,i #aadth ,,congress #b;d ,session ,h4 ,r4 #ddce ,,in ,,the ,,house ,,of ,,representatives ,february #b1 #bjaf ,mr4 ,gene ,green of ,texas 7for himself1 ,ms4 ,de,gette1 ,mr4 ,kennedy1 ,ms4 ,matsui1 ,mr4 ,tonko1 and ,mr4 ,loebsack7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce1 and in addition to the ,committees on the ,judiciary1 ,ways and ,means1 ,education and the ,workforce1 and ,natural ,resources1 for a period to be subsequently determined by the ,speaker1 in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned ,a ,,bill ,to improve access to mental health and substance use disorder prevention1 treatment1 crisis1 and recovery services4 #a4 ,short title2 table of contents 7a7 ,short title ,this ,act may be cited as the ,comprehensive ,behavioral ,health ,reform and ,recovery ,act of #bjaf4 7b7 ,table of contents ,the table of contents for this ,act is as follows3 ,sec4 #a4 ,short title2 table of contents4 ,title ,i--,strengthening and ,investing in ,,samhsa ,programs ,sec4 #aja4 ,assistant ,secretary for ,mental ,health and ,substance ,use ,disorders4 ,sec4 #ajb4 ,office of ,chief ,medical ,officer4 ,sec4 #ajc4 ,independent audit of ,,samhsa4 ,sec4 #ajd4 ,center for ,behavioral ,health ,statistics and ,quality4 ,sec4 #aje4 ,innovation grants4 ,sec4 #ajf4 ,demonstration grants4 ,sec4 #ajg4 ,early intervention and treatment in childhood4 ,sec4 #ajh4 ,block grants4 ,sec4 #aji4 ,children's recovery from trauma4 ,sec4 #aaj4 ,garrett ,lee ,smith ,memorial ,act reauthorization4 ,sec4 #aaa4 ,national ,suicide ,prevention ,lifeline ,program4 ,sec4 #aab4 ,adult suicide prevention4 ,sec4 #aac4 ,peer review and advisory councils4 ,sec4 #aad4 ,adult trauma4 ,sec4 #aae4 ,reducing the stigma of serious mental illness4 ,sec4 #aaf4 ,report on mental health and substance abuse treatment in the ,states4 ,sec4 #aag4 ,mental health first aid training grants4 ,sec4 #aah4 ,acute care bed registry grant for ,states4 ,sec4 #aai4 ,older adult mental health grants4 ,title ,,ii--,interagency ,serious ,mental ,illness ,coordinating ,committee ,sec4 #bja4 ,interagency ,serious ,mental ,illness ,coordinating ,committee4 ,title ,,iii--,communications between individuals1 families1 and providers ,sec4 #cja4 ,clarification of circumstances under which disclosure of protected health information of mental illness patients is permitted4 ,sec4 #cjb4 ,development and dissemination of model training programs4 ,sec4 #cjc4 ,modernizing privacy protections4 ,sec4 #cjd4 ,improving communication with individuals1 families1 and providers4 ,title ,,iv--,improving ,medicaid and ,medicare ,mental ,health ,services ,subtitle ,a--,medicaid ,provisions ,sec4 #dja4 ,enhanced ,medicaid coverage relating to certain mental health services4 ,sec4 #djb4 ,extension and expansion of demonstration programs to improve community mental health services4 ,sec4 #djc4 ,terms for extension and expansion of ,medicaid emergency psychiatric demonstration project4 ,sec4 #djd4 ,community-based mental health services ,medicaid option for children in or at risk of psychiatric residential treatment4 ,sec4 #dje4 ,expansion of ,,cmmi authority to support major mental illness projects in ,medicaid4 ,sec4 #djf4 ,medicaid data and reporting4 ,sec4 #djg4 ,at-risk youth ,medicaid protection4 ,subtitle ,b--,medicare ,provisions ,sec4 #daa4 ,elimination of #aij-;day lifetime limit on coverage of inpatient psychiatric hospital services under ,medicare4 ,sec4 #dab4 ,modifications to ,medicare discharge planning requirements4 ,subtitle ,c--,provisions ,related to ,medicaid and ,medicare ,sec4 #dba4 ,reports on ,medicaid and ,medicare part ,d formulary and appeals practices with respect to coverage of mental health drugs4 ,title ,v--,strengthening the ,behavioral ,health ,workforce and ,improving ,access to ,care ,sec4 #eja4 ,nationwide workforce strategy4 ,sec4 #ejb4 ,report on best practices for peer-support specialist programs1 training1 and certification4 ,sec4 #ejc4 ,advisory ,council on ,graduate ,medical ,education4 ,sec4 #ejd4 ,telepsychiatry and primary care provider training grant program4 ,sec4 #eje4 ,liability protections for health care professional volunteers at community health centers and federally qualified community behavioral health clinics4 ,sec4 #ejf4 ,minority ,fellowship ,program4 ,sec4 #ejg4 ,national ,health ,service ,corps4 ,sec4 #ejh4 ,,samhsa grant program for development and implementation of curricula for continuing education on serious mental illness4 ,sec4 #eji4 ,peer professional workforce development grant program4 ,sec4 #eaj4 ,demonstration grant program to recruit1 train1 and professionally support psychiatric physicians in ,indian health programs4 ,sec4 #eaa4 ,education and training on eating disorders for health professionals4 ,sec4 #eab4 ,primary and behavioral health care integration grant programs4 ,sec4 #eac4 ,health professions competencies to address racial1 ethnic1 sexual1 and gender minority behavioral health disparities4 ,sec4 #ead4 ,behavioral health crisis systems4 ,sec4 #eae4 ,mental health in schools4 ,sec4 #eaf4 ,examining mental health care for children4 ,sec4 #eag4 ,reporting compliance study4 ,sec4 #eah4 ,strengthening connections to community care demonstration grant program4 ,sec4 #eai4 ,assertive community treatment grant program for individuals with serious mental illness4 ,sec4 #ebj4 ,improving mental and behavioral health on college campuses4 ,sec4 #eba4 ,inclusion of occupational therapists in ,national ,health ,service ,corps program4 ,title ,,vi--,improving ,mental ,health ,research and ,coordination ,sec4 #fja4 ,increase in funding for certain research4 ,title ,,vii--,behavioral ,health ,information ,technology ,sec4 #gja4 ,extension of health information technology assistance for behavioral and mental health and substance abuse4 ,sec4 #gjb4 ,extension of eligibility for ,medicare and ,medicaid health information technology implementation assistance4 ,title ,,viii--,making ,parity ,work ,sec4 #hja4 ,strengthening parity in mental health and substance use disorder benefits4 ,sec4 #hjb4 ,report on investigations regarding parity in mental health and substance use disorder benefits4 ,sec4 #hjc4 ,,gao study on preventing discriminatory coverage limitations for individuals with serious mental illness and substance use disorders4 ,sec4 #hjd4 ,report to ,congress on ,federal assistance to ,state insurance regulators regarding mental health parity enforcement4 ,title ,,ix--,substance abuse ,subtitle ,a--,prevention ,sec4 #ija4 ,practitioner education4 ,sec4 #ijb4 ,co-prescribing opioid overdose reversal drugs grant program4 ,sec4 #ijc4 ,opioid overdose reversal co-prescribing guidelines4 ,sec4 #ijd4 ,surveillance capacity building4 ,subtitle ,b--,crisis ,sec4 #iba4 ,grants to support syringe exchange programs4 ,sec4 #ibb4 ,grant program to reduce drug overdose deaths4 ,subtitle ,c--,treatment ,sec4 #ica4 ,expansion of patient limits under waiver4 ,sec4 #icb4 ,definitions4 ,sec4 #icc4 ,evaluation by assistant ,secretary for planning and evaluation4 ,sec4 #icd4 ,reauthorization of residential treatment programs for pregnant and postpartum women4 ,sec4 #ice4 ,pilot program grants for ,state substance abuse agencies4 ,sec4 #icf4 ,evidence-based opioid and heroin treatment and interventions demonstration4 ,sec4 #icg4 ,adolescent treatment and recovery services demonstration grant program4 ,sec4 #ich4 ,study on treatment infrastructure4 ,sec4 #ici4 ,substance use disorder professional loan repayment program4 ,subtitle ,d--,recovery ,sec4 #iea4 ,national youth recovery initiative4 ,sec4 #ieb4 ,grants to enhance and expand recovery support services4 ,i ,strengthening and ,investing in ,,samhsa ,programs #aja4 ,assistant ,secretary for ,mental ,health and ,substance ,use ,disorders 7a7 ,in general ,section #eja of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;aa7 is amended-- 7#a7 in subsection 7c77#a71 by adding at the end the following3 ,the ,administrator shall be selected from individuals who have appropriate education and experience4 ,the ,administrator shall also be the ,assistant ,secretary for ,mental ,health and ,substance ,abuse42 7#b7 in subsection 7d7-- 7,a7 by striking ,the ,secretary and all that follows through 7#a7 supervise the functions and inserting the following3 7#a7 ,secretary's authorities ,the ,secretary1 acting through the ,administrator1 shall-- 7,a7 supervise the functions 2 7,b7 by moving the indentation of each of paragraphs 7#b7 through 7#ah7 #b ems to the right and redesignating such paragraphs as subparagraphs 7,b7 through 7,r71 respectively2 and 7#c7 by adding at the end the following3 7#b7 ,assistant ,secretary's authorities ,the ,assistant ,secretary for ,mental ,health and ,substance ,abuse shall-- 7,a7 serve as the effective and visible advocate for individuals with1 or at risk for1 mental illness and substance use disorders within the ,department of ,health and ,human ,services and with other departments1 agencies1 and instrumentalities of the ,federal ,government2 7,b7 assist the ,secretary in all matters pertaining to issues that impact the prevention1 treatment1 and recovery of individuals with mental illness or substance use disorders2 7,c7 coordinate ,federal programs and activities related to promoting mental health and preventing substance abuse2 7,d7 coordinate activities with ,federal entities to implement and build awareness of programs providing benefits affecting individuals with mental illness or substance use disorders2 7,e7 promote and coordinate research1 treatment1 and services across departments1 agencies1 organizations1 and individuals with respect to prevention1 treatment1 and recovery support research and programs for individuals with1 or at risk for1 substance use disorders or mental illness2 7,f7 coordinate functions within the ,department of ,health and ,human ,services-- 7i7 to improve the treatment of1 and related services to1 individuals with substance use disorders or mental illness2 7ii7 to improve substance misuse and abuse prevention and mental health promotion services2 7iii7 to ensure access to effective1 evidence-based treatment for individuals with mental illnesses and individuals with a substance use disorder2 7iv7 to ensure that grant programs of the ,department adhere to scientific standards for individuals with mental illness or substance use disorders2 and 7v7 to support the development and implementation of initiatives to encourage individuals to pursue careers 7especially in underserved areas and populations7 as psychiatrists1 psychologists1 psychiatric nurse practitioners1 clinical social workers1 physician assistants1 peer support specialists1 and other licensed or certified mental health and substance abuse professionals2 7,g7 within the ,department of ,health and ,human ,services1 coordinate all programs and activities relating to-- 7i7 the prevention of1 and treatment and recovery for1 mental health or substance use disorders2 or 7ii7 the reduction of homelessness among individuals with mental illness or substance use disorders2 7,h7 across the ,federal ,government1 in conjunction with the ,interagency ,serious ,mental ,illness ,coordinating ,committee under section #eja;,a-- 7i7 review all programs and activities relating to the prevention of1 or treatment or rehabilitation for1 mental illness or substance use disorders2 7ii7 identify any such programs and activities that are duplicative2 7iii7 identify any such programs and activities that are not evidence-based1 effective1 or efficient2 and 7iv7 formulate recommendations for expanding1 coordinating1 eliminating1 and improving programs and activities identified pursuant to subparagraph 7,b7 or 7,c7 and merging such programs and activities into other1 successful programs and activities2 and 7,i7 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 efficiency1 effectiveness1 quality1 coordination1 and cost effectiveness4 4 7b7 ,prioritization of integration of services1 early diagnosis1 intervention1 and workforce development ,in carrying out the duties described in section #eja7;d77#b7 of the ,public ,health ,service ,act1 as added by subsection 7a71 the ,assistant ,secretary shall prioritize-- 7#a7 the integration of mental health1 substance use1 and physical health services for the purpose of diagnosing1 preventing1 treating1 or providing rehabilitation for mental illness or substance use disorders1 including any such services provided through the justice system 7including departments of correction7 or other entities other than the ,department of ,health and ,human ,services2 7#b7 crisis intervention for1 early diagnosis and intervention services for the prevention of1 and treatment and rehabilitation for1 serious mental illness1 serious emotional disturbance1 or substance use disorders2 and 7#c7 workforce development for-- 7,a7 appropriate treatment of serious mental illness1 serious emotional disturbance1 or substance use disorders2 and 7,b7 research activities that advance scientific and clinical understandings of these disorders1 including the development and implementation of a continuing nationwide strategy to increase the psychiatric workforce with psychiatrists1 child and adolescent psychiatrists1 psychologists1 psychiatric nurse practitioners1 clinical social workers1 peer support specialists1 and other licensed or certified mental health or substance abuse professionals4 7c7 ,requirements and restrictions on authority ,to award grants ,in awarding any grant or financial assistance1 the ,administrator of the ,substance ,abuse and ,mental ,health ,services ,administration1 and any agency or official within such ,administration1 shall comply with the following3 7#a7 ,any program to be funded shall be demonstrated-- 7,a7 in the case of an ongoing program1 to be effective2 and 7,b7 in the case of a new program1 to have the prospect of being effective4 7#b7 ,the programs and activities to be funded shall1 as appropriate1 use evidence-based best practices or emerging evidence-based practices that are translational and can be expanded or replicated to other ,states1 local communities1 agencies1 tribes1 or through the ,medicaid program under title ,,xix of the ,social ,security ,act4 7#c7 ,an application for the grant or financial assistance shall include1 as applicable1 a scientific justification based on previously demonstrated models1 the number of individuals to be served1 the population to be targeted1 what objective outcomes measures will be used1 and details on how the program or activity to be funded can be replicated and by whom4 7#d7 ,applicants shall be evaluated and selected through a blind1 peer-review process by individuals with expertise appropriate to the grant or other financial assistance1 such as health care providers with professional experience in mental health or substance abuse research or treatment4 7#e7 ,the ,secretary shall adopt a policy that ensures that any member of a peer review group does not have a conflict of interest with respect to any program or grant to be reviewed4 7#f7 ,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-- 7,a7 the best scientific method for both services and data collection is being followed2 and 7,b7 ,federal funds are being used as required by the conditions of the award4 7#g7 ,award recipients that fail an audit or fail to provide information pursuant to an audit shall have their awards terminated or shall be placed on a corrective action plan to address the issues raised in the audit findings4 7d7 ,definition ,in this ,act1 except as inconsistent with the provisions of this ,act1 the term ,assistant ,secretary means the ,assistant ,secretary for ,mental ,health and ,substance ,use ,disorders4 #ajb4 ,office of ,chief ,medical ,officer 7a7 ,in general ,section #eja of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;aa7 is amended-- 7#a7 by redesignating subsections 7g7 through 7o7 as subsections 7h7 through 7p71 respectively2 and 7#b7 by inserting after subsection 7f7 the following3 7g7 ,chief ,medical ,office ,the ,administrator shall establish within the ,administration a ,chief ,medical ,office1 to be headed by a ,chief ,medical ,officer1 who shall be a psychiatrist4 ,the ,chief ,medical ,office shall be staffed by mental health and substance abuse providers4 4 7b7 ,conforming changes ,title ,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;aa et seq47 is amended-- 7#a7 in subsections 7e77#c77;,c7 and 7f77#b77;,c77iii7 of section #eja1 by striking subsection 7k7 and inserting subsection 7l72 and 7#b7 in section #ejh7p71 by striking #eja7k7 and inserting #eja7l74 #ajc4 ,independent audit of ,,samhsa 7a7 ,in general ,the ,secretary shall enter into an contract or cooperative agreement with an external1 independent entity to conduct a full assessment and review of the ,substance ,abuse and ,mental ,health ,services ,administration 7in this section referred to as ,,samhsa74 7b7 ,report ,the contract or cooperative agreement under subsection 7a7 shall require that1 not later than #ah months after the date of enactment of this ,act1 the external1 independent entity will submit to the ,committee on ,energy and ,commerce of the ,house of ,representatives and the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate a report on the findings and conclusion of the assessment and review4 7c7 ,topics ,the assessment and review conducted pursuant to subsection 7a71 and the report submitted pursuant to subsection 7b71 shall address each of the following3 7#a7 ,whether the mission of ,,samhsa is appropriate4 7#b7 ,whether the program authority of ,,samhsa is appropriate4 7#c7 ,whether ,,samhsa has adequate staffing1 including technical expertise1 to fulfill its mission4 7#d7 ,whether ,,samhsa is funded appropriately4 7#e7 ,the efficacy of the programs funded by ,,samhsa4 7#f7 ,whether funding is being spent in a way that effectively supports and promotes the authorities vested by section #eja7;d7 of the ,public ,health ,service ,act1 as amended by section #aja of this ,act4 7#g7 ,whether ,,samhsa's focus on recovery is appropriate4 7#h7 ,additional steps ,,samhsa can take to fulfill its charge of leading public health efforts to advance the behavioral health of the ,nation and reduce the impact of substance abuse and mental illness on the ,nation's communities4 7#i7 ,whether standards for ,,samhsa's grant programs are effective4 7#aj7 ,whether standards for ,,samhsa's appointment of peer-review panels to evaluate grant applications is appropriate4 7#aa7 ,how ,,samhsa serves individuals with mental illness1 serious mental illness1 serious emotional disturbance1 or substance use disorders1 and individuals with co-occurring conditions4 #ajd4 ,center for ,behavioral ,health ,statistics and ,quality ,title ,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;aa et seq47 is amended-- 7#a7 in section #eja7;b7 7#db ,u4,s4,c4 #bij;aa7b771 by adding at the end the following3 7#d7 ,the ,center for ,behavioral ,health ,statistics and ,quality4 2 7#b7 in section #ejb7;a77#a7 7#db ,u4,s4,c4 #bij;aa-#a7;a77#a77-- 7,a7 in subparagraph 7,c71 by striking and at the end2 7,b7 in subparagraph 7,d71 by striking the period at the end and inserting and2 and 7,c7 by inserting after subparagraph 7,d7 the following3 7,e7 the ,center for ,behavioral ,health ,statistics and ,quality4 2 and 7#c7 in part ,b 7#db ,u4,s4,c4 #bij;bb et seq47 by adding at the end the following new subpart3 #d ,center for ,behavioral ,health ,statistics and ,quality #ebj,l4 ,center for ,behavioral ,health ,statistics and ,quality 7a7 ,establishment ,there is established in the ,administration a ,center for ,behavioral ,health ,statistics and ,quality 7in this section referred to as the ,center74 ,the ,center shall be headed by a ,director 7in this section referred to as the ,director7 appointed by the ,secretary from among individuals with extensive experience and academic qualifications in research and analysis in behavioral health care or related fields4 7b7 ,duties ,the ,director of the ,center shall-- 7#a7 coordinate the ,administration's integrated data strategy by coordinating-- 7,a7 surveillance and data collection 7including that authorized by section #eje72 7,b7 evaluation2 7,c7 statistical and analytic support2 7,d7 service systems research2 and 7,e7 performance and quality information systems2 7#b7 maintain operation of the ,national ,registry of ,evidence-,based ,programs and ,practices to provide for the evaluation and dissemination to the ,administration of the evidence-based practices and services delivery models of grantees and other interested parties2 7#c7 recommend a core set of measurement standards for grant programs administered by the ,administration2 and 7#d7 lead evaluation efforts for the grant programs1 contracts1 and collaborative agreements of the ,administration4 7c7 ,biannual report to ,congress ,not later than #b years after the date of enactment of this section1 and every #b years thereafter1 the ,director of the ,center shall submit to ,congress a report on the quality of services furnished through grant programs of the ,administration1 including applicable measures of outcomes for individuals and public outcomes such as-- 7#a7 the number of patients screened positive for unhealthy alcohol use who receive brief counseling as appropriate2 the number of patients screened positive for tobacco use and receiving smoking cessation interventions2 the number of patients with a new diagnosis of major depressive episode who are assessed for suicide risk2 the number of patients screened positive for clinical depression with a documented follow-up plan2 and the number of patients with a documented pain assessment that have a follow-up treatment plan when pain is present2 and satisfaction with care2 7#b7 the incidence and prevalence of substance use and mental disorders2 the number of suicide attempts and suicide completions2 overdoses seen in emergency rooms resulting from alcohol and drug use2 emergency room boarding2 overdose deaths2 emergency psychiatric hospitalizations2 new criminal justice involvement while in treatment2 stable housing2 and rates of involvement in employment1 education1 and training2 and 7#c7 such other measures for outcomes of services as the ,director may determine4 7d7 ,staffing ,composition ,the staff of the ,center may include individuals with advanced degrees and field expertise as well as clinical and research experience in mental and substance use disorders such as-- 7#a7 professionals with clinical and research expertise in the prevention and treatment of1 and recovery from1 substance use and mental disorders2 7#b7 professionals with training and expertise in statistics or research and survey design and methodologies2 and 7#c7 other related fields in the social and behavioral sciences1 as specified by relevant position descriptions4 7e7 ,grants and contracts ,in carrying out the duties established in subsection 7b71 the ,director may make grants to and enter into contracts and cooperative agreements with public and nonprofit private entities4 7f7 ,definition ,in this section1 the term emergency room boarding means the practice of admitting patients to an emergency department and holding such patients in the department until inpatient psychiatric beds become available4 4 #aje4 ,innovation grants 7a7 ,in general ,the ,assistant ,secretary1 acting through the ,substance ,abuse and ,mental ,health ,services ,administration1 shall award grants to ,state and local governments1 tribes and tribal organizations1 educational institutions1 and nonprofit organizations for expanding a model that has been scientifically demonstrated to show promise1 but would benefit from further applied research1 for-- 7#a7 enhancing the screening1 diagnosis1 and treatment of mental illness and serious mental illness2 or 7#b7 integrating or coordinating physical1 mental health1 and substance use services4 7b7 ,duration ,a grant under this section shall be for a period of not less than #c years and not more than #e years4 7c7 ,limitations ,of the amounts made available for carrying out this section for a fiscal year1 not less than one-third shall be awarded for screening1 diagnosis1 treatment1 or services1 as described in subsection 7a71 for individuals 7or subpopulations of individuals7 who are below the age of #ah when activities funded through the grant award are initiated4 7d7 ,guidelines ,as a condition on receipt of an award under this section1 an applicant shall agree to adhere to any requirements or guidelines issued by the ,secretary on research designs and data collection4 7e7 ,termination ,the ,secretary may terminate any award under this section upon a determination that-- 7#a7 the recipient is not providing information requested by the ,secretary in connection with the award2 or 7#b7 there is a clear failure in the effectiveness of the recipient's programs or activities funded through the award4 7f7 ,reporting ,as a condition on receipt of an award under this section1 an applicant shall agree-- 7#a7 to report to the ,secretary the results of programs and activities funded through the award2 and 7#b7 to include in such reporting any relevant data requested by the ,secretary4 7g7 ,authorization of appropriations ,for the purpose of providing grants under this section1 there is authorized to be appropriated #dj1jjj1jjj for each of fiscal years #bjag through #bjba4 #ajf4 ,demonstration grants 7a7 ,grants ,the ,secretary of ,health and ,human ,services 7in this section referred to as the ,secretary71 acting through the ,substance ,abuse and ,mental ,health ,services ,administration1 shall award grants to ,states1 counties1 local governments1 tribes and tribal organizations1 educational institutions1 and private nonprofit organizations for the expansion1 replication1 or scaling of evidence-based programs across a wider area to enhance effective screening1 early diagnosis1 intervention1 and treatment with respect to mental illness1 serious mental illness1 and serious emotional disturbance1 primarily by-- 7#a7 applied delivery of care1 including training staff in effective evidence-based treatment2 and 7#b7 integrating models of care across specialties and jurisdictions4 7b7 ,duration ,a grant under this section shall be for a period of not less than #c years and not more than #e years4 7c7 ,limitations ,of the amounts made available for carrying out this section for a fiscal year-- 7#a7 not less than half shall be awarded for screening1 diagnosis1 intervention1 and treatment1 as described in subsection 7a71 for individuals 7or subpopulations of individuals7 who are below the age of #bf when activities funded through the grant award are initiated2 7#b7 no amounts shall be made available for any program or project that is not evidence-based2 7#c7 no amounts shall be made available for primary prevention2 and 7#d7 no amounts shall be made available solely for the purpose of expanding facilities or increasing staff at an existing program1 although funds may be so used by an existing program if such an expansion or increase is needed to support the implementation of a new program under this section4 7d7 ,termination ,the ,secretary may terminate any award under this section upon a determination that-- 7#a7 the recipient is not providing information requested by the ,secretary in connection with the award2 or 7#b7 there is a clear failure in the effectiveness of the recipient's programs or activities funded through the award4 7e7 ,reporting ,as a condition on receipt of an award under this section1 an applicant shall agree-- 7#a7 to report to the ,secretary the results of programs and activities funded through the award2 and 7#b7 to include in such reporting any relevant data requested by the ,secretary4 7f7 ,authorization of appropriations ,for the purpose of providing grants under this section1 there is authorized to be appropriated #hj1jjj1jjj for each of fiscal years #bjag through #bjba4 #ajg4 ,early intervention and treatment in childhood 7a7 ,grants ,the ,secretary of ,health and ,human ,services 7in this ,act referred to as the ,secretary71 acting through the ,substance ,abuse and ,mental ,health ,services ,administration1 shall-- 7#a7 award grants to eligible entities to initiate and undertake1 for eligible children1 early childhood intervention and treatment programs1 and specialized preschool and elementary school programs1 with the goal of preventing chronic and serious mental illness and serious emotional disturbance2 7#b7 award grants to not more than #c eligible entities for studying the longitudinal outcomes of programs funded under paragraph 7#a7 on eligible children who were treated #e or more years prior to the enactment of this ,act2 and 7#c7 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 settings4 7b7 ,eligible entities and children ,in this section3 7#a7 ,eligible entity ,the term eligible entity means a nonprofit institution that-- 7,a7 is accredited by ,state mental health1 education1 or human services agencies1 as applicable1 for the treatment or education of children from #j to #ab years of age2 and 7,b7 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 7in addition to any learning disability74 7#b7 ,eligible child ,the term eligible child means a child who is at least #j years old and not more than #ab years old-- 7,a7 whose primary need is a social and emotional disability 7in addition to any learning disability72 7,b7 who is at risk of developing serious mental illness and_/or may show early signs of mental illness2 and 7,c7 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 illness4 7c7 ,application ,an eligible entity seeking a grant under subsection 7a7 shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require4 7d7 ,use of funds for early childhood intervention and treatment programs ,an eligible entity shall use amounts awarded under a grant under subsection 7a77#a7 to carry out the following activities3 7#a7 ,deliver 7or facilitate7 for eligible children treatment and education1 early childhood intervention1 and specialized preschool and elementary school programs1 including the provision of medically based child care and early education services4 7#b7 ,treat and educate eligible children1 including startup1 curricula development1 operating and capital needs1 staff and equipment1 assessment and intervention services1 administration and medication requirements1 enrollment costs1 collaboration with primary care providers and psychiatrists1 other related services to meet emergency needs of children1 and communication with families and medical professionals concerning the children4 7#c7 ,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 metrics4 7e7 ,use of funds for longitudinal study ,in conducting a study on longitudinal outcomes through a grant under subsection 7a77#b71 an eligible entity shall include an analysis of-- 7#a7 the individuals treated and educated2 7#b7 the success of such treatment and education in-- 7,a7 avoiding the onset of serious emotional disturbance and serious mental illness2 or 7,b7 the preparation of such children for the care and management of serious emotional disturbance and serious mental illness2 7#c7 any evidence-based best practices generally applicable as a result of such treatment and educational techniques used with such children2 and 7#d7 the ability of programs to be replicated as a best practice model of intervention4 7f7 ,requirements ,in carrying out this section1 the ,secretary shall ensure that each entity receiving a grant under subsection 7a7 maintains a written agreement with the ,secretary1 and provides regular written reports1 as required by the ,secretary1 regarding the quality1 efficiency1 and effectiveness of intervention and treatment for eligible children preventing or treating the development and onset of serious mental illness or serious emotional disturbance4 7g7 ,amount of awards 7#a7 ,amounts for early childhood intervention and treatment programs ,the amount of an award to an eligible entity under subsection 7a77#a7 shall be not more than #fjj1jjj per fiscal year4 7#b7 ,amounts for longitudinal study ,the total amount of an award to an eligible entity under subsection 7a77#b7 7for one or more fiscal years7 shall be not less than #a1jjj1jjj and not greater than #b1jjj1jjj4 7h7 ,project terms ,the period of a grant-- 7#a7 for awards under subsection 7a77#a71 shall be not less than #c fiscal years and not more than #e fiscal years2 and 7#b7 for awards under subsection 7a77#b71 shall be not more than #e fiscal years4 7i7 ,matching funds ,the ,secretary may not award a grant under this section to an eligible entity unless the eligible entity agrees1 with respect to the costs to be incurred by the eligible entity in carrying out the activities described in subparagraph 7,d71 to make available non-,federal contributions 7in cash or in kind7 toward such costs in an amount equal to not less than #aj percent of ,federal funds provided in the grant4 7j7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated #e1jjj1jjj for each of fiscal years #bjag through #bjba4 #ajh4 ,block grants 7a7 ,best practices in clinical care models ,section #aibj of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjx-#i7 is amended by adding at the end the following3 7c7 ,best practices in clinical care models ,the ,substance ,abuse and ,mental ,health ,services ,administration1 acting in collaboration with the ,director of the ,national ,institute of ,mental ,health1 shall require ,states to obligate at least #e percent of the amounts appropriated for a fiscal year under subsection 7a7 to support evidence-based programs that address the needs of individuals with early serious mental illness or serious emotional disturbance1 including psychotic disorders1 regardless of the age of individual onset4 ,such models shall translate evidence-based interventions and best available science into systems of care1 such as through models such as-- 7#a7 the ,recovery ,after an ,initial ,schizophrenia ,episode research project of the ,national ,institute of ,mental ,health2 and 7#b7 the ,north ,american ,prodrome ,longitudinal ,study4 4 7b7 ,additional program requirements 7#a7 ,integrated services ,subsection 7b77#a7 of section #aiab of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjx-#a7;b77#a77 is amended-- 7,a7 by striking ,the plan provides and inserting3 7,a7 ,the plan provides 2 7,b7 in subparagraph 7,a71 as inserted by paragraph 7#a71 in the second sentence1 by striking health and mental health services and inserting integrated physical and mental health services2 7,c7 in such subparagraph 7,a71 by striking ,the plan shall include through the period at the end and inserting ,the plan shall integrate and coordinate services to maximize the efficiency1 effectiveness1 quality1 coordination1 and cost effectiveness of those services and programs to produce the best possible outcomes for those with serious mental illness or serious emotional disturbance42 and 7,d7 by adding at the end the following new subparagraph3 7,b7 ,the plan shall include a separate description of case management services and provide for activities leading to improved outcomes1 such as reduction of rates of suicides1 suicide attempts1 substance abuse1 overdose deaths1 emergency hospitalizations1 incarceration1 crimes1 arrest1 victimization1 homelessness1 joblessness1 medication nonadherence1 and education and vocational programs drop outs4 ,the plan must also include a detailed list of services available for individuals with serious mental illness or serious emotional disturbance in each county or county equivalent4 7,c7 ,the plan shall include a separate description of active programs that seek to engage individuals with serious mental illness in proactively making their own health care decisions and enhancing communication among themselves1 their families1 and their treatment providers by allowing for early intervention by reducing legal proceedings related to involuntary treatment4 ,such programs may include services that help develop psychiatric advanced directives4 4 7#b7 ,data collection system ,subsection 7b77#b7 of section #aiab of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjx-#a7;b77#b77 is amended-- 7,a7 by striking ,the plan contains an estimate of and inserting the following3 ,the plan contains-- 7,a7 an estimate of 2 7,b7 in subparagraph 7,a71 as inserted by paragraph 7#a71 by inserting 1 such as reductions in homelessness1 emergency hospitalization1 incarceration1 and unemployment after targets2 7,c7 in such subparagraph1 by striking the period at the end and inserting 2 and2 and 7,d7 by adding at the end the following new subparagraph3 7,b7 an agreement by the ,state to report to the ,secretary such data as may be required by the ,secretary concerning-- 7i7 comprehensive community mental health services in the ,state2 and 7ii7 public health outcomes for persons with serious mental illness or serious emotional disturbance in the ,state1 such as rates of suicides1 suicide attempts1 substance abuse1 overdose deaths1 emergency hospitalizations1 incarceration1 crimes1 arrest1 victimization1 homelessness1 joblessness1 medication nonadherence1 and education and vocational programs drop outs4 4 7#c7 ,implementation of plan ,subsection 7d77#a7 of section #aiab of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjx-#a7;d77#a77 is amended-- 7,a7 by striking ,except as provided and inserting3 7,a7 ,except as provided 2 and 7,b7 by adding at the end the following new subparagraph3 7,b7 ,for individuals receiving treatment through funds awarded under a grant under section #aiaa1 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 year1 a de-individualized report1 containing information that is de-identified1 on the services provided to those individuals1 including-- 7i7 outcomes and the overall cost of such treatment provided2 and 7ii7 county or county equivalent level data on such population1 such as overall costs and raw number data on rates of involuntary commitment orders1 suicides1 suicide attempts1 substance abuse1 overdose deaths1 emergency hospitalizations1 incarceration1 crimes1 arrest1 victimization1 homelessness1 joblessness1 medication nonadherence1 and education and vocational programs drop outs4 4 7c7 ,incentives for ,state-,based outcome measures ,section #aibj of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjx-#i7 is amended by adding at the end the following3 7c7 ,incentives for state-,based outcome measures 7#a7 ,in general ,in addition to the amounts made available under subsection 7a7 for each fiscal year1 the ,secretary shall provide to each ,state that meets the conditions under paragraph 7#b7 by the end of the first quarter of the subsequent fiscal year1 an equally divided share of the funding under paragraph 7#c74 7#b7 ,conditions ,the ,secretary shall define the conditions under which a ,state is eligible to receive the additional amount under paragraph 7#a74 7#c7 ,authorization of ,appropriations ,for purposes of this subsection1 there is authorized to be appropriated #be1jjj1jjj for each of fiscal years #bjag through #bjba4 ,any amounts made available under paragraph 7#a7 shall be in addition to the ,state's block grant allocation4 4 7d7 ,evidence-,based services delivery models ,section #aiab of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjx-#a7 is amended by adding at the end the following new subsection3 7e7 ,expansion of models 7#a7 ,in general ,taking into account the results of evaluations of block grant programs1 the ,secretary may1 as part of the program of block grants under this subpart1 provide for expanded use across the ,nation of evidence-based service delivery models by providers funded under such block grants1 so long as-- 7,a7 the ,secretary determines that such expansion will-- 7i7 result in more effective use of funds under such block grants without reducing the quality of care2 or 7ii7 improve the quality of patient care without significantly increasing spending2 7,b7 the ,secretary determines that such expansion would improve the quality of patient care2 and 7,c7 the ,secretary determines that the change will-- 7i7 significantly reduce severity and duration of symptoms of mental illness2 7ii7 reduce rates of suicide1 suicide attempts1 substance abuse1 overdose1 emergency hospitalizations1 emergency room boarding1 incarceration1 crime1 arrest1 victimization1 homelessness1 or joblessness2 or 7iii7 significantly improve the quality of patient care and mental health crisis outcomes without significantly increasing spending4 7#b7 ,definition ,in this subsection1 the term emergency room boarding means the practice of admitting patients to an emergency department and holding them in the department until inpatient psychiatric beds become available4 4 7e7 ,period for expenditure of grant funds ,section #aiac of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjx-#b71 as amended1 is further amended by adding at the end the following3 7d7 ,period for expenditure of grant funds ,in implementing a plan submitted under section #aiab7;a71 a ,state receiving grant funds under section #aiaa may make such funds available to providers of services described in subsection 7b7 for the provision of services without fiscal year limitation1 so long as any carryover is spent within #c years of the year in which the funding was provided4 4 7f7 ,active outreach and engagement ,section #aiae of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjx-#d7 is amended by adding at the end of the following3 7c7 ,active ,outreach and ,engagement to ,persons with ,serious ,mental ,illness 7#a7 ,in general ,a funding agreement for a grant under section #aiaa is that the ,state involved has in effect active programs that seek to engage individuals with serious mental illness in comprehensive services in order to avert relapse1 repeated hospitalizations1 arrest1 incarceration1 suicide1 and to provide the individuals with the opportunity to live in the least restrictive setting1 through a comprehensive program of evidence-based and culturally relevant assertive outreach and engagement services focusing on individuals who are homeless1 have co-occurring disorders1 are at risk for incarceration or re-incarceration1 or have a history of treatment failure1 including repeated hospitalizations or emergency room usage4 7#b7 ,evidence-based assertive outreach and engagement services 7,a7 ,,samhsa ,the ,administrator of the ,substance ,abuse and ,mental ,health ,services ,administration1 in cooperation with the ,director of the ,national ,institute of ,mental ,health1 shall develop-- 7i7 a list of evidence-based culturally and linguistically relevant assertive outreach and engagement services2 and 7ii7 criteria to be used to assess the scope and effectiveness of the approaches taken by such services1 such as the ability to provide same-day appointments for emergent situations4 7,b7 ,types of assertive outreach and engagement services ,for purposes of paragraph 7#a71 appropriate programs of evidence-based assertive outreach and engagement services may include peer support programs2 the ,wellness ,recovery ,action ,plan1 ,assertive ,community ,treatment1 and ,forensic ,assertive ,community ,treatment of the ,substance ,abuse and ,mental ,health ,services ,administration2 appropriate supportive housing programs incorporating a ,housing ,first model2 and intensive1 evidence-based approaches to early intervention in psychosis1 such as the ,recovery ,after an ,initial ,schizophrenia ,episode model of the ,national ,institute of ,mental ,health and the ,specialized ,treatment ,early in ,psychosis program4 4 #aji4 ,children's recovery from trauma ,section #ehb of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;hh-#a7 is amended-- 7#a7 in subsection 7a71 by striking developing programs and all that follows through the period at the end and inserting 8developing and maintaining programs that provide for-- 7#a7 the continued operation of the ,national ,child ,traumatic ,stress ,initiative 7referred to in this section as the ,,nctsi71 which includes a coordinating center1 that focuses on the mental1 behavioral1 and biological aspects of psychological trauma response1 prevention of the long-term consequences of child trauma1 and early intervention services and treatment to address the long-term consequences of child trauma2 and 7#b7 the development of knowledge with regard to evidence-based practices for identifying and treating mental1 behavioral1 and biological disorders of children and youth resulting from witnessing or experiencing a traumatic event4 2 7#b7 in subsection 7b7-- 7,a7 by striking subsection 7a7 related and inserting subsection 7a77#b7 7related2 7,b7 by striking treating disorders associated with psychological trauma and inserting treating mental1 behavioral1 and biological disorders associated with psychological trauma72 and 7,c7 by striking mental health agencies and programs that have established clinical and basic research and inserting universities1 hospitals1 mental health agencies1 and other programs that have established clinical expertise and research2 7#c7 by redesignating subsections 7c7 through 7g7 as subsections 7g7 through 7k71 respectively2 7#d7 by inserting after subsection 7b71 the following3 7c7 ,child outcome data ,the ,,nctsi coordinating center shall collect1 analyze1 and report ,,nctsi-wide child treatment process and outcome data regarding the early identification and delivery of evidence-based treatment and services for children and families served by the ,,nctsi grantees4 7d7 ,training ,the ,,nctsi coordinating center shall facilitate the coordination of training initiatives in evidence-based and trauma-informed treatments1 interventions1 and practices offered to ,,nctsi grantees1 providers1 and partners4 7e7 ,dissemination and collaboration ,the ,,nctsi coordinating center shall1 as appropriate1 collaborate with-- 7#a7 the ,secretary1 in the dissemination of evidence-based and trauma-informed interventions1 treatments1 products1 and other resources to appropriate stakeholders2 and 7#b7 appropriate agencies that conduct or fund research within the ,department of ,health and ,human ,services1 for purposes of sharing ,,nctsi expertise1 evaluation data1 and other activities1 as appropriate4 7f7 ,review ,the ,secretary shall1 consistent with the peer review process1 ensure that ,,nctsi applications are reviewed by appropriate experts in the field as part of a consensus review process4 ,the ,secretary shall include review criteria related to expertise and experience in child trauma and evidence-based practices4 2 7#e7 in subsection 7g7 7as so redesignated71 by striking with respect to centers of excellence are distributed equitably among the regions of the country and inserting are distributed equitably among the regions of the ,united ,states2 7#f7 in subsection 7i7 7as so redesignated71 by striking recipient may not exceed #e years and inserting recipient shall not be less than #d years1 but shall not exceed #e years2 and 7#g7 in subsection 7j7 7as so redesignated71 by striking #ej1jjj1jjj and all that follows through #bjjf and inserting #dg1jjj1jjj for each of fiscal years #bjag through #bjba4 #aaj4 ,garrett ,lee ,smith ,memorial ,act reauthorization 7a7 ,interagency research1 training1 and technical assistance centers ,section #ebj;,c of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#cd7 is amended-- 7#a7 in subsection 7d7-- 7,a7 in paragraph 7#a71 by striking youth suicide early intervention and prevention strategies and inserting suicide early intervention and prevention strategies for all ages1 particularly for youth2 7,b7 in paragraph 7#b71 by striking youth suicide early intervention and prevention strategies and inserting suicide early intervention and prevention strategies for all ages1 particularly for youth2 7,c7 in paragraph 7#c7-- 7i7 by striking youth2 and 7ii7 by inserting before the semicolon the following3 for all ages1 particularly for youth2 7,d7 in paragraph 7#d71 by striking youth suicide and inserting suicide for all ages1 particularly among youth2 7,e7 in paragraph 7#e71 by striking youth suicide early intervention techniques and technology and inserting suicide early intervention techniques and technology for all ages1 particularly for youth2 7,f7 in paragraph 7#g7-- 7i7 by striking youth2 and 7ii7 by inserting for all ages1 particularly for youth1 after strategies2 and 7,g7 in paragraph 7#h7-- 7i7 by striking youth suicide each place that such appears and inserting suicide2 and 7ii7 by striking in youth and inserting among all ages1 particularly among youth2 and 7#b7 by amending subsection 7e7 to read as follows3 7e7 ,authorization of appropriations ,for the purpose of carrying out this section1 there is authorized to be appropriated #e1ihh1jjj for each of fiscal years #bjag through #bjba4 4 7b7 ,youth suicide early intervention and prevention strategies ,section #ebj;,e of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#cf7 is amended-- 7#a7 in subsection 7b71 by striking paragraph 7#b7 and inserting the following3 7#b7 ,limitation ,in carrying out this section1 the ,secretary shall ensure that a ,state does not receive more than one grant or cooperative agreement under this section at any one time4 ,for purposes of the preceding sentences1 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 7#a77;,b74 ,nothing in this paragraph shall be construed to apply to entities described in paragraph 7#a77;,c74 2 and 7#b7 by striking subsection 7m7 and inserting the following3 7m7 ,authorization of appropriations ,for the purpose of carrying out this section1 there is authorized to be appropriated #ce1dbg1jjj for each of fiscal years #bjag through #bjba4 4 7c7 ,mental and behavioral health services on campus ,section #ebj;,e-#b7;h7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#cf;b7h77 is amended by striking #e1jjj1jjj for fiscal year #bjje and all that follows through the period and inserting #f1dhh1jjj for each of fiscal years #bjag through #bjba44 #aaa4 ,national ,suicide ,prevention ,lifeline ,program ,subpart #c of part ,b of title ,v of the ,public ,health ,service ,act is amended by inserting after section #ebj;,e-#b of such ,act 7#db ,u4,s4,c4 #bij;bb-#cf;b71 as amended1 the following3 #ebj;,e-#c4 ,national ,suicide ,prevention ,lifeline ,program 7a7 ,in general ,the ,secretary shall maintain the ,national ,suicide ,prevention ,lifeline program1 including by-- 7#a7 coordinating a network of crisis centers across the ,united ,states for providing suicide prevention and crisis intervention services to individuals seeking help at any time1 day or night2 7#b7 maintaining a suicide prevention hotline to link callers to local emergency1 mental health1 and social services resources2 and 7#c7 consulting with the ,secretary of ,veterans ,affairs to ensure that veterans calling the suicide prevention hotline have access to a specialized veterans' suicide prevention hotline4 7b7 ,authorization of appropriations ,to carry out this section1 there are authorized to be appropriated #h1jjj1jjj for each of fiscal years #bjag through #bjba4 4 #aab4 ,adult suicide prevention 7a7 ,grants 7#a7 ,authority ,the ,administrator of the ,substance ,abuse and ,mental ,health ,services ,administration 7referred to in this section as the ,administrator7 may award grants to eligible entities in order to implement suicide prevention efforts amongst adults #be and older4 7#b7 ,purpose ,the grant program under this section shall be designed to raise suicide awareness1 establish referral processes1 and improve clinical care practice standards for treating suicide ideation1 plans1 and attempts among adults4 7#c7 ,recipients ,to be eligible to receive a grant under this section1 an entity shall be a community-based primary care or behavioral health care setting1 an emergency department1 a ,state mental health agency1 an ,indian tribe1 a tribal organization1 or any other entity the ,administrator deems appropriate4 7#d7 ,nature of activities ,the grants awarded under paragraph 7#a7 shall be used to implement programs that-- 7,a7 screen for suicide risk in adults and provide intervention and referral to treatment2 7,b7 implement evidence-based practices to treat individuals who are at suicide risk1 including appropriate follow-up services2 and 7,c7 raise awareness1 reduce stigma1 and foster open dialog about suicide prevention4 7b7 ,additional activities ,the ,administrator shall-- 7#a7 evaluate the activities supported by grants awarded under subsection 7a7 in order to further the ,nation's understanding of effective interventions to prevent suicide in adults2 7#b7 disseminate the findings from the evaluation as the ,administrator considers appropriate2 and 7#c7 provide appropriate information1 training1 and technical assistance to eligible entities that receive a grant under this section1 in order to help such entities to meet the requirements of this section1 including assistance with-- 7,a7 selection and implementation of evidence-based interventions and frameworks to prevent suicide1 such as the ,zero ,suicide framework2 and 7,b7 other activities as the ,administrator determines appropriate4 7c7 ,duration ,a grant under this section shall be for a period of not more than #e years4 7d7 ,authorization of appropriations 7#a7 ,in general ,there is authorized to be appropriated to carry out this section #ae1jjj1jjj for each of fiscal years #bjag through #bjba4 7#b7 ,use of certain funds ,of the funds appropriated to carry out this section in any fiscal year1 the lesser of #e percent of such funds or #ejj1jjj shall be available to the ,administrator for purposes of carrying out subsection 7b74 #aac4 ,peer review and advisory councils 7a7 ,in general ,section #eja of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;aa7 is amended-- 7#a7 in subsection 7i71 as redesignated by section #ajb1 by inserting at the end the following3 ,for any such peer-review group reviewing a proposal or grant related to the treatment of mental illness1 no fewer than half of the members of the group shall be experienced mental health providers42 and 7#b7 in subsection 7m71 as redesignated by section #ajb-- 7,a7 in paragraph 7#b71 by striking and at the end2 and 7,b7 in paragraph 7#c71 by striking the period at the end and inserting 2 and4 7b7 ,advisory councils ,paragraph 7#c7 of section #ejb7;b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;aa-#a7;b77 is amended by adding at the end the following3 7,c7 ,no fewer than one-third of the members of an advisory council for the ,center for ,mental ,health ,services shall be mental health care providers with-- 7i7 experience in mental health research or treatment2 and 7ii7 expertise in the fields on which they are advising4 7,d7 ,the ,secretary shall adopt a policy that ensures members of advisory councils do not have conflicts of interest with any program or grant about which the members are to advise4 4 7c7 ,peer review ,section #ejd of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;aa-#c7 is amended-- 7#a7 by adding at the end of subsection 7b7 the following3 ,at least half of the members of any peer-review group established under subsection 7a7 that pertains to the treatment of mental illness shall be licensed and experienced mental health professionals42 and 7#b7 by adding at the end the following3 7e7 ,scientific controls and standards ,peer review under this section shall ensure that any research concerning an intervention is based on scientific evidence indicating whether the intervention reduces symptoms1 improves medical or behavioral outcomes1 or improves social functioning4 4 #aad4 ,adult trauma 7a7 ,grants 7#a7 ,authority ,the ,administrator of the ,substance ,abuse and ,mental ,health ,services ,administration 7referred to in this section as the ,administrator7 may award grants to eligible entities in order to implement trauma-informed care in primary care and public health settings4 7#b7 ,purpose ,the grant program under this section shall be designed to facilitate and evaluate the impact of appropriate trauma screening and responses in primary care settings in order to further advance the ,nation's understanding of the need for addressing trauma in nonbehavioral health settings4 7#c7 ,recipients ,to be eligible to receive a grant under this section1 an entity shall be a community-based1 primary care setting1 an academic research setting in conjunction with primary care settings1 or any other entity the ,administrator deems appropriate4 7#d7 ,nature of activities ,the grants awarded under paragraph 7#a7 shall be used to implement programs that-- 7,a7 screen for trauma in adults1 provide intervention and referral to treatment1 and provide follow-up services1 as appropriate2 and 7,b7 engage and involve trauma survivors1 people receiving services1 and family members receiving services in program design4 7#e7 ,practitioners ,as a condition on receipt of a grant under paragraph 7#a71 an entity shall agree that practitioners used to carry out any program through the grant will be trained in interventions that1 as described in ,,samhsa's ,concept of ,trauma and ,guidance for a ,trauma-,informed ,approach1 are-- 7,a7 based on the best available empirical evidence and science2 7,b7 culturally appropriate2 and 7,c7 reflecting principles of a trauma-informed approach4 7b7 ,additional activities ,the ,director shall-- 7#a7 evaluate the activities supported by grants awarded under subsection 7a7 in order to further the ,nation's understanding of the need for1 and complexity of1 addressing trauma in nonbehavioral health settings2 7#b7 disseminate the findings from the evaluation as the ,administrator considers appropriate2 7#c7 provide appropriate information1 training1 and technical assistance to eligible entities that receive a grant under this section1 in order to help such entities to meet the requirements of this section1 including assistance with-- 7,a7 selection and implementation of culturally appropriate1 evidence-based interventions that reflect the principles of trauma-informed approach2 7,b7 incorporating principles of peer support and trauma-informed care in hiring1 supervision1 and staff evaluation2 7,c7 establishment of organizational practices and policies to support trauma-informed approaches to care2 and 7,d7 other activities as the ,administrator determines appropriate4 7c7 ,duration ,a grant under this section shall be for a period of not more than #e years4 7d7 ,authorization of appropriations 7#a7 ,in general ,there is authorized to be appropriated to carry out this section #c1jjj1jjj for each of fiscal years #bjag through #bjba4 7#b7 ,use of certain funds ,of the funds appropriated to carry out this section in any fiscal year1 the lesser of #e percent of such funds or #ejj1jjj shall be available to the ,director for purposes of carrying out subsection 7b74 #aae4 ,reducing the stigma of serious mental illness 7a7 ,in general ,the ,secretary of ,health and ,human ,services and the ,secretary of ,education shall organize a national awareness campaign involving public health organizations1 advocacy groups for persons with serious mental illness or serious emotional disturbance1 and social media companies to assist secondary school students and postsecondary students in-- 7#a7 reducing the stigma associated with serious mental illness and serious emotional disturbance2 7#b7 understanding how to assist an individual who is demonstrating signs of a serious mental illness or serious emotional disturbance2 and 7#c7 understanding the importance of seeking treatment from a physician1 clinical psychologist1 psychiatric nurse practitioner1 or licensed mental health professional when a student believes the student may be suffering from a serious mental illness1 serious emotional disturbance1 or behavioral health disorder4 7b7 ,data collection ,the ,secretary of ,health and ,human ,services shall evaluate the program under subsection 7a7 on public health to determine whether the program has made an impact on public health1 such as reducing mortality rates of persons with serious mental illness or serious emotional disturbance1 the prevalence of serious mental illness and serious emotional disturbance1 physician and clinical psychological visits1 and emergency room visits for psychiatric services4 7c7 ,secondary school defined ,for purposes of this section1 the term secondary school has the meaning given the term in section #iaja of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #ghja74 7d7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated #a1jjj1jjj for each of fiscal years #bjag through #bjba4 #aaf4 ,report on mental health and substance abuse treatment in the ,states 7a7 ,in general ,not later than #ah months after the date of enactment of this ,act1 and not less than every #b years thereafter1 the ,secretary of ,health and ,human ,services shall submit to the ,congress and make available to the public a report on mental health and substance use treatment in the ,states1 including the following3 7#a7 ,a detailed report on how ,federal mental health and substance use treatment funds are used in each ,state including3 7,a7 ,the numbers of individuals with mental illness1 serious mental illness1 serious emotional disturbance1 substance use disorders1 or co-occurring disorders who are served with ,federal funds4 7,b7 ,the types of programs made available to individuals with mental illness1 serious mental illness1 substance use disorders1 or co-occurring disorders4 7#b7 ,a summary of best practice models in the ,states highlighting programs that are cost effective1 provide evidence-based care1 increase access to care1 integrate physical1 psychiatric1 psychological1 and behavioral medicine1 and improve outcomes for individuals with mental illness or substance use disorders4 7#c7 ,a statistical report of outcome measures in each ,state1 for individuals with mental illness1 serious mental illness1 substance use disorders1 and co-occurring disorders1 such as-- 7,a7 rates of suicide1 suicide attempts1 substance abuse1 overdose1 overdose deaths1 health outcomes1 emergency psychiatric hospitalizations1 and emergency room boarding2 and 7,b7 arrests1 incarcerations1 victimization1 homelessness1 joblessness1 employment1 and enrollment in educational or vocational programs4 7b7 ,definition ,in this subsection1 the term emergency room boarding means the practice of admitting patients to an emergency department and holding them in the department until inpatient psychiatric beds become available4 #aag4 ,mental health first aid training grants ,section #ebj;,j of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#da7 is amended to read as follows3 #ebj;,j4 ,mental health first aid training grants 7a7 ,grants ,the ,secretary1 acting through the ,administrator1 shall award grants to ,states1 political subdivisions of ,states1 ,indian tribes1 tribal organizations1 and nonprofit private entities to initiate and sustain mental health first aid training programs4 7b7 ,program requirements 7#a7 ,in general ,to be eligible for funding under subsection 7a71 a mental health first aid training program shall-- 7,a7 be designed to train individuals in the categories listed in paragraph 7#b7 to accomplish the objectives described in paragraph 7#c72 7,b7 ensure that training is conducted by trainers that are properly licensed and credentialed by nonprofit entities as designated by the ,secretary2 and 7,c7 include-- 7i7 at a minimum-- 7,i7 a core live training course for individuals in the categories listed in paragraph 7#b7 on the skills1 resources1 and knowledge to assist individuals in crisis to connect with appropriate local mental health care services2 7,,ii7 training on mental health resources1 including the location of community mental health centers described in section #aiac7;c71 in the ,state and local community2 and 7,,iii7 training on action plans and protocols for referral to such resources2 and 7ii7 where feasible1 continuing education and updated training for individuals in the categories listed in paragraph 7#b74 7#b7 ,categories of individuals to be trained ,the categories of individuals listed in this paragraph are the following3 7,a7 ,emergency services personnel and other first responders4 7,b7 ,police officers and other law enforcement personnel4 7,c7 ,teachers and school administrators4 7,d7 ,human resources professionals4 7,e7 ,faith community leaders4 7,f7 ,nurses and other primary care personnel4 7,g7 ,students enrolled in an elementary school1 a secondary school1 or an institution of higher education4 7,h7 ,the parents of students described in subparagraph 7,g74 7,i7 ,veterans4 7,j7 ,other individuals1 audiences or training populations as determined appropriate by the ,secretary4 7#c7 ,objectives of training ,to be eligible for funding under subsection 7a71 a mental health first aid training program shall be designed to train individuals in the categories listed in paragraph 7#b7 to accomplish each of the following objectives 7as appropriate for the individuals to be trained1 taking into consideration their age73 7,a7 ,safe de-escalation of crisis situations4 7,b7 ,recognition of the signs and symptoms of mental illness1 including such common psychiatric conditions as schizophrenia1 bipolar disorder1 major clinical depression1 and anxiety disorders4 7,c7 ,timely referral to mental health services in the early stages of developing mental disorders in order to-- 7i7 avoid more costly subsequent behavioral health care2 and 7ii7 enhance the effectiveness of mental health services4 7c7 ,distribution of ,awards ,in awarding grants under this section1 the ,secretary shall-- 7#a7 ensure that grants are equitably distributed among the geographical regions of the ,united ,states2 and 7#b7 pay particular attention to the mental health training needs of populations and target audiences residing in rural areas4 7d7 ,application ,a ,state1 political subdivision of a ,state1 ,indian tribe1 tribal organization1 or nonprofit private entity that desires a grant under this section shall submit an application to the ,secretary at such time1 in such manner1 and containing such information as the ,secretary may require1 including a plan for the rigorous evaluation of activities that are carried out with funds received under such grant4 7e7 ,evaluation ,a ,state1 political subdivision of a ,state1 ,indian tribe1 tribal organization1 or nonprofit private entity that receives a grant under this section shall prepare and submit an evaluation to the ,secretary at such time1 in such manner1 and containing such information as the ,secretary may reasonably require1 including an evaluation of activities carried out with funds received under such grant and a process and outcome evaluation4 7f7 ,authorization of ,appropriations ,to carry out this section1 there are authorized to be appropriated #bj1jjj1jjj for each of fiscal years #bjag through #bjba4 4 #aah4 ,acute care bed registry grant for ,states 7a7 ,in general ,the ,secretary of ,health and ,human ,services1 acting through the ,administrator of the ,substance ,abuse and ,mental ,health ,services ,administration1 shall award grants to ,state mental health agencies to develop and administer1 or maintain an existing1 real-time ,internet-based bed registry described in subsection 7b71 to collect1 aggregate1 and display information about available beds in public and private inpatient psychiatric facilities and public and private residential crisis stabilization units1 and residential community mental health and residential substance abuse treatment facilities to facilitate the identification and designation of facilities for the temporary treatment of individuals in psychiatric or substance abuse crisis4 7b7 ,registry requirements ,a bed registry described in this subsection is a registry that-- 7#a7 includes descriptive information for every public and private inpatient psychiatric facility1 every public and private residential crisis stabilization unit1 and residential community mental health and residential substance abuse facility in the ,state involved1 including contact information for the facility or unit2 7#b7 provides real-time information about the number of beds available at each facility or unit and1 for each available bed1 the type of patient that may be admitted1 the level of security provided1 and any other information that may be necessary to allow for the proper identification of appropriate facilities for treatment of individuals in psychiatric or substance abuse crisis2 and 7#c7 allows employees and designees of community mental health and substance abuse service providers1 employees of inpatient psychiatric facilities1 public and private residential crisis stabilization units1 or residential substance abuse treatment facilities1 and health care providers working in an emergency room of a hospital or clinic or other facility rendering emergency medical care to perform searches of the registry to identify available beds that are appropriate for the treatment of individuals in psychiatric crisis or substance abuse crisis4 7c7 ,authorization of appropriations ,to carry out this section1 there are authorized to be appropriated #ae1jjj1jjj for each of fiscal years #bjag through #bjba4 #aai4 ,older adult mental health grants 7a7 ,in general ,the ,secretary of ,health and ,human ,services1 acting through the ,director of the ,center for ,mental ,health ,services1 shall award grants1 contracts1 or cooperative agreements to public and private nonprofit entities for projects that address the mental health needs of older adults1 including programs to-- 7#a7 support the establishment and maintenance of interdisciplinary geriatric mental health specialist outreach teams in community settings where older adults reside or receive social services1 in order to provide screening1 referrals1 and evidence-based intervention and treatment services1 including services provided by licensed mental health professionals2 7#b7 develop and implement older adult suicide early intervention and prevention strategies in #a or more settings that serve seniors1 and collect and analyze data on older adult suicide early intervention and prevention services for purposes of monitoring1 research1 and policy development2 and 7#c7 otherwise improve the mental health of older adults1 as determined by the ,secretary4 7b7 ,considerations in awarding grants ,in awarding grants under this section1 the ,secretary1 to the extent feasible1 shall ensure that-- 7#a7 projects are funded in a variety of geographic areas1 including urban and rural areas2 7#b7 a variety of populations1 including racial and ethnic minorities and low-income populations1 are served by projects funded under this section2 and 7#c7 older adult suicide intervention and prevention programs are targeted towards areas with high older adult suicide rates4 7c7 ,application ,to be eligible to receive a grant under this section1 a public or private nonprofit entity shall-- 7#a7 submit an application to the ,secretary 7in such form1 containing such information1 and at such time as the ,secretary may specify72 7#b7 agree to report to the ,secretary standardized clinical and behavioral data or other performance data necessary to evaluate patient or program outcomes and to facilitate evaluations across participating projects2 and 7#c7 demonstrate how such applicant will collaborate with other ,state and local public and private nonprofit organizations4 7d7 ,duration ,a project may receive funding under a grant under this section for a period of up to #c years1 and such funding may be extended for a period of #b additional years1 at the discretion of the ,secretary4 7e7 ,supplement1 not supplant ,funds made available under this section shall be used to supplement1 and not supplant1 other ,federal1 ,state1 or local funds available to an entity to carry out activities described in this section4 7f7 ,report ,grantees under this section shall1 beginning with the end of the second year of the grant1 submit yearly reports to the ,secretary on the activities of the grantee in support of the grant and the latest performance data4 ,such reports shall contain recommendations as how to replicate the project funded through the grant4 7g7 ,definitions ,in this section1 the term older adult has the meaning given the term older individual in section #ajb of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjjb74 7h7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section1 #e1jjj1jjj for each of fiscal years #bjag through #bjba4 ,,ii ,interagency ,serious ,mental ,illness ,coordinating ,committee #bja4 ,interagency ,serious ,mental ,illness ,coordinating ,committee ,title ,v of the ,public ,health ,service ,act1 as amended by section #aja1 is further amended by inserting after section #eja of such ,act the following3 #eja;,a4 ,interagency ,serious ,mental ,illness ,coordinating ,committee 7a7 ,establishment ,the ,assistant ,secretary for ,mental ,health and ,substance ,use ,disorders 7in this section referred to as the ,assistant ,secretary7 shall establish a committee1 to be known as the ,interagency ,serious ,mental ,illness ,coordinating ,committee 7in this section referred to as the ,committee71 to assist the ,assistant ,secretary in carrying out the ,assistant ,secretary's duties4 7b7 ,responsibilities ,the ,committee1 in coordination with the ,assistant ,secretary1 shall-- 7#a7 develop and annually update a summary of advances in serious mental illness research related to causes1 prevention1 treatment1 early screening1 diagnosis or rule out1 intervention1 and access to services and supports for individuals with serious mental illness2 7#b7 monitor ,federal activities with respect to serious mental illness2 7#c7 make recommendations to the ,assistant ,secretary regarding any appropriate changes to such activities1 including recommendations with respect to the strategic plan developed under paragraph 7#e72 7#d7 make recommendations to the ,assistant ,secretary regarding public participation in decisions relating to serious mental illness2 7#e7 develop and update every #e years a strategic plan for the conduct and support of programs and services to assist individuals with serious mental illness1 including-- 7,a7 a summary of the advances in serious mental illness research developed under paragraph 7#a72 7,b7 a list of the ,federal programs and activities identified under paragraph 7#b72 7,c7 an analysis of the efficiency1 effectiveness1 quality1 coordination1 and cost-effectiveness of ,federal programs and activities relating to the prevention1 diagnosis1 treatment1 or rehabilitation of serious mental illness1 including an accounting of the costs of such programs and activities with administrative costs disaggregated from the costs of services and care2 and 7,d7 a plan with recommendations-- 7i7 for the coordination and improvement of ,federal programs and activities related to serious mental illness1 including budgetary requirements2 7ii7 for improving outcomes for individuals with a serious mental illness including appropriate benchmarks to measure progress on achieving improvements2 7iii7 for the mental health workforce2 7iv7 to disseminate relevant information developed by the coordinating committee to the public1 health care providers1 social service providers1 public health officials1 courts1 law enforcement1 and other relevant groups2 7v7 to identify research needs1 including longitudinal studies of pediatric populations2 and 7vi7 for vulnerable and underserved populations1 including pediatric populations1 geriatric populations1 and racial1 ethnic1 sexual1 and gender minorities2 and 7#f7 submit to the ,congress such strategic plan and any updates to such plan4 7c7 ,membership 7#a7 ,in general ,the ,committee shall be composed of-- 7,a7 the ,assistant ,secretary for ,mental ,health and ,substance ,use ,disorders 7or the ,assistant ,secretary's designee71 who shall serve as the ,chair of the ,committee2 7,b7 the ,director of the ,national ,institute of ,mental ,health 7or the ,director's designee72 7,c7 the ,attorney ,general of the ,united ,states 7or the ,attorney ,general's designee72 7,d7 the ,director of the ,centers for ,disease ,control and ,prevention 7or the ,director's designee72 7,e7 the ,director of the ,national ,institutes of ,health 7or the ,director's designee72 7,f7 the ,director of the ,indian ,health ,service2 7,g7 a member of the ,united ,states ,interagency ,council on ,homelessness2 7,h7 the ,administrator of the ,centers for ,medicare ,medicaid ,service 7or the ,administrator's designee72 7,i7 the ,secretary of ,defense 7or the ,secretary's designee72 7,j7 the ,secretary of ,education 7or the ,secretary's designee72 7,k7 the ,secretary of ,labor 7or the ,secretary's designee72 7,l7 the ,secretary of ,veterans ,affairs 7or the ,secretary's designee72 7,m7 the ,commissioner of the ,social ,security ,administration 7or the ,commissioner's designee72 and 7,n7 the additional members appointed under paragraph 7#b74 7#b7 ,additional members ,not fewer than #bj members of the ,committee1 or #a_/c of the total membership of the ,committee1 whichever is greater1 shall be composed of non-,federal public members to be appointed by the ,assistant ,secretary1 of which-- 7,a7 at least five such members shall be an individual in recovery from a diagnosis of serious mental illness who has benefited from medical treatment under the care of a licensed mental health professional2 7,b7 at least three such members shall be a parent or legal guardian of an individual with a history of serious mental illness1 including at least one of whom is the parent or legal guardian of a child who has either attempted suicide or is incarcerated for a crime committed while experiencing a serious mental illness or serious emotional disturbance2 7,c7 at least one such member shall be a representative of a leading research1 advocacy1 and service organization for individuals with serious mental illness2 7,d7 at least one such member shall be-- 7i7 a licensed psychiatrist with experience treating serious mental illness2 or 7ii7 a licensed clinical psychologist with experience treating serious mental illness2 7,e7 at least one member shall be a licensed mental health counselor or psychotherapist2 7,f7 at least one member shall be a licensed clinical social worker2 7,g7 at least one member shall be a licensed psychiatric nurse or nurse practitioner2 7,h7 at least one member shall be a mental health professional with a significant focus in his or her practice working with children and adolescents2 7,i7 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 health2 7,j7 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 suicide2 7,k7 at least one such member shall be a ,state certified mental health peer specialist2 7,l7 at least one member shall be a judge with experience adjudicating cases related to criminal justice and serious mental illness2 7,m7 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 crisis2 and 7,n7 at least one member shall be a corrections officer with extensive experience in interfacing with psychiatric and psychological disorders or individuals in mental health crisis4 7d7 ,reports to ,congress ,not later than #b years after the date of enactment of this ,act1 and every #c years thereafter1 the ,committee shall submit a report to the ,congress-- 7#a7 evaluating the impact of projects addressing priority mental health needs of regional and national significance under sections #eja1 #eji1 #eaf1 and #ebj;,a including measurement of public health outcomes such as-- 7,a7 reduced rates of suicide1 suicide attempts1 substance abuse1 overdose1 overdose deaths1 emergency hospitalizations1 emergency room boarding1 incarceration1 crime1 arrest1 victimization1 homelessness1 and joblessness2 7,b7 increased rates of employment and enrollment in educational and vocational programs2 and 7,c7 such other criteria as may be determined by the ,assistant ,secretary2 7#b7 formulating recommendations for the coordination and improvement of ,federal programs and activities that affect individuals with serious mental illness2 7#c7 identifying any such programs and activities that are duplicative2 and 7#d7 summarizing all recommendations made1 activities carried out1 and results achieved pursuant to the workforce development strategy under section #eja4 7e7 ,administrative support2 terms of service2 other provisions ,the following provisions shall apply with respect to the ,committee3 7#a7 ,the ,assistant ,secretary shall provide such administrative support to the ,committee as may be necessary for the ,committee to carry out its responsibilities4 7#b7 ,members of the ,committee appointed under subsection 7c77#b7 shall serve for a term of #d years1 and may be reappointed for one or more additional #d-year terms4 ,any member appointed to fill a vacancy for an unexpired term shall be appointed for the remainder of such term4 ,a member may serve after the expiration of the member's term until a successor has taken office4 7#c7 ,the ,committee shall meet at the call of the chair or upon the request of the ,assistant ,secretary4 ,the ,committee shall meet not fewer than #b times each year4 7#d7 ,all meetings of the ,committee shall be public and shall include appropriate time periods for questions and presentations by the public4 7f7 ,subcommittees2 establishment and membership ,in carrying out its functions1 the ,committee may establish subcommittees and convene workshops and conferences4 ,such subcommittees shall be composed of ,committee members and may hold such meetings as are necessary to enable the subcommittees to carry out their duties4 7g7 ,authorization of ,appropriations ,there is authorized to be appropriated #a1jjj1jjj to carry out the staffing functions under subsection 7e77#a7 for each of fiscal years #bjag through #bjba4 4 ,,iii ,communications between individuals1 families1 and providers #cja4 ,clarification of circumstances under which disclosure of protected health information of mental illness patients is permitted ,the ,,hitech ,act 7title ,,xiii of division ,a of ,public ,law #aaa-e7 is amended by adding at the end of subtitle ,d of such ,act 7#db ,u4,s4,c4 #agiba et seq47 the following3 #c ,improved privacy and security provisions for mental illness patients #acdca4 ,clarification of circumstances under which disclosure of protected health information is permitted 7a7 ,in general ,not later than one year after the date of enactment of this section1 the ,secretary shall promulgate final regulations clarifying the circumstances under which1 consistent with the standards governing the privacy and security of individually identifiable health information promulgated by the ,secretary under sections #bfb7;a7 and #bfd of the ,health ,insurance ,portability and ,accountability ,act of #aiif1 health care providers and covered entities may disclose the protected health information of patients with a mental illness1 including for purposes of-- 7#a7 communicating with a patient's family1 caregivers1 friends1 or others involved in the patient's care1 including communication about treatments1 side effects1 risk factors1 and the availability of community resources2 7#b7 communicating with family or caregivers when the patient is an adult2 7#c7 communicating with the parent or caregiver of a patient who is a minor2 7#d7 considering the patient's capacity to agree or object to the sharing of their information2 7#e7 communicating and sharing information with a patient's family or caregivers when-- 7,a7 the patient consents2 or 7,b7 the patient does not consent1 but the patient lacks the capacity to agree or object and the communication or sharing of information is in the patient's best interest2 7#f7 involving a patient's family members1 friends1 or caregivers1 or others involved in the patient's care in the patient's care plan1 including treatment and medication adherence1 in dealing with patient failures to adhere to medication or other therapy2 7#g7 listening to or receiving information from family members or caregivers about their loved ones receiving mental illness treatment2 7#h7 communicating with family members1 caregivers1 law enforcement1 or others when the patient presents a serious and imminent threat of harm to self or others2 and 7#i7 communicating to law enforcement and family members or caregivers about the admission of a patient to receive care at a facility or the release of a patient who was admitted to a facility for an emergency psychiatric hold or involuntary treatment4 7b7 ,coordination ,the ,secretary shall carry out this section in coordination with the ,director of the ,office for ,civil ,rights within the ,department of ,health and ,human ,services4 7c7 ,consistency with guidance ,the ,secretary shall ensure that the regulations under this section are consistent with the guidance entitled ,,hipaa ,privacy ,rule and ,sharing ,information ,related to ,mental ,health1 issued by the ,department of ,health and ,human ,services on ,february #bj1 #bjad4 4 #cjb4 ,development and dissemination of model training programs 7a7 ,initial programs and materials ,not later than one year after promulgating final regulations under section #acdca of the ,,hitech ,act1 as added by section #cja1 the ,secretary of ,health and ,human ,services 7in this section referred to as the ,secretary7 shall develop and disseminate-- 7#a7 a model program and materials for training health care providers 7including physicians1 emergency medical personnel1 psychologists1 counselors1 therapists1 behavioral health facilities and clinics1 care managers1 and hospitals7 regarding the circumstances under which1 consistent with the standards governing the privacy and security of individually identifiable health information promulgated by the ,secretary under sections #bfb7;a7 and #bfd of the ,health ,insurance ,portability and ,accountability ,act of #aiif1 the protected health information of patients with a mental illness may be disclosed with and without patient consent2 7#b7 a model program and materials for training lawyers and others in the legal profession on such circumstances2 and 7#c7 a model program and materials for training patients and their families regarding their rights to protect and obtain information under the standards specified in paragraph 7#a74 7b7 ,periodic updates ,the ,secretary shall-- 7#a7 periodically review and update the model programs and materials developed under subsection 7a72 and 7#b7 disseminate the updated model programs and materials4 7c7 ,contents ,the programs and materials developed under subsection 7a7 shall address the guidance entitled ,,hipaa ,privacy ,rule and ,sharing ,information ,related to ,mental ,health1 issued by the ,department of ,health and ,human ,services on ,february #bj1 #bjad4 7d7 ,coordination ,the ,secretary shall carry out this section in coordination with the ,director of the ,office for ,civil ,rights within the ,department of ,health and ,human ,services1 the ,administrator of the ,substance ,abuse and ,mental ,health ,services ,administration1 the ,administrator of the ,health ,resources and ,services ,administration1 and the heads of other relevant agencies within the ,department of ,health and ,human ,services4 7e7 ,input of certain entities ,in developing the model programs and materials required by subsections 7a7 and 7b71 the ,secretary shall solicit the input of relevant national1 ,state1 and local associations1 medical societies1 and licensing boards4 7f7 ,funding ,there is authorized to be appropriated to carry out this section #e1jjj1jjj for fiscal year #bjag and #be1jjj1jjj for the period of fiscal years #bjah through #bjbc4 #cjc4 ,modernizing privacy protections ,not later than two years after the date of the enactment of this ,act1 the ,secretary of ,health and ,human ,services shall issue a final rule modernizing the privacy protections under section #edc of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;dd-#b74 #cjd4 ,improving communication with individuals1 families1 and providers 7a7 ,grants 7#a7 ,authority ,the ,secretary of ,health and ,human ,services1 acting through the ,administrator of the ,substance ,abuse and ,mental ,health ,services ,administration1 shall award grants to eligible entities for the implementation of pilot programs designed to enhance care and promote recovery by supporting communication between individuals in treatment1 their families1 providers1 and other individuals involved in their care4 7#b7 ,recipients ,to be eligible to receive a grant under this section1 an entity shall be a ,state1 county1 city1 tribe1 tribal organization1 institutions of higher education1 public organization1 or private nonprofit organizations4 7#c7 ,nature of activities ,the grants awarded under paragraph 7#a7 shall be used to implement evidence-based or innovative programs1 such as ,adapted or ,open ,dialogue1 that enhance care and promote recovery by supporting communities between individuals and those involved in their treatment1 care1 and support4 7b7 ,additional ,activities ,the ,secretary shall-- 7#a7 evaluate the activities supported by grants awarded under subsection 7a7 in order to further the ,nation's understanding of effective communication strategies between individuals with mental illness and their families and health care providers2 7#b7 disseminate the findings from the evaluation as the ,secretary considers appropriate2 7#c7 make recommendations for scaling up successful models across the country1 including in publicly funded programs2 and 7#d7 other activities as the ,secretary determines appropriate4 7c7 ,duration ,a grant under this section shall be for a period of not more than #e years4 7d7 ,authorization of appropriations 7#a7 ,in general ,there is authorized to be appropriated to carry out this section #b1jjj1jjj for each of fiscal years #bjag through #bjba4 7#b7 ,use of certain funds ,of the funds appropriated to carry out this section in any fiscal year1 no more than #e percent shall be available to the ,secretary for the purposes of carrying out subsection 7b74 ,,iv ,improving ,medicaid and ,medicare ,mental ,health ,services ,a ,medicaid ,provisions #dja4 ,enhanced ,medicaid coverage relating to certain mental health services 7a7 ,medicaid coverage of mental health services and primary care services furnished on the same day ,section #aijb of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7 is amended-- 7#a7 in subsection 7a71 by inserting after paragraph 7#gg7 the following new paragraph3 7#gh7 in the case of a ,state that does not have in effect 7as of the date of the enactment of this paragraph7 under its ,state plan a payment methodology that allows for full reimbursement of all same-day qualifying services through a single payment1 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 #aiac7;c7 of the ,public ,health ,service ,act or a federally qualified health center 7as defined in section #ahfa7;aa77#c77 for which payment would otherwise be payable under the plan1 with respect to such individual1 if such service were not a same-day qualifying service 7as defined in subsection 7ll772 2 and 7#b7 by adding at the end the following new subsection3 7ll7 ,same-,day qualifying services defined ,for purposes of subsection 7a77#gh71 the term same-day qualifying service means-- 7#a7 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 7or another provider7 at the facility2 and 7#b7 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 7or another provider7 at the facility4 4 7b7 ,providing full-,range of ,,epsdt services to children in ,i,m,ds ,section #aije7;h7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7h77 is amended by adding at the end the following new paragraph3 7#c7 ,such term includes the full-range of early and periodic screening1 diagnostic1 and treatment services 7as defined in subsection 7r774 4 7c7 ,optional limited coverage of inpatient services furnished in institutions for mental diseases ,section #aijc7m77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7m77#b77 is amended by adding at the end the following new subparagraph3 7,i7 7i7 ,notwithstanding the limitation specified in the subdivision 7,b7 following paragraph 7#bi7 of section #aije7;a71 beginning on the date of the enactment of this subparagraph1 a ,state may provide1 as part of the monthly capitated payment made by the ,state under this title to a medicaid managed care organization or a prepaid inpatient health plan 7as defined in section #dch4b of title #db1 ,code of ,federal ,regulations 7or any successor regulation771 for payment for limited inpatient psychiatric hospital services provided by such organization or health plan1 at the option of the individual receiving such services1 in lieu of services covered under the ,state plan during the month for which the payment is made4 7ii7 ,in this subparagraph1 the term limited inpatient psychiatric hospital services means the services described in subparagraphs 7,a7 and 7,b7 of section #aije7;h77#a7-- 7,i7 that are furnished to individuals over #ba years of age and under #fe years of age in an institution for mental diseases 7as defined in section #aije7;i77 that is an inpatient hospital facility or a sub-acute care facility providing crisis residential services 7as defined by the ,secretary72 and 7,,ii7 for which the length of stay in such an institution is for a short-term stay of not more than #ae days during the month for which the capitated payment referred to in clause 7i7 is made4 4 7d7 ,effective date 7#a7 ,in general ,subject to paragraph 7#b71 the amendments made by subsections 7a7 and 7b7 shall apply to items and services furnished after the date of the enactment of this section4 7#b7 ,exception for ,state legislation ,in the case of a ,state plan under title ,,xix of the ,social ,security ,act1 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 subsections 7a7 and 7b71 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 ,act4 ,for purposes of the previous sentence1 in the case of a ,state that has a #b-year legislative session1 each year of the session shall be considered to be a separate regular session of the ,state legislature4 #djb4 ,extension and expansion of demonstration programs to improve community mental health ,services ,paragraph 7#c7 of section #bbc7;d7 of the ,protecting ,access to ,medicare ,act of #bjad 7,public ,law #aac-ic2 #abh ,stat4 #ajgg7 is amended to read as follows3 7#c7 ,number and length of demonstration programs 7,a7 ,in general ,except as provided in subparagraphs 7,b7 and 7,c71 not more than #h ,states shall be selected for #b-year demonstration programs under this subsection4 7,b7 ,three-year extension ,a ,state selected to participate in the demonstration project under this subsection shall1 upon the request of the ,state1 be permitted to continue to participate in the demonstration project for an additional #c-year period1 if the ,secretary makes the determination specified in subparagraph 7,d7 with respect to the ,state4 ,the ,secretary shall provide each such ,state with notice of that determination4 7,c7 ,expansion to additional ,states 7i7 ,in general ,the ,secretary may expand the number of eligible ,states participating in the demonstration project1 if1 with respect to any such ,state1 the ,secretary makes the determination specified in subparagraph 7,d74 ,the period of the participation of any such eligible ,state in the demonstration project shall end on ,december #ca1 #bjbb1 regardless of the date on which the ,state begins participating in the demonstration project4 7ii7 ,notification ,the ,secretary shall provide each ,state that applies to be added to the demonstration project under this subsection with notice of the determination under subparagraph 7,d7 and the standards used to make such determination4 7,d7 ,determination ,the determination specified in this subparagraph is that the ,secretary determines that1 in the case of a request under subparagraph 7,b7 or an expansion of the demonstration project under subparagraph 7,c7-- 7i7 the continued participation of a ,state in the demonstration project under this subsection or an expansion of the project to any additional ,state 7as applicable7 will measurably improve access to1 and participation in1 services described in subsection 7a77#b77;,d7 by individuals eligible for medical assistance under the ,state ,medicaid program2 and 7ii7 any such ,state is in full compliance with the reporting requirements under paragraph 7#g7 and any quality reporting requirements established by the ,secretary4 4 #djc4 ,terms for extension and expansion of ,medicaid emergency psychiatric demonstration project ,section #bgjg7;f77#d7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #acif;a note2 ,public ,law #aaa-adh71 as amended by section #b7;c7 of the ,improving ,access to ,emergency ,psychiatric ,care ,act 7,public ,law #aad-ig71 is amended by striking subparagraph 7,c74 #djd4 ,community-based mental health services ,medicaid option for children in or at risk of psychiatric residential treatment ,section #aiae7;c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifn7c77 is amended-- 7#a7 in paragraph 7#a7-- 7,a7 in the first sentence1 by striking or a nursing facility or intermediate care facility for the mentally retarded and inserting 1 nursing facility1 intermediate care facility for the mentally retarded1 or psychiatric residential treatment facility2 and 7,b7 in the second sentence1 by striking or intermediate care facility for the mentally retarded and inserting intermediate care facility for the mentally retarded1 or psychiatric residential treatment facility2 7#b7 in paragraph 7#b7-- 7,a7 in subparagraph 7,b7-- 7i7 in clause 7i71 by striking or services in an intermediate care facility for the mentally retarded and inserting services in an intermediate care facility for the mentally retarded1 or services in a psychiatric residential treatment facility2 and 7ii7 in the matter following clause 7iii71 by striking or services in an intermediate care facility for the mentally retarded and inserting services in an intermediate care facility for the mentally retarded1 or services in a psychiatric residential treatment facility2 and 7,b7 in subparagraph 7,c7-- 7i7 by striking or intermediate care facility for the mentally retarded and inserting intermediate care facility for the mentally retarded1 or psychiatric residential treatment facility2 and 7ii7 by striking or services in an intermediate care facility for the mentally retarded and inserting services in an intermediate care facility for the mentally retarded1 or services in a psychiatric residential treatment facility2 7#c7 in paragraph 7#g77;,a71 by striking or intermediate care facilities for the mentally retarded and inserting intermediate care facilities for the mentally retarded1 or psychiatric residential treatment facilities2 and 7#d7 by adding at the end the following new paragraph3 7#aa7 ,for purposes of this subsection1 the term psychiatric residential treatment facility has the meaning given such term in section #dhc4ceb of title #db1 ,code of ,federal ,regulations 7or any successor regulation74 4 #dje4 ,expansion of ,,cmmi authority to support major mental illness projects in ,medicaid ,section #aaae;,a7b77#b77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acae;a7b77#b77;,b77 is amended by adding at the end the following new clause3 7xxv7 ,focusing primarily on title ,,xix1 preventing major mental illness and substance use disorders and reducing the impact of long-term mental illness and substance use disorders among children1 adolescents1 pregnant women1 and adults through multi-level treatment including but not limited to outreach1 clinical assessment and mental health services1 and supported education and employment4 4 #djf4 ,medicaid data and reporting 7a7 ,guidance on reporting ,medicaid mental health screening and treatment for youth ,the ,secretary of ,health and ,human ,services shall develop guidance for the annual reporting by ,states of mental health screening provided to children eligible for medical assistance for early and periodic screening1 diagnostic1 and treatment services under title ,,xix of the ,social ,security ,act4 ,such guidance shall be provided in the form of a modification of the ,,cms #daf ,annual ,,epsdt ,participation ,report in a manner so that the report includes information on the number of children under #ab years of age1 and the number of individuals who are at least #ab years of age but not older than #ba years of age1 who receive mental health screening services1 the number of such children and individuals who are referred for mental health treatment1 and the number of such children and individuals who are receive treatment for mental health conditions under such title4 7b7 ,,macpac ,section #aijj7;b77#f7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif7;b77#f77 is amended-- 7#a7 by striking ,,macpac shall consult and inserting the following3 7,a7 ,in general ,,macpac shall consult 2 and 7#b7 by adding at the end the following new subparagraph3 7,b7 ,review and reports regarding behavioral health provider reimbursement 7i7 ,in general ,,macpac shall survey selected ,state ,medicaid programs' behavioral health provider reimbursement rates and beneficiary utilization of behavioral health services and shall submit an annual report to ,congress regarding such review4 7ii7 ,required report information ,each such report regarding behavioral health services shall include selected data relating to-- 7,i7 beneficiary behavioral health service encounters2 and 7,,ii7 the amount of ,medicaid behavioral health provider reimbursement rates and the sources for such rates4 7iii7 ,data ,notwithstanding any other provision of law1 the ,secretary regularly shall provide ,,macpac with-- 7,i7 the most recent ,state reports and most recent independent certified audits submitted under section #aibc7;j72 7,,ii7 cost reports submitted under title ,,xviii2 and 7,,iii7 such other data as ,,macpac may request1 for purposes of conducting the reviews and preparing and submitting the annual reports required under this subparagraph4 4 #djg4 ,at-risk youth ,medicaid protection 7a7 ,in general ,section #aijb of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a71 as amended by section #dja1 is further amended-- 7#a7 in subsection 7a7-- 7,a7 by striking and at the end of paragraph 7#hj72 7,b7 by striking the period at the end of paragraph 7#ha7 and inserting 2 and2 and 7,c7 by inserting after paragraph 7#ha7 the following new paragraph3 7#hb7 provide that-- 7,a7 the ,state shall not terminate 7but may suspend7 eligibility for medical assistance under a ,state plan for an individual who is an eligible juvenile 7as defined in subsection 7mm77#b77 because the juvenile is an inmate of a public institution 7as defined in subsection 7mm77#c772 7,b7 the ,state shall automatically restore eligibility for such medical assistance to such an individual upon the individual's release from any such public institution1 unless 7and until such date as7 there is a determination that the individual no longer meets the eligibility requirements for such medical assistance2 and 7,c7 the ,state shall process any application for medical assistance submitted by1 or on behalf of1 a juvenile who is an inmate of a public institution notwithstanding that the juvenile is such an inmate4 2 and 7#b7 by adding at the end the following new subsection3 7mm7 ,juvenile2 eligible juvenile2 public institution ,for purposes of subsection 7a77#hb7 and this subsection3 7#a7 ,juvenile ,the term juvenile means an individual who is-- 7,a7 under #ai years of age 7or such higher age as the ,state has elected under section #dge7h77;,b77iii772 or 7,b7 is described in subsection 7a77#aj77;,a77i77,,ix74 7#b7 ,eligible juvenile ,the term eligible juvenile means a juvenile who is an inmate of a public institution and was eligible for medical assistance under the ,state plan immediately before becoming an inmate of such a public institution or who becomes eligible for such medical assistance while an inmate of a public institution4 7#c7 ,inmate of a public institution ,the term inmate of a public institution has the meaning given such term for purposes of applying the subdivision 7,a7 following paragraph 7#bi7 of section #aije7;a71 taking into account the exception in such subdivision for a patient of a medical institution4 4 7b7 ,no change in exclusion from medical assistance for inmates of public institutions ,nothing in this section shall be construed as changing the exclusion from medical assistance under the subdivision 7,a7 following paragraph 7#bi7 of section #aije7;a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7a771 including any applicable restrictions on a ,state submitting claims for ,federal financial participation under title ,,xix of such ,act for such assistance4 7c7 ,effective date 7#a7 ,in general ,except as provided in paragraph 7#b71 the amendments made by subsection 7a7 shall apply to eligibility of juveniles who become inmates of public institutions on or after the date that is #a year after the date of the enactment of this ,act4 7#b7 ,rule for changes requiring state legislation ,in the case of a ,state plan for medical assistance under title ,,xix of the ,social ,security ,act which the ,secretary of ,health and ,human ,services determines requires ,state legislation 7other than legislation appropriating funds7 in order for the plan to meet the additional requirements imposed by the amendments made by subsection 7a71 the ,state plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet these additional requirements 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 the enactment of this ,act4 ,for purposes of the previous sentence1 in the case of a ,state that has a #b-year legislative session1 each year of such session shall be deemed to be a separate regular session of the ,state legislature4 ,b ,medicare ,provisions #daa4 ,elimination of #aij-;day lifetime limit on coverage of inpatient psychiatric hospital services under ,medicare ,section #ahab of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;d7 is amended-- 7#a7 in subsection 7b7-- 7,a7 in paragraph 7#a71 by adding or at the end2 7,b7 in paragraph 7#b71 by striking 2 or at the end and inserting a period2 and 7,c7 by striking paragraph 7#c72 and 7#b7 in subsection 7c71 by striking or in determining the #aij-;day limit under subsection 7b77#c74 #dab4 ,modifications to ,medicare discharge planning requirements ,section #ahfa7;ee7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7ee77 is amended-- 7#a7 in paragraph 7#a71 by inserting and1 in the case of a psychiatric hospital or a psychiatric unit 7as described in the matter following clause 7v7 of section #ahhf7;d77#a77;,b771 if it also meets the guidelines and standards established by the ,secretary under paragraph 7#d7 before the period at the end2 and 7#b7 by adding at the end the following new paragraph3 7#d7 ,the ,secretary shall develop guidelines and standards1 in addition to those developed under paragraph 7#b71 for the discharge planning process of a psychiatric hospital or a psychiatric unit 7as described in the matter following clause 7v7 of section #ahhf7;d77#a77;,b77 in order to ensure a timely and smooth transition to the most appropriate type of and setting for posthospital or rehabilitative care1 taking into account variations in posthospital care access1 including mental health professional shortage areas designated by the ,health ,resources and ,services ,administration4 ,the ,secretary shall issue final regulations implementing such guidelines and standards not later than #bd months after the date of the enactment of this paragraph4 ,the guidelines and standards shall include the following3 7,a7 ,the hospital or unit must identify the types of services needed upon discharge for the patients being treated by the hospital or unit4 7,b7 ,the hospital or unit must-- 7i7 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 organizations2 and 7ii7 make demonstrated efforts to establish connections1 relationships1 and partnerships with such organizations4 7,c7 ,the hospital or unit must arrange 7with the participation of the patient and of any other individuals selected by the patient for such purpose7 for the development and implementation of a discharge plan for the patient as part of the patient's overall treatment plan from admission to discharge4 ,such discharge plan shall meet the requirements described in subparagraphs 7,g7 and 7,h7 of paragraph 7#b74 7,d7 ,the hospital or unit shall coordinate with the patient 7or assist the patient with7 the referral for posthospital or rehabilitative care and as part of that referral the hospital or unit shall include transmitting to the receiving organization1 in a timely manner1 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 organization4 4 ,c ,provisions ,related to ,medicaid and ,medicare #dba4 ,reports on ,medicaid and ,medicare part ,d formulary and appeals practices with respect to coverage of mental health drugs 7a7 ,medicaid 7#a7 ,in general ,not later than one year after the date of the enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall submit to ,congress a report that1 with respect to mental health drugs1 describes the practices of the ,state with respect to the following 7for both such drugs furnished on a fee-for-service basis and through ,medicaid managed care organizations73 7,a7 ,the establishment of formularies and preferred drugs lists4 7,b7 ,the appeal of any coverage determination4 7#b7 ,mental health drug defined ,in this section1 the term mental health drug means a covered outpatient drug 7as defined in section #aibg7k7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifr-#h7k777 that-- 7,a7 is approved or licensed under section #eje of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cee7 or section #cea of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bfb7 to be used for the treatment of a mental health disorder1 including major depression1 bipolar 7manic-depressive7 disorder1 panic disorder1 obsessive-compulsive disorder1 schizophrenia1 and schizoaffective disorder2 and 7,b7 is covered under the ,state plan under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 7or under a waiver of such plan74 7b7 ,medicare 7#a7 ,study 7,a7 ,in general ,the ,inspector ,general of the ,department of ,health and ,human ,services shall conduct a study that examines1 with respect to the ,medicare program established under title ,,xviii of the ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq471 the extent to which ,medicare part ,d appeals-related processes are transparent1 fair1 effective1 and in compliance with existing statutory and regulatory requirements4 7,b7 ,included elements of study ,the study required under paragraph 7#a7 shall include-- 7i7 an identification1 with respect to a two-year period beginning not earlier than ,january #a1 #bjaj1 of-- 7,i7 the number of grievances1 reconsiderations1 and independent reviews and appeals pursuant to ,medicare part ,d appeals-related processes that were lodged1 requested1 or otherwise filed during such period by part ,d eligible individuals who were enrolled in prescription drug plans offered by ,,pdp sponsors under part ,d of title ,,xviii of the ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq472 and 7,,ii7 with respect to such grievances1 reconsiderations1 and independent reviews and appeals that were so lodged1 requested1 or otherwise filed during such period by such individuals1 the number of such grievances1 reconsiderations1 and independent reviews and appeals that were decided in favor of such individuals2 and 7ii7 an examination of the extent to which ,medicare part ,d appeals-related processes1 with respect to grievances1 reconsiderations1 and independent reviews and appeals that relate to benefits for psychiatric medications under such part1 are transparent1 fair1 effective1 and in compliance with existing statutory and regulatory requirements4 7#b7 ,report ,not later than one year after the date of the enactment of this ,act1 such ,inspector ,general shall submit to ,congress a report on the results of the study described in subsection 7a71 including the recommendations of such ,inspector ,general1 if any1 for improvements that can be made to ,medicare part ,d appeals-related processes4 7#c7 ,definitions ,for purposes of this section3 7,a7 ,medicare part ,d appeals-related processes ,the term ,medicare part ,d appeals-related processes means-- 7i7 grievance procedures provided by ,,pdp sponsors pursuant to subsection 7f7 of section #ahfj;,d-#d of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#ajd72 7ii7 reconsiderations provided by ,,pdp sponsors pursuant to subsection 7g7 of such section2 and 7iii7 independent reviews and appeals to which part ,d eligible individuals are entitled under subsection 7h7 of such section4 7,b7 ,part ,d terms ,the terms part ,d eligible individual1 prescription drug plan1 and ,,pdp sponsor have the meanings given such terms by section #ahdj;,d-#da of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#aea74 7c7 ,access to treatments for resistant depression in the ,medicare and ,medicaid programs ,not later than one year after the date of the enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall submit to ,congress a report that reviews-- 7#a7 access of available treatments for resistant depression under the ,medicare program under title ,,xviii of the ,social ,security ,act and the ,medicaid program under title ,,xix of such ,act2 and 7#b7 the length of time to adopt1 and processes for the adoption of1 newly available treatment for resistant depression for individuals entitled to benefits under part ,a of such title ,,xviii or enrolled under part ,b of such title and for individuals enrolled under a ,state plan under such title ,,xix4 ,v ,strengthening the ,behavioral ,health ,workforce and ,improving ,access to ,care #eja4 ,nationwide workforce strategy 7a7 ,in general ,not later than one year after the date of enactment of this ,act1 the ,substance ,abuse ,mental ,health and ,services ,administration shall1 submit to the ,congress a report containing a nationwide strategy to increase the culturally aware behavioral health workforce and recruit professionals for the treatment of individuals with mental illness and substance use disorders4 7b7 ,design ,the nationwide strategy shall be designed-- 7#a7 to encourage and incentivize students enrolled in accredited medical or osteopathic medical school to enter the specialty of psychiatry2 7#b7 to promote greater research-oriented psychiatrist residency training on evidence-based service delivery models for individuals with serious mental illness or substance use disorders2 7#c7 to promote appropriate ,federal administrative and fiscal mechanisms that support-- 7,a7 evidence-based collaborative care models2 and 7,b7 the necessary trained and culturally aware preventionists1 health care practitioners1 paraprofessionals1 and peers2 7#d7 to increase access to child and adolescent psychiatric services in order to promote early intervention for prevention and mitigation of mental illness2 and 7#e7 to identify populations and locations that are most underserved by mental health and substance use professionals and the most in need of psychiatrists 7including child and adolescent psychiatrists71 psychologists1 psychiatric nurse practitioners1 physician assistants1 clinical social workers1 mental health counselors1 substance abuse counselors1 peer-support specialists1 recovery coaches1 and other mental health and substance use disorder professionals4 #ejb4 ,report on best practices for peer-support specialist programs1 training1 and certification 7a7 ,in general ,not later than #b years after the date of enactment of this ,act1 the ,secretary shall submit to the ,congress and make publicly available a report on best practices and professional standards in ,states for-- 7#a7 establishing and operating health care programs using peer-support specialists2 and 7#b7 training and certifying peer-support specialists4 7b7 ,peer-,support specialist defined ,in this subsection1 the term peer-support specialist means an individual who-- 7#a7 uses his or her lived experience of recovery from mental illness or substance abuse1 plus skills learned in formal training1 to facilitate support groups1 and to work on a one-on-one basis1 with individuals with a serious mental illness or a substance use disorder2 7#b7 has benefited or is benefiting from mental health or substance use treatment services or supports2 7#c7 provides non-medical services2 and 7#d7 performs services only within his or her area of training1 expertise1 competence1 or scope of practice4 7c7 ,contents ,the report under this section shall include information on best practices and standards with regard to the following3 7#a7 ,hours of formal work or volunteer experience related to mental health and substance use issues4 7#b7 ,types of peer support specialists used by different health care programs4 7#c7 ,types of peer specialist exams required4 7#d7 ,code of ethics4 7#e7 ,additional training required prior to certification1 including in areas such as-- 7,a7 ethics2 7,b7 scope of practice2 7,c7 crisis intervention2 7,d7 ,state confidentiality laws2 7,e7 ,federal privacy protections1 including under the ,health ,insurance ,portability and ,accountability ,act of #aiif2 and 7,f7 other areas as determined by the ,secretary4 7#f7 ,requirements to explain what1 where1 when1 and how to accurately complete all required documentation activities4 7#g7 ,required or recommended skill sets1 such as knowledge of-- 7,a7 risk indicators1 including individual stressors1 triggers1 and indicators of escalating symptoms2 7,b7 basic de-escalation techniques2 7,c7 basic suicide prevention concepts and techniques2 7,d7 indicators that the consumer may be experiencing abuse or neglect2 7,e7 stages of change or recovery2 7,f7 the typical process that should be followed to access or participate in community mental health and related services2 and 7,g7 circumstances when it is appropriate to request assistance from other professionals to help meet the consumer's recovery goals4 7#h7 ,requirements for continuing education4 #ejc4 ,advisory ,council on ,graduate ,medical ,education ,section #gfb7;b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bido7b77 is amended-- 7#a7 by redesignating paragraphs 7#d7 through 7#f7 as paragraphs 7#e7 through 7#g71 respectively2 and 7#b7 by inserting after paragraph 7#c7 the following3 7#d7 the ,assistant ,secretary for ,mental ,health and ,substance ,use ,disorders2 4 #ejd4 ,telepsychiatry and primary care provider training grant program 7a7 ,in general ,the ,secretary of ,health and ,human ,services shall establish a grant program 7in this subsection referred to as the grant program7 under which the ,secretary shall award to #aj eligible ,states 7as described in subsection 7e77 grants for carrying out all of the purposes described in subsections 7b71 7c71 and 7d74 7b7 ,training program for certain primary care providers ,for purposes of subsection 7a71 the purpose described in this paragraph1 with respect to a grant awarded to a ,state under the grant program1 is for the ,state to establish a training program to train primary care providers in-- 7#a7 valid and reliable behavioral-health screening tools for violence and suicide risk1 early signs of serious mental illness1 and untreated substance abuse1 including any standardized behavioral-health screening tools that are determined appropriate by the ,secretary2 7#b7 implementing the use of behavioral-health screening tools in their practices2 7#c7 establishment of recommended intervention and treatment protocols for individuals in mental health crisis1 especially for individuals whose illness makes them less receptive to mental health services2 and 7#d7 implementing the evidence-based collaborative care model of integrated medical-behavioral health care in their practices4 7c7 ,payments for mental health services provided by certain primary care providers 7#a7 ,in general ,for purposes of subsection 7a71 the purpose described in this paragraph1 with respect to a grant awarded to a ,state under the grant program1 is for the ,state to provide1 in accordance with this paragraph1 in the case of a primary care physician who participates in the training program of the ,state establish pursuant to subsection 7b71 payments to the primary care providers for services furnished by the primary care providers4 7#b7 ,considerations ,the ,secretary1 in determining the structure1 quality1 and form of payment under paragraph 7#a7 shall seek to find innovative payment systems which may take into account-- 7,a7 the nature and quality of services rendered2 7,b7 the patients' health outcome2 7,c7 the geographical location where services were provided2 7,d7 the acuteness of the patient's medical condition2 7,e7 the duration of services provided2 7,f7 the feasibility of replicating the payment model in other locations nationwide2 and 7,g7 proper triage and enduring linkage to appropriate treatment provider for subspecialty care in child or forensic issues2 family crisis intervention2 drug or alcohol rehabilitation2 management of suicidal or violent behavior risk1 and treatment for serious mental illness4 7d7 ,telehealth services for mental health disorders 7#a7 ,in general ,for purposes of subsection 7a71 the purpose described in this paragraph1 with respect to a grant awarded to a ,state under the grant program1 is for the ,state to provide1 in the case of an individual furnished items and services by a primary care physician during an office visit1 for payment for a consultation provided by a psychiatrist or psychologist to such primary care provider with respect to such individual through the use of qualified telehealth technology for the identification1 diagnosis1 mitigation1 or treatment of a mental health disorder if such consultation occurs not later than the first business day that follows such visit4 7#b7 ,qualified telehealth technology ,for purposes of paragraph 7#a71 the term qualified telehealth technology1 with respect to the provision of items and services to a patient by a health care provider1 includes the use of interactive audio1 audio-only telephone conversation1 video1 or other telecommunications technology by a health care provider to deliver health care services within the scope of the provider's practice including the use of electronic media for consultation relating to the health care diagnosis or treatment of the patient4 7e7 ,eligible ,state 7#a7 ,in general ,for purposes of this subsection1 an eligible ,state is a ,state that has submitted to the ,secretary an application under paragraph 7#b7 and has been selected under paragraph 7#d74 7#b7 ,application ,a ,state seeking to participate in the grant program under this subsection shall submit to the ,secretary1 at such time and in such format as the ,secretary requires1 an application that includes such information1 provisions1 and assurances as the ,secretary may require4 7#c7 ,matching requirement ,the ,secretary may not make a grant under the grant program unless the ,state involved agrees1 with respect to the costs to be incurred by the ,state in carrying out the purposes described in this subsection1 to make available non-,federal contributions 7in cash or in kind7 toward such costs in an amount equal to not less than #bj percent of ,federal funds provided in the grant4 7#d7 ,selection ,a ,state shall be determined eligible for the grant program by the ,secretary on a competitive basis among ,states with applications meeting the requirements of paragraphs 7#b7 and 7#c74 ,in selecting ,state applications for the grant program1 the ,secretary shall seek to achieve an appropriate national balance in the geographic distribution of grants awarded under the grant program4 7f7 ,target population ,in seeking a grant under this subsection1 a ,state shall demonstrate how the grant will improve care for individuals with co-occurring behavioral health and physical health conditions1 vulnerable populations1 socially isolated populations1 rural populations1 and other populations who have limited access to qualified mental health providers4 7g7 ,length of grant program ,the grant program under this subsection shall be conducted for a period of #c consecutive years4 7h7 ,public availability of findings and conclusions ,subject to ,federal privacy protections with respect to individually identifiable information1 the ,secretary shall make the findings and conclusions resulting from the grant program under this subsection available to the public4 7i7 ,authorization of appropriations ,out of any funds in the ,treasury not otherwise appropriated1 there is authorized to be appropriated to carry out this subsection1 #c1jjj1jjj for each of the fiscal years #bjag through #bjba4 7j7 ,reports 7#a7 ,reports ,for each fiscal year that grants are awarded under this subsection1 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 following3 7,a7 ,an evaluation of the grant program outcomes1 including a summary of activities carried out with the grant and the results achieved through those activities4 7,b7 ,recommendations on how to improve access to mental health services at grantee locations4 7,c7 ,an assessment of access to mental health services under the program4 7,d7 ,an assessment of the impact of the demonstration project on the costs of the full range of mental health services 7including inpatient1 emergency and ambulatory care74 7,e7 ,recommendations on congressional action to improve the grant4 7,f7 ,recommendations to improve training of primary care providers4 7#b7 ,report ,not later than ,december #ca1 #bjah1 the ,secretary shall submit to ,congress and make available to the public a report on the findings of the evaluation under subparagraph 7,a7 and also a policy outline on how ,congress can expand the grant program to the national level4 #eje4 ,liability protections for health care professional volunteers at community health centers and federally qualified community behavioral health clinics ,section #bbd of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bcc7 is amended by adding at the end the following3 7q7 7#a7 ,in this subsection1 the term federally qualified community behavioral health clinic means-- 7,a7 a federally qualified community behavioral health clinic with a certification in effect under section #bbc of the ,protecting ,access to ,medicare ,act of #bjad2 or 7,b7 a community mental health center meeting the criteria specified in section #aiac7;c7 of this ,act4 7#b7 ,for purposes of this section1 a health care professional volunteer at an entity described in subsection 7g77#d7 or a federally qualified community behavioral health clinic shall1 in providing health care services eligible for funding under section #ccj or subpart ,i of part ,b of title ,,xix to an individual1 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 7#e77;,c74 ,the preceding sentence is subject to the provisions of this subsection4 7#c7 ,in providing a health care service to an individual1 a health care professional shall for purposes of this subsection be considered to be a health professional volunteer at an entity described in subsection 7g77#d7 or at a federally qualified community behavioral health clinic if the following conditions are met3 7,a7 ,the service is provided to the individual at the facilities of an entity described in subsection 7g77#d71 at a federally qualified community behavioral health clinic1 or through offsite programs or events carried out by the center4 7,b7 ,the center or entity is sponsoring the health care professional volunteer pursuant to paragraph 7#d77;,b74 7,c7 ,the health care professional does not receive any compensation for the service from the individual or from any third-party payer 7including reimbursement under any insurance policy or health plan1 or under any ,federal or ,state health benefits program71 except that the health care professional may receive repayment from the entity described in subsection 7g77#d7 or the center for reasonable expenses incurred by the health care professional in the provision of the service to the individual4 7,d7 ,before the service is provided1 the health care professional or the center or entity described in subsection 7g77#d7 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 subsection4 7,e7 ,at the time the service is provided1 the health care professional is licensed or certified in accordance with applicable law regarding the provision of the service4 7#d7 ,subsection 7g7 7other than paragraphs 7#c7 and 7#e77 and subsections 7h71 7i71 and 7l7 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 officer1 governing board member1 employee1 or contractor of an entity described in subsection 7g77#d71 subject to paragraph 7#e7 and subject to the following3 7,a7 ,the first sentence of paragraph 7#b7 applies in lieu of the first sentence of subsection 7g77#a77;,a74 7,b7 ,with respect to an entity described in subsection 7g77#d7 or a federally qualified community behavioral health clinic1 a health care professional is not a health professional volunteer at such center unless the center sponsors the health care professional4 ,for purposes of this subsection1 the center shall be considered to be sponsoring the health care professional if-- 7i7 with respect to the health care professional1 the center submits to the ,secretary an application meeting the requirements of subsection 7g77#a77;,d72 and 7ii7 the ,secretary1 pursuant to subsection 7g77#a77;,e71 determines that the health care professional is deemed to be an employee of the ,public ,health ,service4 7,c7 ,in the case of a health care professional who is determined by the ,secretary pursuant to subsection 7g77#a77;,e7 to be a health professional volunteer at such center1 this subsection applies to the health care professional 7with respect to services described in paragraph 7#b77 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 determination4 7,d7 ,subsection 7g77#a77;,f7 applies to a health professional volunteer for purposes of this subsection only to the extent that1 in providing health services to an individual1 each of the conditions specified in paragraph 7#c7 is met4 7#e7 7,a7 ,amounts in the fund established under subsection 7k77#b7 shall be available for transfer under subparagraph 7,c7 for purposes of carrying out this subsection for health professional volunteers at entities described in subsection 7g77#d74 7,b7 ,not later than ,may #a of each fiscal year1 the ,attorney ,general1 in consultation with the ,secretary1 shall submit to the ,congress a report providing an estimate of the amount of claims 7together with related fees and expenses of witnesses7 that1 by reason of the acts or omissions of health care professional volunteers1 will be paid pursuant to this subsection during the calendar year that begins in the following fiscal year4 ,subsection 7k77#a77;,b7 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 officers1 governing board members1 employees1 and contractors of entities described in subsection 7g77#d74 7,c7 ,not later than ,december #ca of each fiscal year1 the ,secretary shall transfer from the fund under subsection 7k77#b7 to the appropriate accounts in the ,treasury an amount equal to the estimate made under subparagraph 7,b7 for the calendar year beginning in such fiscal year1 subject to the extent of amounts in the fund4 7#f7 7,a7 ,this subsection takes effect on ,october #a1 #bjag1 except as provided in subparagraph 7,b74 7,b7 ,effective on the date of the enactment of this subsection-- 7i7 the ,secretary may issue regulations for carrying out this subsection1 and the ,secretary may accept and consider applications submitted pursuant to paragraph 7#d77;,b72 and 7ii7 reports under paragraph 7#e77;,b7 may be submitted to the ,congress4 4 #ejf4 ,minority ,fellowship ,program ,title ,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;aa et seq471 as amended1 is further amended by adding at the end the following3 ,k ,minority ,fellowship ,program #eig4 ,fellowships 7a7 ,in general ,the ,secretary shall maintain a program1 to be known as the ,minority ,fellowship ,program1 under which the ,secretary awards fellowships1 which may include stipends1 for the purposes of-- 7#a7 increasing behavioral health practitioners' knowledge of issues related to prevention1 treatment1 and recovery support for mental and substance use disorders among racial and ethnic minority populations2 7#b7 improving the quality of mental and substance use disorder prevention and treatment delivered to ethnic minorities2 and 7#c7 increasing the number of culturally competent behavioral health professionals who teach1 administer1 conduct services research1 and provide direct mental health or substance use services to underserved minority populations4 7b7 ,training covered ,the fellowships under subsection 7a7 shall be for postbaccalaureate training 7including for master's and doctoral degrees7 for mental health professionals1 including in the fields of psychiatry1 nursing1 social work1 psychology1 marriage and family therapy1 professional counseling1 and substance use and addiction counseling4 7c7 ,authorization of appropriations ,to carry out this section1 there are authorized to be appropriated #aa1jjj1jjj for fiscal year #bjag1 #ad1jjj1jjj for fiscal year #bjah1 #af1jjj1jjj for fiscal year #bjai1 #ah1jjj1jjj for fiscal year #bjbj1 and #bj1jjj1jjj for fiscal year #bjba4 4 #ejg4 ,national ,health ,service ,corps 7a7 ,definitions 7#a7 ,primary health services ,section #cca7;a77#c77;,d7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;d7a77#c77 is amended by inserting 7including pediatric mental health subspecialty services7 after pediatrics4 7#b7 ,behavioral and mental health professionals ,clause 7i7 of section #cca7;a77#c77;,e7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;d7a77#c77;,e77 is amended by inserting 7and pediatric subspecialists thereof7 before the period at the end4 7b7 ,eligibility ,to participate in loan repayment program ,section #cch;,b7b77#a77;,b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bedl-#a7;b77#a77;,b77 is amended by inserting 1 including any physician child and adolescent psychiatry residency or fellowship training program after be enrolled in an approved graduate training program in medicine1 osteopathic medicine1 dentistry1 behavioral and mental health1 or other health profession4 #ejh4 ,,samhsa grant program for development and implementation of curricula for continuing education on serious mental illness ,title ,v of the ,public ,health ,service ,act is amended by inserting after section #ebj;,i 7#db ,u4,s4,c4 #bij;bb-#dj7 the following3 #ebj;,i-#a4 ,curricula for continuing education on serious mental illness 7a7 ,grants ,the ,secretary may award grants to eligible entities for the development and implementation of curricula for providing continuing education and training to health care professionals on identifying1 referring1 and treating individuals with serious mental illness or serious emotional disturbance4 7b7 ,eligible entities ,to be eligible to seek a grant under this section1 an entity shall be a public or nonprofit entity that-- 7#a7 provides continuing education or training to health care professionals2 or 7#b7 applies for the grant in partnership with another entity that provides such education and training4 7c7 ,preference ,in awarding grants under this section1 the ,secretary shall give preference to eligible entities proposing to develop and implement curricula for providing continuing education and training to-- 7#a7 health care professionals in primary care specialties2 or 7#b7 health care professionals who are required1 as a condition of ,state licensure1 to participate in continuing education or training specific to mental health4 7d7 ,authorization of appropriations ,to carry out this section1 there are authorized to be appropriated #a1jjj1jjj for each of fiscal years #bjag through #bjba4 4 #eji4 ,peer professional workforce development grant program 7a7 ,in general ,for the purposes described in subsection 7b71 the ,secretary of ,health and ,human ,services shall award grants to develop and sustain behavioral health paraprofessional training and education programs1 including through tuition support4 7b7 ,purposes ,the purposes of grants under this section are-- 7#a7 to increase the number of behavioral health paraprofessionals1 including trained peers1 recovery coaches1 mental health and addiction specialists1 prevention specialists1 and pre-masters-level addiction counselors2 and 7#b7 to help communities develop the infrastructure to train and certify peers as behavioral health paraprofessionals4 7c7 ,eligible entities ,to be eligible to receive a grant under this section1 an entity shall be a community college or other entity the ,secretary deems appropriate4 7d7 ,geographic distribution ,in awarding grants under this section1 the ,secretary shall seek to achieve an appropriate national balance in the geographic distribution of such awards4 7e7 ,special consideration ,in awarding grants under this section1 the ,secretary may give special consideration to proposed and existing programs targeting peer professionals serving youth ages #af to #be4 7f7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated to carry out this section #e1jjj1jjj for each of fiscal years #bjag through #bjba4 #eaj4 ,demonstration grant program to recruit1 train1 and professionally support psychiatric physicians in ,indian health programs 7a7 ,establishment ,the ,secretary of ,health and ,human ,services 7in this section referred to as the ,secretary71 in consultation with the ,director of the ,indian ,health ,service and demonstration programs established under section #abc of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afafp71 shall award one #e-year grant to one eligible entity to carry out a demonstration program 7in this ,act referred to as the ,program7 under which the eligible entity shall carry out the activities described in subsection 7b74 7b7 ,activities ,to be carried out by recipient of grant under ,program ,under the ,program1 the grant recipient shall-- 7#a7 create a nationally replicable workforce model that identifies and incorporates best practices for recruiting1 training1 deploying1 and professionally supporting ,native ,american and non-,native ,american psychiatric physicians to be fully integrated into medical1 mental1 and behavioral health systems in ,indian health programs2 7#b7 recruit to participate in the ,program ,native ,american and non-,native ,american psychiatric physicians who demonstrate interest in providing specialty health care services 7as defined in section #cac7;a77#c7 of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afch;g7a77#c777 and primary care services to ,american ,indians and ,alaska ,natives2 7#c7 provide such psychiatric physicians participating in the ,program with not more than #a year of supplemental clinical and cultural competency training to enable such physicians to provide such specialty health care services and primary care services in ,indian health programs2 7#d7 with respect to such psychiatric physicians who are participating in the ,program and trained under paragraph 7#c71 deploy such physicians to practice specialty care or primary care in ,indian health programs for a period of not less than #b years and professionally support such physicians for such period with respect to practicing such care in such programs2 and 7#e7 not later than #a year after the last day of the #e-year period for which the grant is awarded under subsection 7a71 submit to the ,secretary and to the appropriate committees of ,congress a report that shall include-- 7,a7 the workforce model created under paragraph 7#a72 7,b7 strategies for disseminating the workforce model to other entities with the capability of adopting it2 and 7,c7 recommendations for the ,secretary and ,congress with respect to supporting an effective and stable psychiatric and mental health workforce that serves ,american ,indians and ,alaska ,natives4 7c7 ,eligible entities 7#a7 ,requirements ,to be eligible to receive the grant under this section1 an entity shall-- 7,a7 submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require2 7,b7 be a department of psychiatry within a medical school in the ,united ,states that is accredited by the ,liaison ,committee on ,medical ,education or a public or private nonprofit entity affiliated with a medical school in the ,united ,states that is accredited by the ,liaison ,committee on ,medical ,education2 and 7,c7 have in existence1 as of the time of submission of the application under subparagraph 7,a71 a relationship with ,indian health programs in at least two ,states with a demonstrated need for psychiatric physicians and provide assurances that the grant will be used to serve rural and non-rural ,american ,indian and ,alaska ,native populations in at least two ,states4 7#b7 ,priority in selecting grant recipient ,in awarding the grant under this section1 the ,secretary shall give priority to an eligible entity that satisfies each of the following3 7,a7 ,demonstrates sufficient infrastructure in size1 scope1 and capacity to undertake the supplemental clinical and cultural competency training of a minimum of #e psychiatric physicians1 and to provide ongoing professional support to psychiatric physicians during the deployment period to an ,indian health program4 7,b7 ,demonstrates a record in successfully recruiting1 training1 and deploying physicians who are ,american ,indians and ,alaska ,natives4 7,c7 ,demonstrates the ability to establish a program advisory board1 which may be primarily composed of representatives of federally recognized tribes1 ,alaska ,natives1 and ,indian health programs to be served by the ,program4 7d7 ,eligibility of psychiatric physicians ,to participate in the ,program 7#a7 ,in general ,to be eligible to participate in the ,program1 as described in subsection 7b71 a psychiatric physician shall-- 7,a7 be licensed or eligible for licensure to practice in the ,state to which the physician is to be deployed under subsection 7b77#d72 and 7,b7 demonstrate a commitment beyond the one year of training described in subsection 7b77#c7 and two years of deployment described in subsection 7b77#d7 to a career as a specialty care physician or primary care physician providing mental health services in ,indian health programs4 7#b7 ,preference ,in selecting physicians to participate under the ,program1 as described in subsection 7b77#b71 the grant recipient shall give preference to physicians who are ,american ,indians and ,alaska ,natives4 7e7 ,loan forgiveness ,under the ,program1 any psychiatric physician accepted to participate in the ,program shall1 notwithstanding the provisions of subsection 7b7 of section #ajh of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afaf;a7 and upon acceptance into the ,program1 be deemed eligible and enrolled to participate in the ,indian ,health ,service ,loan ,repayment ,program under such section #ajh4 ,under such ,loan ,repayment ,program1 the ,secretary shall pay on behalf of the physician for each year of deployment under the ,program under this section up to #ce1jjj for loans described in subsection 7g77#a7 of such section #ajh4 7f7 ,deferral of certain service ,the starting date of required service of individuals in the ,national ,health ,service ,corps ,service ,program under title ,,ii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bjb et seq47 who are psychiatric physicians participating under the ,program under this section shall be deferred until the date that is #cj days after the date of completion of the participation of such a physician in the ,program under this section4 7g7 ,definitions ,for purposes of this section3 7#a7 ,american ,indians and ,alaska ,natives ,the term ,american ,indians and ,alaska ,natives has the meaning given the term ,indian in section #ddg4ej7;b77#a7 of title #db1 ,code of ,federal ,regulations1 as in existence as of the date of the enactment of this ,act4 7#b7 ,indian health program ,the term ,indian health program has the meaning given such term in section #ajd7ab7 of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afjc7ab774 7#c7 ,professionally support ,the term professionally support means1 with respect to psychiatric physicians participating in the ,program and deployed to practice specialty care or primary care in ,indian health programs1 the provision of compensation to such physicians for the provision of such care during such deployment and may include the provision1 dissemination1 or sharing of best practices1 field training1 and other activities deemed appropriate by the recipient of the grant under this section4 7#d7 ,psychiatric physician ,the term psychiatric physician means a medical doctor or doctor of osteopathy in good standing who has successfully completed four-year psychiatric residency training or who is enrolled in four-year psychiatric residency training in a residency program accredited by the ,accreditation ,council for ,graduate ,medical ,education4 7h7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #a1jjj1jjj for each of the fiscal years #bjag through #bjba4 #eaa4 ,education and training on eating disorders for health professionals 7a7 ,in general ,the ,secretary of ,health and ,human ,services1 acting through the ,administrator of the ,substance ,abuse and ,mental ,health ,services ,administration1 shall award grants to eligible entities to integrate training into existing curricula for primary care physicians1 other licensed or certified health and mental health professionals1 and public health professionals that may include-- 7#a7 early intervention and identification of eating disorders2 7#b7 types of treatment 7including family-based treatment1 inpatient1 residential1 partial hospitalization programming1 intensive outpatient and outpatient72 7#c7 how to properly refer patients to treatment2 7#d7 steps to aid in the prevention of the development of eating disordered behaviors2 and 7#e7 how to treat individuals with eating disorders4 7b7 ,application ,an entity that desires a grant under this section shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require1 including a plan for the use of funds that may be awarded and an evaluation of the training that will be provided4 7c7 ,use of funds ,an entity that receives a grant under this section shall use the funds made available through such grant to-- 7#a7 use a training program containing evidence-based findings1 promising emerging best practices1 or recommendations that pertain to the identification1 early intervention1 prevention of the development of eating disordered behaviors1 and treatment of eating disorders to conduct educational training and conferences1 including ,internet-based courses and teleconferences1 on-- 7,a7 how to help prevent the development of eating disordered behaviors1 identify1 intervene early1 and appropriately and adequately treat eating disordered patients2 7,b7 how to identify individuals with eating disorders1 and those who are at risk for suffering from eating disorders and1 therefore1 at risk for related severe medical and mental health conditions2 7,c7 how to conduct a comprehensive assessment of individual and familial health risk factors2 and 7,d7 how to conduct a comprehensive assessment of a treatment plan2 and 7#b7 evaluate and report to the ,secretary on the effectiveness of the training provided by such entity in increasing knowledge and changing attitudes and behaviors of trainees4 7d7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #a1jjj1jjj for each of the fiscal years #bjag through #bjba4 #eab4 ,primary and behavioral health care integration grant programs ,section #ebj,k of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#db7 is amended to read as follows3 #ebj,k4 ,integration incentive grants 7a7 ,in general ,the ,secretary shall establish a primary and behavioral health care integration grant program4 ,the ,secretary may award grants and cooperative agreements to eligible entities to expend funds for improvements in integrated settings with integrated practices4 7b7 ,definitions ,in this section3 7#a7 ,integrated care ,the term integrated care means full collaboration in merged or transformed practices offering behavioral and physical health services within the same shared practice space in the same facility1 where the entity-- 7,a7 provides services in a shared space that ensures services will be available and accessible promptly and in a manner which preserves human dignity and assures continuity of care2 7,b7 ensures communication among the integrated care team that is consistent and team-based2 7,c7 ensures shared decisionmaking between behavioral health and primary care providers2 7,d7 provides evidence-based services in a mode of service delivery appropriate for the target population2 7,e7 employs staff who are multidisciplinary and culturally and linguistically competent2 7,f7 provides integrated services related to screening1 diagnosis1 and treatment of mental illness and substance use disorder and co-occurring primary care conditions and chronic diseases2 and 7,g7 provides targeted case management1 including services to assist individuals gaining access to needed medical1 social1 educational1 and other services and applying for income security1 housing1 employment1 and other benefits to which they may be entitled4 7#b7 ,integrated care team ,the term integrated care team means a team that includes-- 7,a7 allopathic or osteopathic medical doctors1 such as a primary care physician and a psychiatrist2 7,b7 licensed clinical behavioral health professionals1 such as psychologists or social workers2 7,c7 a case manager2 and 7,d7 other members1 such as psychiatric advanced practice nurses1 physician assistants1 peer-support specialists or other allied health professionals1 such as mental health counselors4 7#c7 ,special population ,the term special population means-- 7,a7 adults with mental illnesses who have co-occurring primary care conditions with chronic diseases2 7,b7 adults with serious mental illnesses who have co-occurring primary care conditions with chronic diseases2 7,c7 children and adolescents with serious emotional disturbances with co-occurring primary care conditions and chronic diseases2 7,d7 older adults with mental illness who have co-occurring primary care conditions with chronic conditions2 7,e7 individuals with substance use disorder2 or 7,f7 individuals from populations for which there is a significant disparity in the quality1 outcomes1 cost1 or use of mental health or substance use disorder services or a significant disparity in access to such services1 as compared to the general population1 such as racial and ethnic minorities and rural populations4 7c7 ,purpose ,the grant program under this section shall be designed to lead to full collaboration between primary and behavioral health in an integrated practice model to ensure that-- 7#a7 the overall wellness and physical health status of individuals with serious mental illness or serious emotional disturbance and co-occurring substance use disorders is supported through integration of primary care into community mental health centers meeting the criteria specified in section #aiac7;c7 of the ,social ,security ,act or certified community behavioral health clinics described in section #bbc of the ,protecting ,access to ,medicare ,act of #bjad2 or 7#b7 the mental health status of individuals with significant co-occurring psychiatric and physical conditions will be supported through integration of behavioral health into primary care settings4 7d7 ,eligible entities ,to be eligible to receive a grant or cooperative agreement under this section1 an entity shall be a ,state department of health1 ,state mental health or addiction agency1 ,state ,medicaid agency1 or licensed health care provider or institution4 ,the ,administrator may give preference to ,states that have existing integrated care models1 such as those authorized by section #aide of the ,social ,security ,act4 7e7 ,application ,an eligible entity desiring a grant or cooperative agreement under this section shall submit an application to the ,administrator at such time1 in such manner1 and accompanied by such information as the ,administrator may require1 including a description of a plan to achieve fully collaborative agreements to provide services to special populations and-- 7#a7 a document that summarizes the ,state-specific policies that inhibit the provision of integrated care1 and the specific steps that will be taken to address such barriers1 such as through licensing and billing procedures2 and 7#b7 a plan to develop and share a de-identified patient registry to track treatment implementation and clinical outcomes to inform clinical interventions1 patient education1 and engagement with merged or transformed integrated practices in compliance with applicable national and ,state health information privacy laws4 7f7 ,grant amounts ,the maximum annual grant amount under this section shall be #b1jjj1jjj1 of which not more than #aj percent may be allocated to ,state administrative functions1 and the remaining amounts shall be allocated to health facilities that provide integrated care4 7g7 ,duration ,a grant under this section shall be for a period of #e years4 7h7 ,report on program outcomes ,an entity receiving a grant or cooperative agreement under this section shall submit an annual report to the ,administrator that includes-- 7#a7 the progress to reduce barriers to integrated care1 including regulatory and billing barriers1 as described in the entity's application under subsection 7d72 and 7#b7 a description of functional outcomes of special populations1 such as-- 7,a7 with respect to individuals with serious mental illness1 participation in supportive housing or independent living programs1 engagement in social or education activities1 participation in job training or employment opportunities1 attendance at scheduled medical and mental health appointments1 and compliance with treatment plans2 7,b7 with respect to individuals with co-occurring mental illness and primary care conditions and chronic diseases1 attendance at scheduled medical and mental health appointments1 compliance with treatment plans1 and participation in learning opportunities related to improved health and lifestyle practice2 and 7,c7 with respect to children and adolescents with serious emotional disorders who have co-occurring primary care conditions and chronic diseases1 attendance at scheduled medical and mental health appointments1 compliance with treatment plans1 and participation in learning opportunities at school and extracurricular activities4 7i7 ,technical assistance center for primary-,behavioral health care integration 7#a7 ,in general ,the ,secretary shall establish a program through which such ,secretary shall provide appropriate information1 training1 and technical assistance to eligible entities that receive a grant or cooperative agreement under this section1 in order to help such entities to meet the requirements of this section1 including assistance with-- 7,a7 development and selection of integrated care models2 7,b7 dissemination of evidence-based interventions in integrated care2 7,c7 establishment of organizational practices to support operational and administrative success2 and 7,d7 other activities1 as the ,secretary determines appropriate4 7#b7 ,additional dissemination of technical information ,the information and resources provided by the technical assistance program established under paragraph 7#a7 shall be made available to ,states1 political subdivisions of a ,state1 ,indian tribes or tribal organizations 7as defined in section #d of the ,indian ,self-,determination and ,education ,assistance ,act71 outpatient mental health and addiction treatment centers1 community mental health centers that meet the criteria under section #aiac7;c71 certified community behavioral health clinics described in section #bbc of the ,protecting ,access to ,medicare ,act of #bjad1 primary care organizations such as ,federally qualified health centers or rural health centers1 other community-based organizations1 or other entities engaging in integrated care activities1 as the ,secretary determines appropriate4 7j7 ,authorization of appropriations ,to carry out this section1 there are authorized to be appropriated #ej1jjj1jjj for each of fiscal years #bjag through #bjba1 of which #b1jjj1jjj shall be available to the technical assistance program under subsection 7i74 4 #eac4 ,health professions competencies to address racial1 ethnic1 sexual1 and gender minority behavioral health disparities 7a7 ,in general ,the ,secretary of ,health and ,human ,services shall award grants to national organizations for the purpose of developing1 and disseminating to health professional educational programs1 curricula or core competencies addressing behavioral health disparities among racial1 ethnic1 sexual1 and gender minority groups4 7b7 ,use of funds ,organizations receiving funds under subsection 7a7 shall use the funds to develop and disseminate curricula or core competencies1 as described in such subsection1 for use in the training of students in the professions of social work1 psychology1 psychiatry1 nursing1 physician assistants1 marriage and family therapy1 mental health counseling1 substance abuse counseling1 or other mental health and substance use disorder providers that the ,secretary deems appropriate4 7c7 ,allowable activities ,organizations receiving funds under subsection 7a7 may use the funds to engage in the following activities related to the development and dissemination of curricula or core competencies3 7#a7 ,formation of committees or working groups comprised of experts from accredited health professions schools to identify core competencies relating to mental health disparities among racial and ethnic minority groups4 7#b7 ,planning of workshops in national fora to allow for public input into the educational needs associated with mental health disparities among racial and ethnic minority groups4 7#c7 ,dissemination and promotion of the use of curricula or core competencies in undergraduate and graduate health professions training programs nationwide4 7d7 ,definitions ,in this section1 the term racial and ethnic minority group has the meaning given to such term in section #agjg7;g7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjju-#f7;g774 7e7 ,authorization of appropriations ,there are authorized to be appropriated to carry out this section #a1jjj1jjj for each of fiscal years #bjag through #bjba4 #ead4 ,behavioral health crisis systems 7a7 ,definitions ,for purposes of this section1 the following definitions shall apply3 7#a7 ,eligible ,entity ,the term eligible entity means a ,state1 political subdivision of a ,state1 or nonprofit private entity4 7#b7 ,secretary ,the term ,secretary means the ,secretary of ,health and ,human ,services4 7#c7 ,state ,the term ,state means each ,state of the ,united ,states1 the ,district of ,columbia1 each commonwealth1 territory or possession of the ,united ,states1 and each federally recognized ,indian tribe4 7b7 ,establishment of ,grant ,program 7#a7 ,establishment ,the ,secretary shall establish a program to award grants to eligible entities to establish and implement a system for preventing and de-escalating behavioral health crises4 7#b7 ,use of ,funds 7,a7 ,in ,general ,grants under this section may be used to carry out programs that-- 7i7 expand early intervention and treatment services to improve access to behavioral health crisis assistance and address unmet behavioral health care needs2 7ii7 expand the continuum of services to address crisis prevention1 crisis intervention1 and crisis stabilization2 and 7iii7 reduce unnecessary hospitalizations by appropriately utilizing community-based services and improving access to timely behavioral health crisis assistance4 7,b7 ,authorized ,activities ,the programs described in subparagraph 7,a7 may include activities such as3 7i7 ,mobile support or crisis support centers that provide field-based behavioral health assistance to individuals with mental health or substance use disorders and links such individuals in crisis to appropriate services4 7ii7 ,school and community-based early intervention and prevention programs that provide mobile response1 screening and assessment1 training and education1 and peer-based and family services4 7iii7 ,mental health crisis intervention and response training for law enforcement officers to increase officers' understanding and recognition of mental illnesses as well as increase their awareness of health care services available to individuals in crisis4 7#c7 ,application ,to be considered for a grant under this section1 an eligible entity shall submit an application to the ,secretary at such time1 in such manner1 and containing such information as the ,secretary may require4 ,at minimum1 such application shall include a description of-- 7,a7 the activities to be funded with the grant2 7,b7 community needs2 7,c7 the population to be served2 and 7,d7 the interaction between the activities described in subparagraph 7,a7 and public systems of health and mental health care1 law enforcement1 social services1 and related assistance programs4 7#d7 ,selecting among applicants 7,a7 ,in ,general ,grants shall be awarded to eligible entities on a competitive basis4 7,b7 ,selection ,criteria ,the ,secretary shall evaluate applicants based on such criteria as the ,secretary determines to be appropriate1 including the ability of an applicant to carry out the activities described in paragraph 7#b74 7#e7 ,reports 7,a7 ,annual ,reports 7i7 ,eligible ,entities ,as a condition of receiving a grant under this section1 an eligible entity shall agree to submit a report to the ,secretary1 on an annual basis1 describing the activities carried out with the grant and assessing the effectiveness of such activities4 7ii7 ,secretary ,the ,secretary shall1 on an annual basis1 and using the reports received under clause 7i71 report to ,congress on the overall impact and effectiveness of the grant program under this section4 7,b7 ,final ,report ,not later than ,january #ae1 #bjba1 the ,secretary shall submit to ,congress a final report that includes recommendations with respect to the feasibility and advisability of extending or expanding the grant program4 ,the report shall also provide an assessment of which systems and system elements proved most effective4 7#f7 ,collection of data ,the ,secretary shall collect data on the grant program to determine its effectiveness in reducing the social impact of mental health crises and the feasibility and advisability of extending the grant program4 7c7 ,authorization of ,appropriations ,there is authorized to be appropriated to carry out this section #aj1jjj1jjj for each of fiscal years #bjag through #bjba4 #eae4 ,mental health in schools 7a7 ,technical amendments ,the second part ,g 7relating to services provided through religious organizations7 of title ,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bijkk et seq47 is amended-- 7#a7 by redesignating such part as part ,j2 and 7#b7 by redesignating sections #eha through #ehd as sections #eif through #eif;,c1 respectively4 7b7 ,school-,based mental health and children and violence ,section #eha of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;hh7 is amended to read as follows3 #eha4 ,school-based mental health and children and violence 7a7 ,in general ,the ,secretary1 in collaboration with the ,secretary of ,education and in consultation with the ,attorney ,general1 shall1 directly or through grants1 contracts1 or cooperative agreements awarded to public entities and local education agencies1 assist local communities and schools in applying a public health approach to mental health services both in schools and in the community4 ,such approach should provide comprehensive age appropriate services and supports1 be linguistically and culturally appropriate1 be trauma-informed1 and incorporate age appropriate strategies of positive behavioral interventions and supports4 ,a comprehensive school mental health program funded under this section shall assist children in dealing with trauma and violence4 7b7 ,activities ,under the program under subsection 7a71 the ,secretary may-- 7#a7 provide financial support to enable local communities to implement a comprehensive culturally and linguistically appropriate1 trauma-informed1 and age-appropriate1 school mental health program that incorporates positive behavioral interventions1 client treatment1 and supports to foster the health and development of children2 7#b7 provide technical assistance to local communities with respect to the development of programs described in paragraph 7#a72 7#c7 provide assistance to local communities in the development of policies to address child and adolescent trauma and mental health issues and violence when and if it occurs2 7#d7 facilitate community partnerships among families1 students1 law enforcement agencies1 education systems1 mental health and substance use disorder service systems1 family-based mental health service systems1 welfare agencies1 health care service systems 7including physicians71 faith-based programs1 trauma networks1 and other community-based systems2 and 7#e7 establish mechanisms for children and adolescents to report incidents of violence or plans by other children1 adolescents1 or adults to commit violence4 7c7 ,requirements 7#a7 ,in general ,to be eligible for a grant1 contract1 or cooperative agreement under subsection 7a71 an entity shall-- 7,a7 be a partnership between a local education agency and at least one community program or agency that is involved in mental health2 and 7,b7 submit an application1 that is endorsed by all members of the partnership1 that contains the assurances described in paragraph 7#b74 7#b7 ,required assurances ,an application under paragraph 7#a7 shall contain assurances as follows3 7,a7 ,that the applicant will ensure that1 in carrying out activities under this section1 the local educational agency involved will enter into a memorandum of understanding-- 7i7 with1 at least one1 public or private mental health entity1 health care entity1 law enforcement or juvenile justice entity1 child welfare agency1 family-based mental health entity1 family or family organization1 trauma network1 or other community-based entity2 and 7ii7 that clearly states-- 7,i7 the responsibilities of each partner with respect to the activities to be carried out2 7,,ii7 how each such partner will be accountable for carrying out such responsibilities2 and 7,,iii7 the amount of non-,federal funding or in-kind contributions that each such partner will contribute in order to sustain the program4 7,b7 ,that the comprehensive school-based mental health program carried out under this section supports the flexible use of funds to address-- 7i7 the promotion of the social1 emotional1 and behavioral health of all students in an environment that is conducive to learning2 7ii7 the reduction in the likelihood of at risk students developing social1 emotional1 behavioral health problems1 or substance use disorders2 7iii7 the early identification of social1 emotional1 behavioral problems1 or substance use disorders and the provision of early intervention services2 7iv7 the treatment or referral for treatment of students with existing social1 emotional1 behavioral health problems1 or substance use disorders2 and 7v7 the development and implementation of programs to assist children in dealing with trauma and violence4 7,c7 ,that the comprehensive school-based mental health program carried out under this section will provide for in-service training of all school personnel1 including ancillary staff and volunteers1 in-- 7i7 the techniques and supports needed to identify early children with trauma histories and children with1 or at risk of1 mental illness2 7ii7 the use of referral mechanisms that effectively link such children to appropriate treatment and intervention services in the school and in the community and to follow-up when services are not available2 7iii7 strategies that promote a school-wide positive environment2 7iv7 strategies for promoting the social1 emotional1 mental1 and behavioral health of all students2 and 7v7 strategies to increase the knowledge and skills of school and community leaders about the impact of trauma and violence and on the application of a public health approach to comprehensive school-based mental health programs4 7,d7 ,that the comprehensive school-based mental health program carried out under this section will include comprehensive training for parents1 siblings1 and other family members of children with mental health disorders1 and for concerned members of the community in-- 7i7 the techniques and supports needed to identify early children with trauma histories1 and children with1 or at risk of1 mental illness2 7ii7 the use of referral mechanisms that effectively link such children to appropriate treatment and intervention services in the school and in the community and follow-up when such services are not available2 and 7iii7 strategies that promote a school-wide positive environment4 7,e7 ,that the comprehensive school-based mental health program carried out under this section will demonstrate the measures to be taken to sustain the program after funding under this section terminates4 7,f7 ,that the local education agency partnership involved is supported by the ,state educational and mental health system to ensure that the sustainability of the programs is established after funding under this section terminates4 7,g7 ,that the comprehensive school-based mental health program carried out under this section will be based on trauma-informed and evidence-based practices4 7,h7 ,that the comprehensive school-based mental health program carried out under this section will be coordinated with early intervening activities carried out under the ,individuals with ,disabilities ,education ,act4 7,i7 ,that the comprehensive school-based mental health program carried out under this section will be trauma-informed and culturally and linguistically appropriate4 7,j7 ,that the comprehensive school-based mental health program carried out under this section will include a broad needs assessment of youth who drop out of school due to policies of zero tolerance with respect to drugs1 alcohol1 or weapons and an inability to obtain appropriate services4 7,k7 ,that the mental health services provided through the comprehensive school-based mental health program carried out under this section will be provided by qualified mental and behavioral health professionals who are certified or licensed by the ,state involved and practicing within their area of expertise4 7#c7 ,coordinator ,any entity that is a member of a partnership described in paragraph 7#a77;,a7 may serve as the coordinator of funding and activities under the grant if all members of the partnership agree4 7#d7 ,compliance with ,,hipaa ,a grantee under this section shall be deemed to be a covered entity for purposes of compliance with the regulations promulgated under section #bfd7;c7 of the ,health ,insurance ,portability and ,accountability ,act of #aiif with respect to any patient records developed through activities under the grant4 7d7 ,geographical distribution ,the ,secretary shall ensure that grants1 contracts1 or cooperative agreements under subsection 7a7 will be distributed equitably among the regions of the country and among urban and rural areas4 7e7 ,duration of awards ,with respect to a grant1 contract1 or cooperative agreement under subsection 7a71 the period during which payments under such an award will be made to the recipient shall be #e years4 ,an entity may receive only one award under this section1 except that an entity that is providing services and supports on a regional basis may receive additional funding after the expiration of the preceding grant period4 7f7 ,evaluation and measures of outcomes 7#a7 ,development of process ,the ,administrator shall develop a fiscally appropriate process for evaluating activities carried out under this section4 ,such process shall include-- 7,a7 the development of guidelines for the submission of program data by grant1 contract1 or cooperative agreement recipients2 7,b7 the development of measures of outcomes 7in accordance with paragraph 7#b77 to be applied by such recipients in evaluating programs carried out under this section2 and 7,c7 the submission of annual reports by such recipients concerning the effectiveness of programs carried out under this section4 7#b7 ,measures of outcomes 7,a7 ,in general ,the ,administrator shall develop measures of outcomes to be applied by recipients of assistance under this section1 and the ,administrator1 in evaluating the effectiveness of programs carried out under this section4 ,such measures shall include student and family measures as provided for in subparagraph 7,b7 and local educational measures as provided for under subparagraph 7,c74 7,b7 ,student and family measures of outcomes ,the measures of outcomes developed under paragraph 7#a77;,b7 relating to students and families shall1 with respect to activities carried out under a program under this section1 at a minimum include provisions to evaluate whether the program is effective in-- 7i7 increasing social and emotional competency2 7ii7 increasing academic competency 7as defined by the ,secretary72 7iii7 reducing disruptive and aggressive behaviors2 7iv7 improving child functioning2 7v7 reducing substance use disorders2 7vi7 reducing suspensions1 truancy1 expulsions and violence2 7vii7 increasing graduation rates 7as defined in section #aaaa7;b77#b77;,c77vi7 of the ,elementary and ,secondary ,education ,act of #aife72 and 7viii7 improving access to care for mental health disorders4 7,c7 ,local educational outcomes ,the outcome measures developed under paragraph 7#a77;,b7 relating to local educational systems shall1 with respect to activities carried out under a program under this section1 at a minimum include provisions to evaluate-- 7i7 the effectiveness of comprehensive school mental health programs established under this section2 7ii7 the effectiveness of formal partnership linkages among child and family serving institutions1 community support systems1 and the educational system2 7iii7 the progress made in sustaining the program once funding under the grant has expired2 7iv7 the effectiveness of training and professional development programs for all school personnel that incorporate indicators that measure cultural and linguistic competencies under the program in a manner that incorporates appropriate cultural and linguistic training2 7v7 the improvement in perception of a safe and supportive learning environment among school staff1 students1 and parents2 7vi7 the improvement in case-finding of students in need of more intensive services and referral of identified students to early intervention and clinical services2 7vii7 the improvement in the immediate availability of clinical assessment and treatment services within the context of the local community to students posing a danger to themselves or others2 7viii7 the increased successful matriculation to postsecondary school2 and 7ix7 reduced referrals to juvenile justice4 7#c7 ,submission of annual data ,an entity that receives a grant1 contract1 or cooperative agreement under this section shall annually submit to the ,administrator a report that includes data to evaluate the success of the program carried out by the entity based on whether such program is achieving the purposes of the program4 ,such reports shall utilize the measures of outcomes under paragraph 7#b7 in a reasonable manner to demonstrate the progress of the program in achieving such purposes4 7#d7 ,evaluation by ,administrator ,based on the data submitted under paragraph 7#c71 the ,administrator shall annually submit to ,congress a report concerning the results and effectiveness of the programs carried out with assistance received under this section4 7#e7 ,limitation ,a grantee shall use not to exceed #aj percent of amounts received under a grant under this section to carry out evaluation activities under this subsection4 7g7 ,information and education ,the ,secretary shall establish comprehensive information and education programs to disseminate the findings of the knowledge development and application under this section to the general public and to health care professionals4 7h7 ,amount of grants and authorization of appropriations 7#a7 ,amount of grants ,a grant under this section shall be in an amount that is not more than #a1jjj1jjj for each of fiscal years #bjag through #bjba4 ,the ,secretary shall determine the amount of each such grant based on the population of children up to age #ba of the area to be served under the grant4 7#b7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section1 #bj1jjj1jjj for each of fiscal years #bjag through #bjba4 4 7c7 ,conforming amendment ,part ,g of title ,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;hh et seq471 as amended by this section1 is further amended by striking the part heading and inserting the following3 ,g ,school-based mental health 4 #eaf4 ,examining mental health care for children 7a7 ,in general ,not later than one year after the date of enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall conduct an independent evaluation1 and submit to the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate and the ,committee on ,energy and ,commerce of the ,house of ,representatives1 a report concerning the utilization of mental health services for children1 including the usage of psychotropic medications4 7b7 ,content ,the report submitted under subsection 7a7 shall review and assess-- 7#a7 the ways in which children access mental health care1 including information on whether children are screened and treated by primary care or specialty physicians or other health care providers1 what types of referrals for additional care are recommended1 and any barriers to accessing this care2 7#b7 the extent to which children prescribed psychotropic medications in the ,united ,states face barriers to more comprehensive or other mental health services1 interventions1 and treatments2 7#c7 the extent to which children are prescribed psychotropic medications in the ,united ,states including the frequency of concurrent medication usage2 and 7#d7 the tools1 assessments1 and medications that are available and used to diagnose and treat children with mental health disorders4 #eag4 ,reporting compliance study 7a7 ,in general ,the ,secretary of ,health and ,human ,services shall enter into an arrangement with the ,institute of ,medicine of the ,national ,academies 7or1 if the ,institute declines1 another appropriate entity7 under which1 not later than #b years after the date of enactment of this ,act1 the ,institute will submit to the appropriate committees of ,congress a report that evaluates the combined paperwork burden of-- 7#a7 community mental health centers meeting the criteria specified in section #aiac7;c7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjx-#b71 including such centers meeting such criteria as in effect on the day before the date of enactment of this ,act2 and 7#b7 federally qualified community mental health clinics certified pursuant to section #bbc of the ,protecting ,access to ,medicare ,act of #bjad 7,public ,law #aac-ic71 as amended by section #eje4 7b7 ,scope ,in preparing the report under subsection 7a71 the ,institute of ,medicine 7or1 if applicable1 other appropriate entity7 shall examine licensing1 certification1 service definitions1 claims payment1 billing codes1 and financial auditing requirements used by the ,office of ,management and ,budget1 the ,centers for ,medicare ,medicaid ,services1 the ,health ,resources and ,services ,administration1 the ,substance ,abuse and ,mental ,health ,services ,administration1 the ,office of the ,inspector ,general of the ,department of ,health and ,human ,services1 ,state ,medicaid agencies1 ,state departments of health1 ,state departments of education1 and ,state and local juvenile justice1 social service agencies1 and private insurers to-- 7#a7 establish an estimate of the combined nationwide cost of complying with such requirements1 in terms of both administrative funding and staff time2 7#b7 establish an estimate of the per capita cost to each center or clinic described in subparagraph 7,a7 or 7,b7 of paragraph 7#a7 to comply with such requirements1 in terms of both administrative funding and staff time2 and 7#c7 make administrative and statutory recommendations to ,congress 7which recommendations may include a uniform methodology7 to reduce the paperwork burden experienced by centers and clinics described in subparagraph 7,a7 or 7,b7 of paragraph 7#a74 #eah4 ,strengthening connections to community care demonstration grant program 7a7 ,in general ,the ,secretary of ,health and ,human ,services1 acting through the ,substance ,abuse and ,mental ,health ,services ,administration1 shall establish a demonstration grant program to award grants to eligible entities to help to connect incarcerated and recently released individuals with mental illness or substance use disorders with community-based treatment providers and coverage opportunities upon release from a corrections facility4 7b7 ,design ,the demonstration grant program under this section shall be designed to ensure that incarcerated and recently released individuals with mental illness or substance use disorders have the information and help they need to connect to community-based care and coverage upon release from a corrections facility4 7c7 ,recipients ,to be eligible to receive a grant under this section1 an entity shall be a ,state ,medicaid agency1 ,state mental health agency1 ,state substance abuse agency1 county1 city1 nonprofit community-based organization1 or any other entity the ,secretary deems appropriate4 7d7 ,application requirement ,to seek an award under this section1 an applicant shall provide a plan detailing the applicant's strategy for carrying out the program to be funded through the award4 7e7 ,special considerations ,in awarding grants under this section1 the ,secretary may consider-- 7#a7 the number of individuals or correctional facilities proposed to be served2 and 7#b7 the potential for replicability of the model proposed4 7f7 ,reports 7#a7 ,annual reports ,as a condition of receiving a grant under this section1 an eligible entity shall agree to submit a report to the ,secretary1 on an annual basis1 describing the activities carried out with the grant and assessing the effectiveness of such activities4 ,such information shall include-- 7,a7 the number of individuals served with mental illness1 serious mental illness1 substance use disorders1 or co-occurring mental health and substance use disorders2 7,b7 the number of connections completed between individuals and community-based providers2 7,c7 the number of connections completed between individuals and community-based coverage2 and 7,d7 any other information required by the ,secretary4 7#b7 ,secretary ,the ,secretary shall1 on an annual basis1 and using the reports received under paragraph 7#a71 report to ,congress on the overall impact and effectiveness of the grant program under this section4 7#c7 ,final ,report ,not later than ,january #ae1 #bjbj1 the ,secretary shall submit to ,congress a final report that includes recommendations with respect to the feasibility and advisability of extending or expanding the grant program under this section4 ,the report shall also provide an assessment of which programs and program elements proved most effective4 7g7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated to carry out this section #e1jjj1jjj for each of fiscal years #bjag through #bjba4 #eai4 ,assertive community treatment grant program for individuals with serious mental illness 7a7 ,in general ,the ,secretary of ,health and ,human ,services1 acting through the ,substance ,abuse and ,mental ,health ,services ,administration1 shall award grants to eligible entities-- 7#a7 to establish assertive community treatment programs for individuals with serious mental illness2 or 7#b7 to maintain or expand such programs4 7b7 ,eligible entities ,to be eligible to receive a grant under this section1 an entity shall be a ,state1 county1 city1 tribes1 tribal organizations1 mental health system1 health care facility1 or any other entity the ,secretary deems appropriate4 7c7 ,special ,consideration ,in selecting among applicants for a grant under this section1 the ,secretary may give special consideration to the potential of the applicant's program to reduce hospitalization1 homelessness1 incarceration1 and interaction with the criminal justice system while improving the health and social outcomes of the patient4 7d7 ,additional ,activities ,the ,secretary shall-- 7#a7 at the conclusion of each fiscal year1 submit a report to the appropriate congressional committees on the grant program under this section1 including an evaluation of-- 7,a7 cost savings and public health outcomes such as mortality1 suicide1 substance abuse1 hospitalization1 and use of services2 7,b7 rates of incarceration of patients2 7,c7 rates of homelessness among patients2 and 7,d7 patient and family satisfaction with program participation2 and 7#b7 provide appropriate information1 training1 and technical assistance to grant recipients under this section to help such recipients to establish1 maintain1 or expand their assertive community treatment programs4 7e7 ,authorization of appropriations 7#a7 ,in general ,to carry out this section1 there is authorized to be appropriated #bj1jjj1jjj for each of fiscal years #bjag through #bjba4 7#b7 ,use of ,certain ,funds ,of the funds appropriated to carry out this section in any fiscal year1 no more than #e percent shall be available to the ,secretary for carrying out subsection 7d74 #ebj4 ,improving mental and behavioral health on college campuses ,title ,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;aa et seq47 is amended by inserting after section #ebj;,e-#c1 as added by section #aaa of this ,act1 the following3 #ebj;,e-#d4 ,grants to improve mental and behavioral health on college campuses 7a7 ,purpose ,it is the purpose of this section1 with respect to college and university settings1 to-- 7#a7 increase access to mental and behavioral health services2 7#b7 foster and improve the prevention of mental and behavioral health disorders1 and the promotion of mental health wellness2 7#c7 improve the identification and treatment for students at risk2 7#d7 improve collaboration and the development of appropriate levels of mental and behavioral health care2 7#e7 reduce the stigma for students with mental health disorders and enhance their access to mental health services2 and 7#f7 improve the efficacy of outreach efforts4 7b7 ,grants ,the ,secretary1 acting through the ,administrator and in consultation with the ,secretary of ,education1 shall award competitive grants to eligible entities to improve mental and behavioral health services and outreach on college and university campuses4 7c7 ,eligibility ,to be eligible to receive a grant under subsection 7b71 an entity shall-- 7#a7 be an institution of higher education 7as defined in section #aja of the ,higher ,education ,act of #aife 7#bj ,u4,s4,c4 #ajja772 and 7#b7 submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require1 including the information required under subsection 7d74 7d7 ,application ,an application for a grant under this section shall include-- 7#a7 a description of the population to be targeted by the program carried out under the grant1 the particular mental and behavioral health needs of the students involved2 7#b7 a description of the ,federal1 ,state1 local1 private1 and institutional resources available for meeting the needs of such students at the time the application is submitted2 7#c7 an outline of the objectives of the program carried out under the grant2 7#d7 a description of activities1 services1 and training to be provided under the program1 including planned outreach strategies to reach students not currently seeking services2 7#e7 a plan to seek input from community mental health providers1 when available1 community groups1 and other public and private entities in carrying out the program2 7#f7 a plan1 when applicable1 to meet the specific mental and behavioral health needs of veterans attending institutions of higher education2 7#g7 a description of the methods to be used to evaluate the outcomes and effectiveness of the program2 and 7#h7 an assurance that grant funds will be used to supplement1 and not supplant1 any other ,federal1 ,state1 or local funds available to carry out activities of the type carried out under the grant4 7e7 ,special considerations ,in awarding grants under this section1 the ,secretary shall give special consideration to applications that describe programs to be carried out under the grant that-- 7#a7 demonstrate the greatest need for new or additional mental and behavioral health services1 in part by providing information on current ratios of students to mental and behavioral health professionals2 7#b7 propose effective approaches for initiating or expanding campus services and supports using evidence-based practices2 7#c7 target traditionally underserved populations and populations most at risk2 7#d7 where possible1 demonstrate an awareness of1 and a willingness to1 coordinate with a community mental health center or other mental health resource in the community1 to support screening and referral of students requiring intensive services2 7#e7 identify how the college or university will address psychiatric emergencies1 including how information will be communicated with families or other appropriate parties2 7#f7 propose innovative practices that will improve efficiencies in clinical care1 broaden collaborations with primary care1 or improve prevention programs2 and 7#g7 demonstrate the greatest potential for replication and dissemination4 7f7 ,use of funds ,amounts received under a grant under this section may be used to-- 7#a7 provide mental and behavioral health services to students1 including prevention1 promotion of mental health1 voluntary screening1 early intervention1 voluntary assessment1 voluntary treatment1 management1 and education services relating to the mental and behavioral health of students2 7#b7 conduct research through a counseling or health center at the institution of higher education involved regarding improving the mental and behavioral health of college and university students through clinical services1 outreach1 prevention1 or academic success2 7#c7 provide outreach services to notify students about the existence of mental and behavioral health services2 7#d7 educate students1 families1 faculty1 staff1 and communities to increase awareness of mental health issues2 7#e7 support student groups on campus that engage in activities to educate students1 including activities to reduce stigma surrounding mental and behavioral disorders1 and promote mental health wellness2 7#f7 employ appropriately trained staff2 7#g7 provide training to students1 faculty1 and staff to respond effectively to students with mental and behavioral health issues2 7#h7 expand mental health training through internship1 post-doctorate1 and residency programs2 7#i7 develop and support evidence-based and emerging best practices1 including a focus on culturally and linguistically appropriate best practices2 and 7#aj7 evaluate and disseminate best practices to other colleges and universities4 7g7 ,duration of grants ,a grant under this section shall be awarded for a period not to exceed #c years4 7h7 ,evaluation and reporting 7#a7 ,evaluation ,not later than #ah months after the date on which a grant is received under this section1 the eligible entity involved shall submit to the ,secretary the results of an evaluation to be conducted by the entity 7or by another party under contract with the entity7 concerning the effectiveness of the activities carried out under the grant and plans for the sustainability of such efforts4 7#b7 ,report ,not later than #b years after the date of enactment of this section1 the ,secretary shall submit to the appropriate committees of ,congress a report concerning the results of-- 7,a7 the evaluations conducted under paragraph 7#a72 and 7,b7 an evaluation conducted by the ,secretary to analyze the effectiveness and efficacy of the activities conducted with grants under this section4 7i7 ,technical assistance ,the ,secretary may provide technical assistance to grantees in carrying out this section4 7j7 ,authorization of appropriations ,there are authorized to be appropriated #ae1jjj1jjj for each of fiscal years #bjag through #bjba4 4 #eba4 ,inclusion of occupational therapists in ,national ,health ,service ,corps program 7a7 ,inclusion of occupational therapists ,section #cca7;a77#c77;,e77i7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;d7a77#c77;,e77i77 is amended by inserting subject to section #eba7;b77#b7 of the ,comprehensive ,behavioral ,health ,reform and ,recovery ,act of #bjaf1 occupational therapists1 after psychiatric nurse specialists14 7b7 ,effective date2 contingent implementation 7#a7 ,effective date ,subject to paragraph 7#b71 the amendment made by subsection 7a7 shall apply beginning on ,october #a1 #bjaf4 7#b7 ,contingent implementation ,the amendment made by subsection 7a7 shall apply with respect to obligations entered into for a fiscal year after fiscal year #bjaf only if the total amount made available for the purpose of carrying out subparts ,,ii and ,,iii of part ,d of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;d et seq47 for such fiscal year is greater than the total amount made available for such purpose for fiscal year #bjaf4 ,,vi ,improving ,mental ,health ,research and ,coordination #fja4 ,increase in funding for certain research ,section #djb;,a7a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhb;a7a77 is amended by adding at the end the following3 7#c7 ,funding for the brain initiative at the ,national ,institute of ,mental ,health 7,a7 ,funding ,in addition to amounts made available pursuant to paragraphs 7#a7 and 7#b71 there are authorized to be appropriated to the ,national ,institute of ,mental ,health for the purpose described in subparagraph 7,b77ii7 #dj1jjj1jjj for each of fiscal years #bjag through #bjba4 7,b7 ,purposes ,amounts appropriated pursuant to subparagraph 7,a7 shall be used exclusively for the purpose of conducting or supporting-- 7i7 research on the determinants of self- and other directed-violence in mental illness1 including studies directed at the causes of such violence and at intervention to reduce the risk of self harm1 suicide1 and interpersonal violence2 or 7ii7 brain research through the ,brain ,research through ,advancing ,innovative ,neurotechnologies ,initiative4 4 ,,vii ,behavioral ,health ,information ,technology #gja4 ,extension of health information technology assistance for behavioral and mental health and substance abuse ,section #cjjj7c7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;jj7#c77 is amended by inserting before and any other category the following3 behavioral and mental health professionals 7as defined in section #cca7;a77#c77;,e77i771 a substance abuse professional1 a psychiatric hospital 7as defined in section #ahfa7;f7 of the ,social ,security ,act71 a community mental health center meeting the criteria specified in section #aiac7;c71 a residential or outpatient mental health or substance use treatment facility14 #gjb4 ,extension of eligibility for ,medicare and ,medicaid health information technology implementation assistance 7a7 ,payment incentives for eligible professionals under ,medicare ,section #ahdh of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#d7 is amended-- 7#a7 in subsection 7a77#g7-- 7,a7 in subparagraph 7,e71 by adding at the end the following new clause3 7iv7 ,additional eligible professional ,the term additional eligible professional means a clinical psychologist providing qualified psychologist services 7as defined in section #ahfa7;ii774 2 and 7,b7 by adding at the end the following new subparagraph3 7,f7 ,application to additional eligible professionals ,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 professional1 except in applying subparagraph 7,a7-- 7i7 in clause 7i71 the reference to #bjae shall be deemed a reference to #bjbj2 7ii7 in clause 7ii71 the references to #bjae1 #bjaf1 and #bjag shall be deemed references to #bjbj1 #bjba1 and #bjbb1 respectively2 and 7iii7 in clause 7iii71 the reference to #bjah shall be deemed a reference to #bjbc4 2 and 7#b7 in subsection 7o7-- 7,a7 in paragraph 7#e71 by adding at the end the following new subparagraph3 7,d7 ,additional eligible professional ,the term additional eligible professional means a clinical psychologist providing qualified psychologist services 7as defined in section #ahfa7;ii774 2 and 7,b7 by adding at the end the following new paragraph3 7#f7 ,application to additional eligible professionals ,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 professional1 except in applying-- 7,a7 paragraph 7#a77;,a77ii71 the reference to #bjaf shall be deemed a reference to #bjba2 7,b7 paragraph 7#a77;,b77ii71 the references to #bjaa and #bjab shall be deemed references to #bjaf and #bjag1 respectively2 7,c7 paragraph 7#a77;,b77iii71 the references to #bjac shall be deemed references to #bjah2 7,d7 paragraph 7#a77;,b77v71 the references to #bjad shall be deemed references to #bjai2 and 7,e7 paragraph 7#a77;,e71 the reference to #bjaa shall be deemed a reference to #bjaf4 4 7b7 ,eligible hospitals ,section #ahhf of the ,social ,security ,act 7#db ,u4,s4,c4 #acieww7 is amended-- 7#a7 in subsection 7b77#c77;,b77ix71 by adding at the end the following new subclause3 7,v7 ,the ,secretary shall apply the provisions of this subsection with respect to an additional eligible hospital 7as defined in subsection 7n77#f77;,c77 in the same manner as such provisions apply to an eligible hospital1 except in applying-- 7aa7 subclause 7,i71 the references to #bjae1 #bjaf1 and #bjag shall be deemed references to #bjbj1 #bjba1 and #bjbb1 respectively2 and 7bb7 subclause 7,,iii71 the reference to #bjae shall be deemed a reference to #bjbj4 2 and 7#b7 in subsection 7n7-- 7,a7 in paragraph 7#f71 by adding at the end the following new subparagraph3 7,c7 ,additional eligible hospital ,the term additional eligible hospital means an inpatient hospital that is a psychiatric hospital 7as defined in section #ahfa7;f774 2 and 7,b7 by adding at the end the following new paragraph3 7#g7 ,application to additional eligible hospitals ,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 hospital1 except in applying-- 7,a7 paragraph 7#b77;,e77ii71 the references to #bjac and #bjae shall be deemed references to #bjah and #bjbj1 respectively2 and 7,b7 paragraph 7#b77;,g77i71 the reference to #bjaa shall be deemed a reference to #bjaf4 4 7c7 ,medicaid providers ,section #aijc7t7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7t77 is amended-- 7#a7 in paragraph 7#b77;,b7-- 7,a7 in clause 7i71 by striking 1 or at the end and inserting a semicolon2 7,b7 in clause 7ii71 by striking the period at the end and inserting a semicolon2 and 7,c7 by inserting after clause 7ii7 the following new clauses3 7iii7 a public hospital that is principally a psychiatric hospital 7as defined in section #ahfa7;f772 7iv7 a private hospital that is principally a psychiatric hospital 7as defined in section #ahfa7;f77 and that has at least #aj percent of its patient volume 7as estimated in accordance with a methodology established by the ,secretary7 attributable to individuals receiving medical assistance under this title2 7v7 a community mental health center meeting the criteria specified in section #aiac7;c7 of the ,public ,health ,service ,act2 or 7vi7 a residential or outpatient mental health or substance use treatment facility that-- 7,i7 is accredited by the ,joint ,commission on ,accreditation of ,healthcare ,organizations1 the ,commission on ,accreditation of ,rehabilitation ,facilities1 the ,council on ,accreditation1 or any other national accrediting agency recognized by the ,secretary2 and 7,,ii7 has at least #aj percent of its patient volume 7as estimated in accordance with a methodology established by the ,secretary7 attributable to individuals receiving medical assistance under this title4 2 and 7#b7 in paragraph 7#c77;,b7-- 7,a7 in clause 7iv71 by striking 2 and at the end and inserting a semicolon2 7,b7 in clause 7v71 by striking the period at the end and inserting 2 and2 and 7,c7 by adding at the end the following new clause3 7vi7 clinical psychologist providing qualified psychologist services 7as defined in section #ahfa7;ii771 if such clinical psychologist is practicing in an outpatient clinic that-- 7,i7 is led by a clinical psychologist2 and 7,,ii7 is not otherwise receiving payment under paragraph 7#a7 as a ,medicaid provider described in paragraph 7#b77;,b74 4 7d7 ,medicare ,advantage organizations ,section #ahec of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#bc7 is amended-- 7#a7 in subsection 7l7-- 7,a7 in paragraph 7#a7-- 7i7 by inserting or additional eligible professionals 7as described in paragraph 7#i77 after paragraph 7#b72 and 7ii7 by inserting and additional eligible professionals before under such sections2 7,b7 in paragraph 7#c77;,b7-- 7i7 in clause 7i7 in the matter preceding subclause 7,i71 by inserting or an additional eligible professional described in paragraph 7#i7 after paragraph 7#b72 and 7ii7 in clause 7ii7-- 7,i7 in the matter preceding subclause 7,i71 by inserting or an additional eligible professional described in paragraph 7#i7 after paragraph 7#b72 and 7,,ii7 in subclause 7,i71 by inserting or an additional eligible professional1 respectively1 after eligible professional2 7,c7 in paragraph 7#c77;,c71 by inserting and additional eligible professionals after all eligible professionals2 7,d7 in paragraph 7#d77;,d71 by adding at the end the following new sentence3 ,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 year1 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 year42 7,e7 in paragraph 7#f77;,a71 by inserting and1 as applicable1 each additional eligible professional described in paragraph 7#i7 after paragraph 7#b72 7,f7 in paragraph 7#f77;,b71 by inserting and1 as applicable1 each additional eligible hospital described in paragraph 7#i7 after subsection 7m77#a72 7,g7 in paragraph 7#g77;,a71 by inserting and1 as applicable1 additional eligible professionals after eligible professionals2 7,h7 in paragraph 7#g77;,b71 by inserting and1 as applicable1 additional eligible professionals after eligible professionals2 7,i7 in paragraph 7#h77;,b71 by inserting and additional eligible professionals described in paragraph 7#i7 after paragraph 7#b72 and 7,j7 by adding at the end the following new paragraph3 7#i7 ,additional eligible professional described ,with respect to a qualifying ,,ma organization1 an additional eligible professional described in this paragraph is an additional eligible professional 7as defined for purposes of section #ahdh7o77 who-- 7,a7 7i7 is employed by the organization2 or 7ii7 7,i7 is employed by1 or is a partner of1 an entity that through contract with the organization furnishes at least #hj percent of the entity's ,medicare patient care services to enrollees of such organization2 and 7,,ii7 furnishes at least #hj percent of the professional services of the additional eligible professional covered under this title to enrollees of the organization2 and 7,b7 furnishes1 on average1 at least #bj hours per week of patient care services4 2 and 7#b7 in subsection 7m7-- 7,a7 in paragraph 7#a7-- 7i7 by inserting or additional eligible hospitals 7as described in paragraph 7#g77 after paragraph 7#b72 and 7ii7 by inserting and additional eligible hospitals before under such sections2 7,b7 in paragraph 7#c77;,a77i71 by inserting or additional eligible hospital after eligible hospital2 7,c7 in paragraph 7#c77;,a77ii71 by inserting or an additional eligible hospital after eligible hospital in each place it occurs2 7,d7 in paragraph 7#c77;,b7-- 7i7 in clause 7i71 by inserting or an additional eligible hospital described in paragraph 7#g7 after paragraph 7#b72 and 7ii7 in clause 7ii7-- 7,i7 in the matter preceding subclause 7,i71 by inserting or an additional eligible hospital described in paragraph 7#g7 after paragraph 7#b72 and 7,,ii7 in subclause 7,i71 by inserting or an additional eligible hospital1 respectively1 after eligible hospital2 7,e7 in paragraph 7#d77;,a71 by inserting or one or more additional eligible hospitals 7as defined in section #ahhf7n771 as appropriate1 after section #ahhf7n77#f77;,a772 7,f7 in paragraph 7#d77;,d71 by adding at the end the following new sentence3 ,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 period1 the ,secretary shall apply the payment adjustment under this paragraph based on the methodology specified by the ,secretary1 taking into account the proportion of such additional eligible hospitals1 or discharges from such hospitals1 that are not meaningful ,,ehr users for such period42 7,g7 in paragraph 7#e77;,a71 by inserting and1 as applicable1 each additional eligible hospital described in paragraph 7#g7 after paragraph 7#b72 7,h7 in paragraph 7#e77;,b71 by inserting and additional eligible hospitals1 as applicable1 after eligible hospitals2 7,i7 in paragraph 7#f77;,b71 by inserting and additional eligible hospitals described in paragraph 7#g7 after paragraph 7#b72 and 7,j7 by adding at the end the following new paragraph3 7#g7 ,additional eligible hospital described ,with respect to a qualifying ,,ma organization1 an additional eligible hospital described in this paragraph is an additional eligible hospital 7as defined in section #ahhf7n77#f77;,c77 that is under common corporate governance with such organization and serves individuals enrolled under an ,,ma plan offered by such organization4 4 ,,viii ,making ,parity ,work #hja4 ,strengthening parity in mental health and substance use disorder benefits 7a7 ,public ,health ,service ,act ,section #bgbf7;a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;gg-#bf7;a77 is amended by adding at the end the following new paragraphs3 7#f7 ,disclosure and enforcement requirements 7,a7 ,disclosure requirements 7i7 ,regulations ,not later than ,december #ca1 #bjaf1 the ,secretary1 in cooperation with the ,secretaries of ,labor and the ,treasury1 as appropriate1 shall issue additional regulations for carrying out this section1 including an explanation of documents that must be disclosed by plans and issuers1 the process governing such disclosures by plans and issuers1 and analyses that must be conducted by plans and issuers by a group health plan or health insurance issuer offering health insurance coverage in the group or individual market in order for such plan or issuer to demonstrate compliance with the provisions of this section4 7ii7 ,disclosure requirements ,documents required to be disclosed by a group health plan or health insurance issuer offering health insurance coverage in the group or individual market under clause 7i7 shall include an annual report that details the specific analyses performed to ensure compliance of such plan or coverage with the law and regulations4 ,at a minimum1 with respect to the application of non-quantitative treatment limitations 7in this paragraph referred to as ,n,q,t,ls7 to benefits under the plan or coverage1 such report shall-- 7,i7 identify the specific factors the plan or coverage used in performing its ,,nqtl analysis2 7,,ii7 identify and define the specific evidentiary standards relied on to evaluate the factors2 7,,iii7 describe how the evidentiary standards are applied to each service category for mental health1 substance use disorders1 medical benefits1 and surgical benefits2 7,,iv7 disclose the results of the analyses of the specific evidentiary standards in each service category2 and 7,v7 disclose the specific findings of the plan or coverage in each service category and the conclusions reached with respect to whether the processes1 strategies1 evidentiary standards1 or other factors used in applying the ,,nqtl to mental health or substance use disorder benefits are comparable to1 and applied no more stringently than1 the processes1 strategies1 evidentiary standards1 or other factors used in applying the limitation with respect to medical and surgical benefits in the same classification4 7iii7 ,guidance ,the ,secretary1 in cooperation with the ,secretaries of ,labor and the ,treasury1 as appropriate1 shall issue guidance to group health plans and health insurance issuers offering health insurance coverage in the group or individual markets on how to satisfy the requirements of this section with respect to making information available to current and potential participants and beneficiaries4 ,such information shall include certificate of coverage documents and instruments under which the plan or coverage involved is administered and operated that specify1 include1 or refer to procedures1 formulas1 and methodologies applied to determine a participant or beneficiary's benefit under the plan or coverage1 regardless of whether such information is contained in a document designated as the plan document4 ,such guidance shall include a disclosure of how the plan or coverage involved has provided that processes1 strategies1 evidentiary standards1 and other factors used in applying the ,,nqtl to mental health or substance use disorder benefits are comparable to1 and applied no more stringently than1 the processes1 strategies1 evidentiary standards1 or other factors used in applying the limitation with respect to medical and surgical benefits in the same classification4 7iv7 ,definitions ,in this paragraph and paragraph 7#g71 the terms non-quantitative treatment limitations1 comparable to1 and applied no more stringently than have the meanings given such terms in sections #adf and #adg of title #de1 ,code of ,federal ,regulations 7or any successor regulation74 7,b7 ,enforcement 7i7 ,process for complaints ,the ,secretary1 in cooperation with the ,secretaries of ,labor and the ,treasury1 as appropriate1 shall1 with respect to group health plans and health insurance issuers offering health insurance coverage in the group or individual market1 issue guidance to clarify the process and timeline for current and potential participants and beneficiaries 7and authorized representatives and health care providers of such participants and beneficiaries7 with respect to such plans and coverage to file formal complaints of such plans or issuers being in violation of this section1 including guidance1 by plan type1 on the relevant ,state1 regional1 and national offices with which such complaints should be filed4 7ii7 ,authority for public enforcement ,the ,secretary1 in consultation with the ,secretaries of ,labor and the ,treasury1 shall make available to the public on the ,consumer ,parity ,portal website established under paragraph 7#g7 de-identified information on audits and investigations of group health plans and health insurance issuers conducted under this section4 7iii7 ,audits 7,i7 ,randomized audits ,the ,secretary in cooperation with the ,secretaries of ,labor and the ,treasury1 is authorized to conduct randomized audits of group health plans and health insurance issuers offering health insurance coverage in the group or individual market to determine compliance with this section4 ,such audits shall be conducted on no fewer than twelve plans and issuers per plan year4 ,information from such audits shall be made plainly available on the ,consumer ,parity ,portal website established under paragraph 7#g74 7,,ii7 ,additional audits ,in the case of a group health plan or health insurance issuer offering health insurance coverage in the group or individual market with respect to which any claim has been filed during a plan year1 the ,secretary may audit the books and records of such plan or issuer to determine compliance with this section4 ,information detailing the results of the audit shall be made available on the ,consumer ,parity ,portal website established under paragraph 7#g74 7iv7 ,denial rates ,the ,secretary shall collect information on the rates of and reasons for denial by group health plans and health insurance issuers offering health insurance coverage in the group or individual market of claims for outpatient and inpatient mental health and substance use disorder services compared to the rates of and reasons for denial of claims for medical and surgical services4 ,for the first plan year beginning at least two years after the date of the enactment of this paragraph and each subsequent plan year1 the ,secretary shall submit to the ,committee on ,energy and ,commerce of the ,house of ,representatives and the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate1 and make plainly available on the ,consumer ,parity ,portal website under paragraph 7#g71 the information collected under the previous sentence with respect to the previous plan year4 7#g7 ,consumer ,parity ,portal website ,the ,secretary1 in consultation with the ,secretaries of ,labor and the ,treasury1 shall establish a one-stop ,internet website portal for-- 7,a7 submitting complaints and violations relating to this section1 section #gab of the ,employee ,retirement ,income ,security ,act of #aigd1 and section #ihab of the ,internal ,revenue ,code of #aihf2 and 7,b7 for each of such ,secretaries to submit information in order to provide such information to health care consumers pursuant to paragraph 7#f71 section #gab7;a77#f7 of the ,employee ,retirement ,income ,security ,act of #aigd1 and section #ihab7;a77#f7 of the ,internal ,revenue ,code of #aihf4 ,such portal shall have the ability to take basic information related to the complaint1 including name1 contact information1 and brief narrative1 and transmit such information in a timely fashion to the appropriate ,state or ,federal enforcement agency4 ,once the consumer information is submitted1 such portal shall provide the consumer with contact information for the appropriate enforcement agency to follow-up on the complaint4 4 7b7 ,employee ,retirement ,income ,security ,act of #aigd ,section #gab7;a7 of the ,employee ,retirement ,income ,security ,act of #aigd 7#bi ,u4,s4,c4 #aahe;a7a77 is amended by adding at the end the following new paragraph3 7#f7 ,disclosure and enforcement requirements 7,a7 ,disclosure requirements 7i7 ,regulations ,not later than ,december #ca1 #bjaf1 the ,secretary1 in cooperation with the ,secretaries of ,health and ,human ,services and the ,treasury1 as appropriate1 shall issue additional regulations for carrying out this section1 including an explanation of documents that must be disclosed by plans and issuers1 the process governing such disclosures by plans and issuers1 and analyses that must be conducted by plans and issuers by a group health plan 7or health insurance coverage offered in connection with such a plan7 in order for such plan or issuer to demonstrate compliance with the provisions of this section4 7ii7 ,disclosure requirements ,documents required to be disclosed by a group health plan 7or health insurance coverage offered in connection with such a plan7 under clause 7i7 shall include an annual report that details the specific analyses performed to ensure compliance of such plan or coverage with the law or regulations4 ,at a minimum1 with respect to the application of non-quantitative treatment limitations 7in this paragraph referred to as ,n,q,t,ls7 to benefits under the plan or coverage1 such report shall-- 7,i7 identify the specific factors the plan or coverage used in performing its ,,nqtl analysis2 7,,ii7 identify and define the specific evidentiary standards relied on to evaluate the factors2 7,,iii7 describe how the evidentiary standards are applied to each service category for mental health1 substance use disorders1 medical benefits1 and surgical benefits2 7,,iv7 disclose the results of the analyses of the specific evidentiary standards in each service category2 and 7,v7 disclose the specific findings of the plan or coverage in each service category and the conclusions reached with respect to whether the processes1 strategies1 evidentiary standards1 or other factors used in applying the ,,nqtl to mental health or substance use disorder benefits are comparable to1 and applied no more stringently than1 the processes1 strategies1 evidentiary standards1 or other factors used in applying the limitation with respect to medical and surgical benefits in the same classification4 7iii7 ,guidance ,the ,secretary1 in cooperation with the ,secretaries of ,health and ,human ,services and the ,treasury1 as appropriate1 shall issue guidance to group health plans 7and health insurance coverage offered in connection with such a plan7 on how to satisfy the requirements of this section with respect to making information available to current and potential participants and beneficiaries4 ,such information shall include certificate of coverage documents and instruments under which the plan or coverage involved is administered and operated that specify1 include1 or refer to procedures1 formulas1 and methodologies applied to determine a participant or beneficiary's benefit under the plan or coverage1 regardless of whether such information is contained in a document designated as the plan document4 ,such guidance shall include a disclosure of how the plan or coverage involved has provided that processes1 strategies1 evidentiary standards1 and other factors used in applying the ,,nqtl to mental health or substance use disorder benefits are comparable to1 and applied no more stringently than1 the processes1 strategies1 evidentiary standards1 or other factors used in applying the limitation with respect to medical and surgical benefits in the same classification4 7iv7 ,definitions ,in this paragraph1 the terms non-quantitative treatment limitations1 comparable to1 and applied no more stringently than have the meanings given such terms in sections #adf and #adg of title #de1 ,code of ,federal ,regulations 7or any successor regulation74 7,b7 ,enforcement 7i7 ,process for complaints ,the ,secretary1 in cooperation with the ,secretaries of ,health and ,human ,services and the ,treasury1 as appropriate1 shall1 with respect to group health plans 7and health insurance coverage offered in connection with such a plan71 issue guidance to clarify the process and timeline for current and potential participants and beneficiaries 7and authorized representatives and health care providers of such participants and beneficiaries7 with respect to such plans 7and coverage7 to file formal complaints of such plans 7or coverage7 being in violation of this section1 including guidance1 by plan type1 on the relevant ,state1 regional1 and national offices with which such complaints should be filed4 7ii7 ,authority for public enforcement ,the ,secretary1 in consultation with the ,secretaries of ,labor and the ,treasury1 shall make available to the public on the ,consumer ,parity ,portal website established under section #bgbf7;a77#g7 of the ,public ,health ,service ,act de-identified information on audits and investigations of group health plans 7and health insurance coverage offered in connection with such a plan7 conducted under this section4 7iii7 ,audits 7,i7 ,randomized audits ,the ,secretary in cooperation with the ,secretaries of ,health and ,human ,services and the ,treasury1 is authorized to conduct randomized audits of group health plans 7and health insurance coverage offered in connection with such a plan7 to determine compliance with this section4 ,such audits shall be conducted on no fewer than twelve plans and coverage per plan year4 ,information from such audits shall be made plainly available on the ,consumer ,parity ,portal website established under section #bgbf7;a77#g7 of the ,public ,health ,service ,act4 7,,ii7 ,additional audits ,in the case of a group health plan 7or health insurance coverage offered in connection with such a plan7 with respect to which any claim has been filed during a plan year1 the ,secretary may audit the books and records of such plan 7or coverage7 to determine compliance with this section4 ,information detailing the results of the audit shall be made available on the ,consumer ,parity ,portal website established under section #bgbf7;a77#g7 of the ,public ,health ,service ,act4 7iv7 ,denial rates ,the ,secretary shall collect information on the rates of and reasons for denial by group health plans 7and health insurance coverage offered in connection with such a plan7 of claims for outpatient and inpatient mental health and substance use disorder services compared to the rates of and reasons for denial of claims for medical and surgical services4 ,for the first plan year beginning at least two years after the date of the enactment of this paragraph and each subsequent plan year1 the ,secretary shall submit to the ,committee on ,energy and ,commerce of the ,house of ,representatives and the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate1 and make plainly available on the ,consumer ,parity ,portal website under section #bgbf7;a77#g7 of the ,public ,health ,service ,act1 the information collected under the previous sentence with respect to the previous plan year4 4 7c7 ,internal ,revenue ,code of #aihf ,section #ihab7;a7 of the ,internal ,revenue ,code of #aihf is amended by adding at the end the following new paragraph3 7#f7 ,disclosure and enforcement requirements 7,a7 ,disclosure requirements 7i7 ,regulations ,not later than ,december #ca1 #bjaf1 the ,secretary1 in cooperation with the ,secretaries of ,health and ,human ,services and ,labor1 as appropriate1 shall issue additional regulations for carrying out this section1 including an explanation of documents that must be disclosed by plans and issuers1 the process governing such disclosures by plans and issuers1 and analyses that must be conducted by plans and issuers by a group health plan in order for such plan to demonstrate compliance with the provisions of this section4 7ii7 ,disclosure requirements ,documents required to be disclosed by a group health plan under clause 7i7 shall include an annual report that details the specific analyses performed to ensure compliance of such plan with the law and regulations4 ,at a minimum1 with respect to the application of non-quantitative treatment limitations 7in this paragraph referred to as ,n,q,t,ls7 to benefits under the plan or coverage1 such report shall-- 7,i7 identify the specific factors the plan or coverage used in performing its ,,nqtl analysis2 7,,ii7 identify and define the specific evidentiary standards relied on to evaluate the factors2 7,,iii7 describe how the evidentiary standards are applied to each service category for mental health1 substance use disorders1 medical benefits1 and surgical benefits2 7,,iv7 disclose the results of the analyses of the specific evidentiary standards in each service category2 and 7,v7 disclose the specific findings of the plan in each service category and the conclusions reached with respect to whether the processes1 strategies1 evidentiary standards1 or other factors used in applying the ,,nqtl to mental health or substance use disorder benefits are comparable to1 and applied no more stringently than1 the processes1 strategies1 evidentiary standards1 or other factors used in applying the limitation with respect to medical and surgical benefits in the same classification4 7iii7 ,guidance ,the ,secretary1 in cooperation with the ,secretaries of ,health and ,human ,services and ,labor1 as appropriate1 shall issue guidance to group health plans on how to satisfy the requirements of this section with respect to making information available to current and potential participants and beneficiaries4 ,such information shall include certificate of coverage documents and instruments under which the plan involved is administered and operated that specify1 include1 or refer to procedures1 formulas1 and methodologies applied to determine a participant or beneficiary's benefit under the plan1 regardless of whether such information is contained in a document designated as the plan document4 ,such guidance shall include a disclosure of how the plan involved has provided that processes1 strategies1 evidentiary standards1 and other factors used in applying the ,,nqtl to mental health or substance use disorder benefits are comparable to1 and applied no more stringently than1 the processes1 strategies1 evidentiary standards1 or other factors used in applying the limitation with respect to medical and surgical benefits in the same classification4 7iv7 ,definitions ,in this paragraph1 the terms non-quantitative treatment limitations1 comparable to1 and applied no more stringently than have the meanings given such terms in sections #adf and #adg of title #de1 ,code of ,federal ,regulations 7or any successor regulation74 7,b7 ,enforcement 7i7 ,process for complaints ,the ,secretary1 in cooperation with the ,secretaries of ,health and ,human ,services and ,labor1 as appropriate1 shall1 with respect to group health plans1 issue guidance to clarify the process and timeline for current and potential participants and beneficiaries 7and authorized representatives and health care providers of such participants and beneficiaries7 with respect to such plans 7and coverage7 to file formal complaints of such plans being in violation of this section1 including guidance1 by plan type1 on the relevant ,state1 regional1 and national offices with which such complaints should be filed4 7ii7 ,authority for public enforcement ,the ,secretary1 in consultation with the ,secretaries of ,labor and the ,treasury1 shall make available to the public on the ,consumer ,parity ,portal website established under section #bgbf7;a77#g7 of the ,public ,health ,service ,act de-identified information on audits and investigations of group health plans conducted under this section4 7iii7 ,audits 7,i7 ,randomized audits ,the ,secretary in cooperation with the ,secretaries of ,health and ,human ,services and ,labor1 is authorized to conduct randomized audits of group health plans to determine compliance with this section4 ,such audits shall be conducted on no fewer than twelve plans per plan year4 ,information from such audits shall be made plainly available on the ,consumer ,parity ,portal website established under section #bgbf7;a77#g7 of the ,public ,health ,service ,act4 7,,ii7 ,additional audits ,in the case of a group health plan with respect to which any claim has been filed during a plan year1 the ,secretary may audit the books and records of such plan to determine compliance with this section4 ,information detailing the results of the audit shall be made available on the ,consumer ,parity ,portal website established under section #bgbf7;a77#g7 of the ,public ,health ,service ,act4 7iv7 ,denial rates ,the ,secretary shall collect information on the rates of and reasons for denial by group health plans of claims for outpatient and inpatient mental health and substance use disorder services compared to the rates of and reasons for denial of claims for medical and surgical services4 ,for the first plan year beginning at least two years after the date of the enactment of this paragraph and each subsequent plan year1 the ,secretary shall submit to the ,committee on ,energy and ,commerce of the ,house of ,representatives and the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate1 and make plainly available on the ,consumer ,parity ,portal website under section #bgbf7;a77#g7 of the ,public ,health ,service ,act1 the information collected under the previous sentence with respect to the previous plan year4 4 7d7 ,authorization of appropriations ,there is authorized to be appropriated #b1jjj1jjj for each of fiscal years #bjag through #bjba to carry out this section1 including the amendments made by this section4 #hjb4 ,report on investigations regarding parity in mental health and substance use disorder benefits 7a7 ,in general ,not later than one year after the date of the enactment of this ,act1 and annually thereafter1 the ,administrator of the ,centers for ,medicare ,medicaid ,services1 in collaboration with the ,assistant ,secretary of ,labor of the ,employee ,benefits ,security ,administration and the ,secretary of the ,treasury shall submit to the ,congress a report-- 7#a7 identifying ,federal investigations conducted or completed during the preceding #ab-month period regarding compliance with parity in mental health1 substance use disorder benefits1 including benefits provided to persons with mental illness1 including serious mental illness1 and substance use disorders under the ,paul ,wellstone and ,pete ,domenici ,mental ,health ,parity and ,addiction ,equity ,act of #bjjh 7subtitle ,b of title ,v of division ,c of ,public ,law #aaj-cdc72 and 7#b7 summarizing the results of such investigations4 7b7 ,contents ,subject to paragraph 7#c71 each report under paragraph 7#a7 shall include the following information3 7#a7 ,the number of investigations opened and closed during the covered reporting period4 7#b7 ,the benefit classification or classifications examined by each investigation4 7#c7 ,the subject matter or subject matters of each investigation1 including quantitative and nonquantitative treatment limitations4 7#d7 ,a summary of the basis of the final decision rendered for each investigation4 7c7 ,limitation ,individually identifiable information shall be excluded from reports under paragraph 7#a7 consistent with ,federal privacy protections4 #hjc4 ,,gao study on preventing discriminatory coverage limitations for individuals with serious mental illness and substance use disorders ,not later than one year after the date of the enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall submit to ,congress a report describing the evidence regarding the extent to which private health insurance plans have nonquantitative treatment limits for mental health1 substance use disorder1 and other health services4 ,the report shall also assess the ,departments of ,health and ,human ,services1 ,labor1 and the ,treasury's oversight of private health insurance plans and ,medicaid managed care plans under section #aijc of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;b71 compliance with the ,paul ,wellstone and ,pete ,domenici ,mental ,health ,parity and ,addiction ,equity ,act of #bjjh 7subtitle ,b of title ,v of division ,c of ,public ,law #aaj-cdc7 7as amended by ,public ,law #aaa-adh7 7in this section referred to as the law71 including-- 7#a7 how the responsible ,federal departments and agencies ensure that plans comply with the law1 including how the plans apply nonquantitative treatment limitations and medical necessity criteria to behavioral health services compared to medical or surgical services2 and 7#b7 how proper enforcement1 education1 and coordination activities within responsible ,federal departments and agencies can be used to ensure full compliance with the law1 including educational activities directed to ,state insurance commissioners4 #hjd4 ,report to ,congress on ,federal assistance to ,state insurance regulators regarding mental health parity enforcement ,not later than one year after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services shall submit to ,congress a report detailing-- 7#a7 the ways in which ,state governments and ,state insurance regulators are either empowered or required to enforce the ,paul ,wellstone and ,pete ,domenici ,mental ,health ,parity and ,addiction ,equity ,act of #bjjh 7subtitle ,b of title ,v of division ,c of ,public ,law #aaj-cdc72 7#b7 their capability to carry out these enforcement powers or requirements2 and 7#c7 any technical assistance to ,state government and ,state insurance regulators that has been communicated by the ,department of ,health and ,human ,services4 ,,ix ,substance abuse ,a ,prevention #ija4 ,practitioner education 7a7 ,education requirements 7#a7 ,registration consideration ,section #cjc7;f7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbc7;f77 is amended by inserting after paragraph 7#e7 the following3 7#f7 ,the applicant's compliance with the training requirements described in subsection 7g77#c7 during any previous period in which the applicant has been subject to such training requirements4 4 7#b7 ,training requirements ,section #cjc7;g7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbc7;g77 is amended by adding at the end the following3 7#c7 7,a7 ,to be registered to prescribe or otherwise dispense opioids for the treatment of pain1 or pain management1 a practitioner described in paragraph 7#a7 shall comply with the #ab-;hour training requirement of subparagraph 7,b7 at least once during each #c-year period4 7,b7 ,the training requirement of this subparagraph is that the practitioner has completed not less than #ab hours of training 7through classroom situations1 seminars at professional society meetings1 electronic communications1 or otherwise7 with respect to-- 7i7 the treatment and management of opioid-dependent patients2 7ii7 pain management treatment guidelines2 and 7iii7 early detection of opioid addiction1 including through such methods as ,screening1 ,brief ,intervention1 and ,referral to ,treatment 7,,sbirt71 that is provided by the ,american ,society of ,addiction ,medicine1 the ,american ,academy of ,addiction ,psychiatry1 the ,american ,medical ,association1 the ,american ,osteopathic ,association1 the ,american ,psychiatric ,association1 the ,american ,academy of ,pain ,management1 the ,american ,pain ,society1 the ,american ,academy of ,pain ,medicine1 the ,american ,board of ,pain ,medicine1 the ,american ,society of ,interventional ,pain ,physicians1 or any other organization that the ,secretary determines is appropriate for purposes of this subparagraph4 4 7b7 ,funding ,the ,drug ,enforcement ,administration shall fund the enforcement of the requirements specified in section #cjc7;g77#c7 of the ,controlled ,substances ,act 7as added by subsection 7a77 through the use of a portion of the licensing fees paid by controlled substance prescribers under the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hja et seq474 7c7 ,authorization of ,appropriations ,there is authorized to be appropriated to carry out this section #a1jjj1jjj for each of fiscal years #bjag through #bjba4 #ijb4 ,co-prescribing opioid overdose reversal drugs grant program 7a7 ,establishment 7#a7 ,in general ,not later than six months after the date of the enactment of this ,act1 the ,secretary of ,health and ,human ,services shall establish1 in accordance with this section1 a four-year co-prescribing opioid overdose reversal drugs grant program 7in this title referred to as the grant program7 under which the ,secretary shall provide not more than a total of #ab grants to eligible entities to carry out the activities described in subsection 7c74 7#b7 ,eligible entity ,for purposes of this section1 the term eligible entity means a federally qualified health center 7as defined in section #ahfa7;aa7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7aa7771 an opioid treatment program under part #h of title #db1 ,code of ,federal ,regulations1 or section #cjc7;g7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbc7;g771 a program approved by a ,state substance abuse agency1 or any other entity that the ,secretary deems appropriate4 7#c7 ,co-prescribing ,for purposes of this title1 the term co-prescribing means1 with respect to an opioid overdose reversal drug1 the practice of prescribing such drug in conjunction with an opioid prescription for patients at an elevated risk of overdose1 or in conjunction with an opioid agonist approved under section #eje of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cee7 for the treatment of opioid abuse disorders1 or in other circumstances in which a provider identifies a patient at an elevated risk for an intentional or unintentional drug overdose from heroin or prescription opioid therapies4 ,for purposes of the previous sentence1 a patient may be at an elevated risk of overdose if the patient meets the criteria under the existing co-prescribing guidelines that the ,secretary deems appropriate1 such as the criteria provided in the ,opioid ,overdose ,toolkit published by the ,substance ,abuse and ,mental ,health ,services ,administration4 7b7 ,application ,to be eligible to receive a grant under this section1 an eligible entity shall submit to the ,secretary of ,health and ,human ,services1 in such form and manner as specified by the ,secretary1 an application that describes-- 7#a7 the extent to which the area to which the entity will furnish services through use of the grant is experiencing significant morbidity and mortality caused by opioid abuse2 7#b7 the criteria that will be used to identify eligible patients to participate in such program2 and 7#c7 how such program will work to try to identify ,state1 local1 or private funding to continue the program after expiration of the grant4 7c7 ,use of funds ,an eligible entity receiving a grant under this section may use the grant for any of the following activities3 7#a7 ,to establish a program for co-prescribing opioid overdose reversal drugs1 such as naloxone4 7#b7 ,to train and provide resources for health care providers and pharmacists on the co-prescribing of opioid overdose reversal drugs4 7#c7 ,to establish mechanisms and processes1 consistent with applicable ,federal and ,state privacy rules1 for tracking patients participating in the program described in paragraph 7#a7 and the health outcomes of such patients4 7#d7 ,to purchase opioid overdose reversal drugs for distribution under the program described in paragraph 7#a74 7#e7 ,to offset the co-pays and other cost sharing associated with opioid overdose reversal drugs to ensure that cost is not a limiting factor for eligible patients4 7#f7 ,to conduct community outreach1 in conjunction with community-based organizations1 designed to raise awareness of co-prescribing practices1 and the availability of opioid overdose reversal drugs4 7#g7 ,to establish protocols to connect patients who have experienced a drug overdose with appropriate treatment1 including medication assisted treatment and appropriate counseling and behavioral therapies4 7d7 ,evaluations by recipients ,as a condition of receipt of a grant under this section1 an eligible entity shall1 for each year for which the grant is received1 submit to the ,secretary of ,health and ,human ,services information on appropriate outcome measures specified by the ,secretary to assess the outcomes of the program funded by the grant1 including-- 7#a7 the number of prescribers trained2 7#b7 the number of prescribers who have co-prescribed an opioid overdose reversal drugs to at least one patient2 7#c7 the total number of prescriptions written for opioid overdose reversal drugs2 7#d7 the percentage of patients at elevated risk who received a prescription for an opioid overdose reversal drug2 7#e7 the number of patients reporting use of an opioid overdose reversal drug2 and 7#f7 any other outcome measures that the ,secretary deems appropriate4 7e7 ,reports by ,secretary ,for each year of the grant program under this section1 the ,secretary of ,health and ,human ,services shall submit to the appropriate committees of the ,house of ,representatives and of the ,senate a report aggregating the information received from the grant recipients for such year under subsection 7d7 and evaluating the outcomes achieved by the programs funded by grants made under this section4 7f7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section and section #ijc #d1jjj1jjj for each of fiscal years #bjag through #bjba4 #ijc4 ,opioid overdose reversal co-prescribing guidelines 7a7 ,in general ,the ,secretary of ,health and ,human ,services shall establish a grant program under which the ,secretary shall award grants to eligible ,state entities to develop opioid overdose reversal co-prescribing guidelines4 7b7 ,eligible ,state entities ,for purposes of subsection 7a71 eligible ,state entities are ,state departments of health in conjunction with ,state medical boards2 city1 county1 and local health departments2 and community stakeholder groups involved in reducing opioid overdose deaths4 7c7 ,administrative provisions 7#a7 ,grant amounts ,a grant made under this section may not be for more than #bjj1jjj per grant4 7#b7 ,prioritization ,in awarding grants under this section1 the ,secretary shall give priority to eligible ,state entities which propose to base their guidelines on existing guidelines on co-prescribing to speed enactment1 including guidelines of-- 7,a7 the ,department of ,veterans ,affairs2 7,b7 nationwide medical societies1 such as the ,american ,society of ,addiction ,medicine or ,american ,medical ,association2 and 7,c7 the ,centers for ,disease ,control and ,prevention4 #ijd4 ,surveillance capacity building 7a7 ,program authorized ,the ,secretary of ,health and ,human ,services1 acting through the ,director of the ,centers for ,disease ,control and ,prevention1 shall award cooperative agreements or grants to eligible entities to improve fatal and nonfatal drug overdose surveillance and reporting capabilities1 including-- 7#a7 providing training to improve identification of drug overdose as the cause of death by coroners and medical examiners2 7#b7 establishing1 in cooperation with the ,national ,poison ,data ,system1 coroners1 and medical examiners1 a comprehensive national program for surveillance of1 and reporting to an electronic database on1 drug overdose deaths in the ,united ,states2 and 7#c7 establishing1 in cooperation with the ,national ,poison ,data ,system1 a comprehensive national program for surveillance of1 and reporting to an electronic database on1 fatal and nonfatal drug overdose occurrences1 including epidemiological and toxicologic analysis and trends4 7b7 ,eligible entity ,to be eligible to receive a grant or cooperative agreement under this section1 an entity shall be-- 7#a7 a ,state1 local1 or tribal government2 or 7#b7 the ,national ,poison ,data ,system working in conjunction with a ,state1 local1 or tribal government4 7c7 ,application 7#a7 ,in general ,an eligible entity desiring a grant or cooperative agreement under this section shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require4 7#b7 ,contents ,an application described in paragraph 7#a7 shall include-- 7,a7 a description of the activities to be funded through the grant or cooperative agreement2 and 7,b7 evidence that the eligible entity has the capacity to carry out such activities4 7d7 ,report ,as a condition of receipt of a grant or cooperative agreement under this section1 an eligible entity shall agree to prepare and submit1 not later than #ij days after the end of the grant or cooperative agreement period1 a report to the ,secretary describing the results of the activities supported through the grant or cooperative agreement4 7e7 ,national poison data system ,in this section1 the term ,national ,poison ,data ,system means the system operated by the ,american ,association of ,poison ,control ,centers1 in partnership with the ,centers for ,disease ,control and ,prevention1 for real-time local1 ,state1 and national electronic reporting1 and the corresponding database network4 7f7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #e1jjj1jjj for each of the fiscal years #bjag through #bjba4 ,b ,crisis #iba4 ,grants to support syringe exchange programs 7a7 ,in general ,the ,secretary of ,health and ,human ,services may award grants to ,state1 local1 and tribal governments and community organizations to support syringe exchange programs4 7b7 ,use of funds ,grants under subsection 7a7 may be used to support carrying out syringe exchange programs1 including through-- 7#a7 providing outreach1 counseling1 health education1 case management1 syringe disposal1 and other services as determined appropriate by the ,secretary of ,health and ,human ,services2 and 7#b7 providing technical assistance1 including training and capacity building1 to assist the development and implementation of syringe exchange programs4 7c7 ,authorization of appropriations ,there is authorized to be appropriated #ae1jjj1jjj for each of fiscal years #bjag through #bjba to carry out this section1 of which-- 7#a7 at least #ae percent shall be for syringe exchange programs that have been in operation for less than #c years2 and 7#b7 #e percent shall be for technical assistance under subsection 7b77#b74 #ibb4 ,grant program to reduce drug overdose deaths 7a7 ,program authorized ,the ,secretary of ,health and ,human ,services1 acting through the ,administrator of the ,substance ,abuse and ,mental ,health ,services ,administration1 shall award grants or enter into cooperative agreements with eligible entities to enable the eligible entities to reduce deaths occurring from overdoses of drugs4 7b7 ,eligible entities ,to be eligible to receive a grant or cooperative agreement under this section1 an entity shall be a partnership between any of the following3 a ,state1 local1 or tribal government1 a correctional institution1 a law enforcement agency1 a community agency1 a professional organization in the field of poison control and surveillance1 or a private nonprofit organization4 7c7 ,application 7#a7 ,in general ,an eligible entity desiring a grant or cooperative agreement under this section shall submit to the ,secretary of ,health and ,human ,services an application at such time1 in such manner1 and containing such information as the ,secretary may require4 7#b7 ,contents ,an application under paragraph 7#a7 shall include-- 7,a7 a description of the activities to be funded through the grant or cooperative agreement2 and 7,b7 evidence that the eligible entity has the capacity to carry out such activities4 7d7 ,priority ,in entering into grants and cooperative agreements under subsection 7a71 the ,secretary of ,health and ,human ,services shall give priority to eligible entities that-- 7#a7 include a public health agency or community-based organization2 and 7#b7 have expertise in preventing deaths occurring from overdoses of drugs in populations at high risk of such deaths4 7e7 ,eligible activities ,as a condition of receipt of a grant or cooperative agreement under this section1 an eligible entity shall agree to use the grant or cooperative agreement to do each of the following3 7#a7 ,purchase and distribute the drug naloxone or a similarly effective medication4 7#b7 ,carry out one or more of the following activities3 7,a7 ,educating prescribers and pharmacists about overdose prevention and naloxone prescription1 or prescriptions of a similarly effective medication4 7,b7 ,training first responders1 other individuals in a position to respond to an overdose1 and law enforcement and corrections officials on the effective response to individuals who have overdosed on drugs4 ,training pursuant to this subparagraph may include any activity that is educational1 instructional1 or consultative in nature1 and may include volunteer training1 awareness building exercises1 outreach to individuals who are at risk of a drug overdose1 and distribution of educational materials4 7,c7 ,implementing and enhancing programs to provide overdose prevention1 recognition1 treatment1 and response to individuals in need of such services4 7,d7 ,educating the public and providing outreach to the public about overdose prevention and naloxone prescriptions1 or prescriptions of other similarly effective medications4 7f7 ,coordinating center 7#a7 ,establishment ,the ,secretary of ,health and ,human ,services shall establish and provide for the operation of a coordinating center responsible for-- 7,a7 collecting1 compiling1 and disseminating data on the programs and activities under this section1 including tracking and evaluating the distribution and use of naloxone and other similarly effective medication2 7,b7 evaluating such data and1 based on such evaluation1 developing best practices for preventing deaths occurring from drug overdoses2 7,c7 making such best practices specific to the type of community involved2 7,d7 coordinating and harmonizing data collection measures2 7,e7 evaluating the effects of the program on overdose rates2 and 7,f7 education and outreach to the public about overdose prevention and prescription of naloxone and other similarly effective medication4 7#b7 ,reports to center ,as a condition on receipt of a grant or cooperative agreement under this section1 an eligible entity shall agree to prepare and submit1 not later than #ij days after the end of the award period1 a report to such coordinating center and the ,secretary of ,health and ,human ,services describing the results of the activities supported through the grant or cooperative agreement4 7g7 ,duration ,the period of a grant or cooperative agreement under this section shall be #d years4 7h7 ,definition ,in this part1 the term drug-- 7#a7 means a drug1 as defined in section #bja of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cba72 and 7#b7 includes controlled substances1 as defined in section #ajb of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hjb74 7i7 ,authorization of appropriations ,there is authorized to be appropriated #bj1jjj1jjj to carry out this section for each of the fiscal years #bjag through #bjba4 ,c ,treatment #ica4 ,expansion of patient limits under waiver ,section #cjc7;g77#b77;,b7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbc7;g77#b77;,b77 is amended-- 7#a7 in clause 7i71 by striking physician and inserting practitioner2 7#b7 in clause 7iii7-- 7,a7 by striking #cj and inserting #ajj2 and 7,b7 by striking 1 unless1 not sooner and all that follows through the end and inserting a period2 and 7#c7 by inserting at the end the following new clause3 7iv7 ,not earlier than #a year after the date on which a qualifying practitioner obtained an initial waiver pursuant to clause 7iii71 the qualifying practitioner may submit a second notification to the ,secretary of the need and intent of the qualifying practitioner to treat an unlimited number of patients1 if the qualifying practitioner-- 7,i7 7aa7 satisfies the requirements of item 7aa71 7bb71 7cc71 or 7dd7 of subparagraph 7,g77ii77,i72 and 7bb7 agrees to fully participate in the ,prescription ,drug ,monitoring ,program of the ,state in which the qualifying practitioner is licensed1 pursuant to applicable ,state guidelines2 or 7,,ii7 7aa7 satisfies the requirements of item 7ee71 7ff71 or 7gg7 of subparagraph 7,g77ii77,i72 7bb7 agrees to fully participate in the ,prescription ,drug ,monitoring ,program of the ,state in which the qualifying practitioner is licensed1 pursuant to applicable ,state guidelines2 7cc7 practices in a qualified practice setting2 and 7dd7 has completed not less than #bd hours of training 7through classroom situations1 seminars at professional society meetings1 electronic communications1 or otherwise7 with respect to the treatment and management of opiate-dependent patients for substance use disorders provided by the ,american ,society of ,addiction ,medicine1 the ,american ,academy of ,addiction ,psychiatry1 the ,american ,medical ,association1 the ,american ,osteopathic ,association1 the ,american ,psychiatric ,association1 or any other organization that the ,secretary determines is appropriate for purposes of this subclause4 4 #icb4 ,definitions ,section #cjc7;g77#b77;,g7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbc7;g77#b77;,g77 is amended-- 7#a7 by striking clause 7ii7 and inserting the following3 7ii7 ,the term qualifying practitioner means the following3 7,i7 ,a physician who is licensed under ,state law and who meets #a or more of the following conditions3 7aa7 ,the physician holds a board certification in addiction psychiatry from the ,american ,board of ,medical ,specialties4 7bb7 ,the physician holds an addiction certification from the ,american ,society of ,addiction ,medicine4 7cc7 ,the physician holds a board certification in addiction medicine from the ,american ,osteopathic ,association4 7dd7 ,the physician holds a board certification from the ,american ,board of ,addiction ,medicine4 7ee7 ,the physician has completed not less than #h hours of training 7through classroom situations1 seminar at professional society meetings1 electronic communications1 or otherwise7 with respect to the treatment and management of opiate-dependent patients for substance use disorders provided by the ,american ,society of ,addiction ,medicine1 the ,american ,academy of ,addiction ,psychiatry1 the ,american ,medical ,association1 the ,american ,osteopathic ,association1 the ,american ,psychiatric ,association1 or any other organization that the ,secretary determines is appropriate for purposes of this subclause4 7ff7 ,the physician has participated as an investigator in #a or more clinical trials leading to the approval of a narcotic drug in schedule ,,iii1 ,,iv1 or ,v for maintenance or detoxification treatment1 as demonstrated by a statement submitted to the ,secretary by this sponsor of such approved drug4 7gg7 ,the physician has such other training or experience as the ,secretary determines will demonstrate the ability of the physician to treat and manage opiate-dependent patients4 7,,ii7 ,a nurse practitioner or physician assistant who is licensed under ,state law and meets all of the following conditions3 7aa7 ,the nurse practitioner or physician assistant is licensed under ,state law to prescribe schedule ,,iii1 ,,iv1 or ,v medications for pain4 7bb7 ,the nurse practitioner or physician assistant satisfies #a or more of the following3 7,,aa7 ,has completed not fewer than #bd hours of training 7through classroom situations1 seminar at professional society meetings1 electronic communications1 or otherwise7 with respect to the treatment and management of opiate-dependent patients for substance use disorders provided by the ,american ,society of ,addiction ,medicine1 the ,american ,academy of ,addiction ,psychiatry1 the ,american ,medical ,association1 the ,american ,osteopathic ,association1 the ,american ,psychiatric ,association1 or any other organization that the ,secretary determines is appropriate for purposes of this subclause4 7,,bb7 ,has such other training or experience as the ,secretary determines will demonstrate the ability of the nurse practitioner or physician assistant to treat and manage opiate-dependent patients4 7cc7 ,the nurse practitioner or physician assistant practices within the scope of their ,state license1 including compliance with any supervision or collaboration requirements under ,state law4 7dd7 ,the nurse practitioner or physician assistant practice in a qualified practice setting4 2 and 7#b7 by adding at the end the following3 7iii7 ,the term qualified practice setting means #a or more of the following treatment settings3 7,i7 ,a ,national ,committee for ,quality ,assurance-recognized ,patient-,centered ,medical ,home or ,patient-,centered ,specialty ,practice4 7,,ii7 ,a ,centers for ,medicaid ,medicare ,services-recognized ,accountable ,care ,organization4 7,,iii7 ,a clinical facility administered by the ,department of ,veterans ,affairs1 ,department of ,defense1 or ,indian ,health ,service4 7,,iv7 ,a ,behavioral ,health ,home accredited by the ,joint ,commission4 7,v7 ,a ,federally-qualified health center 7as defined in section #aije7l77#b77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7l77#b77;,b777 or a ,federally-qualified health center look-alike4 7,,vi7 ,a ,substance ,abuse and ,mental ,health ,services-certified ,opioid ,treatment ,program4 7,,vii7 ,a clinical program of a ,state or ,federal jail1 prison1 or other facility where individuals are incarcerated4 7,,viii7 ,a clinic that demonstrates compliance with the ,model ,policy on ,,data #bjjj and ,treatment of ,opioid ,addiction in the ,medical ,office issued by the ,federation of ,state ,medical ,boards4 7,,ix7 ,a treatment setting that is part of an ,accreditation ,council for ,graduate ,medical ,education1 ,american ,association of ,colleges of ,osteopathic ,medicine1 or ,american ,osteopathic ,association-accredited residency or fellowship training program4 7,x7 ,any other practice setting approved by a ,state regulatory board1 ,state substance abuse agency1 or ,state ,medicaid ,plan to provide addiction treatment services4 7,,xi7 ,any other practice setting approved by the ,secretary4 4 #icc4 ,evaluation by assistant ,secretary for planning and evaluation ,two years after the date on which the first notification under clause 7iv7 of section #cjc7;g77#b77;,b7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbc7;g77#b77;,b771 as added by section #ica1 is received by the ,secretary of ,health and ,human ,services1 the ,assistant ,secretary for ,planning and ,evaluation shall initiate an evaluation of the effectiveness of the amendments made by sections #cja and #cjb1 which shall include an evaluation of-- 7#a7 any changes in the availability and use of medication-assisted treatment for opioid addiction2 7#b7 the quality of medication-assisted treatment programs2 7#c7 the integration of medication-assisted treatment with routine healthcare services2 7#d7 diversion of opioid addiction treatment medication2 7#e7 changes in ,state or local policies and legislation relating to opioid addiction treatment2 7#f7 the use of nurse practitioners and physician assistants who prescribe opioid addiction medication2 7#g7 the use of ,prescription ,drug ,monitoring ,programs by waived practitioners to maximize safety of patient care and prevent diversion of opioid addiction medication2 7#h7 the findings of the ,drug ,enforcement ,administration inspections of waived practitioners1 including the frequency with which the ,drug ,enforcement ,administration finds no documentation of access to behavioral health services2 and 7#i7 the effectiveness of cross-agency collaboration between the ,department of ,health and ,human ,services and the ,drug ,enforcement ,administration for expanding effective opioid addiction treatment4 #icd4 ,reauthorization of residential treatment programs for pregnant and postpartum women ,section #ejh of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#a7 is amended-- 7#a7 in subsection 7p71 by inserting 7other than subsection 7r77 after section2 and 7#b7 in subsection 7r71 by striking such sums and all that follows through #bjjc and inserting #dj1jjj1jjj for each of fiscal years #bjag through #bjba4 #ice4 ,pilot program grants for ,state substance abuse agencies 7a7 ,in general ,section #ejh of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#a7 is amended-- 7#a7 by redesignating subsection 7r71 as amended by section #icd1 as subsection 7s72 and 7#b7 by inserting after subsection 7q7 the following new subsection3 7r7 ,pilot program for ,state substance abuse agencies 7#a7 ,in general ,from amounts made available under subsection 7s71 the ,director of the ,center for ,substance ,abuse ,treatment shall carry out a pilot program under which competitive grants are made by the ,director to ,state substance abuse agencies to-- 7,a7 enhance flexibility in the use of funds designed to support family-based services for pregnant and postpartum women with a primary diagnosis of a substance use disorder1 including opioid use disorders2 7,b7 help ,state substance abuse agencies address identified gaps in services furnished to such women along the continuum of care1 including services provided to women in non-residential based settings2 and 7,c7 promote a coordinated1 effective1 and efficient ,state system managed by ,state substance abuse agencies by encouraging new approaches and models of service delivery4 7#b7 ,requirements ,in carrying out the pilot program under this subsection1 the ,director shall-- 7,a7 require ,state substance abuse agencies to submit to the ,director applications1 in such form and manner and containing such information as specified by the ,director1 to be eligible to receive a grant under the program2 7,b7 identify1 based on such submitted applications1 ,state substance abuse agencies that are eligible for such grants2 7,c7 require services proposed to be furnished through such a grant to support family based treatment and other services for pregnant and postpartum women with a primary diagnosis of a substance use disorder1 including opioid use disorders2 7,d7 not require that services furnished through such a grant be provided solely to women that reside in facilities2 7,e7 not require that grant recipients under the program make available through use of the grant all services described in subsection 7d72 and 7,f7 consider not applying requirements described in paragraphs 7#a7 and 7#b7 of subsection 7f7 to applicants1 depending on the circumstances of the applicant4 7#c7 ,required services 7,a7 ,in general ,the ,director shall specify a minimum set of services required to be made available to eligible women through a grant awarded under the pilot program under this subsection4 ,such minimum set-- 7i7 shall include requirements described in subsection 7c7 and be based on the recommendations submitted under subparagraph 7,b72 and 7ii7 may be selected from among the services described in subsection 7d7 and include other services as appropriate4 7,b7 ,stakeholder input ,the ,director shall convene and solicit recommendations from stakeholders1 including ,state substance abuse agencies1 health care providers1 persons in recovery from substance abuse1 and other appropriate individuals1 for the minimum set of services described in subparagraph 7,a74 7#d7 ,duration ,the pilot program under this subsection shall not exceed #e years4 7#e7 ,evaluation and ,report to ,congress ,the ,director of the ,center for ,behavioral ,health ,statistics and ,quality shall fund an evaluation of the pilot program at the conclusion of the first grant cycle funded by the pilot program4 ,the ,director of the ,center for ,behavioral ,health ,statistics and ,quality1 in coordination with the ,director of the ,center for ,substance ,abuse ,treatment shall submit to the relevant ,committees of jurisdiction of the ,house of ,representatives and the ,senate a report on such evaluation4 ,the report shall include at a minimum outcomes information from the pilot program1 including any resulting reductions in the use of alcohol and other drugs2 engagement in treatment services2 retention in the appropriate level and duration of services2 increased access to the use of medications approved by the ,food and ,drug ,administration for the treatment of substance use disorders in combination with counseling2 and other appropriate measures4 7#f7 ,state substance abuse agencies defined ,for purposes of this subsection1 the term ,state substance abuse agency means1 with respect to a ,state1 the agency in such ,state that manages the ,substance ,abuse ,prevention and ,treatment ,block ,grant under part ,b of title ,,xix4 4 7b7 ,funding ,subsection 7s7 of section #ejh of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#a71 as amended by section #icd and redesignated by subsection 7a71 is further amended by adding at the end the following new sentence3 ,of the amounts made available for a year pursuant to the previous sentence to carry out this section1 not more than #be percent of such amounts shall be made available for such year to carry out subsection 7r71 other than paragraph 7#e7 of such subsection44 #icf4 ,evidence-based opioid and heroin treatment and interventions demonstration ,subpart #a of part ,b of title ,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb et seq47 is amended-- 7#a7 by redesignating section #ead 7#db ,u4,s4,c4 #bij;bb-#i71 as added by section #cfcb of the ,methamphetamine ,anti-,proliferation ,act of #bjjj 7,public ,law #ajf-caj2 #aad ,stat4 #abcf71 as section #ead;,b2 and 7#b7 by adding at the end the following3 #ead;,c4 ,evidence-based opioid and heroin treatment and interventions demonstration 7a7 ,grants 7#a7 ,authority to make grants ,the ,director of the ,center for ,substance ,abuse ,treatment 7referred to in this section as the ,director7 shall award grants to ,state substance abuse agencies1 units of local government1 nonprofit organizations1 and ,indian tribes or tribal organizations 7as defined in section #d of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afjc77 that have a high rate1 or have had a rapid increase1 in the use of heroin or other opioids1 in order to permit such entities to expand activities1 including an expansion in the availability of medication assisted treatment1 evidence-based counseling1 or behavioral therapies with respect to the treatment of addiction in the specific geographical areas of such entities where there is a rate or rapid increase in the use of heroin or other opioids4 7#b7 ,recipients ,the entities receiving grants under paragraph 7#a7 shall be selected by the ,director4 7#c7 ,nature of activities ,the grant funds awarded under paragraph 7#a7 shall be used for activities that are based on reliable scientific evidence of efficacy in the treatment of problems related to heroin or other opioids4 7b7 ,geographic distribution ,the ,director shall ensure that grants awarded under subsection 7a7 are distributed equitably among the various regions of the ,nation and among rural1 urban1 and suburban areas that are affected by the use of heroin or other opioids4 7c7 ,additional activities ,the ,director shall-- 7#a7 evaluate the activities supported by grants awarded under subsection 7a72 7#b7 disseminate widely such significant information derived from the evaluation as the ,director considers appropriate2 7#c7 provide ,states1 ,indian tribes and tribal organizations1 and providers with technical assistance in connection with the provision of treatment of problems related to heroin and other opioids2 and 7#d7 fund only those applications that specifically support recovery services as a critical component of the grant program4 7d7 ,definition ,the term medication assisted treatment means the use1 for problems relating to heroin and other opioids1 of medications approved by the ,food and ,drug ,administration in combination with counseling and behavioral therapies4 7e7 ,authorization of appropriations 7#a7 ,in general ,there is authorized to be appropriated to carry out this section #cjj1jjj1jjj for each of fiscal years #bjag through #bjba4 7#b7 ,use of certain funds ,of the funds appropriated to carry out this section in any fiscal year1 not more than #e percent of such funds shall be available to the ,director for purposes of carrying out subsection 7c74 4 #icg4 ,adolescent treatment and recovery services demonstration grant program ,subpart #a of part ,b of title ,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb et seq471 as amended by section #icf1 is further amended by adding at the end the following3 #ead;,d4 ,grants to improve access to treatment and recovery for adolescents 7a7 ,in general ,the ,secretary1 acting through the ,director of the ,center for ,substance ,abuse ,treatment1 shall award grants1 contracts1 or cooperative agreements to eligible ,state substance abuse agencies and other entities determined appropriate by the ,director for the purpose of increasing the capacity of substance use disorder treatment and recovery services for adolescents4 7b7 ,eligibility ,to be eligible to receive a grant1 contract1 or cooperative agreement under subsection 7a7 an entity shall-- 7#a7 prepare and submit to the ,director an application at such time1 in such manner1 and contain such information as the ,director may require1 including a plan for the evaluation of any activities carried out with the funds provided under this section2 7#b7 ensure that all entities receiving support under the grant1 contract1 or cooperative agreement comply with all applicable ,state licensure or certification requirements regarding the provision of the services involved2 and 7#c7 provide the ,director with periodic evaluations of the progress of the activities funded under this section and an evaluation at the completion of such activities1 as the ,director determines to be appropriate4 7c7 ,priority ,in awarding grants1 contracts1 and cooperative agreements under subsection 7a71 the ,director shall give priority to applicants who propose to fill a demonstrated geographic need for adolescent specific residential treatment services4 7d7 ,use of funds ,amounts awarded under grants1 contracts1 or cooperative agreements under this section may be used to enable health care providers or facilities that provide treatment and recovery assistance for adolescents with a substance use disorder to provide the following services3 7#a7 ,individualized patient centered care that is specific to circumstances of the individual patient4 7#b7 ,clinically appropriate1 trauma-informed1 gender-specific and age appropriate treatment services that are based on reliable scientific evidence of efficacy in the treatment of problems related to substance use disorders4 7#c7 ,clinically appropriate care to address treatment for substance use and any co-occurring physical and mental health disorders at the same location1 and through access to primary care services4 7#d7 ,coordination of treatment services with recovery and other social support1 including educational1 vocational training1 assistance with the juvenile justice system1 child welfare1 and mental health agencies4 7#e7 ,aftercare and long-term recovery support1 including peer support services4 7e7 ,duration of assistance ,grants1 contracts1 and cooperative agreements awarded under subsection 7a7 shall be for a period not to exceed #e years4 7f7 ,additional activities ,the ,director shall-- 7#a7 collect and evaluate the activities carried out with amount received under subsection 7a72 7#b7 disseminate widely such significant information derived from the evaluation as the ,secretary considers appropriate2 and 7#c7 provide ,states1 ,indian tribes and tribal organizations1 and providers with technical assistance in connection with the provision of treatment and recovery services funded through this section to adolescents related to the abuse of heroin and other opioids4 7g7 ,authorization of appropriations 7#a7 ,in general ,there is authorized to be appropriated to carry out this section1 #be1jjj1jjj for each of fiscal years #bjag through #bjba4 7#b7 ,use of certain funds ,of the funds appropriated to carry out this section in any fiscal year1 not more than #e percent of such funds shall be available to the ,director for purposes of carrying out subsection 7f74 4 #ich4 ,study on treatment infrastructure ,not later than #bd months after the date of enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall initiate an evaluation1 and submit to ,congress a report1 of the inpatient and outpatient treatment capacity1 availability1 and needs of the ,united ,states1 which shall include1 to the extent data is available-- 7#a7 the capacity of acute residential or inpatient detoxification programs2 7#b7 the capacity of inpatient clinical stabilization programs1 transitional residential support services1 and residential rehabilitation programs2 7#c7 the capacity of demographic specific residential or inpatient treatment programs1 such as those designed for pregnant women or adolescents2 7#d7 geographical differences of the availability of residential and outpatient treatment and recovery options for substance use disorders across the continuum of care2 7#e7 the availability of residential and outpatient treatment programs that offer treatment options based on reliable scientific evidence of efficacy for the treatment of substance use disorders1 including the use of ,food and ,drug ,administration-approved medicines and evidence-based nonpharmacological therapies2 7#f7 the number of patients in residential and specialty outpatient treatment services for substance use disorders2 and 7#g7 an assessment of the need for residential and outpatient treatment for substance use disorders across the continuum of care4 #ici4 ,substance use disorder professional loan repayment program ,subpart #c of part ,e of title ,,vii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bie;f et seq47 is amended by adding at the end the following3 #ggi4 ,substance use disorder professional loan repayment program 7a7 ,establishment ,the ,secretary shall establish and carry out a substance use disorder health professional loan repayment program under which qualified health professionals agree to be employed full time for a specified period 7which shall be not less than #b years7 in providing substance use disorder prevention and treatment services4 7b7 ,program administration ,through the program established under this section1 the ,secretary shall enter into contracts with qualified health professionals under which-- 7#a7 a qualified health professional agrees to provide substance use disorder prevention and treatment services with respect to an area or population that 7as determined by the ,secretary7-- 7,a7 has a shortage of such services 7as defined by the ,secretary72 and 7,b7 has a sufficient population of individuals with a substance use disorder to support the provision of such services2 and 7#b7 the ,secretary agrees to make payments on the principal and interest of undergraduate1 or graduate education loans of the qualified health professional-- 7,a7 of not more than #ce1jjj for each year of service described in paragraph 7#a72 and 7,b7 for not more than #c years4 7c7 ,qualified health professional defined ,in this section1 the term qualified health professional means an individual who is 7or will be upon the completion of the individual's graduate education7 a psychiatrist1 psychologist1 nurse practitioner1 physician assistant1 clinical social worker1 substance abuse counselor1 or other substance use disorder health professional4 7d7 ,priority ,in entering into agreements under this section1 the ,secretary shall give priority to applicants who-- 7#a7 have familiarity with evidence-based methods and culturally and linguistically competent health care services2 and 7#b7 demonstrate financial need4 7e7 ,authorization of appropriations ,there is authorized to be appropriated #bj1jjj1jjj for each of fiscal years #bjag through #bjba to carry out this section4 4 ,d ,recovery #iea4 ,national youth recovery initiative 7a7 ,definitions ,in this section3 7#a7 ,eligible entity ,the term eligible entity means-- 7,a7 a high school that has been accredited as a recovery high school by the ,association of ,recovery ,schools2 7,b7 an accredited high school that is seeking to establish or expand recovery support services2 7,c7 an institution of higher education2 7,d7 a recovery program at a nonprofit collegiate institution2 or 7,e7 a nonprofit organization4 7#b7 ,institution of higher education ,the term institution of higher education has the meaning given the term in section #aja of the ,higher ,education ,act of #aife 7#bj ,u4,s4,c4 #ajja74 7#c7 ,recovery program ,the term recovery program-- 7,a7 means a program to help individuals who are recovering from substance use disorders to initiate1 stabilize1 and maintain healthy and productive lives in the community2 and 7,b7 includes peer-to-peer support and communal activities to build recovery skills and supportive social networks4 7b7 ,grants authorized ,the ,secretary of ,health and ,human ,services1 acting through the ,substance ,abuse and ,mental ,health ,services ,administration1 in consultation with the ,secretary of ,education1 may award grants to eligible entities to enable the entities to-- 7#a7 provide substance use recovery support services to young people in high school and enrolled in institutions of higher education2 7#b7 help build communities of support for young people in recovery through a spectrum of activities such as counseling and healthy and wellness-oriented social activities2 and 7#c7 encourage initiatives designed to help young people achieve and sustain recovery from substance use disorders4 7c7 ,use of funds ,grants awarded under subsection 7b7 may be used for activities to develop1 support1 and maintain youth recovery support services1 including-- 7#a7 the development and maintenance of a dedicated physical space for recovery programs2 7#b7 dedicated staff for the provision of recovery programs2 7#c7 healthy and wellness-oriented social activities and community engagement2 7#d7 establishment of recovery high schools2 7#e7 coordination of recovery programs with-- 7,a7 substance use disorder treatment programs and systems2 7,b7 providers of mental health services2 7,c7 primary care providers2 7,d7 the criminal justice system1 including the juvenile justice system2 7,e7 employers2 7,f7 housing services2 7,g7 child welfare services2 7,h7 institutions of secondary higher education and institutions of higher education2 and 7,i7 other programs or services related to the welfare of an individual in recovery from a substance use disorder2 7#f7 the development of peer-to-peer support programs or services2 and 7#g7 additional activities that help youths and young adults to achieve recovery from substance use disorders4 7d7 ,technical support ,the ,secretary of ,health and ,human ,services shall provide technical support to recipients of grants under this section4 7e7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #cj1jjj1jjj for each of fiscal years #bjag through #bjba4 #ieb4 ,grants to enhance and expand recovery support services ,subpart #a of part ,b of title ,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb et seq471 as amended by sections #cjf and #cjg1 is further amended by adding at the end the following3 #ead;,e4 ,grants to enhance and expand recovery support services 7a7 ,in general ,the ,secretary1 acting through the ,administrator of the ,substance ,abuse and ,mental ,health ,services ,administration1 shall award grants to ,state substance abuse agencies and nonprofit organizations to develop1 expand1 and enhance recovery support services for individuals with substance use disorders4 7b7 ,eligible entities ,in the case of an applicant that is not a ,state substance abuse agency1 to be eligible to receive a grant under this section1 the entity shall-- 7#a7 prepare and submit to the ,secretary an application at such time1 in such manner1 and contain such information as the ,secretary may require1 including a plan for the evaluation of any activities carried out with the funds provided under this section2 7#b7 demonstrate the inclusion of individuals in recovery from a substance use disorder in leadership levels or governing bodies of the entity2 7#c7 have as a primary mission the provision of long-term recovery support for substance use disorders2 and 7#d7 be accredited by the ,council on the ,accreditation of ,peer ,recovery ,support ,services or meet any applicable ,state certification requirements regarding the provision of the recovery services involved4 7c7 ,use of funds ,amounts awarded under a grant under this section shall be used to provide for the following activities3 7#a7 ,educating and mentoring that assists individuals and families with substance use disorders in navigating systems of care4 7#b7 ,peer recovery support services which include peer coaching and mentoring4 7#c7 ,recovery-focused community education and outreach programs1 including training on the use of all forms of opioid overdose antagonists used to counter the effects of an overdose4 7#d7 ,training1 mentoring1 and education to develop and enhance peer mentoring and coaching4 7#e7 ,programs aimed at identifying and reducing stigma and discriminatory practices that serve as barriers to substance use disorder recovery and treatment of these disorders4 7#f7 ,developing partnerships between networks that support recovery and other community organizations and services1 including-- 7,a7 public and private substance use disorder treatment programs and systems2 7,b7 health care providers2 7,c7 recovery-focused addiction and recovery professionals2 7,d7 faith-based organizations2 7,e7 organizations focused on criminal justice reform2 7,f7 schools2 and 7,g7 social service agencies in the community1 including educational1 juvenile justice1 child welfare1 housing1 and mental health agencies4 7d7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section1 #ajj1jjj1jjj for each of fiscal years #bjag through #bjba4 4