Us Congress 2023-2024 Regular Session

Us Congress House Bill HB8543 Compare Versions

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Old	New	Differences
1	1	I
2	2	118THCONGRESS
3	3	2
4	4	DSESSION H. R. 8543
5	5	To amend the Social Security Act and the Public Health Service Act to
6	6	permanently authorize certified community behavioral health clinics, and
7	7	for other purposes.
8	8	IN THE HOUSE OF REPRESENTATIVES
9	9	MAY23, 2024
10	10	Ms. M
11	11	ATSUI(for herself, Mr. BUCSHON, Ms. CRAIG, Mr. MOLINARO, and Mr.
12	12	T
13	13	ONKO) introduced the following bill; which was referred to the Com-
14	14	mittee on Energy and Commerce, and in addition to the Committee on
15	15	Ways and Means, for a period to be subsequently determined by the
16	16	Speaker, in each case for consideration of such provisions as fall within
17	17	the jurisdiction of the committee concerned
18	18	A BILL
19	19	To amend the Social Security Act and the Public Health
20	20	Service Act to permanently authorize certified community
21	21	behavioral health clinics, and for other purposes.
22	22	Be it enacted by the Senate and House of Representa-1
23	23	tives of the United States of America in Congress assembled, 2
24	24	SECTION 1. SHORT TITLE. 3
25	25	(a) S
26	26	HORTTITLE.—This Act may be cited as the 4
27	27	‘‘Ensuring Excellence in Mental Health Act’’. 5
28	28	(b) T
29	29	ABLE OFCONTENTS.—The table of contents for 6
30	30	this Act is as follows: 7
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34	34	Sec. 1. Short title.
35	35	TITLE I—ENSURING PERMANENCY FOR CERTIFIED COMMUNITY
36	36	BEHAVIORAL HEALTH CLINICS IN THE MEDICAID PROGRAM
37	37	Sec. 101. Establishing a Medicaid Prospective Payment System for Certified
38	38	Community Behavioral Health Clinics.
39	39	TITLE II—COVERAGE OF CERTIFIED COMMUNITY BEHAVIORAL
40	40	HEALTH CLINIC SERVICES UNDER THE MEDICARE PROGRAM
41	41	Sec. 201. Coverage of certified community behavioral health clinic services
42	42	under the Medicare program.
43	43	TITLE III—COMMUNITY BEHAVIORAL HEALTH CLINIC GRANTS
44	44	Sec. 301. Operating grants for community behavioral health clinics.
45	45	TITLE I—ENSURING PERMA-1
46	46	NENCY FOR CERTIFIED COM-2
47	47	MUNITY BEHAVIORAL 3
48	48	HEALTH CLINICS IN THE 4
49	49	MEDICAID PROGRAM 5
50	50	SEC. 101. ESTABLISHING A MEDICAID PROSPECTIVE PAY-6
51	51	MENT SYSTEM FOR CERTIFIED COMMUNITY 7
52	52	BEHAVIORAL HEALTH CLINICS. 8
53	53	Section 1902 of the Social Security Act (42 U.S.C. 9
54	54	1396a) is amended by adding at the end the following new 10
55	55	subsection: 11
56	56	‘‘(uu) P
57	57	AYMENT FORSERVICESPROVIDED BYCER-12
58	58	TIFIEDCOMMUNITYBEHAVIORALHEALTHCLINICS.— 13
59	59	‘‘(1) I
60	60	N GENERAL.—Beginning with fiscal year 14
61	61	2024, with respect to services furnished on or after 15
62	62	January 1, 2024, and each succeeding fiscal year, a 16
63	63	State may provide under the State plan under this 17
64	64	title (or under a waiver of such plan) for payment 18
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68	68	for services described in section 1905(a)(31) fur-1
69	69	nished by a certified community behavioral health 2
70	70	clinic (in this subsection referred to as a ‘clinic’) in 3
71	71	accordance with the provisions of this subsection. 4
72	72	‘‘(2) P
73	73	AYMENT FOR SERVICES IN INITIAL YEAR 5
74	74	AND EVERY THIRD YEAR .—Subject to paragraphs 6
75	75	(4), (5), and (6), for services furnished by a clinic 7
76	76	in the first fiscal year for which a State elects to 8
77	77	provide for payment for services described in section 9
78	78	1905(a)(31) in accordance with the payment option 10
79	79	under paragraph (1), and every third fiscal year 11
80	80	thereafter in which the State makes such an elec-12
81	81	tion, the State shall provide for payment for such 13
82	82	services in an amount (calculated on the basis of 14
83	83	daily visits or unduplicated monthly visits, at the 15
84	84	State’s election) that is equal to 100 percent of the 16
85	85	average costs of the clinic of furnishing any of the 17
86	86	services described in paragraph (31) of section 18
87	87	1905(a) during the 2 fiscal years preceding the fis-19
88	88	cal year involved which are reasonable and related to 20
89	89	the costs of furnishing such services; provided that, 21
90	90	in the absence of complete actual cost data rep-22
91	91	resenting the provision of the full covered benefit in 23
92	92	such preceding fiscal years, certified community be-24
93	93	havioral health clinics may, at the State’s discretion, 25
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97	97	use estimated or projected data relating to specific 1
98	98	services for which they lack cost experience. The 2
99	99	per-unit rate derived from such cost data shall be 3
100	100	adjusted to take into account any increase or de-4
101	101	crease in the scope of such services furnished by the 5
102	102	clinic in the fiscal year involved. 6
103	103	‘‘(3) P
104	104	AYMENT FOR SERVICES IN SUCCEEDING 7
105	105	FISCAL YEARS.—Subject to paragraphs (4), (5), and 8
106	106	(6), for services described in section 1905(a)(31) 9
107	107	furnished by a clinic for which a State elects to pro-10
108	108	vide for payment for such services in accordance 11
109	109	with the payment option under paragraph (1) and 12
110	110	that are furnished in a fiscal year that is not de-13
111	111	scribed in paragraph (2), the State plan shall pro-14
112	112	vide for payment for such services in an amount 15
113	113	(calculated on the basis of daily visits or 16
114	114	unduplicated monthly visits, at the State’s election) 17
115	115	that is equal to the amount calculated under this 18
116	116	subsection for such services and clinic for the pre-19
117	117	ceding year— 20
118	118	‘‘(A) increased by the percentage increase 21
119	119	in the inflationary factor described in section 22
120	120	1834(aa)(2)(C); and 23
121	121	‘‘(B) adjusted to take into account any in-24
122	122	crease or decrease in the scope of such services 25
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126	126	furnished by the clinic during the fiscal year in-1
127	127	volved. 2
128	128	‘‘(4) E
129	129	STABLISHMENT OF INITIAL YEAR PAY -3
130	130	MENT FOR NEW CLINICS .—In any case in which an 4
131	131	entity first qualifies as a certified community behav-5
132	132	ioral health clinic after the first fiscal year in which 6
133	133	a State elects to provide for payment for services de-7
134	134	scribed in section 1905(a)(31) in accordance with 8
135	135	the payment option under paragraph (1), the State 9
136	136	plan shall provide for payment for such services in 10
137	137	the first 2 years in which the clinic so qualifies in 11
138	138	an amount (calculated on the basis of daily visits or 12
139	139	unduplicated monthly visits, at the State’s election) 13
140	140	that is equal to the rates established under this sub-14
141	141	section for other such clinics located in the same or 15
142	142	adjacent area with a similar case load, or in the ab-16
143	143	sence of any such clinic, based on the average per- 17
144	144	unit rate for other certified community behavioral 18
145	145	health clinics in the State; provided, however, that 19
146	146	effective, at latest, as of the 3rd year in which the 20
147	147	clinic furnishes such services, the State establishes a 21
148	148	unique payment rate for the clinic based on the 22
149	149	methodology described in paragraph (2), using al-23
150	150	lowable costs from the clinic’s first 2 fiscal years of 24
151	151	operation as the basis for establishing such rates; 25
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155	155	and provided, additionally, that in any year following 1
156	156	the establishment of an initial rate under this para-2
157	157	graph, the State plan or waiver provides for the pay-3
158	158	ment amount to be calculated in accordance with 4
159	159	paragraph (2) or (3) (as applicable). 5
160	160	‘‘(5) A
161	161	DMINISTRATION IN THE CASE OF MAN -6
162	162	AGED CARE.— 7
163	163	‘‘(A) I
164	164	N GENERAL.—In the case of services 8
165	165	furnished by a certified community behavioral 9
166	166	health clinic pursuant to a contract between the 10
167	167	clinic and a managed care entity (as defined in 11
168	168	section 1932(a)(1)(B)), the State plan or a 12
169	169	waiver of such plan shall provide for 1 of the 13
170	170	following: 14
171	171	‘‘(i) Payment to the clinic by the 15
172	172	State of a supplemental payment equal to 16
173	173	the amount (if any) by which the amount 17
174	174	determined under paragraph (2), (3), or 18
175	175	(4) (as applicable) exceeds the amount of 19
176	176	payments under the contract, with such 20
177	177	supplemental payment being made pursu-21
178	178	ant to a payment schedule agreed to by the 22
179	179	State and the certified community behav-23
180	180	ioral health clinic, but in no case less fre-24
181	181	quently than every 3 months. 25
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185	185	‘‘(ii) Delegation by the State to the 1
186	186	managed care entity of the obligation to 2
187	187	pay the clinic at least the rate determined 3
188	188	under paragraph (2), (3), or (4) (as appli-4
189	189	cable); provided, however, that the State 5
190	190	shall use reconciliation and oversight proc-6
191	191	esses to ensure that each clinic is paid at 7
192	192	least the amounts required under such 8
193	193	paragraphs. 9
194	194	‘‘(6) A
195	195	LTERNATIVE PAYMENT METHODOLO -10
196	196	GIES.—Notwithstanding any other provision of this 11
197	197	subsection, the State plan or a waiver of such plan 12
198	198	may provide for payment in any year to a certified 13
199	199	community behavioral health clinic for services de-14
200	200	scribed in paragraph (31) of section 1905(a) in an 15
201	201	amount which is determined under an alternative 16
202	202	payment methodology that— 17
203	203	‘‘(A) is agreed to by the State and the clin-18
204	204	ic; and 19
205	205	‘‘(B) results in payment to the clinic of an 20
206	206	amount which is not less than the amount oth-21
207	207	erwise required to be paid to the clinic under 22
208	208	this subsection.’’. 23
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212	212	TITLE II—COVERAGE OF CER-1
213	213	TIFIED COMMUNITY BEHAV-2
214	214	IORAL HEALTH CLINIC SERV-3
215	215	ICES UNDER THE MEDICARE 4
216	216	PROGRAM 5
217	217	SEC. 201. COVERAGE OF CERTIFIED COMMUNITY BEHAV-6
218	218	IORAL HEALTH CLINIC SERVICES UNDER THE 7
219	219	MEDICARE PROGRAM. 8
220	220	(a) C
221	221	OVERAGE.—Section 1861(s)(2) of the Social Se-9
222	222	curity Act (42 U.S.C. 1395x(s)(2)) is amended— 10
223	223	(1) in subparagraph (II), by striking ‘‘and’’ at 11
224	224	the end; 12
225	225	(2) in subparagraph (JJ), by inserting ‘‘and’’ 13
226	226	at the end; and 14
227	227	(3) by adding at the end the following new sub-15
228	228	paragraph: 16
229	229	‘‘(KK) certified community behavioral health 17
230	230	clinic services (as defined in subsection (aa)(8)) fur-18
231	231	nished on or after January 1, 2024.’’. 19
232	232	(b) D
233	233	EFINITIONS.—Section 1861(aa) of the Social 20
234	234	Security Act (42 U.S.C. 1395x) is amended— 21
235	235	(1) in the heading, by striking ‘‘and Federally 22
236	236	Qualified Health Center Services’’ and inserting ‘‘, 23
237	237	Federally Qualified Health Center Services, and Cer-24
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241	241	tified Community Behavioral Health Clinic Serv-1
242	242	ices’’; and 2
243	243	(2) by adding at the end the following new 3
244	244	paragraph: 4
245	245	‘‘(8) The terms ‘certified community behavioral 5
246	246	health clinic services’ and ‘certified community behavioral 6
247	247	health clinic’ have the meaning given those terms in para-7
248	248	graphs (1) and (2), respectively, of section 1905(jj).’’. 8
249	249	(c) P
250	250	AYMENT.— 9
251	251	(1) I
252	252	N GENERAL.—Section 1833(a)(1) of the 10
253	253	Social Security Act (42 U.S.C. 1395l(a)(1)) is 11
254	254	amended— 12
255	255	(A) by striking ‘‘and (HH)’’ and inserting 13
256	256	‘‘(HH)’’; and 14
257	257	(B) by inserting before the semicolon at 15
258	258	the end the following: ‘‘, and (II) with respect 16
259	259	to certified community behavioral health clinic 17
260	260	services for which payment is made under sec-18
261	261	tion 1834(aa), the amounts paid shall be equal 19
262	262	to 80 percent of the lesser of the actual charge 20
263	263	or the amount determined under such section’’. 21
264	264	(2) D
265	265	EVELOPMENT AND IMPLEMENTATION OF 22
266	266	PROSPECTIVE PAYMENT SYSTEM .—Section 1834 of 23
267	267	the Social Security Act (42 U.S.C. 1395m) is 24
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271	271	amended by adding at the end the following new 1
272	272	subsection: 2
273	273	‘‘(aa) D
274	274	EVELOPMENT AND IMPLEMENTATION OF 3
275	275	P
276	276	ROSPECTIVEPAYMENTSYSTEM FORCERTIFIEDCOM-4
277	277	MUNITYBEHAVIORALHEALTHCLINICS.— 5
278	278	‘‘(1) D
279	279	EVELOPMENT.—The Secretary shall de-6
280	280	velop a prospective payment system for payment to 7
281	281	certified community behavioral health clinics (as de-8
282	282	fined in section 1861(aa)(8)) for the furnishing of 9
283	283	certified community behavioral health clinic services 10
284	284	(as defined in such section) under this title. Such 11
285	285	system shall be established to take into account the 12
286	286	type, intensity, and duration of services furnished by 13
287	287	certified community behavioral health clinics. Such 14
288	288	system may include adjustments, including geo-15
289	289	graphic adjustments, as determined appropriate by 16
290	290	the Secretary. 17
291	291	‘‘(2) I
292	292	MPLEMENTATION.— 18
293	293	‘‘(A) I
294	294	N GENERAL.—The Secretary shall 19
295	295	provide, for cost reporting periods beginning on 20
296	296	or after January 1, 2024, for payments of pro-21
297	297	spective payment rates for certified community 22
298	298	behavioral health clinic services furnished by 23
299	299	certified community behavioral health clinics 24
300	300	under this title in accordance with the prospec-25
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304	304	tive payment system developed by the Secretary 1
305	305	under paragraph (1). 2
306	306	‘‘(B) I
307	307	NITIAL PAYMENTS.—The Secretary 3
308	308	shall implement such prospective payment sys-4
309	309	tem to reflect the national average allowable 5
310	310	service costs of such clinics on the basis of the 6
311	311	most current audited cost report data for two 7
312	312	fiscal years available to the Secretary; provided 8
313	313	that, in the absence of complete actual cost 9
314	314	data representing the provision of the full cov-10
315	315	ered benefit during the relevant fiscal years, 11
316	316	certified community behavioral health clinics 12
317	317	may, at the Secretary’s discretion, use esti-13
318	318	mated or projected data relating to specific 14
319	319	services. Initial payments shall be established 15
320	320	without the application of a per visit limit or 16
321	321	productivity screen and shall be based on na-17
322	322	tional average costs per unit of service, updated 18
323	323	as appropriate by the inflationary adjustment 19
324	324	described in subparagraph (C). 20
325	325	‘‘(C) P
326	326	AYMENTS IN SUBSEQUENT YEARS .— 21
327	327	Payment rates in years after the year of imple-22
328	328	mentation of such system shall be the payment 23
329	329	rates in the previous year increased— 24
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333	333	‘‘(i) in the first year after implemen-1
334	334	tation of such system, by the percentage 2
335	335	increase in the MEI (as defined in section 3
336	336	1842(i)(3)) for the year involved; and 4
337	337	‘‘(ii) in subsequent years, by the per-5
338	338	centage increase in a market basket of cer-6
339	339	tified community behavioral health clinic 7
340	340	services, designed by the Secretary, or if 8
341	341	such an index is not available, by the per-9
342	342	centage increase in the MEI (as defined in 10
343	343	section 1842(i)(3)) for the year involved. 11
344	344	‘‘(3) U
345	345	NIT OF PAYMENT .—In establishing a 12
346	346	prospective payment amount under the system under 13
347	347	this subsection, the Secretary shall consider an ap-14
348	348	propriate unit of service and a general system design 15
349	349	that provides for continued access to quality serv-16
350	350	ices. 17
351	351	‘‘(4) P
352	352	ERIODIC REEVALUATION OF RATES .—At 18
353	353	the Secretary’s discretion, the Secretary shall, from 19
354	354	time to time, adjust the amounts that would other-20
355	355	wise be applicable under subparagraph (2) by a per-21
356	356	centage determined appropriate by the Secretary to 22
357	357	reflect such factors as changes in the intensity of 23
358	358	services furnished within a unit of service, the aver-24
359	359	age cost of providing care per unit of service, and 25
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363	363	other factors that the Secretary considers to be rel-1
364	364	evant. Such adjustment shall be made before the up-2
365	365	date under clause (i) or (ii) of paragraph (2)(C)(i) 3
366	366	has been applied for the year.’’. 4
367	367	(d) W
368	368	AIVER OFAPPLICATION OFDEDUCTIBLE.— 5
369	369	Section 1833(b)(4) of the Social Security Act (42 U.S.C. 6
370	370	1395l(b)(4)) is amended by inserting ‘‘or certified commu-7
371	371	nity behavioral health clinic services’’ before the comma 8
372	372	at the end. 9
373	373	(e) PRRB R
374	374	EVIEW OFCOSTREPORTS.—Section 10
375	375	1878(j) of the Social Security Act (42 U.S.C. 1395oo(j)) 11
376	376	is amended by striking ‘‘and a Federally qualified health 12
377	377	center’’ and inserting ‘‘, a Federally qualified health cen-13
378	378	ter, and a certified community behavioral health clinic’’. 14
379	379	(f) S
380	380	AFEHARBOR FORWAIVER OFCOINSURANCE.— 15
381	381	Section 1128B(b)(3)(D) of the Social Security Act (42 16
382	382	U.S.C. 1320a–7b(b)(3)(D)) is amended by inserting ‘‘or 17
383	383	a certified community behavioral health clinic’’ after 18
384	384	‘‘Federally qualified health care center’’. 19
385	385	(g) E
386	386	FFECTIVEDATE.—The amendments made by 20
387	387	this section shall apply with respect to services furnished 21
388	388	on or after January 1, 2024. 22
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392	392	TITLE III—COMMUNITY BEHAV-1
393	393	IORAL HEALTH CLINIC 2
394	394	GRANTS 3
395	395	SEC. 301. OPERATING GRANTS FOR COMMUNITY BEHAV-4
396	396	IORAL HEALTH CLINICS. 5
397	397	Part D of title III of the Public Health Service Act 6
398	398	(42 U.S.C. 254b et seq.) is amended by adding at the end 7
399	399	the following: 8
400	400	‘‘Subpart XIII—Community Behavioral Health 9
401	401	Clinics 10
402	402	‘‘SEC. 340J. DEFINITIONS. 11
403	403	‘‘In this subpart: 12
404	404	‘‘(1) C
405	405	ERTIFIED COMMUNITY BEHAVIORAL 13
406	406	HEALTH CLINIC.—The term ‘certified community be-14
407	407	havioral health clinic’ has the meaning given the 15
408	408	term in section 1905(jj)(2)) of the Social Security 16
409	409	Act. 17
410	410	‘‘(2) C
411	411	ERTIFIED COMMUNITY BEHAVIORAL 18
412	412	HEALTH SERVICES.—The term ‘certified community 19
413	413	behavioral health services’ has the meaning given the 20
414	414	term in section 1905(jj)(1) of the Social Security 21
415	415	Act. 22
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419	419	‘‘SEC. 340J–1. COMMUNITY BEHAVIORAL HEALTH CLINIC 1
420	420	CERTIFICATION. 2
421	421	‘‘(a) I
422	422	NGENERAL.—Not later than 180 days after 3
423	423	the date of enactment of the Ensuring Excellence in Men-4
424	424	tal Health Act, the Secretary, after public notice and op-5
425	425	portunity for comment, shall publish in the Federal Reg-6
426	426	ister criteria for a clinic to be certified as a community 7
427	427	behavioral health clinic for purposes of section 8
428	428	1905(jj)(2)(D)(ii) of the Social Security Act. 9
429	429	‘‘(b) R
430	430	EQUIREMENTS.—The criteria published under 10
431	431	subsection (a) shall include criteria with respect to the fol-11
432	432	lowing: 12
433	433	‘‘(1) S
434	434	TAFFING.—Staffing requirements, includ-13
435	435	ing criteria that staff have diverse disciplinary back-14
436	436	grounds, have necessary State-required license and 15
437	437	accreditation, and are culturally and linguistically 16
438	438	trained to serve the needs of the patient populations 17
439	439	of the community behavioral health clinic. 18
440	440	‘‘(2) A
441	441	VAILABILITY AND ACCESSIBILITY OF 19
442	442	SERVICES.—Availability and accessibility of services, 20
443	443	including crisis management services that are avail-21
444	444	able and accessible 24 hours a day, the use of a slid-22
445	445	ing scale for payment, and no rejection for services 23
446	446	or limiting of services on the basis of a patient’s 24
447	447	ability to pay or a place of residence. 25
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451	451	‘‘(3) CARE COORDINATION.—Care coordination, 1
452	452	including requirements to coordinate care across set-2
453	453	tings and providers to ensure seamless transitions 3
454	454	for patients across the full spectrum of health serv-4
455	455	ices including acute, chronic, and behavioral health 5
456	456	needs. Care coordination requirements shall include 6
457	457	partnerships or formal contracts with the following: 7
458	458	‘‘(A) Federally-qualified health centers (as 8
459	459	defined in section 1905(l) of the Social Security 9
460	460	Act) and, as applicable, rural health clinics (as 10
461	461	so defined), to provide Federally-qualified 11
462	462	health center services (as so defined) and, as 12
463	463	applicable, rural health clinic services (as so de-13
464	464	fined), to the extent such services are not pro-14
465	465	vided directly through the community behav-15
466	466	ioral health clinic. 16
467	467	‘‘(B) Inpatient psychiatric facilities and 17
468	468	substance use detoxification, post-detoxification 18
469	469	step-down services, and residential programs. 19
470	470	‘‘(C) Other community or regional services, 20
471	471	supports, and providers, including schools, child 21
472	472	welfare agencies, juvenile and criminal justice 22
473	473	agencies and facilities, Indian Health Service 23
474	474	youth regional treatment centers, State-licensed 24
475	475	and nationally accredited child placing agencies 25
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478	478	•HR 8543 IH
479	479	for therapeutic foster care service, and other so-1
480	480	cial and human services. 2
481	481	‘‘(D) Medical centers, outpatient clinics, 3
482	482	and drop-in centers of the Department of Vet-4
483	483	erans Affairs and other facilities of the Depart-5
484	484	ment (as defined in section 1701 of title 38, 6
485	485	United States Code). 7
486	486	‘‘(E) Inpatient acute care hospitals and 8
487	487	hospital outpatient clinics. 9
488	488	‘‘(4) S
489	489	COPE OF SERVICES .—Provision (in a 10
490	490	manner reflecting person-centered care) of the full 11
491	491	array of certified community behavioral health serv-12
492	492	ices which, if not available directly through the com-13
493	493	munity behavioral health clinic, are provided or re-14
494	494	ferred through formal relationships with other pro-15
495	495	viders. 16
496	496	‘‘(5) Q
497	497	UALITY AND OTHER REPORTING .—Re-17
498	498	quirements relating to development by the commu-18
499	499	nity behavioral health clinic of an effective procedure 19
500	500	for compiling and reporting to the Secretary such 20
501	501	statistics and other information as the Secretary 21
502	502	may require relating to— 22
503	503	‘‘(A) the costs of its operations; 23
504	504	‘‘(B) the patterns of use of its services, in-24
505	505	cluding the reporting of encounter data, clinical 25
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508	508	•HR 8543 IH
509	509	outcomes data, quality data, and such other 1
510	510	data as the Secretary may require; 2
511	511	‘‘(C) the availability, accessibility, and ac-3
512	512	ceptability of its services; and 4
513	513	‘‘(D) such other matters relating to oper-5
514	514	ations of the applicant as the Secretary may re-6
515	515	quire. 7
516	516	‘‘(6) O
517	517	RGANIZATIONAL AUTHORITY .—Require-8
518	518	ments that a community behavioral health clinic 9
519	519	be— 10
520	520	‘‘(A) a nonprofit entity; 11
521	521	‘‘(B) part of a local government behavioral 12
522	522	health authority; 13
523	523	‘‘(C) operated under the authority of the 14
524	524	Indian Health Service; 15
525	525	‘‘(D) operated by an Indian Tribe or Trib-16
526	526	al organization pursuant to a contract, grant, 17
527	527	cooperative agreement, or compact with the In-18
528	528	dian Health Service pursuant to the Indian 19
529	529	Self-Determination and Education Assistance 20
530	530	Act; or 21
531	531	‘‘(E) operated by an urban Indian organi-22
532	532	zation pursuant to a grant or contract with the 23
533	533	Indian Health Service under title V of the In-24
534	534	dian Health Care Improvement Act. 25
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537	537	•HR 8543 IH
538	538	‘‘SEC. 340J–2. OPERATING GRANTS FOR COMMUNITY BE-1
539	539	HAVIORAL HEALTH CLINICS. 2
540	540	‘‘(a) I
541	541	NGENERAL.—The Secretary shall establish a 3
542	542	grant program under which the Secretary shall award 4
543	543	grants to eligible community behavioral health clinics to 5
544	544	provide (in a manner reflecting person-centered care) the 6
545	545	full array of certified community behavioral health serv-7
546	546	ices. 8
547	547	‘‘(b) E
548	548	LIGIBILITY.—To be eligible to receive a grant 9
549	549	under subsection (a), a community behavioral health clinic 10
550	550	shall be— 11
551	551	‘‘(1) a certified community behavioral health 12
552	552	clinic; or 13
553	553	‘‘(2) a community behavioral health clinic that 14
554	554	indicates in the grant application that the clinic will 15
555	555	use the grant funds to meet the criteria described in 16
556	556	section 340J–1(a). 17
557	557	‘‘(c) U
558	558	SE OFFUNDS.—A community behavioral 18
559	559	health clinic that receives a grant under subsection (a)— 19
560	560	‘‘(1) shall use the grant funds— 20
561	561	‘‘(A) to provide the services described in 21
562	562	subsection (a); and 22
563	563	‘‘(B) in the case of a community behavioral 23
564	564	health clinic described in subsection (b)(2), to 24
565	565	meet the criteria described in section 340J– 25
566	566	1(a); and 26
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569	569	•HR 8543 IH
570	570	‘‘(2) may use the grant funds— 1
571	571	‘‘(A) to carry out other activities that— 2
572	572	‘‘(i) reduce costs associated with the 3
573	573	provision of certified community behavioral 4
574	574	health services; 5
575	575	‘‘(ii) improve access to, and avail-6
576	576	ability of, certified community behavioral 7
577	577	health services provided to individuals 8
578	578	served by the community behavioral health 9
579	579	clinic; 10
580	580	‘‘(iii) enhance the quality and coordi-11
581	581	nation of certified community behavioral 12
582	582	health services; or 13
583	583	‘‘(iv) improve the health status of 14
584	584	communities; and 15
585	585	‘‘(B) to pay for— 16
586	586	‘‘(i) the costs of acquiring and leasing 17
587	587	buildings and equipment (including the 18
588	588	costs of amortizing the principal of, and 19
589	589	paying interest on, loans); 20
590	590	‘‘(ii) costs relating to the purchase or 21
591	591	lease of equipment, including data and in-22
592	592	formation systems and behavioral health 23
593	593	information technology to facilitate data 24
594	594	reporting and other purposes; 25
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597	597	•HR 8543 IH
598	598	‘‘(iii) the costs of in-service staff 1
599	599	training and other operational or infra-2
600	600	structure costs identified by the Secretary; 3
601	601	and 4
602	602	‘‘(iv) costs associated with expanding 5
603	603	and modernizing existing buildings or con-6
604	604	structing new buildings (including the 7
605	605	costs of amortizing the principal of, and 8
606	606	paying the interest on, loans), if such costs 9
607	607	are specifically allowed for in the grant op-10
608	608	portunity published by the Secretary. 11
609	609	‘‘(d) T
610	610	ERM.—Grants awarded under subsection (a) 12
611	611	shall be for a period of not more than 5 years. 13
612	612	‘‘(e) C
613	613	ONDITION ONRECEIPT OFFUNDS.—The Sec-14
614	614	retary shall not make a grant to an applicant under sub-15
615	615	section (a) unless the applicant provides assurances to the 16
616	616	Secretary that within 120 days of receiving grant funding 17
617	617	for the operation of the clinic, the applicant will submit 18
618	618	for approval by the Secretary an implementation plan that 19
619	619	describes how the applicant will— 20
620	620	‘‘(1) provide the services described in subsection 21
621	621	(a); and 22
622	622	‘‘(2) in the case of a community behavioral 23
623	623	health clinic described in subsection (b)(2), meet the 24
624	624	criteria described in section 340J–1(a). 25
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627	627	•HR 8543 IH
628	628	‘‘(f) AMOUNT OFGRANT.— 1
629	629	‘‘(1) I
630	630	N GENERAL.—Subject to paragraph (2), 2
631	631	the amount of a grant made in any fiscal year to a 3
632	632	community behavioral health clinic under subsection 4
633	633	(a) shall be determined by the Secretary based on 5
634	634	information provided by the community behavioral 6
635	635	health clinic, but may not exceed an amount equal 7
636	636	to the difference obtained by subtracting— 8
637	637	‘‘(A) the sum obtained by adding— 9
638	638	‘‘(i) the total State, local, and other 10
639	639	operational funding provided to the clinic 11
640	640	for such fiscal year; and 12
641	641	‘‘(ii) the fees, premiums, and third- 13
642	642	party reimbursements that the clinic rea-14
643	643	sonably expects to receive for its operations 15
644	644	in such fiscal year; from 16
645	645	‘‘(B) the costs of operating the clinic to 17
646	646	meet the purposes and requirements of the 18
647	647	grant program under this section during such 19
648	648	fiscal year. 20
649	649	‘‘(2) R
650	650	EQUIREMENT.— 21
651	651	‘‘(A) I
652	652	N GENERAL.—In determining the 22
653	653	costs described in paragraph (1)(B), the Sec-23
654	654	retary may estimate the anticipated costs of the 24
655	655	grant recipient in— 25
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658	658	•HR 8543 IH
659	659	‘‘(i) providing the services described in 1
660	660	subsection (a), including the anticipated 2
661	661	costs of providing any individual certified 3
662	662	community behavioral health service that 4
663	663	the applicant entity does not have cost ex-5
664	664	perience providing at the time of submit-6
665	665	ting an application for such grant; and 7
666	666	‘‘(ii) if applicable, meeting the criteria 8
667	667	described in section 340J–1(a). 9
668	668	‘‘(B) A
669	669	NTICIPATED COSTS.—The Secretary 10
670	670	shall base the estimate of anticipated costs 11
671	671	under subparagraph (A) on an estimate of an-12
672	672	ticipated costs provided by the applicable com-13
673	673	munity behavioral health clinic. 14
674	674	‘‘(3) P
675	675	AYMENTS.—The Secretary may— 15
676	676	‘‘(A) award grants under subsection (a)— 16
677	677	‘‘(i) in advance or through reimburse-17
678	678	ment; and 18
679	679	‘‘(ii) in installments; 19
680	680	‘‘(B) make adjustments to account for 20
681	681	overpayments or underpayments. 21
682	682	‘‘(g) U
683	683	SE OFACCREDITATION.— 22
684	684	‘‘(1) I
685	685	N GENERAL.—In selecting grant recipi-23
686	686	ents under this section, the Secretary may take into 24
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689	689	•HR 8543 IH
690	690	account whether an applicant community behavioral 1
691	691	health clinic is accredited under section 340J–5(a). 2
692	692	‘‘(2) C
693	693	OMPLIANCE.—In determining whether a 3
694	694	community behavioral health clinic receiving a grant 4
695	695	under this section is providing the services described 5
696	696	in subsection (a) and, if applicable, meeting the cri-6
697	697	teria described in section 340J–1(a), the Secretary 7
698	698	may take into account whether the community be-8
699	699	havioral health clinic is accredited under section 9
700	700	340J–5(a). 10
701	701	‘‘(h) A
702	702	UTHORIZATION OFAPPROPRIATIONS.— 11
703	703	‘‘(1) I
704	704	N GENERAL.—There is authorized to be 12
705	705	appropriated to carry out this section, $552,500,000 13
706	706	for each of fiscal years 2024 through 2028. 14
707	707	‘‘(2) M
708	708	AINTENANCE OF FUNDING .—The 15
709	709	amount made available under paragraph (1) shall 16
710	710	supplement (and not supplant) any other Federal 17
711	711	funding made available for community behavioral 18
712	712	health clinics. 19
713	713	‘‘SEC. 340J–3. TECHNICAL ASSISTANCE. 20
714	714	‘‘(a) I
715	715	NGENERAL.—Not later than 180 days after 21
716	716	the date of enactment of the Ensuring Excellence in Men-22
717	717	tal Health Act, the Secretary shall establish programs 23
718	718	through which the Secretary shall provide (either through 24
719	719	the Department of Health and Human Services or by 25
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722	722	•HR 8543 IH
723	723	grant or contract) technical assistance and other assist-1
724	724	ance to any of the following: 2
725	725	‘‘(1) Entities that receive a grant under section 3
726	726	340J–2. 4
727	727	‘‘(2) Entities participating in a Medicaid dem-5
728	728	onstration program under section 223(d) of the Pro-6
729	729	tecting Access to Medicare Act. 7
730	730	‘‘(3) Certified community behavioral health clin-8
731	731	ics (as defined in sections 1861(aa)(8) and 9
732	732	1905(jj)(2) of the Social Security Act), furnishing 10
733	733	services under title XVIII or title XIX of such Act. 11
734	734	‘‘(4) Health or social service provider organiza-12
735	735	tions pursuing or considering certified community 13
736	736	behavioral health clinic status or partnering with 14
737	737	certified community behavioral health clinics. 15
738	738	‘‘(5) Other stakeholders, for the purpose of fa-16
739	739	cilitating successful implementation of the certified 17
740	740	community behavioral health clinic model. 18
741	741	‘‘(b) I
742	742	NCLUSIONS.—Assistance provided by the Sec-19
743	743	retary under subsection (a) may include technical and 20
744	744	nonfinancial assistance, including— 21
745	745	‘‘(1) fiscal and program management assist-22
746	746	ance; 23
747	747	‘‘(2) operational and administrative support; 24
748	748	and 25
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751	751	•HR 8543 IH
752	752	‘‘(3) the provision of information to the entities 1
753	753	about the variety of resources available under this 2
754	754	part and how those resources can be best used to 3
755	755	meet the health and behavioral health needs of the 4
756	756	communities served by the entities. 5
757	757	‘‘(c) A
758	758	UTHORIZATION OF APPROPRIATIONS.—There 6
759	759	is authorized to be appropriated to carry out this section 7
760	760	$6,000,000 for each of fiscal years 2024 through 2028. 8
761	761	‘‘SEC. 340J–4. DATA INFRASTRUCTURE FOR COMMUNITY 9
762	762	BEHAVIORAL HEALTH CLINIC REPORTING. 10
763	763	‘‘(a) I
764	764	NGENERAL.—Not later than 180 days after 11
765	765	the date of enactment of the Ensuring Excellence in Men-12
766	766	tal Health Act, the Secretary shall establish a system 13
767	767	under which the Secretary shall collect and analyze data 14
768	768	on community behavioral health clinics. 15
769	769	‘‘(b) S
770	770	COPE OFDATACOLLECTION.—The system es-16
771	771	tablished under subsection (a) shall be used by the Sec-17
772	772	retary to collect and analyze data from— 18
773	773	‘‘(1) entities that receive a grant under section 19
774	774	340J–2; and 20
775	775	‘‘(2) organizations that provide services, or have 21
776	776	applied to provide services, under title XVIII of the 22
777	777	Social Security Act, as described in section 23
778	778	1861(aa)(8) of such Act, or under a State Medicaid 24
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781	781	•HR 8543 IH
782	782	program in accordance with section 1905(jj) of such 1
783	783	Act. 2
784	784	‘‘(c) A
785	785	UTHORIZATION OF APPROPRIATIONS.—There 3
786	786	is authorized to be appropriated to carry out this section 4
787	787	$51,000,000 for each of fiscal years 2024 through 2028. 5
788	788	‘‘SEC. 340J–5. COMMUNITY BEHAVIORAL HEALTH CLINIC 6
789	789	ACCREDITATION. 7
790	790	‘‘(a) A
791	791	CCREDITATIONSTANDARDS.—A community 8
792	792	behavioral health clinic may be accredited if the entity— 9
793	793	‘‘(1) meets the standards of an approved ac-10
794	794	creditation body; and 11
795	795	‘‘(2) authorizes the accreditation body to sub-12
796	796	mit to the Secretary (or such agency as the Sec-13
797	797	retary may designate) such records or other infor-14
798	798	mation as the Secretary may require. 15
799	799	‘‘(b) A
800	800	PPROVAL OFACCREDITATIONBODIES.— 16
801	801	‘‘(1) I
802	802	N GENERAL.—The Secretary may approve 17
803	803	a private nonprofit organization to be an accredita-18
804	804	tion body for the accreditation of community behav-19
805	805	ioral health clinics under subsection (a) if— 20
806	806	‘‘(A) using inspectors qualified to evaluate 21
807	807	quality of care in a behavioral health service 22
808	808	setting, the accreditation body agrees to inspect 23
809	809	the clinic with such frequency as is determined 24
810	810	by the Secretary; 25
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814	814	‘‘(B) the standards applied by the body in 1
815	815	determining whether or not to accredit a clinic 2
816	816	correspond to the criteria described in section 3
817	817	340J–1(a), and are not less restrictive than 4
818	818	such criteria; 5
819	819	‘‘(C) there is adequate provision for assur-6
820	820	ing that the standards of the accreditation body 7
821	821	continue to be met by the clinic; 8
822	822	‘‘(D) in the case of any clinic previously 9
823	823	accredited by the body which has had its ac-10
824	824	creditation denied, suspended, withdrawn, or re-11
825	825	voked or which has had any other action taken 12
826	826	against it by the accrediting body, the accred-13
827	827	iting body agrees to submit to the Secretary the 14
828	828	name of such clinic within 30 days of the action 15
829	829	taken; and 16
830	830	‘‘(E) if the accreditation body has its ap-17
831	831	proval withdrawn by the Secretary, the body 18
832	832	agrees to notify each clinic accredited by the 19
833	833	body of the withdrawal within 10 days of the 20
834	834	withdrawal.’’. 21
835	835	Æ
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