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 and Substance
Use (Assistant Secretary) to head the Substance Abuse and
Mental Health Services
Administration (SAMHSA).
The
authorities of the existing SAMHSA Administrator are
transferred to the Assistant
Secretary.
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 and evidence-based practices to service providers to improve
treatment and prevention services and incorporate these findings
into SAMHSA programs;
o
Ensure that
grants are subject to performance
and outcome evaluations and that center
directors consistently document the grant process and conduct ongoing
oversight of grantees;
o
Consult with stakeholders
to improve community-based and other mental health services,
including adults
with a serious mental
illness (SMI), and children
with a serious emotional
disturbance (SED);
o
Collaborate with other federal departments,
including the Departments of
Defense (DOD), Veterans Affairs
(VA), Housing and Urban Development (HUD), and Labor (DOL) to improve care for veterans and service members, and support
programs to address chronic
homelessness; and
o
Work with stakeholders to improve the recruitment and retention
of mental health and substance use disorder professionals.
Sec.
6003. Chief Medical Officer
•
Establishes a
Chief Medical Officer (CMO)
within SAMHSA to assist the Assistant Secretary in evaluating and organizing programs within the agency and to promote evidence-based and
promising best practices emphasizing clinical focus.
•
Requires
the CMO to have real-world experience providing mental health care or
substance use disorder
treatment services.
•
Requires
the CMO to coordinate with the Assistant
Secretary for Planning and Evaluation (ASPE) to assess the use of
performance metrics
to evaluate SAMHSA programs, and to coordinate with the Assistant
Secretary to ensure consistent utilization of
appropriate performance metrics and evaluation designs.
Sec. 6004. Improving the Quality of Behavioral Health Programs
•
Codifies the existing Center for
Behavioral Health Statistics and Quality (CBHSQ)
at SAMHSA.
•
CBHSQ is required to coordinate with the Assistant Secretary, the ASPE,
and
the CMO to improve the quality
of
services provided
by SAMHSA.
Sec. 6005. Strategic
Plan
•
Requires SAMHSA to develop a strategic plan every four years that
identifies priorities, including a strategy
for improving the recruitment, training, and retention of the
mental health workforce.
•
The plan must
take into consideration recommendations of the ASPE and the
Interdepartmental Serious Mental Illness Coordinating Committee established in
Sec. 121.
•
The plan will:
o
Identify strategic
priorities, goals, and measurable
objectives for mental
and substance use disorder
activities 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 best practices
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 Congress
containing a
review of progress toward strategic
priorities, goals, and objectives identified in the strategic plan as well as
an assessment of programs, and a description of coordination activities.
•
This report
will also include program improvement recommendations made by
the ASPE.
•
The Assistant
Secretary may also consolidate
existing reporting requirements into the
biennial report to ease the agency’s administrative burden.
Sec.
6007. Authorities of the
Centers for Mental Health Services
(CMHS), Substance Abuse Prevention (CSAP), and Substance Abuse Treatment (CSAT)
•
Updates statute
to reflect changes in terminology
as well as increases coordination and cooperation with other relevant federal agencies.
•
Requires
the Director of CMHS
to collaborate
with the National Institute of Mental
Health (NIMH) to ensure mental health programs
reflect the best available science and are evidence-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
on Alcohol Abuse and Alcoholism,
and the National Institute
on Drug Abuse as ex officio members
of the applicable advisory
councils;
o
Ensure that at least half of the appointed
advisory council members
for CMHS have a medical
degree, doctoral
degree in psychology, or an advanced degree
in nursing or social
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 medical
degree, doctoral degree, an advanced degree
in nursing, 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 review group that is reviewing a grant, cooperative agreement, or
contract related to mental
illness have a medical degree, a doctoral degree
in psychology, or an advanced
degree in nursing
or social work. The Secretary shall
also ensure to the extent possible
that peer review groups
include broad geographic representation.
SUBTITLE
B—Oversight and Accountability
Sec.
6021. Improving Oversight of Mental and Substance
Use Disorders Programs Through the
Assistant Secretary for Planning and Evaluation
•
Outlines
the role and responsibilities of the ASPE at the Department of Health and Human Services
(HHS) in planning
and evaluating activities related to mental health and substance use disorder programs.
•
Requires
the ASPE to provide
recommendations to Secretary
of
HHS, the Assistant Secretary
for
Mental Health and Substance Use, and Congress on improving
related mental and substance use disorder prevention and treatment programs.
•
Requires
the ASPE, within 180 days of enactment
of
the Helping Families in Mental Health Crisis
Reform Act of 2016, to develop a strategy for conducting ongoing evaluations on key programs
across the agency. The evaluation shall focus on:
o
Prevention,
intervention, treatment, and recovery support
services;
o
The reduction
of homelessness and incarceration among
those with mental illness or SUD; and
o A plan for assessing the use of
performance metrics to evaluate related activities
by
those receiving relevant grants, contracts,
or
cooperative agreements.
The
recommendations of the ASPE must
be
included in the biennial report
required in Section 106.
Sec. 6022. Reporting for Protection and Advocacy
Organizations
•
Requires Protection and
Advocacy Organizations to provide a
detailed, disaggregated accounting
of from where their funds were received.
This does not represent
a new reporting requirement.
Sec. 6023. GAO Study
•
Requires
the Government Accountability Office
(GAO) to conduct a study on programs funded under Title I of the Protection and Advocacy for Individuals with Mental
Illness Act.
•
The report will review
programs carried out by states
and private, non-profit organizations,
compliance with statutory
and regulatory responsibilities including
relating to the
grievance procedure for clients,
prospective clients or their
family members, availability of adequate medical and behavioral health treatment, and denial of rights for individuals with mental illness.
SUBTITLE C—Interdepartmental
Serious Mental Illness Coordinating Committee Sec. 6031. Inter-Departmental Serious
Mental Illness Coordinating Committee
•
Creates
a coordinating committee to evaluate federal programs
related to SMI and provide recommendations to better coordinate mental health services
for
people with SMI.
•
The committee is made up of HHS, the
Centers for Medicare and Medicaid
Services (CMS), the Department of Justice
(DOJ), VA, DOD, HUD, the Department of Education,
DOL, and the Social Security Administration (SSA),
as well
as
patients, health care providers, researchers, a judge, and a law enforcement officer.
•
The committee will make recommendations
to Congress
for better coordination of mental health services
for people with SMI 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 Recovery Programs Keep Pace with
Science and Technology
Sec.
7001. Encouraging Innovation and Evidence-Based Programs
•
Establishes
the National Mental Health and Substance
Use Policy Laboratory
(NMHSUPL) within SAMHSA
and moves the existing functions
of
the Office of Policy, Planning, and Innovation (OPPI) underneath.
•
The NMHSUPL will promote evidence-based practices and service delivery models through evaluating models that would benefit from further development and through expanding,
replicating, or scaling evidence-based programs across a wider area.
•
Authorizes the appropriation of $14 million for the
period of fiscal years 2018-2020 for such grants.
Sec. 7002. Promoting
Access to Information on Evidence-Based Programs and Practices
•
Allows
the Assistant Secretary to improve access to information on evidence-based programs
and practices for states, local
communities, nonprofit entities,
and other stakeholders.
Sec.
7003. Priority Mental Health Needs
of Regional
and National Significance
•
Updates
and reauthorizes the Priority
Mental Health Needs
of
Regional and National
Significance Program to support prevention,
treatment, and rehabilitation of mental health services and other
programs to target
responses based on mental 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
of Regional
and National
Significance
•
Updates
and reauthorizes the Priority
Substance Use
Disorder Treatment Needs of
Regional and National Significance Program
to improve the quality and availability of treatment
and rehabilitation services for substance use disorder
services 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 Prevention Needs of Regional and National Significance
•
Updates
and reauthorizes the Priority
Mental Health Needs
of
Regional and National
Significance Program to support projects
and programs for prevention of substance use and other 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 Activities and Reponses to Mental Health
and Substance Use Disorder Needs
Sec.
8001. Community Mental
Health Services Block Grant
•
Gives states
additional flexibility to use Community
Mental Health Services (CMHS)
block grant funding
to provide community mental 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. o Describe
how the state promotes
evidence-based practices, including
programs for SMI.
o Ensure states will:
§ Coordinate services to maximize
efficiency, effectiveness, quality, and cost-effectiveness to improve outcomes.
§ Provide for an organized community-based system
of care for individuals with mental
illness and co-occurring disorders.
•
Reauthorizes the CMHS Block Grant at the last appropriated level of $532,571,000 for fiscal years 2018-
2022.
Sec. 8002. Substance Abuse Prevention and Treatment Block Grant
•
Clarifies the state will ensure
ongoing training for substance use disorder prevention and treatment
professionals on recent trends
in
drug abuse in the state, evidence-based practices for substance
use disorder services, performance-based accountability, 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 and establish
goals and objectives;
o
Provide information on the need for substance use
disorder prevention and treatment services; o Describe state and local
coordination of prevention and treatment
services with other agencies; o Describe
how the state promotes
evidence-based practices;
o Describe
how the state integrates substance use disorder
services 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 health and substance abuse block
grants. This is a codification of existing
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 being distributed to states and territories according to need,
and recommend changes if
necessary.
•
Requires
the report
to be submitted to Congress within two
years of enactment of the bill.
Title IX—Promoting Access to Mental Health
and Substance Use Disorder Care
SUBTITLE A—Helping Individuals and Families
Sec. 9001. Grants for Treatment and Recovery for
Homeless Individuals
•
Reauthorizes
and makes technical updates
to grants for treatment and recovery for
homeless individuals to support mental 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 and implement programs to divert individuals
with a mental illness from 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 Behavioral
Health 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
integrated services 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 from Homelessness
•
Reauthorizes
and makes updates
to grants for states to provide services to homeless individuals who are suffering from serious mental illness, or co-occurring serious mental
illness and substance
use disorders.
•
Directs
the Administrator to evaluate
the formula used to determine
funding allotments and report to
Congress within 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 Suicide
Prevention Lifeline program, including:
o
Coordinating a
network of crisis
centers to provide suicide prevention and crisis
intervention services;
o Maintaining a suicide prevention hotline
to link callers
to local emergency, mental health,
and social services
resources;
o
Consulting with the Secretary of Veterans Affairs
to ensure veterans calling
the suicide prevention hotline have access to a specialized veterans’ suicide
prevention 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
Treatment Referral
Routing Service to help individuals and families
locate mental health and substance use disorder
treatment providers
through a nationwide phone system and internet website.
Sec. 9007. Strengthening Community Crisis
Response Systems
•
Authorizes the Secretary to award grants to state
and local governments, Indian tribes, and tribal
organizations to strengthen
community-based crisis response systems or to develop,
maintain, or enhance a database of beds at inpatient
psychiatric facilities, crisis
stabilization units, and residential community mental health and residential substance use disorder
treatment facilities.
•
An entity receiving a grant
must submit a report
at the Secretary’s request,
including an evaluation of the effect of such grants
on local crisis response activities
for
individuals receiving crisis planning and early intervention support, individuals reporting improved outcomes,
and individuals receiving regular follow-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 to provide
information and training
for suicide prevention, surveillance, and intervention strategies for
all ages, particularly among groups at high risk.
o
Reauthorizes the appropriation at the last appropriated level of $5,988,000 for each of fiscal
years 2018-2022.
•
Reauthorizes the Youth Suicide Early Intervention and Prevention Strategies grants
to states
and tribes, and clarifies that
states may receive continuation grants
after the first grant
is awarded.
o
Reauthorizes the appropriation of $30 million for each of fiscal years 2018-2022.
Sec.
9009. Adult Suicide Prevention
•
Establishes
suicide prevention and intervention programs grants for individuals aged 25 years
or
older. The grants are to raise awareness
of suicide, establish referral processes,
and improve care and outcomes for such individuals who are at risk
of
suicide.
•
Authorizes the appropriation of $30 million for the
period of fiscal years 2018-2022.
Sec.
9010. Mental Health Awareness Training Grants
•
Reauthorizes grants
to states, political subdivisions of states, Indian tribes, tribal organizations,
and nonprofit private entities
to train teachers,
appropriate school personnel, emergency
services personnel, and others, as appropriate, to recognize the
signs and symptoms of mental
illness, to become familiar with resources
in
the community for individuals with mental
illnesses, and for the purpose
of the safe de- escalation of crisis
situations involving 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 HHS should prioritize programs
and activities for populations with disproportionately
high rates of suicide, such as American Indians and Alaska Natives.
Sec.
9012. Evidence-Based Practices for Older Adults
•
Requires
the Secretary
to disseminate information and
provide technical assistance on evidence-based practices for 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 and Prevention (CDC) to improve, particularly through the inclusion
of other states,
the existing National Violent Death Reporting System.
•
The reporting
system was created in 2002 and currently
collects surveillance data from 32 states.
Sec.
9014. Assisted Outpatient Treatment
•
Increases
and extends an existing
authorization for a grant program for Assisted Outpatient Treatment at SAMHSA.
•
Reauthorizes
appropriations of $15 million in fiscal
year 2017, $20 million for fiscal year 2018, $19 million for each of fiscal years 2019 and 2020, and
$18 million for each of fiscal
years 2021 and 2022.
Sec.
9015. Assertive Community Treatment
•
Establishes a grant program
establish, maintain, or
expand assertive community treatment programs for adults with SMI.
•
The Secretary
is required to report no later than
2021 an evaluation of;
o
Any cost savings
and public health outcomes;
o
Rate of involvement with the criminal
justice system of
patients; and,
o
Rates of homelessness among patients.
•
Authorizes
appropriations of $5 million for the period of fiscal
years 2018-2022.
Sec.
9016 Sober Truth on Preventing Underage Drinking Reauthorization
•
Reauthorizes the
Interagency Coordinating Committee for $1 million for each of
fiscal years 2018-2022, the National Media
Campaign to Prevent
Underage Drinking for $1 million for each of fiscal
years
2018-2022, the Community-
Based Coalition Enhancement grants for $5 million for each of fiscal
years 2018-2022, and funding for additional
research on underage drinking
for $3 million for each of fiscal
years 2018-2022.
•
The Secretary may
also make grants
under this section for practices to reduce alcohol use
among individuals under the age of 21 through screening
and brief intervention.
Sec.
9017. Center and Program
Repeals
•
Repeals section 514 of the Public
Health Service Act relating to
methamphetamine 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 Workforce Sec. 9021. Mental and Behavioral
Health Education Training Grants
•
Reauthorizes grants
to institutions of
higher education or
accredited professional training programs to support the recruitment and education of mental health care providers.
•
Creates
a priority for programs that train psychology,
psychiatry, and social
work professionals to work in integrated care
settings, and programs for paraprofessionals that emphasize
the role of the family and the lived experience
of the consumer
and family-paraprofessional partnerships.
•
Requires
the Administrator to include in the biennial report an assessment on the effectiveness of grants.
•
Reauthorizes the appropriation of such sums as may be necessary for fiscal years 2017-2021.
•
Reauthorizes
appropriations at the
last appropriated level of $50 million for each of
fiscal years 2018-2022.
Sec.
9022. Strengthening the Mental and Substance Use Disorders Workforce
•
Authorizes the Secretary to establish a training
demonstration program
within the Health Resources
and Services Administration (HRSA) to award five-year
minimum grants for:
o
Medical residents
and fellows
to practice psychiatry and addiction medicine
in underserved, community-based settings;
o
Nurse practitioners, physician assistants, health service
psychologists, and social workers
to provide mental and substance use disorder
services in underserved community-based settings;
and
o
Establishing, maintaining,
or
improving academic
programs that provide
training to improve the ability
to recognize, diagnose,
and treat mental and substance 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 Repayment Programs.
•
Directs
the Administrator of HRSA to clarify the existing eligibility of child and adolescent psychiatrists for the National Health Service Corps (NHSC) Loan Repayment Program.
•
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 or substance use disorder
services to underserved, minority populations, and to improve the quality of mental and substance use disorder prevention and treatment for ethnic minorities.
•
Authorizes
appropriations of $12,669,000 for each of fiscal years 2018-2022.
Sec.
9025. Liability Protections for Health Professional Volunteers at Community Health Centers
•
Provides medical liability protections
for
volunteers at deemed Community Health Centers
through the Federal
Tort 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- and state-level projections for the supply and demand of mental health and substance use disorder health workers
and trends within the mental health and substance
use disorder provider workforce.
•
Requires Comptroller General
to study peer-support specialist programs in states
receiving grants from SAMHSA
and report to Congress on:
o
Hours
of formal work or volunteer experience related to mental and substance use disorders
conducted;
o
Types
of peer support specialist exams and codes
of ethics
required for such programs;
and
o
Recommended skill
sets and requirements
for continuing education.
SUBTITLE C—Mental Health
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 to
increase awareness and training to respond effectively to students with mental health and substance use disorders,
to provide outreach to administer voluntary screenings and assessments to students, to enhance networks
with health care providers 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 years 2018-2022.
Sec. 9032. Interagency Working Group on College
Mental Health
•
Provides federal
leadership by
establishing an interagency
working group to discuss mental and behavioral health on college
campuses and to promote
federal agency collaboration to support
innovations in mental health services
and supports for students on college
and university campuses.
•
Authorizes
appropriations of $1 million for the period of fiscal
years 2018-2022 to carry
out these activities.
Sec.
9033. Mental and Behavioral Health Outreach and Education on College Campuses
•
Directs
the Secretary
of
HHS in collaboration with the CDC to convene
an interagency,
public-private sector work group to plan, establish,
and begin coordinating and evaluating a targeted, public-education campaign to focus on mental and behavioral health on the campuses of institutions
of
higher education.
•
Authorizes
appropriations of $1 million for the period of fiscal
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 Emotional Disturbances
•
Reauthorizes
and updates programs to provide comprehensive community 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 health integration in pediatric
primary care.
•
Establishes
eligibility requirements for statewide or regional pediatric
mental health care
telehealth programs
in order to receive grant funding.
•
Requires grantees
to submit a comprehensive evaluation of activities carried out and a performance
and outcome evaluation.
•
Requires
the state receiving the grant to match at least 20
percent of the federal funds.
•
Authorizes
appropriations of $9 million for the period of fiscal
years 2018-2022.
Sec.
10003. Substance Use Disorder Treatment and
Early Intervention Services
for Children and Adolescents
•
Reauthorizes
and makes technical updates
to grants for substance use disorder treatment and early intervention for
children and adolescents to provide early identification and services.
•
Reauthorizes
appropriations at the
last appropriated level of $29.6 million 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 trauma centers,
including university, hospital, and community-based centers and affiliate
members.
•
Supports the coordinating center’s collection, analysis, and reporting of
child outcome and other data to inform
evidence-based treatments
and services.
Also supports the continuum
of training initiatives
related to such evidence-based treatments, interventions, and practices offered to providers.
•
Encourages
the collaboration between NCTSI and
HHS to disseminate 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, or maintain
programs for screening assessment and treatment
services for women who are pregnant,
or
who have given birth within the preceding 12 months,
for
maternal depression.
•
Allows
the Secretary to prioritize grants to states proposing to improve or enhance access to screening services for maternal depression in primary care
settings.
•
Activities supported by
the grant
should include providing appropriate
training to health care providers, information to health 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 years 2017-2021.
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 treatment
programs 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-based models, practices, and methods.
•
Requires
the state receiving the grant to match at least 10
percent of 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 needed regarding
existing permitted uses and disclosures of health information under the Health Information Portability and Accountability Act (HIPAA) by health care professionals to communicate with caregivers
of adults with SMI to facilitate treatment.
Sec.
11002. Confidentiality of Records
•
Requires
the Secretary
to, within a year of finalizing updated rules
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, health outcomes,
and patient privacy.
Sec.
11003. Clarification on Permitted Uses and Disclosures of Protected Health Information
•
Directs
the Secretary through the Director
of the Office for Civil rights
to clarify circumstances when a health care provider
or covered entity may use or disclosure protected health information related to the treatment of an adult with a mental
or
substance use disorder.
Sec.
11004. Development and Dissemination of Model Training Programs
•
Requires
the Secretary
to identify or recognize
private or public entities
to develop model training and educational programs to educate
health care providers,
regulatory compliance staff, and others
regarding the permitted
use and disclosure of
health information under HIPAA.
•
Authorizes
appropriations of $10 million for the period of fiscal years 2018-2022.
Title XII—Medicaid Mental Health Coverage
Sec.
12001. Rule of Construction
Related to Medicaid Coverage
of Mental Health Services and Primary Care Services Furnished on the Same Day
•
Clarifies that nothing
in the Medicaid
statute should be construed as prohibiting separate payment
for the provision of mental health and primary care
services provided to an individual on the same day.
Sec.
12002. Study and Report
Related to Medicaid Managed
Care Regulation
•
Directs
the Secretary acting
through the Administrator of CMS to conduct
a study and report
on the provision of care to
adults aged 21 to 65
enrolled in Medicaid
managed care plans receiving treatment for a mental health disorder in an Institution for Mental Diseases
(IMD). The report is
due within three
years and must include information on the number of individuals receiving treatment in IMDs, their
lengths of stay, and
how Medicaid managed care plans determine
when to provide services 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 Medicaid Director letter, within one year of enactment, on opportunities to design innovative service delivery systems to improve
care for individuals with serious
mental illness or serious emotional disturbance.
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 that participated in the Medicaid
Emergency Psychiatric Demonstration Project establish under Section 2707 of the Affordable Care Act. The report
is due no
later than two
years after enactment.
Sec. 12005. Providing
EPSDT Services to Children in IMDS
•
This section specifies
that, effective January
1, 2019, children receiving
Medicaid-covered inpatient psychiatric
hospital services are also
eligible for the full range
of early and periodic
screening, diagnostic, and treatment
services.
Sec.
12006. Electronic Visit
Verification System Required
for Personal Care Services and Home
Health Care Services Under Medicaid
•
Directs States
to require the use of an electronic visit verification system for Medicaid-provided personal care
services and home health services (but this policy
does not require
States to adopt a single system for providers
within their State). States that do not require
a system for personal care services by January 1, 2019, and
home health services by January
1, 2023, will face a modest, incremental reduction in percentage. This policy offsets
the 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 noncompliance with existing mental health parity requirements, including disclosure requirements and non-quantitative treatment limitations.
•
Requires
HHS to seek public comment on ways to improve
consumer access to documents
about mental health and substance use
disorder benefits which are required
by law to be disclosed.
•
Requires
HHS to issue new guidance documents
to assist health plans comply
with existing mental health parity
requirements.
•
Guidance documents will be subject to a
comment period of no less 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 been found to have violated
existing mental health parity laws 5 times.
Sec.
13002. Action Plan for Enhanced Enforcement of Mental Health
and Substance Use Disorder Coverage
•
Requires
HHS to convene a public meeting within
six
months of enactment
to produce an action plan for improved federal and state coordination related to the
enforcement of mental health parity and addiction
equity requirements.
•
The action plan must take
into consideration the recommendations
of
the President’s Mental Health and Substance
Use Disorder Parity
Task Force Final Report released in October of 2016.
•
The action plan must identify specific, strategic
objectives regarding how the various
federal and state agencies charged with enforcement
of mental health parity and addiction
equity requirements will collaborate
to improve enforcement; provide
a timeline for when such objectives shall be met;
and provide specific examples
of how such objectives may be met.
Sec.
13003. Report on Investigations Regarding Parity in Mental Health
and Substance Use Disorder Benefits
•
Requires
the Administrator of the Centers
for Medicare & Medicaid Services to conduct an annual report
for
five years summarizing the results of all closed federal
investigations completed during the preceding
year with findings
of
any serious violation
regarding compliance with exiting mental health parity requirements.
Sec. 13004. GAO study on Parity
in Mental Health and Substance Use Disorders Benefits
•
Requires
GAO, within three years of enactment, to conduct a study on the enforcement of existing mental health parity requirements; including compliance with non-quantitative
treatment limitations, an assessment of how the Secretary has
used its authority to conduct audits, a
review of how the various federal
and state agencies responsible for enforcing
mental health parity
requirements have improved enforcement
in
line with 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 parity requirements.
Sec. 13005. Information and Awareness on Eating Disorders
•
Allows HHS to update resource
lists and fact sheets
related to eating disorders
and increase public
awareness, through existing programs
and activities, on the signs and symptoms of eating disorders and treating
individuals with eating disorders.
Sec. 13006. Education and Training on Eating Disorders
•
Allows HHS to facilitate the identification of model programs
and materials for educating
and training health professionals in effective strategies to identify individuals with 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, including residential treatment, under existing
mental health parity requirements.
TITLE XIV –
MENTAL HEALTH AND SAFE
COMMUNITIES
SUBTITLE A–Mental
Health and Safe Communities
Sec.
14001. Law Enforcement Grants for Crisis Intervention Teams, Mental Health Purposes
•
Amends
the Byrne Justice Assistance Grant (JAG) Program to allow law
enforcement to use funds for the creation
of mental health response
and corrections programs, including police
crisis intervention teams. Also allows
state and local governments to use Byrne JAG funds
in order to comply with current
laws requiring the upload of certain mental health records to the
National Instant Criminal Background Check System (NICS).
•
Amends
the Community
Oriented Policing Services
Grant Program (COPS) to
allow law enforcement to use funds for specialized mental health response
training, including crisis
de-escalation.
•
Amends
the Fire Prevention and Control Act to
allow existing grant funds to be used for training first responders and paramedics on best practices
for
responding to mental health emergencies, including crisis
de-escalation.
Sec.
14002. Assisted Outpatient Treatment Programs
•
Allows federal mental health court
grant funds to be used for the creation of
court-ordered outpatient treatment programs to prevent
the escalation of mental health crises.
Sec.
14003. Federal Drug and Mental
Health Courts
•
Requires
the Attorney General
and the Director of the Administrative
Office of
United States Courts to create a Drug and Mental Health Court pilot program in at
least one Federal Judicial
District. As part of this program,
low-level offenders who are 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 and
local governments operate similar
problem-solving court programs.
Sec. 14004. Mental Health in the Judicial System
•
Amends
the America’s Law
Enforcement and Mental Health Project Act to allow state and local governments to use funds for the creation and
deployment of behavioral health risk and
needs assessments for mentally ill individuals in the criminal
justice system.
Sec. 14005. Forensic
Assertive Community Treatment
Initiatives
•
Amends
the Mentally
Ill Offender
Treatment and Crime Reduction
(MIOTCRA) to allow state and local governments to use
existing authorized grant funds for the
operation of Forensic
Assertive Community
Treatment (FACT) Initiatives. FACT Initiatives provide high-intensity community-based services
for individuals
with mental illness
who are involved
in the criminal justice
system.
Sec.
14006. Assistance for Individuals Transitioning Out of Systems
•
Amends
the Second Chance Act to
allow state and local
governments to use
reentry demonstration project grant funds for the provision of mental health treatment and transitional services (including housing)
for mentally ill offenders who are re-entering the community.
Sec.
14007. Co-occurring Substance Abuse and Mental Health Challenges
in Drug Courts
•
Amends
the federal Drug Court Grant Program to allow state and local
governments to use their existing grant funds to include
targeted interventions for individuals who have both a mental health and substance
abuse disorder. Also allows funds
to be used for the training
of drug court professionals
to identify
and
respond to these co-occurring disorders.
Sec. 14008. Mental Health Training for Federal Uniformed
Services
•
Requires
the appropriate cabinet-level Secretary to provide mental
health crisis and response
training programs for members
of each of the Federal Uniformed Services.
Sec. 14009. Advancing Mental Health as Part of
Offender Reentry
•
Amends
the Second Chance Act to
allow state and local
governments to use
reentry demonstration project grant funds under this program
for the purpose of providing mental health services
and to coordinate transitional services for individuals re-entering society with mental illness, substance abuse problems,
or a chronic homelessness.
Sec. 14010. School Mental
Health Crisis Intervention Teams
•
Amends
the Department
of
Justice Secure Our
Schools program to allow state and local
governments to use existing grant funds to develop and operate school-based mental health crisis intervention teams that
include coordination with law enforcement agencies and specialized training for school officials.
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, and local
law
enforcement officials.
Sec.
14012. Co-occurring Substance Abuse and Mental Health Challenges
in Residential Substance
Abuse Treatment Programs
•
Amends
the Residential
Substance Abuse Treatment grant program to allow
state and local governments
to use funds for the purpose
of developing and implementing specialized residential
substance abuse treatment
programs that provide
treatment to individuals with co-occurring mental health and substance abuse disorders.
Sec.
14013. Mental Health and Drug Treatment
Alternatives to Incarceration Programs
•
Updates
the existing Prosecution Drug Treatment Alternatives to Incarceration Program statute
to allow state and
local governments to use grant funds under
this program for creating and operating
programs that divert
individuals with mental
illness and co-occurring disorders from prisons and
jails pursuant to a court-
supervised intensive
treatment program. Current
law only allows funds
under this program to be used for addressing substance abuse
issues.
Sec. 14014. National Criminal
Justice and Mental Health Training and Technical
Assistance
•
Amends MIOTCRA
to allow the Attorney General
to use existing authorized funds to award grants to
non- profit organizations for the creation of a National Criminal Justice and Mental Health Training Center.
This entity would coordinate best practices on responding to mental illness in the
criminal justice system,
and would 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 law enforcement
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, and local costs
of
imprisonment for individuals with serious mental
illness, including the number
and types of crimes committed
by mentally
ill individuals.
Sec.
14017. Department of Veterans Affairs Patients’ Rights
•
Ensures that veterans
enjoy due process
protections before being 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 Health
Sec. 14021. Sequential Intercept Model
•
Authorizes the Sequential Intercept Model which outlines sequential points at which a person with mental
illness can be “intercepted”
and kept from going further into
the criminal justice
system.
Sec.
14022. Prison and Jails
•
Authorizes
funding for prison and jail-based programs, including
transitional and re-entry
programs that reduce
the likelihood of recidivism when a mentally-ill offender is released.
Sec.
14023. Allowable Uses
•
Expands the allowable
use of grant resources to enhance the capabilities of law enforcement, corrections, and mental health personnel
to better identify and respond to individuals with mental
illnesses who consume a
disproportionate quantity of crisis
services.
Sec.
14024. Law Enforcement Training
•
Authorizes
resources for expanded
training activities,
providing more officers with a basic
understanding of the issues
involved when responding situations with individuals with mental health crises.
Sec.
14025. Federal Law Enforcement Training
•
Requires
the Attorney General
to create programs that
offer federal 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 first responders, tactical units, and corrections officers are trained
to use in responding to individuals with mental
illness, procedures to appropriately respond to incidents, the
application of evidence-based practices in criminal
justice settings, and recommendations on how the
Department of Justice
can improve information sharing and dissemination of best practices.
Sec.
14027. Evidence Based Practices
•
Requires
DOJ
to prioritize grant applications to those who use 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 MIOTCRA
program only if the offender
is selected unanimously for
participation in the program
by the prosecuting attorney, the defense attorney,
the judge, the mental
health agency representative, 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’s provisions to prevent waste, fraud, and abuse of funds by grantees.
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