Obama Signs 21st Century Cure Bill: Here's what's in it for mentally ill - Mental Illness Policy Org

Obama Signs 21st Century Cure Bill: Here’s what’s in it for mentally ill

The CURE bill was signed by President Obama on Dec. 13.  Following are Mental Illness provisions

SUBTITLE A— Leadership

Sec. 6001. Assistant Secretary for Mental Health and Substance Use

Establishes an Assistant Secretary for Mental Health andSubstance Use (Assistant Secretary) to head theSubstance Abuse and Mental Health ServicesAdministration (SAMHSA). The authorities of the existingSAMHSA Administrator are transferred to the AssistantSecretary.

Sec. 6002. Strengthening the Leadership of the Substance Abuse and Mental Health Services Administration

  • Requires the Assistant Secretary to:

o   Maintain a system to disseminate research findings andevidence-based practices to service providers to improve treatment and prevention services and incorporate thesefindings into SAMHSA programs;

o   Ensure that grants are subject to performance and outcome evaluations and that center directorsconsistently document the grant process and conductongoing oversight of grantees;

o   Consult with stakeholders to improve community-basedand other mental health services, including adults with a serious mental illness (SMI), and children with a seriousemotional disturbance (SED);

o   Collaborate with other federal departments, including theDepartments of Defense (DOD), Veterans Affairs (VA),Housing and Urban Development (HUD), and Labor (DOL) to improve care for veterans and servicemembers, and support programs to address chronic homelessness; and

o   Work with stakeholders to improve the recruitment andretention of mental health and substance use disorder professionals.

Sec. 6003. Chief Medical Officer

  • Establishes a Chief Medical Officer (CMO) within SAMHSA toassist the Assistant Secretary in evaluating and organizingprograms within the agency and to promote evidence-basedand promising best practices emphasizing clinical focus.
  • Requires the CMO to have real-world experience providing mental health care or substance use disorder treatmentservices.
  • Requires the CMO to coordinate with the Assistant Secretary for Planning and Evaluation (ASPE) to assess the use ofperformance metrics to evaluate SAMHSA programs, and tocoordinate with the Assistant Secretary to ensure consistentutilization of appropriate performance metrics and evaluationdesigns.

Sec. 6004. Improving the Quality of Behavioral Health Programs

  • Codifies the existing Center for Behavioral Health Statistics andQuality (CBHSQ) at SAMHSA.
  • CBHSQ is required to coordinate with the AssistantSecretary, the ASPE, and the CMO to improve the qualityof services provided by SAMHSA.

Sec. 6005. Strategic Plan

  • Requires SAMHSA to develop a strategic plan every four yearsthat identifies priorities, including a strategy for improving therecruitment, training, and retention of the mental healthworkforce.
  • The plan must take into consideration recommendations ofthe ASPE and the Interdepartmental Serious Mental IllnessCoordinating Committee established in Sec. 121.
  • The plan will:

o   Identify strategic priorities, goals, and measurable objectives for mental and substance use disorderactivities and programs;

o   Identify ways to improve program quality;
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o   Ensure programs are providing access to effective and evidence-based prevention, diagnosis,intervention, treatment, and recovery services;

o   Identify ways to address workforce issues; and,

o   Include a strategy to disseminate evidence-based bestpractices for prevention, diagnosis, early intervention,treatment, and recovery focusing on those with SMI, SED, and Substance Use Disorder (SUD).

Sec. 6006. Biennial Report Concerning Activities and Progress

  • Requires SAMHSA to submit a biennial report to Congresscontaining a review of progress toward strategic priorities,goals, and objectives identified in the strategic plan as well as anassessment of programs, and a description of coordinationactivities.
  • This report will also include program improvementrecommendations made by the ASPE.
  • The Assistant Secretary may also consolidate existing reportingrequirements into the biennial report to ease the agency’sadministrative burden.

Sec. 6007. Authorities of the Centers for Mental Health Services(CMHS), Substance Abuse Prevention (CSAP), and SubstanceAbuse Treatment (CSAT)

  • Updates statute to reflect changes in terminology as well as increases coordination and cooperation with other relevantfederal agencies.
  • Requires the Director of CMHS to collaborate with theNational Institute of Mental Health (NIMH) to ensure mentalhealth programs reflect the best available science and areevidence-based and to improve grants management.

Sec. 6008. Advisory Councils

  • Amends current law regarding the advisory councils for SAMHSA, CSAT, CSAP, and CMHS to:

o   Add the Directors of the NIMH, the National Institute onAlcohol Abuse and Alcoholism, and the NationalInstitute on Drug Abuse as ex officio members of theapplicable advisory councils;

o   Ensure that at least half of the appointed advisory councilmembers for CMHS have a medical degree, doctoraldegree in psychology, or an advanced degree in nursing orsocial work, and specialize in mental health; and

o   Ensure that at least half of the appointment advisory council members for CSAP and CSAT have a medicaldegree, doctoral degree, an advanced degree innursing, public health, behavioral or social sciences,social work, or are a certified physician assistant, and have relevant experience.

Sec. 6009. Peer Review

  • Ensures that at least half of the members of a peer reviewgroup that is reviewing a grant, cooperative agreement, orcontract related to mental illness have a medical degree, adoctoral degree in psychology, or an advanced degree innursing or social work. The Secretary shall also ensure to the extent possible that peer review groups include broadgeographic representation.

SUBTITLE B—Oversight and Accountability

Sec. 6021. Improving Oversight of Mental and Substance Use Disorders Programs Through the Assistant Secretary forPlanning and Evaluation

  • Outlines the role and responsibilities of the ASPE at theDepartment of Health and Human Services (HHS) in planningand evaluating activities related to mental health and substance use disorder programs.
  • Requires the ASPE to provide recommendations to Secretary ofHHS, the Assistant Secretary for Mental Health and SubstanceUse, and Congress on improving related mental and substanceuse disorder prevention and treatment programs.

 

  • Requires the ASPE, within 180 days of enactment of theHelping Families in Mental Health Crisis Reform Act of 2016, to develop a strategy for conducting ongoing evaluations onkey programs across the agency. The evaluation shall focus on:

o   Prevention, intervention, treatment, and recovery supportservices;

o   The reduction of homelessness and incarceration amongthose with mental illness or SUD; and

o   A plan for assessing the use of performance metrics to evaluate related activities by those receiving relevantgrants, contracts, or cooperative agreements. Therecommendations of the ASPE must be included in thebiennial report required in Section 106.

Sec. 6022. Reporting for Protection and Advocacy Organizations

  • Requires Protection and Advocacy Organizations to provide adetailed, disaggregated accounting of from where their fundswere received. This does not represent a new reportingrequirement.

Sec. 6023. GAO Study

  • Requires the Government Accountability Office (GAO) to conducta study on programs funded under Title I of the Protection andAdvocacy for Individuals with Mental Illness Act.
  • The report will review programs carried out by states and private,non-profit organizations, compliance with statutory andregulatory responsibilities including relating to the grievance procedure for clients, prospective clients or their familymembers, availability of adequate medical and behavioral healthtreatment, and denial of rights for individuals with mental illness.

SUBTITLE C—Interdepartmental SeriousMental Illness Coordinating Committee Sec. 6031. Inter-Departmental Serious Mental Illness CoordinatingCommittee

  • Creates a coordinating committee to evaluatefederal programs related to SMI and providerecommendations to better coordinate mentalhealth services for people with SMI.
  • The committee is made up of HHS, the Centers for Medicare andMedicaid Services (CMS), the Department of Justice (DOJ), VA,DOD, HUD, the Department of Education, DOL, and the SocialSecurity Administration (SSA), as well as patients, health careproviders, researchers, a judge, and a law enforcement officer.
  • The committee will make recommendations to Congress for better coordination of mental health services for people withSMI or SED and will convene working groups on relevant issues.
  • The committee will sunset after six years.

Title VII—Ensuring Mental and Substance Use Disorder Prevention, Treatment, and RecoveryPrograms Keep Pace with Science and Technology

Sec. 7001. Encouraging Innovation and Evidence-BasedPrograms

  • Establishes the National Mental Health and SubstanceUse Policy Laboratory (NMHSUPL) within SAMHSA andmoves the existing functions of the Office of Policy,Planning, and Innovation (OPPI) underneath.
  • The NMHSUPL will promote evidence-based practices andservice delivery models through evaluating models thatwould benefit from further development and throughexpanding, replicating, or scaling evidence-based programsacross a wider area.
  • Authorizes the appropriation of $14 million for the period of fiscalyears 2018-2020 for such grants.

Sec. 7002. Promoting Access to Information on Evidence-BasedPrograms and Practices

  • Allows the Assistant Secretary to improve access to informationon evidence-based programs and practices for states, localcommunities, nonprofit entities, and other stakeholders.

 

Sec. 7003. Priority Mental Health Needs of Regional and NationalSignificance

  • Updates and reauthorizes the Priority Mental Health Needs ofRegional and National Significance Program to supportprevention, treatment, and rehabilitation of mental healthservices and other programs to target responses based onmental health needs.
  • Reauthorizes the appropriation at the last appropriated level of$394,550,000 for fiscal years 2018-2022.

Sec. 7004. Substance Use Disorder Treatment Needs ofRegional and National Significance

  • Updates and reauthorizes the Priority Substance Use Disorder Treatment Needs of Regional and National SignificanceProgram to improve the quality and availability of treatmentand rehabilitation services for substance use disorderservices in targeted areas.
  • Reauthorizes the appropriation at the last appropriated level of$333,806,000 for fiscal years 2018-2022.

Sec. 7005. Priority Substance Use Disorder PreventionNeeds of Regional and National Significance

  • Updates and reauthorizes the Priority Mental Health Needs ofRegional and National Significance Program to supportprojects and programs for prevention of substance use andother programs to target responses based on health needs.
  • Reauthorizes the appropriation at the last appropriated level of$211,148,000 for fiscal years 2018-2022.

Title VIII—Supporting State Prevention Activitiesand Reponses to MentalHealth and Substance Use Disorder Needs

Sec. 8001. Community Mental Health Services Block Grant

  • Gives states additional flexibility to use Community Mental HealthServices (CMHS) block grant funding to provide communitymental health services for adults with SMI and children with SED.
  • Updates state plan requirements to:

o   Identify a single state agency to administer the grant and establish goals and objectives. oDescribe how the state promotes evidence-basedpractices, including programs for SMI. o Ensurestates will:

  • Coordinate services to maximize efficiency,effectiveness, quality, and cost-effectiveness toimprove outcomes.
  • Provide for an organized community-based systemof care for individuals with mental illness and co-occurring disorders.
  • Reauthorizes the CMHS Block Grant at the last appropriatedlevel of $532,571,000 for fiscal years 2018- 2022.

Sec. 8002. Substance Abuse Prevention and Treatment BlockGrant

  • Clarifies the state will ensure ongoing training for substance usedisorder prevention and treatment professionals on recenttrends in drug abuse in the state, evidence-based practices forsubstance use disorder services, performance-basedaccountability, and data collection and reporting requirements.
  • Modifies the state plan requirements to:

o   Include a description of the state’s system of care;

o   Identify a single state agency to administer the grant andestablish goals and objectives;

o   Provide information on the need for substance usedisorder prevention and treatment services; oDescribe state and local coordination of prevention andtreatment services with other agencies; o Describehow the state promotes evidence-based practices;

o   Describe how the state integrates substance use disorderservices with primary health care and mental health care;

  • Reauthorizes the block grant at the last appropriated level of $1,858,079,000 billion for fiscal years 2018- 2022.

 

Sec. 8003. Additional Provisions Related to the Block Grants

  • Allows states to submit a joint application for the mental healthand substance abuse block grants. This is a codification ofexisting practice.
  • Allows the Assistant Secretary to waive application deadlines and compliance requirements for states in the case of a public health emergency declared by the HHS Secretary.

Sec. 8004. Study of Distribution of Funds under the Substance Abuse Prevention and Treatment Block Grant and the Community Mental Health Services Block Grant

  • Requires the Secretary of HHS to study whether funding for the mental health and substance abuse block grants are beingdistributed to states and territories according to need, and recommend changes if necessary.
  • Requires the report to be submitted to Congress within two yearsof enactment of the bill.

Title IX—Promoting Access to Mental Health and Substance Use Disorder Care

SUBTITLE A—Helping Individualsand Families

Sec. 9001. Grants for Treatment and Recovery for HomelessIndividuals

  • Reauthorizes and makes technical updates to grants fortreatment and recovery for homeless individuals to supportmental health and substance use disorder services.
  • Reauthorizes appropriations at the last appropriated level of$41,304,000 for each of fiscal years 2018-2022.

Sec. 9002. Grants for Jail Diversion Programs

  • Reauthorizes and makes technical updates to develop andimplement programs to divert individuals with a mental illnessfrom the criminal justice system to community-based services.
  • Reauthorizes appropriations at the last appropriated level of$4,269,000 for each of fiscal years 2018-2022.

Sec. 9003. Promoting Integration of Primary and BehavioralHealth Care

  • Reauthorizes grants to support integrated care models for primary care and behavioral health care services.
  • Requires grant applicants to submit a plan to provide integratedservices to special populations.
  • Reauthorizes appropriations at the last appropriated level of$51,878,000 for each of fiscal years 2018-2022.

Sec. 9004. Projects for Assistance in Transition fromHomelessness

  • Reauthorizes and makes updates to grants for states toprovide services to homeless individuals who are sufferingfrom serious mental illness, or co-occurring serious mentalillness and substance use disorders.
  • Directs the Administrator to evaluate the formula used todetermine funding allotments and report to Congresswithin two years.
  • Reauthorizes appropriations at the last appropriated level of$64,635,000 for each of fiscal years 2018-2022.

Sec. 9005. National Suicide Prevention Lifeline Program

  • Requires the Secretary to continue the National SuicidePrevention Lifeline program, including:

o   Coordinating a network of crisis centers to provide suicideprevention and crisis intervention services;

o   Maintaining a suicide prevention hotline to link callers to local emergency, mental health, and social servicesresources;

o   Consulting with the Secretary of Veterans Affairs to ensure veterans calling the suicide prevention hotlinehave access to a specialized veterans’ suicideprevention hotline.

  • Authorizes appropriations at the last appropriated level of$7,198,000 for each of fiscal years 2018-2022.

Sec. 9006. Connecting Individuals and Families with Care

 

  • Requires the Secretary to maintain the National TreatmentReferral Routing Service to help individuals and families locatemental health and substance use disorder treatment providersthrough a nationwide phone system and internet website.

Sec. 9007. Strengthening Community Crisis Response Systems

  • Authorizes the Secretary to award grants to state and localgovernments, Indian tribes, and tribal organizations to strengthen community-based crisis response systems or to develop, maintain, or enhance a database of beds at inpatientpsychiatric facilities, crisis stabilization units, and residentialcommunity mental health and residential substance usedisorder treatment facilities.
  • An entity receiving a grant must submit a report at theSecretary’s request, including an evaluation of the effect of suchgrants on local crisis response activities for individuals receivingcrisis planning and early intervention support, individualsreporting improved outcomes, and individuals receiving regularfollow-up care following a crisis.
  • Authorizes the appropriation of $12.5 million for the period of fiscal years 2018-2022.

Sec. 9008. Garrett Lee Smith Memorial Act Reauthorization

  • Codifies the suicide prevention technical assistance center toprovide information and training for suicide prevention,surveillance, and intervention strategies for all ages, particularlyamong groups at high risk.

o   Reauthorizes the appropriation at the last appropriatedlevel of $5,988,000 for each of fiscal years 2018-2022.

  • Reauthorizes the Youth Suicide Early Intervention andPrevention Strategies grants to states and tribes, and clarifiesthat states may receive continuation grants after the first grant is awarded.

o   Reauthorizes the appropriation of $30 million for each offiscal years 2018-2022.

Sec. 9009. Adult Suicide Prevention

  • Establishes suicide prevention and intervention programs grantsfor individuals aged 25 years or older. The grants are to raiseawareness of suicide, establish referral processes, and improvecare and outcomes for such individuals who are at risk ofsuicide.
  • Authorizes the appropriation of $30 million for the period of fiscalyears 2018-2022.

Sec. 9010. Mental Health Awareness Training Grants

  • Reauthorizes grants to states, political subdivisions of states,Indian tribes, tribal organizations, and nonprofit private entitiesto train teachers, appropriate school personnel, emergencyservices personnel, and others, as appropriate, to recognize thesigns and symptoms of mental illness, to become familiar withresources in the community for individuals with mental illnesses,and for the purpose of the safe de- escalation of crisis situationsinvolving individuals with mental illness.
  • Reauthorizes the appropriation at the last appropriated level of$14,963,000 for each of fiscal years 2018- 2022.

Sec. 9011. Sense of Congress on prioritizing American Indians and Alaska Native youth within suicide prevention program

  • States it is the Sense of Congress that the Secretary of HHSshould prioritize programs and activities for populations withdisproportionately high rates of suicide, such as AmericanIndians and Alaska Natives.

Sec. 9012. Evidence-Based Practices for Older Adults

  • Requires the Secretary to disseminate information andprovide technical assistance on evidence-based practicesfor mental health and substance use disorders in older adults.

Sec. 9013. National Violent Death Reporting System

  • Encourages the Director of the Centers for Disease Control andPrevention (CDC) to improve, particularly through the inclusionof other states, the existing National Violent Death ReportingSystem.

 

  • The reporting system was created in 2002 and currently collectssurveillance data from 32 states.

Sec. 9014. Assisted Outpatient Treatment

  • Increases and extends an existing authorization for a grantprogram for Assisted Outpatient Treatment at SAMHSA.
  • Reauthorizes appropriations of $15 million in fiscal year 2017, $20 million for fiscal year 2018, $19 million for eachof fiscal years 2019 and 2020, and $18 million for each offiscal years 2021 and 2022.

Sec. 9015. Assertive Community Treatment

  • Establishes a grant program establish, maintain, or expandassertive community treatment programs for adults withSMI.
  • The Secretary is required to report no later than 2021 anevaluation of;

o   Any cost savings and public health outcomes;

o   Rate of involvement with the criminal justice system ofpatients; and,

o   Rates of homelessness among patients.

  • Authorizes appropriations of $5 million for the period of fiscalyears 2018-2022.

Sec. 9016 Sober Truth on Preventing Underage DrinkingReauthorization

  • Reauthorizes the Interagency Coordinating Committee for $1million for each of fiscal years 2018-2022, the NationalMedia Campaign to Prevent Underage Drinking for $1 millionfor each of fiscal years

2018-2022, the Community- Based Coalition Enhancementgrants for $5 million for each of fiscal years 2018-2022, andfunding for additional research on underage drinking for $3million for each of fiscal years 2018-2022.

  • The Secretary may also make grants under this section for practices to reduce alcohol use amongindividuals under the age of 21 through screening andbrief intervention.

Sec. 9017. Center and Program Repeals

  • Repeals section 514 of the Public Health Service Act relating tomethamphetamine and amphetamine initiatives, section 506B of the Public Health Service Act relating to ecstasy and other club drugs, and eight other outdated programs.

SUBTITLE B—Strengthening the Health Care WorkforceSec. 9021. Mental and Behavioral HealthEducation Training Grants

  • Reauthorizes grants to institutions of higher education oraccredited professional training programs to support therecruitment and education of mental health care providers.
  • Creates a priority for programs that train psychology,psychiatry, and social work professionals to work in integratedcare settings, and programs for paraprofessionals thatemphasize the role of the family and the lived experience ofthe consumer and family-paraprofessional partnerships.
  • Requires the Administrator to include in the biennial report anassessment on the effectiveness of grants.
  • Reauthorizes the appropriation of such sums as may benecessary for fiscal years 2017-2021.
  • Reauthorizes appropriations at the last appropriated level of $50million for each of fiscal years 2018-2022.

Sec. 9022. Strengthening the Mental and Substance Use Disorders Workforce

  • Authorizes the Secretary to establish a trainingdemonstration program within the Health Resources andServices Administration (HRSA) to award five-year minimumgrants for:

o   Medical residents and fellows to practice psychiatry and addiction medicine in underserved,community-based settings;

o   Nurse practitioners, physician assistants, health servicepsychologists, and social workers to provide mental andsubstance use disorder services in underservedcommunity-based settings; and

 

o   Establishing, maintaining, or improving academicprograms that provide training to improve the abilityto recognize, diagnose, and treat mental andsubstance use disorders.

  • Requires a study on the results of the demonstration project.
  • Authorizes appropriations of $10 million for fiscal years 2018-2022.

Sec. 9023. Clarification on Current Eligibility for Loan RepaymentPrograms.

  • Directs the Administrator of HRSA to clarify the existingeligibility of child and adolescent psychiatrists for theNational Health Service Corps (NHSC) Loan RepaymentProgram.
  • This section does not expand participation in the NHSC.

Sec. 9024. Minority Fellowship Program

  • Codifies the Minority Fellowship Program for the Secretary to increase the number of professionals who provide mental orsubstance use disorder services to underserved, minoritypopulations, and to improve the quality of mental andsubstance use disorder prevention and treatment for ethnicminorities.
  • Authorizes appropriations of $12,669,000 for each of fiscal years2018-2022.

Sec. 9025. Liability Protections for Health ProfessionalVolunteers at Community Health Centers

  • Provides medical liability protections for volunteers atdeemed Community Health Centers through the FederalTort Claims Act to remove barriers for volunteering.
  • Requires the Attorney General to report to Congress annually on an estimate of claims to be paid during the year.
  • Sunsets the coverage after five years.

Sec. 9026. Reports

  • Requires SAMHSA and HRSA to issue a report on national- andstate-level projections for the supply and demand of mentalhealth and substance use disorder health workers and trendswithin the mental health and substance use disorder providerworkforce.
  • Requires Comptroller General to study peer-supportspecialist programs in states receiving grants fromSAMHSA and report to Congress on:

o   Hours of formal work or volunteer experiencerelated to mental and substance use disordersconducted;

o   Types of peer support specialist exams and codes of ethicsrequired for such programs; and

o   Recommended skill sets and requirements for continuingeducation.

SUBTITLE C—MentalHealth on Campus Improvement Sec. 9031. Mental Health and Substance Use Disorder Services on Campus

  • Reauthorizes the Mental Health and Substance Use Disorder Services on Campuses grant program and

allows for the education of students, families, faculty, and staff toincrease awareness and training to  respond effectively to students with mental health and substance use disorders, toprovide outreach to administer voluntary screenings andassessments to students, to enhance networks with health careproviders who treat mental health and substance use disorders,and to provide direct mental health services.

Incorporates consideration of the needs of veterans enrolled as students on campus

  • Reauthorizes appropriations of $7 million for each of fiscal years2018-2022.

Sec. 9032. Interagency Working Group on College Mental Health

  • Provides federal leadership by establishing an interagencyworking group to discuss mental and behavioral health oncollege campuses and to promote federal agency collaborationto support innovations in mental health services and supportsfor students on college and university campuses.
  • Authorizes appropriations of $1 million for the period of fiscalyears 2018-2022 to carry out these activities.

 

Sec. 9033. Mental and Behavioral Health Outreach and Educationon College Campuses

  • Directs the Secretary of HHS in collaboration with the CDC toconvene an interagency, public-private sector work group toplan, establish, and begin coordinating and evaluating a targeted, public-education campaign to focus on mental and behavioral health on the campuses of institutions of highereducation.
  • Authorizes appropriations of $1 million for the period offiscal years 2018-2022 to carry out these activities.

Title X—Strengthening Mental and Substance Use Disorder Care for Women, Children,and Adolescents

Sec. 10001. Programs for Children with Serious EmotionalDisturbances

  • Reauthorizes and updates programs to provide comprehensivecommunity mental health services to children with SED.
  • Reauthorizes appropriations at the last appropriated level of$119,026,000 for fiscal years 2018-2022.

Sec. 10002. Increasing Access to Pediatric Mental Health Care

  • Authorizes HRSA to award grants to promote behavioral healthintegration in pediatric primary care.
  • Establishes eligibility requirements for statewide or regional pediatric mental health care telehealthprograms in order to receive grant funding.
  • Requires grantees to submit a comprehensive evaluation of activities carried out and a performance and outcomeevaluation.
  • Requires the state receiving the grant to match at least 20 percentof the federal funds.
  • Authorizes appropriations of $9 million for the period of fiscal years2018-2022.

Sec. 10003. Substance Use Disorder Treatment and EarlyIntervention Services for Children and Adolescents

  • Reauthorizes and makes technical updates to grants forsubstance use disorder treatment and earlyintervention for children and adolescents to provideearly identification and services.
  • Reauthorizes appropriations at the last appropriated level of $29.6million for each of 2018-2022.

Sec. 10004. Children’s Recovery from Trauma

  • Reauthorizes the National Child Traumatic Stress Initiative(NCTSI), which supports a national network of child traumacenters, including university, hospital, and community-basedcenters and affiliate members.
  • Supports the coordinating center’s collection, analysis, andreporting of child outcome and other data to inform evidence-based treatments and services. Also supports the continuum oftraining initiatives related to such evidence-based treatments,interventions, and practices offered to providers.
  • Encourages the collaboration between NCTSI and HHS todisseminate evidence-based and trauma-informed interventions,treatments, and other resources to appropriate stakeholders.
  • Reauthorizes appropriations at the last appropriated level of$46.9 million for each of fiscal years 2018- 2022.

Sec. 10005. Screening and Treatment for Maternal Depression

  • Establishes a grant program for states to establish, improve, ormaintain programs for screening assessment and treatmentservices for women who are pregnant, or who have given birthwithin the preceding 12 months, for maternal depression.
  • Allows the Secretary to prioritize grants to states proposingto improve or enhance access to screening services formaternal depression in primary care settings.

 

  • Activities supported by the grant should include providingappropriate training to health care providers, information tohealth care providers on maternal depression screening,treatment, and follow-up support services, and linkages to community-based resources.
  • Authorizes the appropriation of $5 million for each of fiscal years2017-2021.

Sec. 10006. Infant and Early Childhood Mental Health Promotion,Intervention, and Treatment

  • Establishes a grant program to develop, maintain, or enhance mental health prevention, intervention, and treatmentprograms for infants and children at significant risk of developing or showing early signs of mental disorders,including SED, or social or emotional disability.
  • The Secretary will ensure that programs receiving grants are replicable and utilize evidence-informed or evidence-basedmodels, practices, and methods.
  • Requires the state receiving the grant to match at least 10 percentof the federal funds.
  • Authorizes $20 million for the period of fiscal years 2018-2022.

Title XI—Compassionate Communication on HIPAA

Sec. 11001. Sense of Congress

  • The Sense of Congress finds that clarification is neededregarding existing permitted uses and disclosures of healthinformation under the Health Information Portability andAccountability Act (HIPAA) by health care professionals tocommunicate with caregivers of adults with SMI to facilitate treatment.

Sec. 11002. Confidentiality of Records

  • Requires the Secretary to, within a year of finalizing updatedrules related to the confidentiality of health records related to alcohol and drug abuse, convene relevant stakeholders to determine the effect of the regulation on patient care, healthoutcomes, and patient privacy.

Sec. 11003. Clarification on Permitted Uses and Disclosures ofProtected Health Information

  • Directs the Secretary through the Director of the Office for Civil rights to clarify circumstances when a health careprovider or covered entity may use or disclosure protectedhealth information related to the treatment of an adult with amental or substance use disorder.

Sec. 11004. Development and Dissemination of Model TrainingPrograms

  • Requires the Secretary to identify or recognize private or publicentities to develop model training and educational programs to educate health care providers, regulatory compliance staff, andothers regarding the permitted use and disclosure of healthinformation under HIPAA.
  • Authorizes appropriations of $10 million for the period of fiscalyears 2018-2022.

Title XII—Medicaid Mental Health Coverage

Sec. 12001. Rule of Construction Related to Medicaid Coverageof Mental Health Services and Primary Care ServicesFurnished on the Same Day

  • Clarifies that nothing in the Medicaid statute should beconstrued as prohibiting separate payment for the provision ofmental health and primary care services provided to anindividual on the same day.

Sec. 12002. Study and Report Related to Medicaid Managed Care Regulation

  • Directs the Secretary acting through the Administrator of CMS toconduct a study and report on the provision of care to adultsaged 21 to 65 enrolled in Medicaid managed care plansreceiving treatment for a mental health disorder in an Institutionfor Mental Diseases (IMD). The report is due within three yearsand must include information on the number of individualsreceiving treatment in IMDs, their lengths of stay, and how Medicaid managed care plans determine when to provideservices in an IMD in lieu of other benefits, such as community-based mental health services.

 

Sec. 12003 Guidance on Opportunities for Innovation

  • Directs the Administrator of CMS to issue a State MedicaidDirector letter, within one year of enactment, on opportunities todesign innovative service delivery systems to improve care for individuals with serious mental illness or serious emotionaldisturbance.

Sec. 12004. Study and Report on Medicaid Emergency Psychiatric Demonstration Project

  • Directs the Secretary, acting through the Administrator of CMS to collect, analyze, and report on data from states thatparticipated in the Medicaid Emergency PsychiatricDemonstration Project establish under Section 2707 of theAffordable Care Act. The report is due no later than two yearsafter enactment.

Sec. 12005. Providing EPSDT Services to Children in IMDS

  • This section specifies that, effective January 1, 2019, childrenreceiving Medicaid-covered inpatient psychiatric hospitalservices are also eligible for the full range of early and periodicscreening, diagnostic, and treatment services.

Sec. 12006. Electronic Visit Verification System Required for Personal Care Services and Home Health Care Services UnderMedicaid

  • Directs States to require the use of an electronic visit verificationsystem for Medicaid-provided personal care services and homehealth services (but this policy does not require States to adopt asingle system for providers within their State). States that do notrequire a system for personal care services by January 1, 2019, and home health services by January 1, 2023, will face amodest, incremental reduction in percentage. This policy offsetsthe cost of Sec. 705.

Title VIII—Mental Health Parity

Sec. 13001. Enhanced Compliance with Mental Health and Substance Use Disorder Coverage Requirements

  • Requires the Departments of HHS, Labor, and Treasury to release a compliance program guidance providing illustrative examples of past findings of compliance and noncompliancewith existing mental health parity requirements, includingdisclosure requirements and non-quantitative treatmentlimitations.
  • Requires HHS to seek public comment on ways to improve consumer access to documents about mental health andsubstance use disorder benefits which are required by law tobe disclosed.
  • Requires HHS to issue new guidance documents to assisthealth plans comply with existing mental health parityrequirements.
  • Guidance documents will be subject to a comment period of noless than 60 days before being finalized.
  • Clarifies the Secretaries’ of HHS, Labor, and Treasury authority to audit a health plan in the case that such plan has beenfound to have violated existing mental health parity laws 5times.

Sec. 13002. Action Plan for Enhanced Enforcement of MentalHealth and Substance Use Disorder Coverage

  • Requires HHS to convene a public meeting within six months of enactment to produce an action plan for improved federaland state coordination related to the enforcement of mentalhealth parity and addiction equity requirements.
  • The action plan must take into consideration therecommendations of the President’s Mental Health andSubstance Use Disorder Parity Task Force Final Reportreleased in October of 2016.
  • The action plan must identify specific, strategic objectives regarding how the various federal and state agencies chargedwith enforcement of mental health parity and addiction equityrequirements will collaborate to improve enforcement; providea timeline for when such objectives shall be met; and providespecific examples of how such objectives may be met.

 

Sec. 13003. Report on Investigations Regarding Parity in MentalHealth and Substance Use Disorder Benefits

  • Requires the Administrator of the Centers for Medicare & Medicaid Services to conduct an annual report for five yearssummarizing the results of all closed federal investigationscompleted during the preceding year with findings of any seriousviolation regarding compliance with exiting mental health parityrequirements.

Sec. 13004. GAO study on Parity in Mental Health and Substance Use Disorders Benefits

  • Requires GAO, within three years of enactment, to conduct astudy on the enforcement of existing mental health parityrequirements; including compliance with non-quantitative treatment limitations, an assessment of how the Secretary hasused its authority to conduct audits, a review of how the variousfederal and state agencies responsible for enforcing mentalhealth parity requirements have improved enforcement in linewith the stated objectives outlined in the action plan under Sec.605, and recommendations for additional enforcement,education, and coordination activities and legal authorities could better ensure compliance with existing mental health parityrequirements.

Sec. 13005. Information and Awareness on Eating Disorders

  • Allows HHS to update resource lists and fact sheets relatedto eating disorders and increase public awareness, throughexisting programs and activities, on the signs and symptomsof eating disorders and treating individuals with eatingdisorders.

Sec. 13006. Education and Training on Eating Disorders

  • Allows HHS to facilitate the identification of model programsand materials for educating and training healthprofessionals in effective strategies to identify individualswith eating disorders, provide early intervention services,and refer patients to appropriate treatment.

Sec. 13007. Clarification of Existing Parity Rules

  • Clarifies the coverage of eating disorder benefits, includingresidential treatment, under existing mental health parityrequirements.

TITLE XIV – MENTAL HEALTH AND SAFE COMMUNITIES

SUBTITLE A–Mental Health and Safe Communities

Sec. 14001. Law Enforcement Grants for Crisis InterventionTeams, Mental Health Purposes

  • Amends the Byrne Justice Assistance Grant (JAG) Program toallow law enforcement to use funds for the creation of mentalhealth response and corrections programs, including policecrisis intervention teams. Also allows state and localgovernments to use Byrne JAG funds in order to comply withcurrent laws requiring the upload of certain mental healthrecords to the National Instant Criminal Background CheckSystem (NICS).
  • Amends the Community Oriented Policing Services GrantProgram (COPS) to allow law enforcement to use funds forspecialized mental health response training, including crisis de-escalation.
  • Amends the Fire Prevention and Control Act to allow existinggrant funds to be used for training first responders and paramedics on best practices for responding to mental healthemergencies, including crisis de-escalation.

Sec. 14002. Assisted Outpatient Treatment Programs

  • Allows federal mental health court grant funds to be usedfor the creation of court-ordered outpatient treatmentprograms to prevent the escalation of mental healthcrises.

Sec. 14003. Federal Drug and Mental Health Courts

 

  • Requires the Attorney General and the Director of theAdministrative Office of United States Courts to create a Drugand Mental Health Court pilot program in at least one FederalJudicial District. As part of this program, low-level offenders whoare mentally ill or addicted to narcotics would be eligible for diversion from prison so long as they comply with an intensive court-mandated treatment program. A large number of state andlocal governments operate similar problem-solving courtprograms.

Sec. 14004. Mental Health in the Judicial System

  • Amends the America’s Law Enforcement and Mental HealthProject Act to allow state and local governments to use fundsfor the creation and deployment of behavioral health risk andneeds assessments for mentally ill individuals in the criminaljustice system.

Sec. 14005. Forensic Assertive Community Treatment Initiatives

  • Amends the Mentally Ill Offender Treatment and CrimeReduction (MIOTCRA) to allow state and local governmentsto use existing authorized grant funds for the operation of Forensic Assertive Community Treatment (FACT) Initiatives.FACT Initiatives provide high-intensity community-basedservices for individuals with mental illness who are involvedin the criminal justice system.

Sec. 14006. Assistance for Individuals Transitioning Out of Systems

  • Amends the Second Chance Act to allow state and localgovernments to use reentry demonstration project grant fundsfor the provision of mental health treatment and transitionalservices (including housing) for mentally ill offenders who arere-entering the community.

Sec. 14007. Co-occurring Substance Abuse and MentalHealth Challenges in Drug Courts

  • Amends the federal Drug Court Grant Program to allow state and local governments to use their existing grant funds toinclude targeted interventions for individuals who have both amental health and substance abuse disorder. Also allowsfunds to be used for the training of drug court professionals toidentify and respond to these co-occurring disorders.

Sec. 14008. Mental Health Training for Federal UniformedServices

  • Requires the appropriate cabinet-level Secretary to provide mental health crisis and response trainingprograms for members of each of the Federal UniformedServices.

Sec. 14009. Advancing Mental Health as Part of Offender Reentry

  • Amends the Second Chance Act to allow state and localgovernments to use reentry demonstration project grant fundsunder this program for the purpose of providing mental healthservices and to coordinate transitional services for individualsre-entering society with mental illness, substance abuseproblems, or a chronic homelessness.

Sec. 14010. School Mental Health Crisis Intervention Teams

  • Amends the Department of Justice Secure Our Schools programto allow state and local governments to use existing grant fundsto develop and operate school-based mental health crisisintervention teams that include coordination with lawenforcement agencies and specialized training for schoolofficials.

Sec. 14011. Active-shooter Training for Law Enforcement

  • Permanently authorizes the existing Department of Justice VALOR Initiative, which provides crisis response training and active-shooter training for federal, state, andlocal law enforcement officials.

 

Sec. 14012. Co-occurring Substance Abuse and MentalHealth Challenges in Residential Substance Abuse Treatment Programs

  • Amends the Residential Substance Abuse Treatment grantprogram to allow state and local governments to use funds forthe purpose of developing and implementing specializedresidential substance abuse treatment programs that providetreatment to individuals with co-occurring mental health andsubstance abuse disorders.

Sec. 14013. Mental Health and Drug Treatment Alternativesto Incarceration Programs

  • Updates the existing Prosecution Drug Treatment Alternativesto Incarceration Program statute to allow state and localgovernments to use grant funds under this program for creatingand operating programs that divert individuals with mentalillness and co-occurring disorders from prisons and jailspursuant to a court- supervised intensive treatment program.Current law only allows funds under this program to be used foraddressing substance abuse issues.

Sec. 14014. National Criminal Justice and Mental Health Trainingand Technical Assistance

  • Amends MIOTCRA to allow the Attorney General to use existingauthorized funds to award grants to non- profit organizations forthe creation of a National Criminal Justice and Mental HealthTraining Center. This entity would coordinate best practices onresponding to mental illness in the criminal justice system, andwould provide technical assistance to governmental agencies who wish to implement these best practices.

Sec. 14015. Improving Department of Justice Data Collection on Mental Illness Involved in Crime

  • Requires the Attorney General to collect and disseminate data regarding the involvement of mental illness in all homicides, as well as deaths or serious bodily injuries involving lawenforcement officers.

Sec. 14016. Reports on the Number of Mentally Ill Offenders in Prison

  • Requires the Comptroller General of the United States to submit a report to Congress detailing the federal, state, andlocal costs of imprisonment for individuals with serious mentalillness, including the number and types of crimes committed bymentally ill individuals.

Sec. 14017. Department of Veterans Affairs Patients’ Rights

  • Ensures that veterans enjoy due process protections beforebeing adjudicated as mentally ill by the Veterans Administration

Sec. 14018. Reauthorization of Appropriations

  • Reauthorizes MIOTCRA at the previously authorized (but expired)level of $50 million/yr.

SUBTITLE B–Comprehensive Justice and Mental HealthSec. 14021. Sequential Intercept Model

  • Authorizes the Sequential Intercept Model which outlinessequential points at which a person with mental illness can be“intercepted” and kept from going further into the criminaljustice system.

Sec. 14022. Prison and Jails

  • Authorizes funding for prison and jail-based programs,including transitional and re-entry programs that reduce thelikelihood of recidivism when a mentally-ill offender isreleased.

Sec. 14023. Allowable Uses

 

  • Expands the allowable use of grant resources to enhance thecapabilities of law enforcement, corrections, and mental healthpersonnel to better identify and respond to individuals withmental illnesses who consume a disproportionate quantity ofcrisis services.

Sec. 14024. Law Enforcement Training

  • Authorizes resources for expanded training activities, providing more officers with a basic understanding of the issues involvedwhen responding situations with individuals with mental healthcrises.

Sec. 14025. Federal Law Enforcement Training

  • Requires the Attorney General to create programs that offerfederal first responders and tactical units comprehensive training in procedures to identify and respond appropriately to incidents involving mentally ill individuals.

Sec. 14026. GAO Report

  • Requires a GAO report detailing the practices that federal firstresponders, tactical units, and corrections officers are trainedto use in responding to individuals with mental illness,procedures to appropriately respond to incidents, theapplication of evidence-based practices in criminal justice settings, and recommendations on how the Department ofJustice can improve information sharing and dissemination ofbest practices.

Sec. 14027. Evidence Based Practices

  • Requires DOJ to prioritize grant applications to those whouse evidence-based interventions and risk assessment tools to reduce recidivism.

Sec. 14028. Transparency, Program Accountability and Enhancing Local Authority

  • Clarifies that an offender may participate in a MIOTCRAprogram only if the offender is selected unanimously for participation in the program by the prosecuting attorney, thedefense attorney, the judge, the mental health agencyrepresentative, and the probation officer.

Sec. 14029. Grant Accountability

  • Requires the Inspector General of the Department of Justice to conduct annual audits of all grant recipients under the bill’sprovisions to prevent waste, fraud, and abuse of funds bygrantees.
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