,i #aaith ,,congress #b;d ,session ,h4 ,r4 #hdhg ,,in ,,the ,,house ,,of ,,representatives ,april #bc1 #bjbf,ms4 ,matsui 7for herself1 ,mr4 ,pfluger1 ,ms4 ,craig1 ,mr4 ,alford1 ,mr4 ,tonko1 ,mr4 ,fitzpatrick1 and ,mr4 ,goldman of ,texas7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce1 and in addition to the ,committee on ,ways and ,means1 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 amend titles ,,xviii and ,,xix of the ,social ,security ,act to adjust coverage and payment for certified community behavioral health clinic services under the ,medicare and ,medicaid programs1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,ensuring ,excellence in ,mental ,health ,act4 #b4 ,table of contents ,the table of contents for this ,act is as follows3 ,sec4 #a4 ,short title4 ,sec4 #b4 ,table of contents4 ,title ,i--,strengthening and providing cost-related payment for certified community behavioral health clinics under the ,medicaid program ,sec4 #aja4 ,coordination of ,medicaid certified community behavioral health clinic services with ,,ccbhc operating grant program2 ,,ccbhc accreditation option4 ,sec4 #ajb4 ,establishing a prospective payment system for certified community behavioral health clinics4 ,sec4 #ajc4 ,expanding ,,ccbhc services within ,medicaid demonstration program4 ,sec4 #ajd4 ,expanding scope of ,,ccbhc services covered under the ,medicaid program4 ,title ,,ii--,coverage of certified community behavioral health clinic services under the ,medicare program ,sec4 #bja4 ,coverage of certified community behavioral health clinic services under the medicare program4 ,sec4 #bjb4 ,payment for certified community behavioral health clinic services under the medicare program4 ,sec4 #bjc4 ,non-application of ,medicare part ,b deductible for ,,ccbhc services4 ,sec4 #bjd4 ,right to seek review of cost reports from ,provider ,reimbursement ,review ,board4 ,sec4 #bje4 ,extending safe harbor under ,anti-,kickback ,statute to waivers of ,,ccbhc coinsurance4 ,sec4 #bjf4 ,effective date4 ,title ,,iii--,community behavioral health clinic grants ,sec4 #cja4 ,operating grants1 technical assistance1 data infrastructure1 and accreditation for community behavioral health clinics4 ,title ,,iv--,liability protection for certified community behavioral health clinic clinicians ,sec4 #dja4 ,conferring protection under the ,federal ,tort ,claims ,act to clinicians in certified community behavioral health clinics4 ,i ,strengthening and providing cost-related payment for certified community behavioral health clinics under the ,medicaid program #aja4 ,coordination of ,medicaid certified community behavioral health clinic services with ,,ccbhc operating grant program2 ,,ccbhc accreditation option ,section #aije7;jj77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7jj77#b77 is amended-- 7#a7 in subparagraph 7,b7-- 7,a7 by inserting 7or providing or referring through formal relationships1 as applicable7 after furnishing2 7,b7 by striking described in paragraph 7#a7 and inserting described in paragraph 7#a77;,b72 and 7,c7 by striking and at the end2 7#b7 in subparagraph 7,c71 by striking the period at the end and inserting 1 and including any such data as the ,state1 by agreement with the ,secretary1 shall access via the system described in section #cdj;,j-#c of the ,public ,health ,service ,act2 and2 and 7#c7 by adding at the end the following new subparagraph3 7,d7 beginning ,january #a1 #bjbf1 at the option of the ,state1 has received accreditation by an accreditation body approved under section #cdj;,j-#d of the ,public ,health ,service ,act4 4 #ajb4 ,establishing a prospective payment system for certified community behavioral health clinics 7a7 ,in general ,section #aijb of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7 is amended by adding at the end the following new subsection3 7yy7 ,payment for services provided by certified community behavioral health clinics 7#a7 ,in general ,beginning with fiscal year #bjbf with respect to services furnished on or after ,january #a1 #bjbf1 and for each succeeding fiscal year1 if a ,state elects to make medical assistance available for certified community behavioral health clinic services under section #aije7;a77#ca71 the ,state plan shall provide for payment for such services furnished by 7or under arrangement with7 a certified community behavioral health clinic described in section #aije7;jj77#b7 7in this subsection referred to as a clinic7 in accordance with the provisions of this subsection4 7#b7 ,prospective payment system 7,a7 ,in general ,subject to paragraph 7#d71 a ,state shall provide for payment for certified community behavioral health clinic services furnished by 7or under arrangement with7 a clinic in the first fiscal year 7or portion of a fiscal year7 described in paragraph 7#a7 for which a ,state elects to provide medical assistance for such services under section #aije7;a77#ca7 under a prospective payment system developed by the ,state in accordance with this paragraph4 7,b7 ,unit of payment ,in establishing the system under subparagraph 7,a71 the ,state shall apply as the unit of service-- 7i7 daily visits2 or 7ii7 monthly visits 7excluding repeat visits from the same individual74 7,c7 ,system design ,under the system under subparagraph 7,a71 the ,state may1 consistent with the methodology described in guidance issued under section #bbc7;b7 of the ,protecting ,access to ,medicare ,act of #bjad-- 7i7 establish separate prospective payment system rates for special populations2 7ii7 use a system of outlier payments for a portion of costs of furnishing certified community behavioral health clinic services2 or 7iii7 with respect to certified community behavioral health clinic services that are crisis services-- 7,i7 require that each cost report of a clinic segregate costs relating to mobile crisis teams1 emergency crisis intervention services1 or crisis stabilization from other components of the services described in section #aije7;a77#ca72 and 7,,ii7 provide for a prospective payment system rate for any or all of such crisis services that is distinct from the rate encompassing the remainder of the services described in section #aije7;a77#ca74 7,d7 ,payment basis ,subject to subparagraph 7,e71 the ,state shall provide for computation of a prospective payment amount for an individual certified community behavioral health clinic under the system under subparagraph 7,a7 as follows3 7i7 ,for the first fiscal year 7or portion of a fiscal year7 for which a ,state elects to provide medical assistance for such services under section #aije7;a77#ca71 such amount-- 7,i7 in the case of a ,state that did not operate a demonstration program under section #bbc of the ,protecting ,access to ,medicare ,act of #bjad during a base year corresponding to the fiscal year immediately preceding such first fiscal year 7or portion of a fiscal year71 shall be equal to #ajj percent of the costs of the clinic which are reasonable and related to the furnishing of such services during such base year2 and 7,,ii7 in the case of a ,state that did operate a demonstration program under section #bbc of the ,protecting ,access to ,medicare ,act of #bjad during such base year1 shall be equal to1 at the option of the ,state-- 7aa7 the amount described in subclause 7,i72 or 7bb7 the amount that would have otherwise applied with respect to such services under such demonstration4 7ii7 ,for each subsequent fiscal year for which a ,state elects to provide medical assistance for such services under section #aije7;a77#ca71 such amount shall be1 subject to subparagraph 7,f71 the amount calculated under this subparagraph for the preceding fiscal year-- 7,i7 increased by the percentage increase described in section #ahcd7;aa77#c77;,c7 for the calendar year in which such preceding fiscal year began2 and 7,,ii7 adjusted to take into account any increase or decrease in the scope of such services furnished by the clinic during the fiscal year involved4 7,e7 ,establishment of initial fiscal year payment for new clinics ,for purposes of subparagraph 7,d7-- 7i7 in the case of a certified community behavioral health clinic that does not have available complete actual cost data representing the provision of all certified community behavioral health clinic services provided in the base year described in clause 7i77,i7 of such subparagraph1 the ,state may use estimated or projected data relating to specific services for which the clinics lack cost experience2 and 7ii7 in the case of an entity that first enrolls under this title as a certified community behavioral health clinic in a year after the first fiscal year in which the ,state first provides for payment for the services described in section #aije7;a77#ca7 in accordance with paragraph 7#a7-- 7,i7 for the first fiscal year in which the clinic furnishes such services1 the amount determined by the ,state for such clinic shall be-- 7aa7 determined on the basis of the amounts established under this paragraph for other such clinics located in the same or adjacent area 7as defined by the ,secretary7 with a similar case load2 or 7bb7 in the absence of any such clinic1 based on the reasonable projected costs per visit of the clinic2 7,,ii7 for the second fiscal year in which the clinic furnishes such services1 the amount determined by the ,state for such clinic shall be determined under clause 7i77,i7 of such subparagraph on the basis of the reasonable and related costs and visits from the clinic's first fiscal year of operation2 and 7,,iii7 for the third and each subsequent fiscal year in which the clinic furnishes such services1 the amount determined by the ,state for such clinic shall be determined under clause 7ii7 of such subparagraph4 7,f7 ,rebasing ,a ,state may periodically 7but no less frequently than every third fiscal year after the first fiscal year described in subparagraph 7,d77 rebase the prospective payment amount determined under subparagraph 7,d7 such that costs from the fiscal year preceding the rebasing year1 rather than costs from the base year described in clause 7i77,i7 of such subparagraph1 shall be used in establishing a new cost-related rate for each clinic4 ,such rebasing shall include those clinics with initial rates determined under subparagraph 7,e74 7#c7 ,administration in the case of managed care 7,a7 ,in general ,in the case of services furnished by a certified community behavioral health clinic pursuant to a contract between the clinic and a managed care entity 7as defined in section #aicb7;a77#a77;,b77 or other specified entity 7as defined in #aijc7m77#i77;,d77iii771 the ,state shall provide for payment to the clinic by the ,state of a supplemental payment equal to the amount 7if any7 by which the amount determined under the preceding paragraphs of this subsection 7or paragraph 7#d71 as applicable7 exceeds the amount of payments provided under the contract4 ,such supplemental payment shall be made pursuant to a payment schedule agreed to by the ,state and the clinic1 but in no case less frequently than every #d months4 7,b7 ,option to delegate ,,pps payment to managed care entities through an alternative payment methodology ,notwithstanding subparagraph 7,a71 nothing in this subsection shall be interpreted to preclude a ,state from amending its ,state plan to provide for an alternative payment methodology under paragraph 7#d71 under which the ,state may delegate to a managed care entity1 as defined in section #aicb7;a77#a77;,b71 the responsibility to pay the clinic at least the rate determined under the preceding subparagraphs 7or paragraph 7#d71 as applicable71 provided that the ,state shall meet all requirements described in paragraph 7#d71 and shall use oversight processes to ensure that each clinic is paid at least the amounts required under the preceding paragraphs of this subsection4 7#d7 ,alternative payment methodologies ,notwithstanding any other provision of this subsection1 the ,state plan may provide for payment in any fiscal year to a certified community behavioral health clinic for services described in paragraph 7#ca7 of section #aije7;a7 in an amount which is determined under an alternative payment methodology that-- 7,a7 is agreed to by the ,state and the clinic2 and 7,b7 results in payment to the clinic of an amount which is not less than the amount otherwise required to be paid to the clinic under this subsection4 4 7b7 ,requirement ,to use prospective payment system under benchmark or benchmark equivalent coverage ,section #aicg7;b77#d7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifu-#g7;b77#d77 is amended-- 7#a7 in the paragraph heading1 by inserting 2 coverage of ,,ccbhc services after ,,fqhc services2 7#b7 by redesignating subparagraphs 7,a7 and 7,b7 as clauses 7i7 and 7ii71 respectively1 and adjusting the margins accordingly2 7#c7 by striking this section1 a ,state and inserting3 this section-- 7,a7 a ,state 2 and 7#d7 by adding at the end the following new subparagraph3 7,b7 in the case that a ,state provides for medical assistance for certified community behavioral health clinic services 7as defined in section #aije7;jj77#a77 through enrollment of an individual with benchmark coverage or benchmark equivalent coverage under this section1 payment for such services shall be made in accordance with the requirements of section #aijb7yy74 4 #ajc4 ,expanding ,,ccbhc services within ,medicaid demonstration program 7a7 ,additional services within demonstration program ,section #bbc of the ,protecting ,access to ,medicare ,act of #bjad 7#db ,u4,s4,c4 #acif;a note7 is amended-- 7#a7 in section 7a77#b77;,d7-- 7,a7 by redesignating clauses 7i7 through 7ix7 as subclauses 7,i7 through 7,,ix71 respectively1 and adjusting the margins accordingly2 7,b7 by striking ,provision and all that follows through relationships with other providers3 and inserting3 7i7 ,in general ,provision 7in a manner reflecting person-centered care7 of-- 7,i7 the required ,,ccbhc services 7as defined in clause 7ii772 and 7,,ii7 the additional ,,ccbhc services 7as defined in clause 7iii774 7ii7 ,required ,,ccbhc services ,for purposes of clause 7i71 the term required ,,ccbhc services means any of the following services which1 if not available directly through the certified community behavioral health clinic1 are provided or referred through formal relationships with other providers3 2 and 7,c7 by adding at the end the following new clause3 7iii7 ,additional ,,ccbhc services ,for purposes of clause 7i71 the term additional ,,ccbhc services means services available directly through the certified community behavioral health clinic-- 7,i7 that are not required ,,ccbhc services 7as defined in clause 7ii772 7,,ii7 that are appropriate to meet the health needs of the population served2 and 7,,iii7 which may include any of the primary health services defined in section #ccj 7b77#a77;,a7 of the ,public ,health ,service ,act4 2 7#b7 in subsection 7b77#a71 by striking mental health services and inserting certified community behavioral health clinic services2 and 7#c7 in subsection 7e7-- 7,a7 by redesignating paragraphs 7#a7 through 7#d7 as paragraphs 7#b7 through 7#e71 respectively2 and 7,b7 by inserting before paragraph 7#b71 as so redesignated1 the following new paragraph3 7#a7 ,certified community behavioral health clinic services ,the term certified community behavioral health clinic services means-- 7,a7 required ,,ccbhc services 7as defined in subsection 7a77#b77;,d77ii772 and 7,b7 additional ,,ccbhc services 7as defined in subsection 7a77#b77;,d77iii771 to the extent that a certified community behavioral health clinic elects to furnish any such services4 4 7b7 ,effective date ,the amendments made by this section shall apply with respect to services furnished on or after ,october #a1 #bjbf4 #ajd4 ,expanding scope of ,,ccbhc services covered under the ,medicaid program 7a7 ,additional services within ,,ccbhc benefit ,section #aije7;jj7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7jj77 is amended-- 7#a7 in the subsection heading1 by inserting 2 certified community behavioral health clinic after ,certified community behavioral health clinic services2 and 7#b7 in paragraph 7#a7-- 7,a7 in the paragraph heading1 by striking ,in general and inserting ,certified community behavioral health clinic services2 7,b7 by redesignating subparagraphs 7,a7 through 7,i7 as clauses 7i7 through 7ix71 respectively1 and adjusting the margins accordingly2 7,c7 by striking ,the term and all that follows through relationships with other providers3 and inserting3 7,a7 ,in general ,the term certified community behavioral health clinic services means-- 7i7 the required ,,ccbhc services 7as defined in subparagraph 7,b772 and 7ii7 the additional ,,ccbhc services 7as defined in subparagraph 7,c774 7,b7 ,required ,,ccbhc services ,for purposes of subparagraph 7,a71 the term required ,,ccbhc services means any of the following services when furnished to an individual as a patient of a certified community behavioral health clinic 7as defined in paragraph 7#b771 in a manner reflecting person-centered care and which1 if not available directly through a certified community behavioral health clinic1 may be provided or referred through formal relationships with other providers3 2 and 7,d7 by adding at the end the following new subparagraph3 7,c7 ,additional ,,ccbhc services ,for purposes of subparagraph 7,a71 the term additional ,,ccbhc services means services furnished to an individual as a patient of a certified community behavioral health clinic 7as defined in paragraph 7#b771 in a manner reflecting person-centered care-- 7i7 that are not required ,,ccbhc services under subparagraph 7,b72 7ii7 that are appropriate to meet the health needs of the population served2 and 7iii7 which may include any of the primary health services defined in section #ccj7;b77#a7 of the ,public ,health ,service ,act4 4 7b7 ,effective date ,the amendments made by this section shall apply with respect to services furnished on or after ,october #a1 #bjbf4 ,,ii ,coverage of certified community behavioral health clinic services under the ,medicare program #bja4 ,coverage of certified community behavioral health clinic services under the medicare program 7a7 ,coverage ,section #ahfa7s77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7s77#b77 is amended-- 7#a7 in subparagraph 7,,jj71 by adding and at the end2 and 7#b7 by adding at the end the following new subparagraph3 7,,kk7 certified community behavioral health clinic services 7as defined in subsection 7aa77#h77 furnished on or after ,january #a1 #bjbg4 4 7b7 ,definitions ,section #ahfa7;aa7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7 is amended-- 7#a7 in the heading1 by striking and ,federally ,qualified ,health ,center ,services and inserting 1 ,federally qualified health center services1 and certified community behavioral health clinic services2 and 7#b7 by adding at the end the following new paragraph3 7#h7 ,the terms certified community behavioral health clinic services and certified community behavioral health clinic have the meaning given each such term in section #aije7;jj74 4 #bjb4 ,payment for certified community behavioral health clinic services under the medicare program 7a7 ,in general ,section #ahcc7;a77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciel7a77#a77 is amended-- 7#a7 by striking and 7,,hh7 and inserting 7,,hh72 and 7#b7 by inserting before the semicolon at the end the following3 1 and 7,,ii7 with respect to certified community behavioral health clinic services 7as defined in section #ahfa7;aa77#h771 the amounts paid shall be equal to #hj percent of the lesser of the actual charge or the amount determined under section #ahcd7;aa74 7b7 ,development and implementation of prospective payment system ,section #ahcd of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7 is amended by adding at the end the following new subsection3 7aa7 ,development and implementation of prospective payment system for certified community behavioral health clinics 7#a7 ,in general ,the ,secretary shall develop a prospective payment system for payment to certified community behavioral health clinic services 7as defined in section #ahfa7;aa77#h77 furnished by certified community behavioral health clinics 7as defined in such section7 under this title4 ,in establishing such system1 the ,secretary-- 7,a7 shall take into account the type1 intensity1 and duration of services furnished by certified community behavioral health clinics2 and 7,b7 may incorporate such adjustments1 including geographic adjustments1 as the ,secretary determines appropriate4 7#b7 ,unit of payment ,in establishing a prospective payment amount under the system under this subsection1 the ,secretary shall consider an appropriate unit of service and a general system design that provides for continued access to quality services4 7#c7 ,payment basis ,under the system under this subsection1 the ,secretary shall provide for computation of a prospective payment amount for services furnished during a year as follows3 7,a7 ,for #bjbg1 such amount shall be based on the average costs of such clinics which are reasonable 7as determined without the application of a per visit payment limit or productivity screen and prior to the application of section #ahff7;a77#b77;,a77ii77 and related to the furnishing of the services described in section #aije7;jj77#a77;,b71 as determined on the basis of the most current audited cost report data for #b consecutive fiscal years available to the ,secretary4 ,in the absence of complete actual cost data representing the provision of such services during the relevant fiscal years1 certified community behavioral health clinics may1 at the ,secretary's discretion1 submit estimated or projected data relating to specific services4 7,b7 ,for #bjbh1 such amount shall be equal to the amount determined under subparagraph 7,a71 increased by the percentage increase in the ,,mei 7as defined in section #ahdb7;i77#c77 for the year involved4 7,c7 ,for #bjbi and each subsequent year1 such amount shall be equal to the amount determined under this paragraph for the preceding year1 increased by the percentage increase in a market basket of certified community behavioral health clinic services designed by the ,secretary 7or1 if such an index is not available1 by the percentage increase in the federally-qualified health center market basket 7as described in section #ahcd7o77#b77;,b77ii77,,ii777 for the year involved4 7#d7 ,periodic reevaluation of rates ,the ,secretary may1 from time to time1 adjust the amounts that would otherwise be applicable under paragraph 7#c7 for a year by a percentage determined appropriate by the ,secretary to reflect such factors as changes in the intensity of services furnished within a unit of service1 the average cost of providing care per unit of service1 and other factors that the ,secretary considers to be relevant4 ,such adjustment shall be made before the update under paragraph 7#b77;,c7 has been applied for the year4 4 #bjc4 ,non-application of ,medicare part ,b deductible for ,,ccbhc services ,section #ahcc7;b77#d7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciel7b77#d77 is amended by inserting or certified community behavioral health clinic services after such deductible shall not apply to ,federally qualified health center services4 #bjd4 ,right to seek review of cost reports from ,provider ,reimbursement ,review ,board ,section #ahgh7;j7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acieoo7j77 is amended by striking and a ,federally qualified health center and inserting 1 a ,federally qualified health center1 and a certified community behavioral health clinic4 #bje4 ,extending safe harbor under ,anti-,kickback ,statute to waivers of ,,ccbhc coinsurance ,section #aabh;,b7b77#c77;,d7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;a-#g;b7b77#c77;,d77 is amended by inserting or a certified community behavioral health clinic after ,federally qualified health care center4 #bjf4 ,effective date ,the amendments made by this title shall apply with respect to services furnished on or after ,january #a1 #bjbf4 ,,iii ,community behavioral health clinic grants #cja4 ,operating grants1 technical assistance1 data infrastructure1 and accreditation for community behavioral health clinics ,part ,d of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;b et seq47 is amended by adding at the end the following new subpart3 ,,xiii ,community behavioral health clinics #cdj;,j4 ,definitions ,in this subpart3 7#a7 ,certified community behavioral health clinic ,the term certified community behavioral health clinic has the meaning given such term in section #aije7;jj77#b7 of the ,social ,security ,act4 7#b7 ,certified community behavioral health clinic services ,the term certified community behavioral health clinic services has the meaning given such term in section #aije7;jj77#a7 of the ,social ,security ,act4 #cdj;,j-#a4 ,operating grants for community behavioral health clinics 7a7 ,in general ,the ,secretary shall establish a grant program under which the ,secretary shall award grants to eligible community behavioral health clinics to provide 7in a manner reflecting person-centered care7 certified community behavioral health clinic services that are required ,,ccbhc services 7as defined in section #aije7;jj77#a77;,b7 of the ,social ,security ,act74 7b7 ,eligibility2 selection 7#a7 ,eligibility ,an entity is eligible to receive a grant under subsection 7a7 if such entity is-- 7,a7 a certified community behavioral health clinic2 or 7,b7 a community behavioral health clinic that indicates in the grant application that the clinic will use the grant funds to meet the criteria established by the ,secretary under section #bbc7;a7 of the ,protecting ,access to ,medicare ,act of #bjad as of ,march #bjbc1 and any subsequent updates to such criteria4 7#b7 ,selection ,in selecting eligible entities to receive a grant under subsection 7a71 the ,secretary-- 7,a7 may elect to impose as a condition for the receipt of a grant under this section that the entity be accredited1 per section #cdj;,j-#d7;a72 7,b7 may award a grant to an entity described in paragraph 7#a77;,b7 that specializes in providing services to children1 youth1 or veterans1 if such entity demonstrates to the satisfaction of the ,secretary that the entity can ensure access to care for all individuals in the relevant community served by the entity through referral or other formal arrangements with other providers of services2 and 7,c7 may establish additional conditions for the receipt of a grant under this section to-- 7i7 ensure improved geographic distribution of community behavioral health clinics2 7ii7 prioritize the awarding of grants to eligible entities that serve communities with elevated behavioral health needs2 7iii7 prioritize eligible entities that are prepared to offer all required ,,ccbhc services 7as defined in section #aije7;jj77#a77;,b7 of the ,social ,security ,act72 and 7iv7 ensure consistency in planning with ,state ,,ccbhc programs4 7c7 ,use of funds ,an eligible entity that receives a grant under subsection 7a7-- 7#a7 shall use the grant funds-- 7,a7 to provide certified community behavioral health clinic services2 and 7,b7 in the case of an entity described in subparagraph 7,b7 of subsection 7b77#a71 to meet the criteria described in such subparagraph2 and 7#b7 may use the grant funds-- 7,a7 to carry out other activities that-- 7i7 reduce costs associated with the provision of certified community behavioral health clinic services2 7ii7 improve access to1 and availability of1 certified community behavioral health clinic services provided to individuals in the relevant community served by the community behavioral health clinic2 7iii7 enhance the quality and coordination of certified community behavioral health clinic services2 or 7iv7 otherwise improve the health status of communities2 and 7,b7 to pay for-- 7i7 the costs of acquiring and leasing buildings and equipment 7including the costs of amortizing the principal of1 and paying interest on1 loans72 7ii7 costs relating to the purchase or lease of equipment1 including data and information systems and behavioral health information technology to facilitate data reporting and other purposes2 7iii7 the costs of in-service staff training and other operational or infrastructure costs as the ,secretary determines appropriate2 or 7iv7 costs associated with expanding and modernizing existing buildings or constructing new buildings 7including the costs of amortizing the principal of1 and paying the interest on1 loans71 if such costs are specifically allowed for in the grant opportunity published by the ,secretary4 7d7 ,use of nongrant funds ,amounts described in subsection 7g77#a77;,b71 including any such funds in excess of those estimated under such subsection1 shall be used as permitted under this section1 and may be used for such other purposes as are not specifically prohibited under this section if such use furthers the objectives of the grant4 7e7 ,term ,grants awarded under subsection 7a7 shall be for a period of not more than #e years4 7f7 ,condition on receipt of funds ,the ,secretary may not award a grant to an eligible entity under subsection 7a7 unless the entity provides assurances to the ,secretary that1 not later than #abj days after receiving notice that the entity has been selected under subsection 7b77#b7 to receive a grant1 the entity will submit to the ,secretary for approval an implementation plan that describes how the entity will-- 7#a7 provide certified community behavioral health clinic services2 and 7#b7 in the case of an entity described in subparagraph 7,b7 of subsection 7b77#a71 to meet the criteria described in such subparagraph4 7g7 ,amount of grant 7#a7 ,in general ,subject to paragraph 7#b71 in determining the amount of a grant made in any fiscal year to an eligible entity under subsection 7a71 the ,secretary shall take into account information provided by the entity with respect to the following3 7,a7 ,the total ,state1 local1 and other operational funding provided to the entity for such fiscal year4 7,b7 ,the fees1 premiums1 and third-party reimbursements that the entity reasonably expects to receive for items and services furnished during such fiscal year4 7,c7 ,the costs to the entity of meeting the purposes and requirements of the grant program under this section during such fiscal year1 as estimated by the ,secretary based upon the anticipated costs to the entity of-- 7i7 providing certified community behavioral health clinic services1 including the anticipated costs of providing any individual certified community behavioral health service that the entity does not have experience providing at the time of submitting an application for such grant2 and 7ii7 in the case of an entity described in subparagraph 7,b7 of subsection 7b77#a71 meeting the criteria described in such subparagraph4 7#b7 ,payments ,the ,secretary may award grants under subsection 7a7 in such form and manner as the ,secretary determines appropriate 7including by making grant amounts available in advance or through reimbursement1 and including by making such amounts available in installments71 and may adjust grant amounts to account for overpayments or underpayments4 7h7 ,use of accreditation in monitoring grant progress ,regardless of whether the ,secretary elects under subsection 7b7 to use accreditation under section #cdj;,j-#d7;a7 as a condition for the award of a grant under subsection 7a71 the ,secretary may take such accreditation into account in determining whether an entity receiving such a grant is providing the services described in subsection 7a7 and1 if applicable1 meeting such criteria as are described in subsection 7b77#b74 7i7 ,authorization of appropriations 7#a7 ,in general ,there is authorized to be appropriated to carry out this section #eeb1ejj1jjj for each of fiscal years #bjbf through #bjcj4 7#b7 ,maintenance of funding ,the amount made available under paragraph 7#a7 shall supplement 7and not supplant7 any other ,federal funding made available for certified community behavioral health clinics4 7j7 ,guidance for clinics serving specialized populations ,not later than #a year after the date of enactment of this section1 the ,secretary shall publish guidance clarifying how certified community behavioral health clinics that focus on distinct populations1 such as children1 youth1 or veterans1 may meet any relevant requirement to furnish appropriate treatment to all individuals4 ,such guidance shall not affect such clinics' qualification to participate in the demonstration program under section #bbc7;d7 of the ,protecting ,access to ,medicare ,act of #bjad or to furnish the services described under section #aije7;a77#ca7 of the ,social ,security ,act4 #cdj;,j-#b4 ,technical assistance 7a7 ,in general ,not later than #ahj days after the date of enactment of the ,ensuring ,excellence in ,mental ,health ,act1 the ,secretary shall establish a program or programs through which the ,secretary shall provide 7either through the ,department of ,health and ,human ,services or by grant or contract7 technical assistance1 and such other assistance as the ,secretary determines appropriate1 to any of the following3 7#a7 ,entities receiving a grant under section #cdj;,j-#a4 7#b7 ,entities participating in a demonstration program under section #bbc7;d7 of the ,protecting ,access to ,medicare ,act of #bjad4 7#c7 ,certified community behavioral health clinics 7as defined in sections #ahfa7;aa77#h7 and #aije7;jj77#b7 of the ,social ,security ,act7 furnishing services under title ,,xviii or title ,,xix of such ,act4 7#d7 ,health or social service provider organizations pursuing or considering certified community behavioral health clinic status or partnering with certified community behavioral health clinics4 7#e7 ,states and territories1 for the purpose of assisting in the consideration of demonstration programs carried out under section #bbc7;d7 of the ,protecting ,access to ,medicare ,act of #bjad1 the planning and development of new ,state certified community behavioral health clinic programs1 or the ongoing implementation and improvement of established ,state certified community behavioral health clinic programs4 7#f7 ,other stakeholders1 for the purpose of facilitating the successful implementation of the certified community behavioral health clinic model4 7b7 ,inclusions ,assistance provided by the ,secretary under subsection 7a7 may include technical and nonfinancial assistance1 including1 but not limited to-- 7#a7 fiscal and program management assistance2 7#b7 operational and administrative support2 and 7#c7 the provision of information to the entities about the variety of resources available under this part and how those resources can be best used to meet the health and behavioral health needs of the communities served by the entities4 7c7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #h1jjj1jjj for each of fiscal years #bjbf through #bjcj4 #cdj;,j-#c4 ,data infrastructure for community behavioral health clinic reporting 7a7 ,in general ,not later than #ahj days after the date of enactment of the ,ensuring ,excellence in ,mental ,health ,act1 the ,secretary shall establish a system under which the ,secretary shall collect and analyze data on community behavioral health clinics4 7b7 ,scope of data collection ,the system established under subsection 7a7 shall be used by the ,secretary to collect and analyze data from-- 7#a7 entities that receive a grant under section #cdj;,j-#a2 and 7#b7 certified community behavioral health clinics 7as defined in sections #ahfa7;aa77#h7 and #aije7;jj77#b7 of the ,social ,security ,act7 furnishing services under title ,,xviii or title ,,xix of such ,act4 7c7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #ea1jjj1jjj for each of fiscal years #bjbf through #bjcj4 #cdj;,j-#d4 ,certified community behavioral health clinic accreditation 7a7 ,accreditation standards ,a clinic is accredited as a certified community behavioral health clinic under this section if the clinic-- 7#a7 is accredited by an accreditation body approved by the ,secretary under subsection 7b72 and 7#b7 authorizes the accreditation body to submit to the ,secretary 7or such agency as the ,secretary may designate7 such records or other information as the ,secretary may require4 7b7 ,approval of accreditation bodies ,the ,secretary may approve a private nonprofit organization to be an accreditation body for the accreditation of certified community behavioral health clinics under subsection 7a7 if-- 7#a7 the accreditation body agrees to inspect the clinic1 using inspectors qualified to evaluate quality of care in a behavioral health service setting1 with such frequency the ,secretary determines appropriate2 7#b7 the ,secretary determines that the standards applied by the accreditation body in determining whether or not to accredit a clinic correspond to 7and are not less restrictive than7 the criteria described in section #cdj;,j-#a7;b77#a77;,b72 7#c7 the accreditation body has made adequate assurances that the standards of the accreditation body continue to be met by each clinic that it accredited2 7#d7 the accreditation body agrees that1 for the #c-year period following accreditation of a clinic1 in the case that the accreditation body suspends1 withdraws1 or revokes such accreditation1 denies an application to renew such accreditation1 or takes any other disciplinary action with respect to such clinic1 the accreditation body shall submit to the ,secretary the name of such clinic not later than #cj days after such action is taken2 7#e7 the accreditation body agrees that1 in the case that its approval is withdrawn by the ,secretary1 the body will notify each clinic accredited by the body of the withdrawal within #aj days of the withdrawal2 and 7#f7 the accreditation body complies with such other requirements as the ,secretary determines appropriate4 7c7 ,oversight of accreditation bodies ,the ,secretary may provide ongoing oversight of accrediting bodies approved under subsection 7b74 ,such ongoing oversight may include the following actions3 7#a7 ,providing continual oversight and review of approved accreditation processes through regular communication with such bodies4 7#b7 ,providing additional review of individual certified community behavioral health clinic accreditations to assure alignment with the criteria established by the ,secretary under section #bbc7;a7 of the ,protecting ,access to ,medicare ,act of #bjad and1 in cases where potential issues are identified with individual certified community behavioral health clinic accreditations1 to provide review of such issues4 7#c7 ,mediating disputes between providers seeking certified community behavioral health clinic accreditation and approved accreditation bodies4 7#d7 ,providing ongoing support and coordination across approved accreditation bodies4 7#e7 ,in cases where an approved accreditation body is found to not provide accreditation in alignment with the criteria established by the ,secretary under section #bbc7;a7 of the ,protecting ,access to ,medicare ,act of #bjad1 developing a process to terminate the approval provided under subsection 7b7 with respect to such body4 7#f7 ,periodically reviewing accreditation body processes and renewing the approval provided under subsection 7b7 with respect to such bodies4 7#g7 ,such other activities as the ,secretary determines necessary for the oversight of accreditation bodies approved under subsection 7b74 4 ,,iv ,liability protection for certified community behavioral health clinic clinicians #dja4 ,conferring protection under the ,federal ,tort ,claims ,act to clinicians in certified community behavioral health clinics ,section #bbd7;g77#d7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bcc7;g77#d77 is amended by inserting or a certified community behavioral health clinic 7as defined in section #aije7;jj77#b7 of the ,social ,security ,act7 before the period at the end4