S 1188 ISCommentsClose CommentsPermalink

To amend the Public Health Service Act with respect to mental health services.CommentsClose CommentsPermalink

June 4, 2009CommentsClose CommentsPermalink

Mr. REED (for himself, Ms. MURKOWSKI, and Mr. WHITEHOUSE) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and PensionsCommentsClose CommentsPermalink

To amend the Public Health Service Act with respect to mental health services.CommentsClose CommentsPermalink

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,CommentsClose CommentsPermalink

SECTION 1. SHORT TITLE.

This Act may be cited as the ‘Community Mental Health Services Improvement Act’.CommentsClose CommentsPermalink

SEC. 2. FINDINGS.

Congress finds that--CommentsClose CommentsPermalink





(1) almost 60,000,000 Americans, or one in four adults and one in five children, have a mental illness that can be diagnosed and treated in a given year;CommentsClose CommentsPermalink





(2) mental illness costs our economy more than $80,000,000,000 annually, accounting for 15 percent of the total economic burden of disease;CommentsClose CommentsPermalink





(3) alcohol and drug abuse contributes to the death of more than 100,000 people and costs society upwards of half a trillion dollars a year;CommentsClose CommentsPermalink





(4) individuals with serious mental illness die on average 25 years sooner than individuals in the general population; andCommentsClose CommentsPermalink





(5) community mental and behavioral health organizations provide cost-efficient and evidence-based treatment and care for millions of Americans with mental illness and addiction disorders.CommentsClose CommentsPermalink

SEC. 3. CO-LOCATING PRIMARY AND SPECIALTY CARE IN COMMUNITY-BASED MENTAL HEALTH SETTINGS.

Subpart 3 of part B of title V of the Public Health Service Act (42 U.S.C. 290bb-31 et seq.) is amended by adding at the end the following:CommentsClose CommentsPermalink

‘SEC. 520K. GRANTS FOR CO-LOCATING PRIMARY AND SPECIALTY CARE IN COMMUNITY-BASED MENTAL HEALTH SETTINGS.

‘(a) Definitions- In this section:CommentsClose CommentsPermalink





‘(1) ELIGIBLE ENTITY- The term ‘eligible entity’ means a qualified community mental health program defined under section 1913(b)(1).CommentsClose CommentsPermalink





‘(2) SPECIAL POPULATIONS- The term ‘special populations’ refers to the following 3 groups:CommentsClose CommentsPermalink





‘(A) Children and adolescents with mental and emotional disturbances who have co-occurring primary care conditions and chronic diseases.CommentsClose CommentsPermalink





‘(B) Adults with mental illnesses who have co-occurring primary care conditions and chronic diseases.CommentsClose CommentsPermalink





‘(C) Older adults with mental illnesses who have co-occurring primary care conditions and chronic diseases.CommentsClose CommentsPermalink





‘(b) Program Authorized- The Secretary, acting through the Administrator of the Substance Abuse and Mental Health Services Administration and in coordination with the Director of the Health Resources and Services Administration, shall award grants to eligible entities to establish demonstration projects for the provision of coordinated and integrated services to special populations through the co-location of primary and specialty care services in community-based mental and behavioral health settings.CommentsClose CommentsPermalink





‘(c) Application- To be eligible to receive a grant under this section, an eligible entity shall submit an application to the Administrator at such time, in such manner, and accompanied by such information as the Administrator may require. Each such application shall include--CommentsClose CommentsPermalink





‘(1) an assessment of the primary care needs of the patients served by the eligible entity and a description of how the eligible entity will address such needs; andCommentsClose CommentsPermalink





‘(2) a description of partnerships, cooperative agreements, or other arrangements with local primary care providers, including community health centers, to provide services to special populations.CommentsClose CommentsPermalink





‘(d) Use of Funds-CommentsClose CommentsPermalink





‘(1) IN GENERAL- For the benefit of special populations, an eligible entity shall use funds awarded under this section for--CommentsClose CommentsPermalink





‘(A) the provision, by qualified primary care professionals on a reasonable cost basis, of--CommentsClose CommentsPermalink





‘(i) primary care services on site at the eligible entity;CommentsClose CommentsPermalink





‘(ii) diagnostic and laboratory services; orCommentsClose CommentsPermalink





‘(iii) adult and pediatric eye, ear, and dental screenings;CommentsClose CommentsPermalink





‘(B) reasonable costs associated with medically necessary referrals to qualified specialty care professionals as well as to other coordinators of care or, if permitted by the terms of the grant, for the provision, by qualified specialty care professionals on a reasonable cost basis on site at the eligible entity;CommentsClose CommentsPermalink





‘(C) information technology required to accommodate the clinical needs of primary and specialty care professionals; orCommentsClose CommentsPermalink





‘(D) facility improvements or modifications needed to bring primary and specialty care professionals on site at the eligible entity.CommentsClose CommentsPermalink





‘(2) LIMITATION- Not to exceed 15 percent of grant funds may be used for activities described in subparagraphs (C) and (D) of paragraph (1).CommentsClose CommentsPermalink





‘(e) Geographic Distribution- The Secretary shall ensure that grants awarded under this section are equitably distributed among the geographical regions of the United States and between urban and rural populations.CommentsClose CommentsPermalink





‘(f) Evaluation- Not later than 3 months after a grant or cooperative agreement awarded under this section expires, an eligible entity shall submit to the Secretary the results of an evaluation to be conducted by the entity concerning the effectiveness of the activities carried out under the grant or agreement.CommentsClose CommentsPermalink





‘(g) Report- Not later than 5 years after the date of enactment of this section, the Secretary shall prepare and submit to the appropriate committees of Congress a report that shall evaluate the activities funded under this section. The report shall include an evaluation of the impact of co-locating primary and specialty care in community mental and behavioral health settings on overall patient health status and recommendations on whether or not the demonstration program under this section should be made permanent.CommentsClose CommentsPermalink





‘(h) Authorization of Appropriations- There are authorized to be appropriated to carry out this section, $50,000,0000 for fiscal year 2010 and such sums as may be necessary for each of fiscal years 2011 through 2014.’.CommentsClose CommentsPermalink

SEC. 4. INTEGRATING TREATMENT FOR MENTAL HEALTH AND SUBSTANCE ABUSE CO-OCCURRING DISORDERS.

Section 520I of the Public Health Service Act (42 U.S.C. 290bb-40) is amended--CommentsClose CommentsPermalink





(1) by striking subsection (i) and inserting the following:CommentsClose CommentsPermalink





‘(j) Funding- The Secretary shall make available to carry out this section, $14,000,000 for fiscal year 2010, $20,000,000 for fiscal year 2011, and such sums as may be necessary for each of fiscal years 2012 through 2014. Such sums shall be made available in equal amount from amounts appropriated under sections 509 and 520A.’; andCommentsClose CommentsPermalink





(2) by inserting before subsection (j), the following:CommentsClose CommentsPermalink





‘(i) Community Mental Health Program- For purposes of eligibility under this section, the term ‘private nonprofit organization’ includes a qualified community mental health program as defined under section 1913(b)(1).’.CommentsClose CommentsPermalink

SEC. 5. IMPROVING THE MENTAL HEALTH WORKFORCE.

(a) National Health Service Corps- Paragraph (1) of section 332(a) of the Public Health Service Act (42 U.S.C. 254e(a)) is amended by inserting ‘and community mental health centers meeting the criteria specified in section 1913(c)’ after ‘Social Security Act (42 U.S.C. 1395x(aa)),’.CommentsClose CommentsPermalink





(b) Recruitment and Retention of Mental Health Professionals- Subpart X of part D of title III of the Public Health Service Act (42 U.S.C. 256f et seq.) is amended by adding at the end the following:CommentsClose CommentsPermalink

‘SEC. 340H. GRANTS FOR RECRUITMENT AND RETENTION OF MENTAL HEALTH PROFESSIONALS.

‘(a) Establishment- The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall award grants to States, territories, and Indian tribes or tribal organizations for innovative programs to address the behavioral and mental health workforce needs of designated mental health professional shortage areas.CommentsClose CommentsPermalink





‘(b) Use of Funds- An eligible entity shall use grant funds awarded under this section for--CommentsClose CommentsPermalink





‘(1) loan forgiveness and repayment programs (to be carried out in a manner similar to the loan repayment programs carried out under subpart III of part D) for behavioral and mental health professionals who--CommentsClose CommentsPermalink





‘(A) agree to practice in designated mental health professional shortage areas;CommentsClose CommentsPermalink





‘(B) are graduates of programs in behavioral or mental health;CommentsClose CommentsPermalink





‘(C) agree to serve in community-based nonprofit entities, or as public mental health professionals for the Federal, State or local government; andCommentsClose CommentsPermalink





‘(D) agree to--CommentsClose CommentsPermalink





‘(i) provide services to patients regardless of such patients’ ability to pay; andCommentsClose CommentsPermalink





‘(ii) use a sliding payment scale for patients who are unable to pay the total cost of services;CommentsClose CommentsPermalink





‘(2) behavioral and mental health professional recruitment and retention efforts, with a particular emphasis on candidates from racial and ethnic minority and medically underserved communities;CommentsClose CommentsPermalink





‘(3) grants or low-interest or no-interest loans for behavioral and mental health professionals who participate in the Medicaid program under title XIX of the Social Security Act to establish or expand practices in designated mental health professional shortage areas, or to serve in qualified community mental health programs as defined in section 1913(b)(1);CommentsClose CommentsPermalink





‘(4) placement and support for behavioral and mental health students, residents, trainees, and fellows or interns; orCommentsClose CommentsPermalink





‘(5) continuing behavioral and mental health education, including distance-based education.CommentsClose CommentsPermalink





‘(c) Application-CommentsClose CommentsPermalink





‘(1) IN GENERAL- Each eligible entity desiring a grant under this section shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may reasonably require.CommentsClose CommentsPermalink





‘(2) ASSURANCES- The application shall include assurances that the applicant will meet the requirements of this subsection and that the applicant possesses sufficient infrastructure to manage the activities to be funded through the grant and to evaluate and report on the outcomes resulting from such activities.CommentsClose CommentsPermalink





‘(d) Matching Requirement- The Secretary may not make a grant to an eligible entity under this section unless that entity agrees that, with respect to the costs to be incurred by the entity in carrying out the activities for which the grant was awarded, the entity will provide non-Federal contributions in an amount equal to not less than 35 percent of Federal funds provided under the grant. The entity may provide the contributions in cash or in kind, fairly evaluated, including plant, equipment, and services, and may provide the contributions from State, local, or private sources.CommentsClose CommentsPermalink





‘(e) Supplement Not Supplant- A grant awarded under this section shall be expended to supplement, and not supplant, the expenditures of the eligible entity and the value of in-kind contributions for carrying out the activities for which the grant was awarded.CommentsClose CommentsPermalink





‘(f) Geographic Distribution- The Secretary shall ensure that grants awarded under this section are equitably distributed among the geographical regions of the United States and between urban and rural populations.CommentsClose CommentsPermalink





‘(g) Evaluation- Not later than 3 months after a grant awarded under this section expires, an eligible entity shall submit to the Secretary the results of an evaluation to be conducted by the entity concerning the effectiveness of the activities carried out under the grant.CommentsClose CommentsPermalink





‘(h) Report- Not later than 5 years after the date of enactment of this section, the Secretary shall prepare and submit to the appropriate committees of Congress a report containing data relating to whether grants provided under this section have increased access to behavioral and mental health services in designated mental health professional shortage areas.CommentsClose CommentsPermalink





‘(i) Authorization of Appropriations- There are authorized to be appropriated to carry out this section, $10,000,000 for fiscal year 2010, and such sums as may be necessary for each of fiscal years 2011 through 2014.’.CommentsClose CommentsPermalink





(c) Behavioral and Mental Health Education and Training Programs- Part A of title V of the Public Health Service Act (42 U.S.C. 290aa et seq.) is amended by adding at the end the following:CommentsClose CommentsPermalink

‘SEC. 506C. GRANTS FOR BEHAVIORAL AND MENTAL HEALTH EDUCATION AND TRAINING PROGRAMS.

‘(a) Definition- For the purposes of this section, the term ‘related mental health personnel’ means an individual who--CommentsClose CommentsPermalink





‘(1) facilitates access to a medical, social, educational, or other service; andCommentsClose CommentsPermalink





‘(2) is not a mental health professional, but who is the first point of contact with persons who are seeking mental health services.CommentsClose CommentsPermalink





‘(b) Establishment- The Secretary, acting through the Administrator of the Substance Abuse and Mental Health Services Administration, shall establish a program to increase the number of trained behavioral and mental health professionals and related mental health personnel by awarding grants on a competitive basis to mental and behavioral health nonprofit organizations or accredited institutions of higher education to enable such entities to establish or expand accredited mental and behavioral health education programs.CommentsClose CommentsPermalink





‘(c) Application-CommentsClose CommentsPermalink





‘(1) IN GENERAL- Each eligible entity desiring a grant under this section shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may reasonably require.CommentsClose CommentsPermalink





‘(2) ASSURANCES- The application shall include assurances that the applicant will meet the requirements of this subsection and that the applicant possesses sufficient infrastructure to manage the activities to be funded through the grant and to evaluate and report on the outcomes resulting from such activities.CommentsClose CommentsPermalink





‘(d) Priority- In awarding grants under this section, the Secretary shall give priority to applicants that--CommentsClose CommentsPermalink





‘(1) demonstrate a familiarity with the use of evidence-based methods in behavioral and mental health services;CommentsClose CommentsPermalink





‘(2) provide interdisciplinary training experiences; andCommentsClose CommentsPermalink





‘(3) demonstrate a commitment to training methods and practices that emphasize the integrated treatment of mental health and substance abuse disorders.CommentsClose CommentsPermalink





‘(e) Use of Funds- Funds awarded under this section shall be used to--CommentsClose CommentsPermalink





‘(1) establish or expand accredited behavioral and mental health education programs, including improving the coursework, related field placements, or faculty of such programs; orCommentsClose CommentsPermalink





‘(2) establish or expand accredited mental and behavioral health training programs for related mental health personnel.CommentsClose CommentsPermalink





‘(f) Requirements- The Secretary may award a grant to an eligible entity only if such entity agrees that--CommentsClose CommentsPermalink





‘(1) any behavioral or mental health program assisted under the grant will prioritize cultural competency and the recruitment of trainees from racial and ethnic minority and medically underserved communities; andCommentsClose CommentsPermalink





‘(2) with respect to any violation of the agreement between the Secretary and the entity, the entity will pay such liquidated damages as prescribed by the Secretary.CommentsClose CommentsPermalink





‘(g) Geographic Distribution- The Secretary shall ensure that grants awarded under this section are equitably distributed among the geographical regions of the United States and between urban and rural populations.CommentsClose CommentsPermalink





‘(h) Evaluation- Not later than 3 months after a grant awarded under this section expires, an eligible entity shall submit to the Secretary the results of an evaluation to be conducted by the entity concerning the effectiveness of the activities carried out under the grant.CommentsClose CommentsPermalink





‘(i) Report- Not later than 5 years after the date of enactment of this section, the Secretary shall prepare and submit to the appropriate committees of Congress a report containing data relating to whether grants provided under this section have increased access to behavioral and mental health services in designated mental health professional shortage areas.CommentsClose CommentsPermalink





‘(j) Authorization of Appropriations- There are authorized to be appropriated to carry out this section $4,000,0000 for fiscal year 2010, and such sums as may be necessary for each of fiscal years 2011 through 2014.’.CommentsClose CommentsPermalink

SEC. 6. IMPROVING ACCESS TO MENTAL HEALTH SERVICES IN MEDICALLY UNDERSERVED AREAS.

Subpart 3 of part B of title V of the Public Health Service Act (42 U.S.C. 290bb-31 et seq.), as amended by section 3, is amended by inserting after section 520A the following:CommentsClose CommentsPermalink

‘SEC. 520B. GRANTS FOR TELE-MENTAL HEALTH IN MEDICALLY UNDERSERVED AREAS.

‘(a) Program Authorized- The Secretary, acting through the Administrator of the Substance Abuse and Mental Health Services Administration, shall award grants to eligible entities to provide tele-mental health in medically underserved areas.CommentsClose CommentsPermalink





‘(b) Eligible Entity- To be eligible for assistance under the program under subsection (a), an entity shall be a qualified community mental health program (as defined in section 1913(b)(1)).CommentsClose CommentsPermalink





‘(c) Application-CommentsClose CommentsPermalink





‘(1) IN GENERAL- Each eligible entity desiring a grant under this section shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may reasonably require.CommentsClose CommentsPermalink





‘(2) ASSURANCES- The application shall include assurances that the applicant will meet the requirements of this subsection and that the applicant possesses sufficient infrastructure to manage the activities to be funded through the grant and to evaluate and report on the outcomes resulting from such activities.CommentsClose CommentsPermalink





‘(d) Use of Funds- An eligible entity shall use funds received under a grant under this section for--CommentsClose CommentsPermalink





‘(1) the provision of tele-mental health services; orCommentsClose CommentsPermalink





‘(2) infrastructure improvements for the provision of tele-mental health services.CommentsClose CommentsPermalink





‘(e) Geographic Distribution- The Secretary shall ensure that grants awarded under this section are equitably distributed among the geographical regions of the United States and between urban and rural populations.CommentsClose CommentsPermalink





‘(f) Evaluation- Not later than 3 months after a grant awarded under this section expires, an eligible entity shall submit to the Secretary the results of an evaluation to be conducted by the entity concerning the effectiveness of the activities carried out under the grant.CommentsClose CommentsPermalink





‘(g) Report- Not later than 5 years after the date of enactment of this section, the Secretary shall prepare and submit to the appropriate committees of Congress a report that shall evaluate the activities funded under this section.CommentsClose CommentsPermalink





‘(h) Authorization of Appropriations- There are authorized to be appropriated to carry out this section $20,000,000 for fiscal year 2010, and such sums as may be necessary for each of fiscal years 2011 through 2014.’.CommentsClose CommentsPermalink

SEC. 7. IMPROVING HEALTH INFORMATION TECHNOLOGY FOR MENTAL HEALTH PROVIDERS.

Part A of title V of the Public Health Service Act (42 U.S.C. 290aa et seq.), as amended by section 5(c), is further amended by adding at the end the following:CommentsClose CommentsPermalink

‘SEC. 506D. IMPROVING HEALTH INFORMATION TECHNOLOGY FOR MENTAL HEALTH PROVIDERS.

‘(a) In General- The Secretary, in consultation with the Secretary of Veterans Affairs, shall collaborate with the Administrator of the Substance Abuse and Mental Health Services Administration and the National Coordinator for Health Information Technology to--CommentsClose CommentsPermalink





‘(1) develop and implement a plan for ensuring that various components of the National Health Information Infrastructure, including data and privacy standards, electronic health records, and community and regional health networks, address the needs of mental health and substance abuse treatment providers; andCommentsClose CommentsPermalink





‘(2) finance related infrastructure improvements, technical support, personnel training, and ongoing quality improvements.CommentsClose CommentsPermalink





‘(b) Authorization of Appropriations- There are authorized to be appropriated to carry out this section $10,000,000 for fiscal year 2010, and such sums as may be necessary for each of fiscal years 2011 through 2014.’.CommentsClose CommentsPermalink