,i #aaeth ,,congress #ast ,session ,h4 ,r4 #bccf ,,in ,,the ,,house ,,of ,,representatives ,may #c1 #bjag,mr4 ,loebsack 7for himself and ,mr4 ,tonko7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce ,a ,,bill ,to amend the ,public ,health ,service ,act to authorize a primary and behavioral health care integration grant program4 #a4 ,short title ,this ,act may be cited as the ,behavioral ,health ,care ,integration ,act of #bjag4 #b4 ,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 disorders 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 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 #bjah through #bjbb1 of which #b1jjj1jjj shall be available to the technical assistance program under subsection 7i74 4