,,ii #aacth ,,congress #ast ,session ,s4 #bfd ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,february #g1 #bjac ,ms4 ,stabenow 7for herself1 ,mr4 ,reed1 ,mr4 ,blunt1 ,mr4 ,rubio1 ,ms4 ,collins1 ,mrs4 ,boxer1 ,mr4 ,rockefeller1 ,mr4 ,tester1 ,mr4 ,begich1 and ,mr4 ,leahy7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to expand access to community mental health centers and improve the quality of mental health care for all ,americans4 #a4 ,short title ,this ,act may be cited as the ,excellence in ,mental ,health ,act4 #b4 ,establishing community behavioral health centers ,section #aiac of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjx-#b7 is amended-- 7#a7 in subsection 7a77#b77;,a71 by striking community mental health services and inserting behavioral health services 7of the type offered by federally qualified community behavioral health centers consistent with subsection 7c77#c772 7#b7 in subsection 7b7-- 7,a7 by striking paragraph 7#a7 and inserting the following3 7#a7 services under the plan will be provided only through appropriate1 qualified community programs 7which may include federally qualified community behavioral health centers1 child mental health programs1 psychosocial rehabilitation programs1 mental health peer-support programs1 outpatient addiction treatment programs1 acute detoxification services1 and mental health primary consumer-directed programs72 and 2 and 7,b7 in paragraph 7#b71 by striking community mental health centers and inserting federally qualified community behavioral health centers2 and 7#c7 by striking subsection 7c7 and inserting the following3 7c7 ,criteria for ,federally ,qualified ,community ,behavioral ,health ,centers 7#a7 ,in general ,the ,administrator shall certify1 and recertify at least every #e years1 federally qualified community behavioral health centers as meeting the criteria specified in this subsection4 7#b7 ,regulations ,not later than #ah months after the date of the enactment of the ,excellence in ,mental ,health ,act1 the ,administrator1 in consultation with ,state ,mental ,health and ,substance ,abuse ,authorities1 shall issue final regulations for certifying non-profit or local government centers as centers under paragraph 7#a74 7#c7 ,criteria ,the criteria referred to in subsection 7b77#b7 are that the center performs each of the following3 7,a7 ,provide services in locations that ensure services will be available and accessible promptly and in a manner which preserves human dignity and assures continuity of care4 7,b7 ,provide services in a mode of service delivery appropriate for the target population4 7,c7 ,provide individuals with a choice of service options where there is more than one efficacious treatment4 7,d7 ,employ a core staff of clinical staff that is multidisciplinary and culturally and linguistically competent4 7,e7 ,provide services1 within the limits of the capacities of the center1 to any individual residing or employed in the service area of the center1 regardless of the ability of the individual to pay4 7,f7 ,provide1 directly or through contract1 to the extent covered for adults in the ,state ,medicaid plan under title ,,xix of the ,social ,security ,act and for children in accordance with section #aije7r7 of such ,act regarding early and periodic screening1 diagnosis1 and treatment1 each of the following services3 7i7 ,screening1 assessment1 and diagnosis1 including risk assessment4 7ii7 ,person-centered treatment planning or similar processes1 including risk assessment and crisis planning4 7iii7 ,outpatient mental health and substance use services1 including screening1 assessment1 diagnosis1 psychotherapy1 medication management1 and integrated treatment for mental illness and substance abuse which shall be evidence-based 7including cognitive behavioral therapy and other such therapies which are evidence-based74 7iv7 ,outpatient clinic primary care screening and monitoring of key health indicators and health risk 7including screening for diabetes1 hypertension1 and cardiovascular disease and monitoring of weight1 height1 body mass index 7,,bmi71 blood pressure1 blood glucose or ,hb,a#a;,c1 and lipid profile74 7v7 ,crisis mental health services1 including #bd-;hour mobile crisis teams1 emergency crisis intervention services1 and crisis stabilization4 7vi7 ,targeted case management 7services to assist individuals gaining access to needed medical1 social1 educational1 and other services and applying for income security and other benefits to which they may be entitled74 7vii7 ,psychiatric rehabilitation services including skills training1 assertive community treatment1 family psychoeducation1 disability self-management1 supported employment1 supported housing services1 therapeutic foster care services1 and such other evidence-based practices as the ,secretary may require4 7viii7 ,peer support and counselor services and family supports4 7,g7 ,maintain linkages1 and where possible enter into formal contracts with the following3 7i7 ,federally qualified health centers4 7ii7 ,inpatient psychiatric facilities and substance use detoxification1 post-detoxification step-down services1 and residential programs4 7iii7 ,adult and youth peer support and counselor services4 7iv7 ,family support services for families of children with serious mental or substance use disorders4 7v7 ,other community or regional services1 supports1 and providers1 including schools1 child welfare agencies1 juvenile and criminal justice agencies and facilities1 housing agencies and programs1 employers1 and other social services4 7vi7 ,onsite or offsite access to primary care services4 7vii7 ,enabling services1 including outreach1 transportation1 and translation4 7viii7 ,health and wellness services1 including services for tobacco cessation4 7,h7 ,where feasible1 provide outreach and engagement to encourage individuals who could benefit from mental health care to freely participate in receiving the services described in this subsection4 7#d7 ,rule of construction ,nothing in paragraph 7#a7 shall be construed as prohibiting ,states receiving funds appropriated through the ,community ,mental ,health ,services ,block ,grant under subpart ,i of part ,b of this title from financing qualified community programs 7whether such programs meet the definition of eligible programs prior to or after the date of enactment of this subsection74 7#e7 ,limitation ,with respect to federally qualified behavioral health centers authorized under this subsection1 #bj percent of the total number of such centers shall become newly eligible to receive reimbursement under this section in each of the first #e years after the initial year of eligibility through fiscal year #bjbc4 ,in implementing this paragraph1 the ,secretary shall ensure geographic diversity of such sites1 take into account the ability of such sites to provide required services1 and the ability of such sites to report required data4 4 #c4 ,medicaid coverage and payment for community behavioral health center services 7a7 ,payment for services provided by federally qualified community behavioral health centers ,section #aijb7;bb7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7bb77 is amended-- 7#a7 in the heading1 by striking and ,rural ,health ,clinics and inserting 1 federally qualified community behavioral health centers1 and ,rural ,health ,clinics2 7#b7 in paragraph 7#a71 by inserting 7and beginning with fiscal year #bjaf with respect to services furnished on or after ,january #a1 #bjaf1 and each succeeding fiscal year1 for services described in section #aije7;a77#b77;,d7 furnished by a federally qualified community behavioral health center7 after by a rural health clinic2 7#c7 in paragraph 7#b7-- 7,a7 by striking the heading and inserting ,initial fiscal year2 7,b7 by inserting 7or1 in the case of services described in section #aije7;a77#b77;,d7 furnished by a federally qualified community behavioral health center1 for services furnished on and after ,january #a1 #bjaf1 during fiscal year #bjaf7 after ,january #a1 #bjja1 during fiscal year #bjja2 7,c7 by inserting 7or1 in the case of services described in section #aije7;a77#b77;,d7 furnished by a federally qualified community behavioral health center1 during fiscal years #bjad and #bjae7 after #aiii and #bjjj2 and 7,d7 by inserting 7or1 in the case of services described in section #aije7;a77#b77;,d7 furnished by a federally qualified community behavioral health center1 during fiscal year #bjaf7 before the period2 7#d7 in paragraph 7#c7-- 7,a7 in the heading1 by striking ,fiscal year #bjjb and succeeding and inserting ,succeeding2 and 7,b7 by inserting 7or1 in the case of services described in section #aije7;a77#b77;,d7 furnished by a federally qualified community behavioral health center1 for services furnished during fiscal year #bjag or a succeeding fiscal year7 after #bjjb or a succeeding fiscal year2 7#e7 in paragraph 7#d7-- 7,a7 by inserting 7or as a federally qualified community behavioral health center after fiscal year #bjae7 after or rural health clinic after fiscal year #bjjj2 7,b7 by striking furnished by the center or and inserting furnished by the federally qualified health center1 services described in section #aije7;a77#b77;,d7 furnished by the federally qualified community behavioral health center1 or2 and 7,c7 in the second sentence1 by striking or rural health clinic and inserting 1 federally qualified community behavioral health center1 or rural health clinic2 7#f7 in paragraph 7#e71 in each of subparagraphs 7,a7 and 7,b71 by striking or rural health clinic and inserting 1 federally qualified community behavioral health center1 or rural health clinic2 and 7#g7 in paragraph 7#f71 by striking or to a rural health clinic and inserting 1 to a federally qualified community behavioral health center for services described in section #aije7;a77#b77;,d71 or to a rural health clinic4 7b7 ,inclusion of community behavioral health center services in the term medical assistance ,section #aije7;a77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7a77#b77 is amended-- 7#a7 by striking and before 7,c72 and 7#b7 by inserting before the semicolon at the end the following3 1 and 7,d7 federally qualified community behavioral health center services 7as defined in subsection 7l77#d774 7c7 ,definition of federally qualified community behavioral health center services ,section #aije7l7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7l77 is amended by adding at the end the following paragraph3 7#d7 7,a7 ,the term community behavioral health center services means services furnished to an individual at a federally qualified community behavioral health center 7as defined by subparagraph 7,b774 7,b7 ,the term federally qualified community behavioral health center means an entity that is certified under section #aiac7;c7 of the ,public ,health ,service ,act as meeting the criteria described in paragraph 7#c7 of such section4 4 7d7 ,effective date ,the amendments made by this section take effect on ,january #a1 #bjaf4 #d4 ,community-based mental health infrastructure improvement ,title ,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhj;g et seq47 is amended by adding at the end the following3 ,h ,community-based mental health infrastructure improvements #efj4 ,grants for community-based mental health infrastructure improvements 7a7 ,grants authorized ,the ,secretary may award grants to eligible entities to expend funds for the construction or modernization of facilities used to provide mental health and substance abuse services to individuals4 7b7 ,eligible entity ,in this section1 the term eligible entity means-- 7#a7 a ,state that is the recipient of a ,community ,mental ,health ,services ,block ,grant under subpart ,i of part ,b of title ,,xix and a ,substance ,abuse ,prevention and ,treatment ,block ,grant under subpart ,,ii of such part2 or 7#b7 an ,indian tribe or a tribal organization 7as such terms are defined in sections #d7;b7 and #d7;c7 of the ,indian ,self-,determination and ,education ,assistance ,act74 7c7 ,application ,a eligible entity desiring a grant under this section shall submit to the ,secretary an application at such time1 in such manner1 and containing-- 7#a7 a plan for the construction or modernization of facilities used to provide mental health and substance abuse services to individuals that-- 7,a7 designates a single ,state or tribal agency as the sole agency for the supervision and administration of the grant2 7,b7 contains satisfactory evidence that such agency so designated will have the authority to carry out the plan2 7,c7 provides for the designation of an advisory council1 which shall include representatives of nongovernmental organizations or groups1 and of the relevant ,state or tribal agencies1 that aided in the development of the plan and that will implement and monitor any grant awarded to the eligible entity under this section2 7,d7 in the case of an eligible entity that is a ,state1 includes a copy of the ,state plan under section #aiab7;b7 and section #aicb7;b72 7,e7 7i7 includes a listing of the projects to be funded by the grant2 and 7ii7 in the case of an eligible entity that is a ,state1 explains how each listed project helps the ,state in accomplishing its goals and objectives under the ,community ,mental ,health ,services ,block ,grant under subpart ,i of part ,b of title ,,xix and the ,substance ,abuse ,prevention and ,treatment ,block ,grant under subpart ,,ii of such part2 7,f7 includes assurances that the facilities will be used for a period of not less than #aj years for the provision of community-based mental health or substance abuse services for those who cannot pay for such services1 subject to subsection 7e72 and 7,g7 in the case of a facility that is not a public facility1 includes the name and executive director of the entity who will provide services in the facility2 and 7#b7 with respect to each construction or modernization project described in the application-- 7,a7 a description of the site for the project2 7,b7 plans and specifications for the project and ,state or tribal approval for the plans and specifications2 7,c7 assurance that the title for the site is or will be vested with either the public entity or private nonprofit entity who will provide the services in the facility2 7,d7 assurance that adequate financial resources will be available for the construction or major rehabilitation of the project and for the maintenance and operation of the facility2 7,e7 estimates of the cost of the project2 and 7,f7 the estimated length of time for completion of the project4 7d7 ,subgrants by ,states 7#a7 ,in general ,a ,state that receives a grant under this section may award a subgrant to a qualified community program 7as such term is used in section #aiac7;b77#a774 7#b7 ,use of funds ,subgrants awarded pursuant to paragraph 7#a7 may be used for activities such as-- 7,a7 the construction1 expansion1 and modernization of facilities used to provide mental health and substance abuse services to individuals2 7,b7 acquiring and leasing facilities and equipment 7including paying the costs of amortizing the principal of1 and paying the interest on1 loans for such facilities and equipment7 to support or further the operation of the subgrantee2 7,c7 the construction and structural modification 7including equipment acquisition7 of facilities to permit the integrated delivery of behavioral health and primary care of specialty medical services to individuals with co-occurring mental illnesses and chronic medical or surgical diseases at a single service site2 and 7,d7 acquiring information technology required to accommodate the clinical needs of primary and specialty care professionals4 7#c7 ,limitation ,not to exceed #ae percent of grant funds may be used for activities described in paragraph 7#b77;,d74 7e7 ,request ,to transfer obligation ,an eligible entity that receives a grant under this section may submit a request to the ,secretary for permission to transfer the #aj-year obligation of facility use1 as described in subsection 7c77#a77;,f71 to another facility4 7f7 ,agreement to ,federal share ,as a condition of receipt of a grant under this section1 an eligible entity shall agree1 with respect to the costs to be incurred by the entity in carrying out the activities for which such grant is awarded1 that the entity will make available non-,federal contributions 7which may include ,state or local funds1 or funds from the qualified community program7 in an amount equal to not less than #a for every #a of ,federal funds provided under the grant4 7g7 ,reporting 7#a7 ,reporting by ,states ,during the #aj-year period referred to in subsection 7c77#a77;,f71 the ,secretary shall require that a ,state that receives a grant under this section submit1 as part of the report of the ,state required under the ,community ,mental ,health ,services ,block ,grant under subpart ,i of part ,b of title ,,xix and the ,substance ,abuse ,prevention and ,treatment ,block ,grant under subpart ,,ii of such part1 a description of the progress on-- 7,a7 the projects carried out pursuant to the grant under this section2 and 7,b7 the assurances that the facilities involved continue to be used for the purpose for which they were funded under such grant during such #aj-year period4 7#b7 ,reporting by ,indian tribes and tribal organizations ,the ,secretary shall establish reporting requirements for ,indian tribes and tribal organizations that receive a grant under this section4 ,such reporting requirements shall include that such ,indian tribe or tribal organization provide a description of the progress on-- 7,a7 the projects carried out pursuant to the grant under this section2 and 7,b7 the assurances that the facilities involved continue to be used for the purpose for which they were funded under such grant during the #aj-year period referred to in subsection 7c77#a77;,f74 7h7 ,failure ,to meet obligations 7#a7 ,in general ,if an eligible entity that receives a grant under this section fails to meet any of the obligations of the entity required under this section1 the ,secretary shall take appropriate steps1 which may include-- 7,a7 requiring that the entity return the unused portion of the funds awarded under this section for the projects that are incomplete2 and 7,b7 extending the length of time that the entity must ensure that the facility involved is used for the purposes for which it is intended1 as described in subsection 7c77#a77;,f74 7#b7 ,hearing ,prior to requesting the return of the funds under paragraph 7#a77;,b71 the ,secretary shall provide the entity notice and opportunity for a hearing4 7i7 ,collaboration ,the ,secretary may establish intergovernmental and interdepartmental memorandums of agreement as necessary to carry out this section4 7j7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years #bjad through #bjah4 4