as the
Positive Aging Act of
2013.
2.
Demonstration projects to support
integration of Mental Health Services in primary care settings
Subpart 3 of part B of title V of the
Public Health Service Act (42 U.S.C.
290bb–31 et seq.) is amended—
(1) in section 520(b)—
(A) in paragraph (14), by striking
and after the semicolon;
(B) in paragraph (15), by striking the period
at the end and inserting ; and; and
(C) by adding at the end the following:
(16) conduct the demonstration projects
specified in section 520L.
;
and
(2) by adding at the end the following:
520L.
Projects to demonstrate integration of
Mental Health Services in primary care settings
(a)
In general
The Secretary, acting through the Director
of the Center for Mental Health Services, shall award grants to public and
private nonprofit entities for projects to demonstrate ways of integrating
mental health services for older adults into primary care settings, such as
health centers receiving a grant under section 330 (or determined by the
Secretary to meet the requirements for receiving such a grant), other federally
qualified health centers, primary care clinics, and private practice
sites.
(b)
Requirements
In order to be eligible for a grant under
this section, the project to be carried out by the entity shall provide for
collaborative care within a primary care setting, provided by licensed mental
health professionals with appropriate training and experience in the treatment
of older adults, in which screening, assessment, and intervention services are
combined into an integrated service delivery model, including—
(1) screening services by a mental health
professional with at least a masters degree in an appropriate field of
training;
(2) referrals for necessary prevention,
intervention, follow-up care, consultations, and care planning oversight for
mental health and other service needs, as indicated; and
(3) adoption and implementation of
evidence-based intervention and treatment protocols (to the extent such
protocols are available) for mental disorders prevalent in older adults
including, but not limited to, mood and anxiety disorders, dementias of all
kinds (including the behavioral and psychological symptoms of dementia),
psychotic disorders, and substance-related disorders.
(c)
Considerations in awarding
grants
In awarding grants
under this section, the Secretary, to the extent feasible, shall ensure
that—
(1) projects are funded in a variety of
geographic areas, including urban and rural areas; and
(2) a variety of populations, including racial
and ethnic minorities and low-income populations, are served by projects funded
under this section.
(d)
Duration
A project may receive funding pursuant to a
grant under this section for a period of up to 3 years, with an extension
period of 2 additional years at the discretion of the Secretary.
(e)
Application
To be eligible to receive a grant under
this section, a public or private nonprofit entity shall—
(1) submit an application to the Secretary (in
such form, containing such information, and at such time as the Secretary may
specify); and
(2) agree to report to the Secretary
standardized clinical and behavioral data and other performance data necessary
to evaluate patient outcomes and to facilitate evaluations across participating
projects.
(f)
Evaluation
Not later than July 31 of the second
calendar year after the date of enactment of this section, and July 31 of every
year thereafter, the Secretary shall submit to Congress a report evaluating the
projects receiving awards under this section for the year involved.
(g)
Supplement, not supplant
Funds made available under this section
shall supplement, and not supplant, other Federal, State, or local funds
available to an entity to carry out activities described in this
section.
(h)
Authorization of
appropriations
There are
authorized to be appropriated such sums as may be necessary to carry out this
section for fiscal year 2014 and each fiscal year
thereafter.
.
3.
Grants for community-based mental health
treatment outreach teams
Subpart 3 of part B of title V of the
Public Health Service Act (42 U.S.C.
290bb–31 et seq.), as amended by section 2, is further amended by adding at the
end the following:
520M.
Grants for community-based mental health
treatment outreach teams
(a)
In general
The Secretary, acting through the Director
of the Center for Mental Health Services, shall award grants to public or
private nonprofit entities that are community-based providers of geriatric
mental health services, to support the establishment and maintenance by such
entities of interdisciplinary geriatric mental health outreach teams in
community settings where older adults reside or receive social services.
Entities eligible for such grants include—
(1) mental health service providers of a State
or local government;
(2) outpatient programs of private, nonprofit
hospitals;
(3) community mental health centers meeting the
criteria specified in section 1913(c); and
(4) other community-based providers of mental
health services.
(b)
Requirements
To be eligible to receive a grant under
this section, an entity shall—
(1) adopt and implement, for use by its mental
health outreach team, evidence-based intervention and treatment protocols (to
the extent such protocols are available) for mental disorders prevalent in
older adults including, but not limited to, mood and anxiety disorders,
dementias of all kinds (including the behavioral and psychological symptoms of
dementia), psychotic disorders, and substance-related disorders, relying to the
greatest extent feasible on protocols that have been developed—
(A) by or under the auspices of the Secretary;
or
(B) by academicians;
(2) provide screening for mental disorders,
diagnostic services, referrals for treatment, and case management and
coordination through such teams; and
(3) coordinate and integrate the services
provided by such team with the services of social service, mental health, and
medical providers at the site or sites where the team is based in order
to—
(A) improve patient outcomes; and
(B) to assure, to the maximum extent feasible,
the continuing independence of older adults who are residing in the
community.
(c)
Cooperative arrangements with sites serving
as bases for outreach
An
entity receiving a grant under this section may enter into an agreement with a
person operating a site at which a geriatric mental health outreach team of the
entity is based, including—
(1) senior centers;
(2) adult day care programs;
(3) assisted living facilities; and
(4) recipients of grants to provide services to
older adults under the Older Americans Act of
1965, under which such person provides (and is reimbursed by the
entity, out of funds received under the grant, for) any supportive services,
such as transportation and administrative support, that such person provides to
an outreach team of such entity.
(d)
Considerations in awarding
grants
In awarding grants
under this section, the Secretary, to the extent feasible, shall ensure
that—
(1) projects are funded in a variety of
geographic areas, including urban and rural areas; and
(2) a variety of populations, including racial
and ethnic minorities and low-income populations, are served by projects funded
under this section.
(e)
Application
To be eligible to receive a grant under
this section, an entity shall—
(1) submit an application to the Secretary (in
such form, containing such information, at such time as the Secretary may
specify); and
(2) agree to report to the Secretary
standardized clinical and behavioral data and other performance data necessary
to evaluate patient outcomes and to facilitate evaluations across participating
projects.
(f)
Coordination
The Secretary shall provide for appropriate
coordination of programs and activities receiving funds pursuant to a grant
under this section with programs and activities receiving funds pursuant to
grants under section 520L and sections 381, 422, and 423 of the
Older Americans Act of 1965.
(g)
Evaluation
Not later than July 31 of the second
calendar year after the date of enactment of this section, and July 31 of every
year thereafter, the Secretary shall submit to Congress a report evaluating the
projects receiving awards under this section for such year.
(h)
Supplement, not supplant
Funds made available under this section
shall supplement, and not supplant, other Federal, State, or local funds
available to an entity to carry out activities described in this
section.
(i)
Authorization of
appropriations
There are
authorized to be appropriated such sums as may be necessary to carry out this
section for fiscal year 2014 and each fiscal year
thereafter.
.
4.
Designation of Deputy Director for Older
Adult Mental Health Services in Center for Mental Health Services
Section 520 of the
Public Health Service Act (42 U.S.C.
290bb–31) is amended—
(1) by redesignating subsection (c) as
subsection (d); and
(2) by inserting after subsection (b) the
following:
(c)
Deputy Director for Older Adult Mental
Health Services in Center for Mental Health Services
The Director, after consultation with the
Administrator, shall designate a Deputy Director for Older Adult Mental Health
Services, who shall be responsible for the development and implementation of
initiatives of the Center to address the mental health needs of older adults.
Such initiatives shall include—
(1) research on prevention and identification
of mental disorders in the older adult population;
(2) innovative demonstration projects for the
delivery of community-based mental health services for older adults;
(3) support for the development and
dissemination of evidence-based practice models, including models to address
substance-related disorders in older adults; and
(4) development of model training programs for
mental health professionals and caregivers serving older
adults.
.
5.
Membership of advisory council for the
Center for Mental Health Services
Section 502(b)(3) of the
Public Health Service Act (42 U.S.C.
290aa–1(b)(3)) is amended by adding at the end the following:
(C) In the case of the advisory council for the
Center for Mental Health Services, the members appointed pursuant to
subparagraphs (A) and (B) shall include representatives of older adults or
their families, and professionals with an expertise in geriatric mental
health.
.
6.
Projects of national significance targeting
substance abuse in older adults
Section 509(b)(2) of the
Public Health Service Act (42 U.S.C.
290bb–2(b)(2)) is amended by inserting before the period the following:
, and to providing treatment for older adults with substance-related
disorders.
7.
Criteria for State plans under community
Mental Health Services block grants
(a)
In general
Section 1912(b)(4) of the
Public Health Service Act (42 U.S.C.
300x–2(b)(4)) is amended to read as follows:
(4)
Targeted services to older individuals,
individuals who are homeless, and individuals living in rural
areas
The plan describes the
State’s outreach to and services for older individuals, individuals who are
homeless, and individuals living in rural areas, and how community-based
services will be provided to these
individuals.
.
(b)
Effective
date
The amendment made by
subsection (a) shall apply to State plans submitted on or after the date that
is 180 days after the date of enactment of this Act.