II
118THCONGRESS
1
STSESSION S. 2993
To amend the Social Security Act and the Public Health Service Act to
permanently authorize certified community behavioral health clinics, and
for other purposes.
IN THE SENATE OF THE UNITED STATES
SEPTEMBER28 (legislative day, SEPTEMBER22), 2023
Ms. S
TABENOW(for herself and Mr. CORNYN) introduced the following bill;
which was read twice and referred to the Committee on Finance
A BILL
To amend the Social Security Act and the Public Health
Service Act to permanently authorize certified community
behavioral health clinics, and for other purposes.
Be it enacted by the Senate and House of Representa-1
tives of the United States of America in Congress assembled, 2
SECTION 1. SHORT TITLE. 3
(a) S
HORTTITLE.—This Act may be cited as the 4
‘‘Ensuring Excellence in Mental Health Act’’. 5
(b) T
ABLE OFCONTENTS.—The table of contents for 6
this Act is as follows: 7
Sec. 1. Short title.
TITLE I—ENSURING PERMANENCY FOR CERTIFIED COMMUNITY
BEHAVIORAL HEALTH CLINICS IN THE MEDICAID PROGRAM
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Sec. 101. Establishing Certified Community Behavioral Health Clinic Services
as a Medicaid State Plan Option.
Sec. 102. Establishing a Medicaid Prospective Payment System for Certified
Community Behavioral Health Clinics.
TITLE II—COVERAGE OF CERTIFIED COMMUNITY BEHAVIORAL
HEALTH CLINIC SERVICES UNDER THE MEDICARE PROGRAM
Sec. 201. Coverage of certified community behavioral health clinic services
under the Medicare program.
TITLE III—COMMUNITY BEHAVIORAL HEALTH CLINIC GRANTS
Sec. 301. Operating grants for community behavioral health clinics.
TITLE I—ENSURING PERMA-1
NENCY FOR CERTIFIED COM-2
MUNITY BEHAVIORAL 3
HEALTH CLINICS IN THE 4
MEDICAID PROGRAM 5
SEC. 101. ESTABLISHING CERTIFIED COMMUNITY BEHAV-6
IORAL HEALTH CLINIC SERVICES AS A MED-7
ICAID STATE PLAN OPTION. 8
(a) I
NGENERAL.—Section 1905 of the Social Secu-9
rity Act (42 U.S.C. 1396d) is amended— 10
(1) in subsection (a)— 11
(A) in paragraph (30), by striking ‘‘; and’’ 12
and inserting a semicolon; 13
(B) by redesignating paragraph (31) as 14
paragraph (32); and 15
(C) by inserting after paragraph (30) the 16
following new paragraph: 17
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‘‘(31) certified community behavioral health 1
clinic services, as defined in subsection (jj); and’’; 2
and 3
(2) by adding at the end the following new sub-4
section: 5
‘‘(jj) C
ERTIFIEDCOMMUNITYBEHAVIORALHEALTH 6
C
LINICSERVICES.— 7
‘‘(1) I
N GENERAL.—The term ‘certified commu-8
nity behavioral health services’ means any of the fol-9
lowing when furnished to an individual as a patient 10
of a certified community behavioral health clinic (as 11
defined in paragraph (2)), in a manner reflecting 12
person-centered care and which, if not available di-13
rectly through a certified community behavioral 14
health clinic, may be provided or referred through 15
formal relationships with other providers: 16
‘‘(A) Crisis mental health services, includ-17
ing 24-hour mobile crisis teams, emergency cri-18
sis intervention services, and crisis stabilization. 19
‘‘(B) Screening, assessment, and diagnosis, 20
including risk assessment. 21
‘‘(C) Patient-centered treatment planning 22
or similar processes, including risk assessment 23
and crisis planning. 24
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‘‘(D) Outpatient mental health and sub-1
stance use services. 2
‘‘(E) Outpatient clinic primary care screen-3
ing and monitoring of key health indicators and 4
health risk. 5
‘‘(F) Targeted case management. 6
‘‘(G) Psychiatric rehabilitation services. 7
‘‘(H) Peer support and counselor services 8
and family supports. 9
‘‘(I) Intensive, community-based mental 10
health care for members of the armed forces 11
and veterans, particularly those members and 12
veterans located in rural areas, provided the 13
care is consistent with minimum clinical mental 14
health guidelines promulgated by the Veterans 15
Health Administration, including clinical guide-16
lines contained in the Uniform Mental Health 17
Services Handbook of such Administration. 18
‘‘(2) C
ERTIFIED COMMUNITY BEHAVIORAL 19
HEALTH CLINIC.—The term ‘certified community be-20
havioral health clinic’ means an organization that— 21
‘‘(A) is engaged in furnishing to patients 22
all of the services described in paragraph (1); 23
‘‘(B) is legally authorized to furnish such 24
services under State law; 25
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‘‘(C) agrees, as a condition of the certifi-1
cation described in subparagraph (D), to fur-2
nish to the State or Secretary any data re-3
quired as part of ongoing monitoring of the or-4
ganization’s provision of services, including any 5
such data as the State, by agreement with the 6
Secretary, shall access via the system described 7
in section 340J–4 of the Public Health Service 8
Act; and 9
‘‘(D) has been certified by a State— 10
‘‘(i) as meeting the criteria established 11
by the Secretary pursuant to subsection 12
(a) of section 223 of the Protecting Access 13
to Medicare Act and is carrying out a dem-14
onstration program under this title under 15
subsection (d) of such section; or 16
‘‘(ii) for purposes of services furnished 17
on or after January 1, 2024, subject to 18
paragraph (3), as meeting the criteria es-19
tablished under section 340J–1(a) of the 20
Public Health Service Act, and as being el-21
igible to furnish medical assistance under 22
the State plan under this title (or under a 23
waiver of such plan) for certified commu-24
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nity behavioral health services described in 1
paragraph (1). 2
‘‘(3) A
CCREDITATION.—In the case of services 3
furnished on or after January 1, 2024, at State op-4
tion, a State may determine that an organization 5
does not meet the criteria established under section 6
340J–1(a) of the Public Health Service Act unless 7
the organization has an accreditation by an accredi-8
tation body approved under section 340J–5 of the 9
Public Health Service Act. An election by a State 10
under the preceding sentence shall not relieve a 11
State of the requirement to certify an organization 12
under paragraph (2)(D).’’. 13
(b) C
ONFORMINGAMENDMENTS.— 14
(1) Section 1902(nn)(3) of such Act (42 U.S.C. 15
1396a(nn)(3)), is amended by striking ‘‘paragraph 16
(31)’’ and inserting ‘‘the last numbered paragraph’’. 17
(2) The fifth sentence of section 1905(a) of 18
such Act (42 U.S.C. 1396d(a)) is amended by strik-19
ing ‘‘paragraph (30)’’ and inserting ‘‘the last num-20
bered paragraph’’. 21
(3) Effective July 1, 2025, section 22
1902(a)(84)(A) of such Act (42 U.S.C. 23
1396a(a)(84)(A)), as amended by section 5122(a)(2) 24
of division FF of Public Law 117–328, is amended 25
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by striking ‘‘paragraph (31)’’ and inserting ‘‘the last 1
numbered paragraph’’. 2
SEC. 102. ESTABLISHING A MEDICAID PROSPECTIVE PAY-3
MENT SYSTEM FOR CERTIFIED COMMUNITY 4
BEHAVIORAL HEALTH CLINICS. 5
Section 1902 of the Social Security Act (42 U.S.C. 6
1396a) is amended by adding at the end the following new 7
subsection: 8
‘‘(uu) P
AYMENT FORSERVICESPROVIDED BYCER-9
TIFIEDCOMMUNITYBEHAVIORALHEALTHCLINICS.— 10
‘‘(1) I
N GENERAL.—Beginning with fiscal year 11
2024, with respect to services furnished on or after 12
January 1, 2024, and each succeeding fiscal year, a 13
State may provide under the State plan under this 14
title (or under a waiver of such plan) for payment 15
for services described in section 1905(a)(31) fur-16
nished by a certified community behavioral health 17
clinic (in this subsection referred to as a ‘clinic’) in 18
accordance with the provisions of this subsection. 19
‘‘(2) P
AYMENT FOR SERVICES IN INITIAL YEAR 20
AND EVERY THIRD YEAR .—Subject to paragraphs 21
(4), (5), and (6), for services furnished by a clinic 22
in the first fiscal year for which a State elects to 23
provide for payment for services described in section 24
1905(a)(31) in accordance with the payment option 25
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under paragraph (1), and every third fiscal year 1
thereafter in which the State makes such an elec-2
tion, the State shall provide for payment for such 3
services in an amount (calculated on the basis of 4
daily visits or unduplicated monthly visits, at the 5
State’s election) that is equal to 100 percent of the 6
average costs of the clinic of furnishing any of the 7
services described in paragraph (31) of section 8
1905(a) during the 2 fiscal years preceding the fis-9
cal year involved which are reasonable and related to 10
the costs of furnishing such services; provided that, 11
in the absence of complete actual cost data rep-12
resenting the provision of the full covered benefit in 13
such preceding fiscal years, certified community be-14
havioral health clinics may, at the State’s discretion, 15
use estimated or projected data relating to specific 16
services for which they lack cost experience. The 17
per-unit rate derived from such cost data shall be 18
adjusted to take into account any increase or de-19
crease in the scope of such services furnished by the 20
clinic in the fiscal year involved. 21
‘‘(3) P
AYMENT FOR SERVICES IN SUCCEEDING 22
FISCAL YEARS.—Subject to paragraphs (4), (5), and 23
(6), for services described in section 1905(a)(31) 24
furnished by a clinic for which a State elects to pro-25
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vide for payment for such services in accordance 1
with the payment option under paragraph (1) and 2
that are furnished in a fiscal year that is not de-3
scribed in paragraph (2), the State plan shall pro-4
vide for payment for such services in an amount 5
(calculated on the basis of daily visits or 6
unduplicated monthly visits, at the State’s election) 7
that is equal to the amount calculated under this 8
subsection for such services and clinic for the pre-9
ceding year— 10
‘‘(A) increased by the percentage increase 11
in the inflationary factor described in section 12
1834(aa)(2)(C); and 13
‘‘(B) adjusted to take into account any in-14
crease or decrease in the scope of such services 15
furnished by the clinic during the fiscal year in-16
volved. 17
‘‘(4) E
STABLISHMENT OF INITIAL YEAR PAY -18
MENT FOR NEW CLINICS .—In any case in which an 19
entity first qualifies as a certified community behav-20
ioral health clinic after the first fiscal year in which 21
a State elects to provide for payment for services de-22
scribed in section 1905(a)(31) in accordance with 23
the payment option under paragraph (1), the State 24
plan shall provide for payment for such services in 25
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the first 2 years in which the clinic so qualifies in 1
an amount (calculated on the basis of daily visits or 2
unduplicated monthly visits, at the State’s election) 3
that is equal to the rates established under this sub-4
section for other such clinics located in the same or 5
adjacent area with a similar case load, or in the ab-6
sence of any such clinic, based on the average per- 7
unit rate for other certified community behavioral 8
health clinics in the State; provided, however, that 9
effective, at latest, as of the 3rd year in which the 10
clinic furnishes such services, the State establishes a 11
unique payment rate for the clinic based on the 12
methodology described in paragraph (2), using al-13
lowable costs from the clinic’s first 2 fiscal years of 14
operation as the basis for establishing such rates; 15
and provided, additionally, that in any year following 16
the establishment of an initial rate under this para-17
graph, the State plan or waiver provides for the pay-18
ment amount to be calculated in accordance with 19
paragraph (2) or (3) (as applicable). 20
‘‘(5) A
DMINISTRATION IN THE CASE OF MAN -21
AGED CARE.— 22
‘‘(A) I
N GENERAL.—In the case of services 23
furnished by a certified community behavioral 24
health clinic pursuant to a contract between the 25
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clinic and a managed care entity (as defined in 1
section 1932(a)(1)(B)), the State plan or a 2
waiver of such plan shall provide for 1 of the 3
following: 4
‘‘(i) Payment to the clinic by the 5
State of a supplemental payment equal to 6
the amount (if any) by which the amount 7
determined under paragraph (2), (3), or 8
(4) (as applicable) exceeds the amount of 9
payments under the contract, with such 10
supplemental payment being made pursu-11
ant to a payment schedule agreed to by the 12
State and the certified community behav-13
ioral health clinic, but in no case less fre-14
quently than every 3 months. 15
‘‘(ii) Delegation by the State to the 16
managed care entity of the obligation to 17
pay the clinic at least the rate determined 18
under paragraph (2), (3), or (4) (as appli-19
cable); provided, however, that the State 20
shall use reconciliation and oversight proc-21
esses to ensure that each clinic is paid at 22
least the amounts required under such 23
paragraphs. 24
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‘‘(6) ALTERNATIVE PAYMENT METHODOLO -1
GIES.—Notwithstanding any other provision of this 2
subsection, the State plan or a waiver of such plan 3
may provide for payment in any year to a certified 4
community behavioral health clinic for services de-5
scribed in paragraph (31) of section 1905(a) in an 6
amount which is determined under an alternative 7
payment methodology that— 8
‘‘(A) is agreed to by the State and the clin-9
ic; and 10
‘‘(B) results in payment to the clinic of an 11
amount which is not less than the amount oth-12
erwise required to be paid to the clinic under 13
this subsection.’’. 14
TITLE II—COVERAGE OF CER-15
TIFIED COMMUNITY BEHAV-16
IORAL HEALTH CLINIC SERV-17
ICES UNDER THE MEDICARE 18
PROGRAM 19
SEC. 201. COVERAGE OF CERTIFIED COMMUNITY BEHAV-20
IORAL HEALTH CLINIC SERVICES UNDER THE 21
MEDICARE PROGRAM. 22
(a) C
OVERAGE.—Section 1861(s)(2) of the Social Se-23
curity Act (42 U.S.C. 1395x(s)(2)) is amended— 24
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(1) in subparagraph (II), by striking ‘‘and’’ at 1
the end; 2
(2) in subparagraph (JJ), by inserting ‘‘and’’ 3
at the end; and 4
(3) by adding at the end the following new sub-5
paragraph: 6
‘‘(KK) certified community behavioral health 7
clinic services (as defined in subsection (aa)(8)) fur-8
nished on or after January 1, 2024.’’. 9
(b) D
EFINITIONS.—Section 1861(aa) of the Social 10
Security Act (42 U.S.C. 1395x) is amended— 11
(1) in the heading, by striking ‘‘and Federally 12
Qualified Health Center Services’’ and inserting ‘‘, 13
Federally Qualified Health Center Services, and Cer-14
tified Community Behavioral Health Clinic Serv-15
ices’’; and 16
(2) by adding at the end the following new 17
paragraph: 18
‘‘(8) The terms ‘certified community behavioral 19
health clinic services’ and ‘certified community behavioral 20
health clinic’ have the meaning given those terms in para-21
graphs (1) and (2), respectively, of section 1905(jj).’’. 22
(c) P
AYMENT.— 23
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(1) IN GENERAL.—Section 1833(a)(1) of the 1
Social Security Act (42 U.S.C. 1395l(a)(1)) is 2
amended— 3
(A) by striking ‘‘and (HH)’’ and inserting 4
‘‘(HH)’’; and 5
(B) by inserting before the semicolon at 6
the end the following: ‘‘, and (II) with respect 7
to certified community behavioral health clinic 8
services for which payment is made under sec-9
tion 1834(aa), the amounts paid shall be equal 10
to 80 percent of the lesser of the actual charge 11
or the amount determined under such section’’. 12
(2) D
EVELOPMENT AND IMPLEMENTATION OF 13
PROSPECTIVE PAYMENT SYSTEM .—Section 1834 of 14
the Social Security Act (42 U.S.C. 1395m) is 15
amended by adding at the end the following new 16
subsection: 17
‘‘(aa) D
EVELOPMENT AND IMPLEMENTATION OF 18
P
ROSPECTIVEPAYMENTSYSTEM FORCERTIFIEDCOM-19
MUNITYBEHAVIORALHEALTHCLINICS.— 20
‘‘(1) D
EVELOPMENT.—The Secretary shall de-21
velop a prospective payment system for payment to 22
certified community behavioral health clinics (as de-23
fined in section 1861(aa)(8)) for the furnishing of 24
certified community behavioral health clinic services 25
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(as defined in such section) under this title. Such 1
system shall be established to take into account the 2
type, intensity, and duration of services furnished by 3
certified community behavioral health clinics. Such 4
system may include adjustments, including geo-5
graphic adjustments, as determined appropriate by 6
the Secretary. 7
‘‘(2) I
MPLEMENTATION.— 8
‘‘(A) I
N GENERAL.—The Secretary shall 9
provide, for cost reporting periods beginning on 10
or after January 1, 2024, for payments of pro-11
spective payment rates for certified community 12
behavioral health clinic services furnished by 13
certified community behavioral health clinics 14
under this title in accordance with the prospec-15
tive payment system developed by the Secretary 16
under paragraph (1). 17
‘‘(B) I
NITIAL PAYMENTS.—The Secretary 18
shall implement such prospective payment sys-19
tem to reflect the national average allowable 20
service costs of such clinics on the basis of the 21
most current audited cost report data for two 22
fiscal years available to the Secretary; provided 23
that, in the absence of complete actual cost 24
data representing the provision of the full cov-25
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ered benefit during the relevant fiscal years, 1
certified community behavioral health clinics 2
may, at the Secretary’s discretion, use esti-3
mated or projected data relating to specific 4
services. Initial payments shall be established 5
without the application of a per visit limit or 6
productivity screen and shall be based on na-7
tional average costs per unit of service, updated 8
as appropriate by the inflationary adjustment 9
described in subparagraph (C). 10
‘‘(C) P
AYMENTS IN SUBSEQUENT YEARS .— 11
Payment rates in years after the year of imple-12
mentation of such system shall be the payment 13
rates in the previous year increased— 14
‘‘(i) in the first year after implemen-15
tation of such system, by the percentage 16
increase in the MEI (as defined in section 17
1842(i)(3)) for the year involved; and 18
‘‘(ii) in subsequent years, by the per-19
centage increase in a market basket of cer-20
tified community behavioral health clinic 21
services, designed by the Secretary, or if 22
such an index is not available, by the per-23
centage increase in the MEI (as defined in 24
section 1842(i)(3)) for the year involved. 25
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‘‘(3) UNIT OF PAYMENT .—In establishing a 1
prospective payment amount under the system under 2
this subsection, the Secretary shall consider an ap-3
propriate unit of service and a general system design 4
that provides for continued access to quality serv-5
ices. 6
‘‘(4) P
ERIODIC REEVALUATION OF RATES .—At 7
the Secretary’s discretion, the Secretary shall, from 8
time to time, adjust the amounts that would other-9
wise be applicable under subparagraph (2) by a per-10
centage determined appropriate by the Secretary to 11
reflect such factors as changes in the intensity of 12
services furnished within a unit of service, the aver-13
age cost of providing care per unit of service, and 14
other factors that the Secretary considers to be rel-15
evant. Such adjustment shall be made before the up-16
date under clause (i) or (ii) of paragraph (2)(C)(i) 17
has been applied for the year.’’. 18
(d) W
AIVER OFAPPLICATION OFDEDUCTIBLE.— 19
Section 1833(b)(4) of the Social Security Act (42 U.S.C. 20
1395l(b)(4)) is amended by inserting ‘‘or certified commu-21
nity behavioral health clinic services’’ before the comma 22
at the end. 23
(e) PRRB R
EVIEW OFCOSTREPORTS.—Section 24
1878(j) of the Social Security Act (42 U.S.C. 1395oo(j)) 25
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is amended by striking ‘‘and a Federally qualified health 1
center’’ and inserting ‘‘, a Federally qualified health cen-2
ter, and a certified community behavioral health clinic’’. 3
(f) S
AFEHARBOR FORWAIVER OFCOINSURANCE.— 4
Section 1128B(b)(3)(D) of the Social Security Act (42 5
U.S.C. 1320a–7b(b)(3)(D)) is amended by inserting ‘‘or 6
a certified community behavioral health clinic’’ after 7
‘‘Federally qualified health care center’’. 8
(g) E
FFECTIVEDATE.—The amendments made by 9
this section shall apply with respect to services furnished 10
on or after January 1, 2024. 11
TITLE III—COMMUNITY BEHAV-12
IORAL HEALTH CLINIC 13
GRANTS 14
SEC. 301. OPERATING GRANTS FOR COMMUNITY BEHAV-15
IORAL HEALTH CLINICS. 16
Part D of title III of the Public Health Service Act 17
(42 U.S.C. 254b et seq.) is amended by adding at the end 18
the following: 19
‘‘Subpart XIII—Community Behavioral Health 20
Clinics 21
‘‘SEC. 340J. DEFINITIONS. 22
‘‘In this subpart: 23
‘‘(1) C
ERTIFIED COMMUNITY BEHAVIORAL 24
HEALTH CLINIC.—The term ‘certified community be-25
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havioral health clinic’ has the meaning given the 1
term in section 1905(jj)(2)) of the Social Security 2
Act. 3
‘‘(2) C
ERTIFIED COMMUNITY BEHAVIORAL 4
HEALTH SERVICES.—The term ‘certified community 5
behavioral health services’ has the meaning given the 6
term in section 1905(jj)(1) of the Social Security 7
Act. 8
‘‘SEC. 340J–1. COMMUNITY BEHAVIORAL HEALTH CLINIC 9
CERTIFICATION. 10
‘‘(a) I
NGENERAL.—Not later than 180 days after 11
the date of enactment of the Ensuring Excellence in Men-12
tal Health Act, the Secretary, after public notice and op-13
portunity for comment, shall publish in the Federal Reg-14
ister criteria for a clinic to be certified as a community 15
behavioral health clinic for purposes of section 16
1905(jj)(2)(D)(ii) of the Social Security Act. 17
‘‘(b) R
EQUIREMENTS.—The criteria published under 18
subsection (a) shall include criteria with respect to the fol-19
lowing: 20
‘‘(1) S
TAFFING.—Staffing requirements, includ-21
ing criteria that staff have diverse disciplinary back-22
grounds, have necessary State-required license and 23
accreditation, and are culturally and linguistically 24
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trained to serve the needs of the patient populations 1
of the community behavioral health clinic. 2
‘‘(2) A
VAILABILITY AND ACCESSIBILITY OF 3
SERVICES.—Availability and accessibility of services, 4
including crisis management services that are avail-5
able and accessible 24 hours a day, the use of a slid-6
ing scale for payment, and no rejection for services 7
or limiting of services on the basis of a patient’s 8
ability to pay or a place of residence. 9
‘‘(3) C
ARE COORDINATION.—Care coordination, 10
including requirements to coordinate care across set-11
tings and providers to ensure seamless transitions 12
for patients across the full spectrum of health serv-13
ices including acute, chronic, and behavioral health 14
needs. Care coordination requirements shall include 15
partnerships or formal contracts with the following: 16
‘‘(A) Federally-qualified health centers (as 17
defined in section 1905(l) of the Social Security 18
Act) and, as applicable, rural health clinics (as 19
so defined), to provide Federally-qualified 20
health center services (as so defined) and, as 21
applicable, rural health clinic services (as so de-22
fined), to the extent such services are not pro-23
vided directly through the community behav-24
ioral health clinic. 25
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‘‘(B) Inpatient psychiatric facilities and 1
substance use detoxification, post-detoxification 2
step-down services, and residential programs. 3
‘‘(C) Other community or regional services, 4
supports, and providers, including schools, child 5
welfare agencies, juvenile and criminal justice 6
agencies and facilities, Indian Health Service 7
youth regional treatment centers, State-licensed 8
and nationally accredited child placing agencies 9
for therapeutic foster care service, and other so-10
cial and human services. 11
‘‘(D) Medical centers, outpatient clinics, 12
and drop-in centers of the Department of Vet-13
erans Affairs and other facilities of the Depart-14
ment (as defined in section 1701 of title 38, 15
United States Code). 16
‘‘(E) Inpatient acute care hospitals and 17
hospital outpatient clinics. 18
‘‘(4) S
COPE OF SERVICES .—Provision (in a 19
manner reflecting person-centered care) of the full 20
array of certified community behavioral health serv-21
ices which, if not available directly through the com-22
munity behavioral health clinic, are provided or re-23
ferred through formal relationships with other pro-24
viders. 25
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‘‘(5) QUALITY AND OTHER REPORTING .—Re-1
quirements relating to development by the commu-2
nity behavioral health clinic of an effective procedure 3
for compiling and reporting to the Secretary such 4
statistics and other information as the Secretary 5
may require relating to— 6
‘‘(A) the costs of its operations; 7
‘‘(B) the patterns of use of its services, in-8
cluding the reporting of encounter data, clinical 9
outcomes data, quality data, and such other 10
data as the Secretary may require; 11
‘‘(C) the availability, accessibility, and ac-12
ceptability of its services; and 13
‘‘(D) such other matters relating to oper-14
ations of the applicant as the Secretary may re-15
quire. 16
‘‘(6) O
RGANIZATIONAL AUTHORITY .—Require-17
ments that a community behavioral health clinic 18
be— 19
‘‘(A) a nonprofit entity; 20
‘‘(B) part of a local government behavioral 21
health authority; 22
‘‘(C) operated under the authority of the 23
Indian Health Service; 24
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‘‘(D) operated by an Indian Tribe or Trib-1
al organization pursuant to a contract, grant, 2
cooperative agreement, or compact with the In-3
dian Health Service pursuant to the Indian 4
Self-Determination and Education Assistance 5
Act; or 6
‘‘(E) operated by an urban Indian organi-7
zation pursuant to a grant or contract with the 8
Indian Health Service under title V of the In-9
dian Health Care Improvement Act. 10
‘‘SEC. 340J–2. OPERATING GRANTS FOR COMMUNITY BE-11
HAVIORAL HEALTH CLINICS. 12
‘‘(a) I
NGENERAL.—The Secretary shall establish a 13
grant program under which the Secretary shall award 14
grants to eligible community behavioral health clinics to 15
provide (in a manner reflecting person-centered care) the 16
full array of certified community behavioral health serv-17
ices. 18
‘‘(b) E
LIGIBILITY.—To be eligible to receive a grant 19
under subsection (a), a community behavioral health clinic 20
shall be— 21
‘‘(1) a certified community behavioral health 22
clinic; or 23
‘‘(2) a community behavioral health clinic that 24
indicates in the grant application that the clinic will 25
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use the grant funds to meet the criteria described in 1
section 340J–1(a). 2
‘‘(c) U
SE OFFUNDS.—A community behavioral 3
health clinic that receives a grant under subsection (a)— 4
‘‘(1) shall use the grant funds— 5
‘‘(A) to provide the services described in 6
subsection (a); and 7
‘‘(B) in the case of a community behavioral 8
health clinic described in subsection (b)(2), to 9
meet the criteria described in section 340J– 10
1(a); and 11
‘‘(2) may use the grant funds— 12
‘‘(A) to carry out other activities that— 13
‘‘(i) reduce costs associated with the 14
provision of certified community behavioral 15
health services; 16
‘‘(ii) improve access to, and avail-17
ability of, certified community behavioral 18
health services provided to individuals 19
served by the community behavioral health 20
clinic; 21
‘‘(iii) enhance the quality and coordi-22
nation of certified community behavioral 23
health services; or 24
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‘‘(iv) improve the health status of 1
communities; and 2
‘‘(B) to pay for— 3
‘‘(i) the costs of acquiring and leasing 4
buildings and equipment (including the 5
costs of amortizing the principal of, and 6
paying interest on, loans); 7
‘‘(ii) costs relating to the purchase or 8
lease of equipment, including data and in-9
formation systems and behavioral health 10
information technology to facilitate data 11
reporting and other purposes; 12
‘‘(iii) the costs of in-service staff 13
training and other operational or infra-14
structure costs identified by the Secretary; 15
and 16
‘‘(iv) costs associated with expanding 17
and modernizing existing buildings or con-18
structing new buildings (including the 19
costs of amortizing the principal of, and 20
paying the interest on, loans), if such costs 21
are specifically allowed for in the grant op-22
portunity published by the Secretary. 23
‘‘(d) T
ERM.—Grants awarded under subsection (a) 24
shall be for a period of not more than 5 years. 25
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‘‘(e) CONDITION ONRECEIPT OFFUNDS.—The Sec-1
retary shall not make a grant to an applicant under sub-2
section (a) unless the applicant provides assurances to the 3
Secretary that within 120 days of receiving grant funding 4
for the operation of the clinic, the applicant will submit 5
for approval by the Secretary an implementation plan that 6
describes how the applicant will— 7
‘‘(1) provide the services described in subsection 8
(a); and 9
‘‘(2) in the case of a community behavioral 10
health clinic described in subsection (b)(2), meet the 11
criteria described in section 340J–1(a). 12
‘‘(f) A
MOUNT OFGRANT.— 13
‘‘(1) I
N GENERAL.—Subject to paragraph (2), 14
the amount of a grant made in any fiscal year to a 15
community behavioral health clinic under subsection 16
(a) shall be determined by the Secretary based on 17
information provided by the community behavioral 18
health clinic, but may not exceed an amount equal 19
to the difference obtained by subtracting— 20
‘‘(A) the sum obtained by adding— 21
‘‘(i) the total State, local, and other 22
operational funding provided to the clinic 23
for such fiscal year; and 24
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‘‘(ii) the fees, premiums, and third- 1
party reimbursements that the clinic rea-2
sonably expects to receive for its operations 3
in such fiscal year; from 4
‘‘(B) the costs of operating the clinic to 5
meet the purposes and requirements of the 6
grant program under this section during such 7
fiscal year. 8
‘‘(2) R
EQUIREMENT.— 9
‘‘(A) I
N GENERAL.—In determining the 10
costs described in paragraph (1)(B), the Sec-11
retary may estimate the anticipated costs of the 12
grant recipient in— 13
‘‘(i) providing the services described in 14
subsection (a), including the anticipated 15
costs of providing any individual certified 16
community behavioral health service that 17
the applicant entity does not have cost ex-18
perience providing at the time of submit-19
ting an application for such grant; and 20
‘‘(ii) if applicable, meeting the criteria 21
described in section 340J–1(a). 22
‘‘(B) A
NTICIPATED COSTS.—The Secretary 23
shall base the estimate of anticipated costs 24
under subparagraph (A) on an estimate of an-25
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ticipated costs provided by the applicable com-1
munity behavioral health clinic. 2
‘‘(3) P
AYMENTS.—The Secretary may— 3
‘‘(A) award grants under subsection (a)— 4
‘‘(i) in advance or through reimburse-5
ment; and 6
‘‘(ii) in installments; 7
‘‘(B) make adjustments to account for 8
overpayments or underpayments. 9
‘‘(g) U
SE OFACCREDITATION.— 10
‘‘(1) I
N GENERAL.—In selecting grant recipi-11
ents under this section, the Secretary may take into 12
account whether an applicant community behavioral 13
health clinic is accredited under section 340J–5(a). 14
‘‘(2) C
OMPLIANCE.—In determining whether a 15
community behavioral health clinic receiving a grant 16
under this section is providing the services described 17
in subsection (a) and, if applicable, meeting the cri-18
teria described in section 340J–1(a), the Secretary 19
may take into account whether the community be-20
havioral health clinic is accredited under section 21
340J–5(a). 22
‘‘(h) A
UTHORIZATION OFAPPROPRIATIONS.— 23
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‘‘(1) IN GENERAL.—There is authorized to be 1
appropriated to carry out this section, $552,500,000 2
for each of fiscal years 2024 through 2028. 3
‘‘(2) M
AINTENANCE OF FUNDING .—The 4
amount made available under paragraph (1) shall 5
supplement (and not supplant) any other Federal 6
funding made available for community behavioral 7
health clinics. 8
‘‘SEC. 340J–3. TECHNICAL ASSISTANCE. 9
‘‘(a) I
NGENERAL.—Not later than 180 days after 10
the date of enactment of the Ensuring Excellence in Men-11
tal Health Act, the Secretary shall establish programs 12
through which the Secretary shall provide (either through 13
the Department of Health and Human Services or by 14
grant or contract) technical assistance and other assist-15
ance to any of the following: 16
‘‘(1) Entities that receive a grant under section 17
340J–2. 18
‘‘(2) Entities participating in a Medicaid dem-19
onstration program under section 223(d) of the Pro-20
tecting Access to Medicare Act. 21
‘‘(3) Certified community behavioral health clin-22
ics (as defined in sections 1861(aa)(8) and 23
1905(jj)(2) of the Social Security Act), furnishing 24
services under title XVIII or title XIX of such Act. 25
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‘‘(4) Health or social service provider organiza-1
tions pursuing or considering certified community 2
behavioral health clinic status or partnering with 3
certified community behavioral health clinics. 4
‘‘(5) Other stakeholders, for the purpose of fa-5
cilitating successful implementation of the certified 6
community behavioral health clinic model. 7
‘‘(b) I
NCLUSIONS.—Assistance provided by the Sec-8
retary under subsection (a) may include technical and 9
nonfinancial assistance, including— 10
‘‘(1) fiscal and program management assist-11
ance; 12
‘‘(2) operational and administrative support; 13
and 14
‘‘(3) the provision of information to the entities 15
about the variety of resources available under this 16
part and how those resources can be best used to 17
meet the health and behavioral health needs of the 18
communities served by the entities. 19
‘‘(c) A
UTHORIZATION OF APPROPRIATIONS.—There 20
is authorized to be appropriated to carry out this section 21
$6,000,000 for each of fiscal years 2024 through 2028. 22
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‘‘SEC. 340J–4. DATA INFRASTRUCTURE FOR COMMUNITY 1
BEHAVIORAL HEALTH CLINIC REPORTING. 2
‘‘(a) I
NGENERAL.—Not later than 180 days after 3
the date of enactment of the Ensuring Excellence in Men-4
tal Health Act, the Secretary shall establish a system 5
under which the Secretary shall collect and analyze data 6
on community behavioral health clinics. 7
‘‘(b) S
COPE OFDATACOLLECTION.—The system es-8
tablished under subsection (a) shall be used by the Sec-9
retary to collect and analyze data from— 10
‘‘(1) entities that receive a grant under section 11
340J–2; and 12
‘‘(2) organizations that provide services, or have 13
applied to provide services, under title XVIII of the 14
Social Security Act, as described in section 15
1861(aa)(8) of such Act, or under a State Medicaid 16
program in accordance with section 1905(jj) of such 17
Act. 18
‘‘(c) A
UTHORIZATION OF APPROPRIATIONS.—There 19
is authorized to be appropriated to carry out this section 20
$51,000,000 for each of fiscal years 2024 through 2028. 21
‘‘SEC. 340J–5. COMMUNITY BEHAVIORAL HEALTH CLINIC 22
ACCREDITATION. 23
‘‘(a) A
CCREDITATIONSTANDARDS.—A community 24
behavioral health clinic may be accredited if the entity— 25
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‘‘(1) meets the standards of an approved ac-1
creditation body; and 2
‘‘(2) authorizes the accreditation body to sub-3
mit to the Secretary (or such agency as the Sec-4
retary may designate) such records or other infor-5
mation as the Secretary may require. 6
‘‘(b) A
PPROVAL OFACCREDITATIONBODIES.— 7
‘‘(1) I
N GENERAL.—The Secretary may approve 8
a private nonprofit organization to be an accredita-9
tion body for the accreditation of community behav-10
ioral health clinics under subsection (a) if— 11
‘‘(A) using inspectors qualified to evaluate 12
quality of care in a behavioral health service 13
setting, the accreditation body agrees to inspect 14
the clinic with such frequency as is determined 15
by the Secretary; 16
‘‘(B) the standards applied by the body in 17
determining whether or not to accredit a clinic 18
correspond to the criteria described in section 19
340J–1(a), and are not less restrictive than 20
such criteria; 21
‘‘(C) there is adequate provision for assur-22
ing that the standards of the accreditation body 23
continue to be met by the clinic; 24
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‘‘(D) in the case of any clinic previously 1
accredited by the body which has had its ac-2
creditation denied, suspended, withdrawn, or re-3
voked or which has had any other action taken 4
against it by the accrediting body, the accred-5
iting body agrees to submit to the Secretary the 6
name of such clinic within 30 days of the action 7
taken; and 8
‘‘(E) if the accreditation body has its ap-9
proval withdrawn by the Secretary, the body 10
agrees to notify each clinic accredited by the 11
body of the withdrawal within 10 days of the 12
withdrawal.’’. 13
Æ
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