[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4574 Introduced in House (IH)]
113th CONGRESS
2d Session
H. R. 4574
To maximize the access of individuals with mental illness to community-
based services, to strengthen the impact of such services, and for
other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 6, 2014
Mr. Barber (for himself, Ms. DeGette, Mr. Tonko, Ms. Matsui, and Mrs.
Napolitano) introduced the following bill; which was referred to the
Committee on Energy and Commerce, and in addition to the Committees on
Ways and Means, the Judiciary, Armed Services, Veterans' Affairs,
Education and the Workforce, and Natural Resources, for a period to be
subsequently determined by the Speaker, in each case for consideration
of such provisions as fall within the jurisdiction of the committee
concerned
_______________________________________________________________________
A BILL
To maximize the access of individuals with mental illness to community-
based services, to strengthen the impact of such services, and for
other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Strengthening
Mental Health in Our Communities Act of 2014''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title; table of contents.
Sec. 2. Purpose.
TITLE I--WHITE HOUSE OFFICE OF MENTAL HEALTH POLICY
Sec. 101. White House Office of Mental Health Policy.
Sec. 102. Appointment and duties of the Director.
Sec. 103. National strategy for mental health.
Sec. 104. Coordination with Federal departments and agencies.
Sec. 105. National mental health advisory board.
TITLE II--STRENGTHENING AND INVESTING IN SAMHSA PROGRAMS
Sec. 201. Community mental health services block grant reauthorization.
Sec. 202. Reporting requirements for block grants regarding mental
health and substance use disorders.
Sec. 203. Garrett Lee Smith Memorial Act reauthorization.
Sec. 204. Priority mental health needs of regional and national
significance reauthorization.
Sec. 205. Grants for jail diversion programs reauthorization.
Sec. 206. Projects for assistance in transition from homelessness.
Sec. 207. Comprehensive community mental health services for children
with serious emotional disturbances.
Sec. 208. Children's recovery from trauma.
Sec. 209. Protection and advocacy for individuals with mental illness
reauthorization.
Sec. 210. Mental health awareness training grants.
Sec. 211. National media campaign to reduce the stigma associated with
mental illness.
Sec. 212. SAMHSA and HRSA integration of behavioral health services
into primary care settings.
Sec. 213. Geriatric mental health disorders.
Sec. 214. Assessing barriers to behavioral health integration.
Sec. 215. Acute care bed registry grant for States.
Sec. 216. Awards for co-locating primary and specialty care in
community-based mental health settings.
Sec. 217. Grants for the benefit of homeless individuals.
TITLE III--IMPROVING MEDICAID AND MEDICARE MENTAL HEALTH SERVICES
Sec. 301. Access to mental health prescription drugs under Medicare.
Sec. 302. Medicaid coverage of mental health services and primary care
services furnished on the same day.
Sec. 303. Elimination of 190-day lifetime limit on inpatient
psychiatric hospital services.
Sec. 304. Expanding the Medicaid home and community-based services
waiver to include youth in need of services
provided in a psychiatric residential
treatment facility.
Sec. 305. Application of Rosa's Law for individuals with intellectual
disabilities.
Sec. 306. Complete application of mental health and substance use
parity rules under Medicaid and CHIP.
Sec. 307. Coverage of marriage and family therapist services and mental
health counselor services under part B of
the Medicare program.
TITLE IV--DEVELOPING THE BEHAVIORAL HEALTH WORKFORCE
Sec. 401. National health service corps scholarship and loan repayment
funding for behavioral and mental health
professionals.
Sec. 402. Reauthorization of HRSA's mental and behavioral health
education and training program.
Sec. 403. SAMHSA grant program for development and implementation of
curricula for continuing education on
serious mental illness.
Sec. 404. Demonstration grant program to recruit, train, deploy, and
professionally support psychiatric
physicians in Indian health programs.
Sec. 405. Including occupational therapists as behavioral and mental
health professionals for purposes of the
National Health Service Corps.
Sec. 406. Extension of certain health care workforce loan repayment
programs through fiscal year 2019.
TITLE V--IMPROVING MENTAL HEALTH RESEARCH AND COORDINATION
Sec. 501. National Institute of Mental Health research program on
serious mental illness and suicide
prevention.
Sec. 502. Youth mental health research network.
Sec. 503. National violent death reporting system.
TITLE VI--EDUCATION AND YOUTH
Sec. 601. School-based mental health programs.
Sec. 602. Examining mental health care for children.
TITLE VII--JUSTICE AND MENTAL HEALTH COLLABORATION
Sec. 701. Assisting veterans.
Sec. 702. Correctional facilities.
Sec. 703. High utilizers.
Sec. 704. Academy training.
Sec. 705. Evidence-based practices.
Sec. 706. Safe communities.
Sec. 707. Reauthorization of appropriations.
TITLE VIII--BEHAVIORAL HEALTH INFORMATION TECHNOLOGY
Sec. 801. Extension of health information technology assistance for
behavioral and mental health and substance
abuse.
Sec. 802. Extension of eligibility for Medicare and Medicaid health
information technology implementation
assistance.
TITLE IX--SERVICEMEMBERS AND VETERANS MENTAL HEALTH
Sec. 901. Preliminary mental health assessments.
Sec. 902. Unlimited eligibility for health care for mental illnesses
for veterans of combat service during
certain periods of hostilities and war.
Sec. 903. Timeline for implementing integrated electronic health
records.
Sec. 904. Pilot program for repayment of educational loans for certain
psychiatrists of Veterans Health
Administration.
TITLE X--MAKING PARITY WORK
Sec. 1001. GAO study on mental health and substance use disorder parity
enforcement efforts.
Sec. 1002. Report to Congress on Federal assistance to State insurance
regulators regarding mental health parity
enforcement.
Sec. 1003. Annual report to Congress by Secretaries of Labor and Health
and Human Services.
SEC. 2. PURPOSE.
The purposes of this Act are--
(1) to improve the responsiveness, coordination,
accountability, accessibility, and integration of person-
centered behavioral health services to provide timely and
appropriate help to individuals, families, and communities;
(2) to reduce mental health crises, homelessness, and
incarceration by strengthening community-based services,
including early intervention, outreach, engagement, prevention,
crisis support, rehabilitation, and peer-run services for
persons of all ages;
(3) to ensure that all Americans with mental illnesses and
their families can--
(A) gain access to evidence-based and emerging best
practices based on the values and principles of trauma-
informed care and mental health recovery, delivered in
a culturally and linguistically competent manner; and
(B) fully participate in the most integrated
settings within their chosen communities;
(4) to develop an integrated behavioral health workforce
through improved training and education, recruitment, and
retention to meet the needs of all communities and populations;
(5) to increase mental health awareness and reduce stigma
and discrimination through mental health training, education,
and literacy; and
(6) to ensure the full implementation and enforcement of
mental health parity for all Americans.
TITLE I--WHITE HOUSE OFFICE OF MENTAL HEALTH POLICY
SEC. 101. WHITE HOUSE OFFICE OF MENTAL HEALTH POLICY.
(a) Establishment of Office.--There is established in the Executive
Office of the President the White House Office of Mental Health Policy
(hereafter referred to as the ``Office''), which shall--
(1) monitor Federal activities with respect to mental
health, serious mental illness, and serious emotional
disturbances;
(2) make recommendations to the Secretary of Health and
Human Services regarding any appropriate changes to such
activities, including recommendations with respect to the
national strategy developed under paragraph (3);
(3) develop and annually update a National Strategy for
Mental Health to maximize the access of individuals with mental
illness to community-based services, strengthen the impact of
such services, and meet the comprehensive needs of individuals
with mental illness;
(4) make recommendations to the Secretary of Health and
Human Services regarding public participation in decisions
relating to mental health, serious mental illness, and serious
emotional disturbances;
(5) review and make recommendations with respect to the
budgets for Federal mental health services to ensure the
adequacy of those budgets;
(6) submit to the Congress the national strategy and any
updates to such strategy;
(7) coordinate the mental health services provided by
Federal departments and agencies and coordinate Federal
interagency mental health services;
(8) consult, coordinate with, facilitate joint efforts
among, and support State, local, and tribal governments,
nongovernmental entities, and individuals with a mental
illness, particularly individuals with a serious mental illness
and children and adolescents with a serious emotional
disturbance, with respect to improving community-based and
other mental health services; and
(9) develop and annually update a summary of advances in
serious mental illness and serious emotional disturbances
research related to causes, prevention, treatment, early
screening, diagnosis or rule out, intervention, and access to
services and supports for individuals with serious mental
illness and children and adolescents with a serious emotional
disturbance.
(b) Director.--There shall be a Director who shall head the Office
(hereafter referred to as the ``Director'') and who shall hold the same
rank and status as the head of an executive department listed in
section 101 of title 5, United States Code.
(c) Access by Congress.--The location of the Office in the
Executive Office of the President shall not be construed as affecting
access by Congress, or any committee of the House of Representatives or
the Senate, to any--
(1) information, document, or study in the possession of,
or conducted by or at the direction of, the Director; or
(2) personnel of the Office.
SEC. 102. APPOINTMENT AND DUTIES OF THE DIRECTOR.
(a) Appointment.--
(1) In general.--The President shall appoint the Director,
by and with the advice and consent of the Senate. The Director
shall serve at the pleasure of the President.
(2) Prohibition.--No person shall serve as Director while
serving in any other position in the Federal Government or
while employed in a full-time position outside of the Federal
Government.
(b) Responsibilities.--The Director shall--
(1) assist the President--
(A) to establish policies, goals, objectives, and
priorities with respect to mental health, particularly
serious mental illness and serious emotional
disturbances;
(B) to maximize the access of individuals with
mental illness to community-based services;
(C) to strengthen the impact of such services; and
(D) to meet the comprehensive needs of individuals
with mental illness;
(2) work with Federal departments and agencies providing
mental health services to strengthen the coordination of mental
health services in order to maximize the access of individuals
with a mental illness, particularly individuals with a serious
mental illness and children and adolescents with a serious
emotional disturbance, to community-based services, strengthen
the impact of services, and meet the comprehensive needs of
individuals with a mental illness;
(3) coordinate and oversee the development, coordination,
implementation, and evaluation of the National Strategy for
Mental Health;
(4) promulgate the National Strategy for Mental Health,
ensuring its wide availability to government officials and the
public;
(5) make such recommendations to the President as the
Director determines are appropriate with respect to the
organization, management, and budgets of Federal departments
and agencies providing mental health services, including
changes in the allocation of personnel to and within those
departments and agencies to implement the policies, goals,
objectives, and priorities established under paragraph (1) and
the National Strategy for Mental Health;
(6) consult, coordinate with, facilitate joint efforts
among, and support State, local, and tribal governments,
nongovernmental entities, and individuals with a mental
illness, particularly individuals with a serious mental illness
and children and adolescents with a serious emotional
disturbance, with respect to improving mental health services;
(7) appear before duly constituted committees and
subcommittees of the House of Representatives and of the Senate
to represent the policies of the President related to mental
health and serve as the spokesperson of the President, if the
President determines it appropriate, on issues related to
mental health, and the National Strategy for Mental Health;
(8) submit an annual report to Congress detailing how the
Director has consulted and coordinated with the National Mental
Health Council described in section 104(d), the National Mental
Health Advisory Board described in section 105, State, local,
and tribal governments, nongovernmental entities, and
individuals with a mental illness, particularly individuals
with a serious mental illness and children and adolescents with
a serious emotional disturbance; and
(9) ensure the Office meets each of its responsibilities
under this title.
(c) Budget Review and Recommendations.--
(1) Review of budget requests.--Each department or agency
of the Federal Government providing mental health services and
benefits shall transmit each year to the Director a copy of the
proposed budget request of that department or agency with
respect to mental health services and benefits at a time not
later than that department or agency's submitting of such
budget request to the Office of Management and Budget for
preparation of the budget of the President submitted to
Congress under section 1105(a) of title 31, United States Code.
The proposed budget request shall be transmitted to the
Director in such form as the Director, in consultation with the
Office of Management and Budget, determines appropriate.
(2) Recommendations with respect to budget requests.--After
the receipt of proposed budget requests pursuant to paragraph
(1), the Director shall provide budget recommendations with
respect to Federal mental health services and benefits to the
Director of the Office of Management and Budget and to the
President at a time that allows such recommendations to be
incorporated, as appropriate, into the budget of the President
submitted to Congress under section 1105(a) of title 31, United
States Code. The recommendations shall address funding
priorities developed in the National Strategy for Mental Health
and shall address future fiscal projections as determined by
the Director.
(d) Powers of the Director.--In carrying out this title, the
Director may--
(1) select, appoint, employ, and fix the compensation of
such officers and employees of the Office as may be necessary
to carry out the functions of the Office under this title;
(2) request the head of a department or agency of the
Federal Government to place department or agency personnel who
are engaged in activities with respect to mental health, on
temporary detail to another department or agency in order to
implement the National Strategy for Mental Health, and the head
of such department or agency shall comply with such request;
(3) use for administrative purposes, on a reimbursable
basis, the available services, equipment, personnel, and
facilities of Federal, State, local, and tribal departments and
agencies;
(4) procure the services of experts and consultants in
accordance with section 3109 of title 5, United States Code,
relating to appointments in the Federal Service, at rates of
compensation for individuals not to exceed the daily equivalent
of the rate of pay payable under level IV of the Executive
Schedule under section 5311 of title 5, United States Code;
(5) use the mails in the same manner as any other
department or agency of the executive branch; and
(6) monitor implementation of the National Strategy for
Mental Health, including--
(A) conducting program and performance audits and
evaluations; and
(B) requesting assistance from the Inspector
General of the relevant department or agency in such
audits and evaluations.
SEC. 103. NATIONAL STRATEGY FOR MENTAL HEALTH.
(a) In General.--Not later than February 1 of each year, the
Director shall submit to the President and Congress and make available
to the public a National Strategy for Mental Health (in this title
referred to as the ``National Strategy for Mental Health'' or the
``Strategy'') setting forth a comprehensive plan to maximize the access
of individuals with mental illness to community-based services, to
strengthen the impact of such services, and to meet the comprehensive
needs of individuals with mental illness.
(b) Process.--In preparing the Strategy, the Director shall
actively consult and work in coordination with the following:
(1) The heads of all Federal departments and agencies that
provide mental health services.
(2) The National Mental Health Council.
(3) The National Mental Health Advisory Board.
(4) Existing Federal interagency efforts related to mental
health services, such as the Military and Veterans Mental
Health Interagency Task Force.
(5) State, local, and tribal governments.
(6) Nongovernmental entities.
(7) Individuals with mental illness, particularly
individuals with a serious mental illness and children and
adolescents with a serious emotional disturbance.
(c) Contents.--The Director shall ensure the Strategy meets the
following requirements:
(1) Goals and performance measures.--The Strategy shall
contain comprehensive, research-based goals and quantifiable
performance measures that shall serve as targets for the year
with respect to which the Strategy applies for--
(A) improving the outcomes of and accessibility to
evidence-based mental programs and services;
(B) promoting community integration of individuals
with mental illness;
(C) increasing access to prevention and early
intervention services related to mental health;
(D) promoting mental health awareness and reducing
stigma; and
(E) advancing mental health research.
(2) Accountability for past performance measures.--The
Strategy shall contain a report on Federal effectiveness with
respect to meeting those performance measures set by the
Strategy for the preceding year, including an evaluation of
whether or not such performance measures were met and the
reasons therefore, including--
(A) the extent of coordination between Federal
departments and agencies providing mental health
services;
(B) the extent to which the objectives and budgets
of Federal departments and agencies providing mental
health services were consistent with the
recommendations of the Strategy for the preceding year;
and
(C) the efficiency and adequacy of Federal programs
and policies with respect to mental health services.
(3) Reporting on and identifying gaps in mental health
services.--The Strategy shall contain a report on--
(A) the mental health diagnoses, disaggregated by
age, race, gender, geographic distribution, population
density, socioeconomic status, and other target
populations determined necessary for inclusion by the
Director;
(B) the quality and quantity of mental health
services, including community-based services, for
individuals with mental illness, disaggregated by age,
race, gender, geographic distribution, population
density, socioeconomic status, and other target
populations determined necessary for inclusion by the
Director; and
(C) the size and allocation of Federal resources
devoted to supporting individuals with mental illness,
particularly serious mental illness, and children and
adolescents with a serious emotional disturbance,
disaggregated by age, race, gender, geographic
distribution, population density, socioeconomic status,
and other target populations determined necessary for
inclusion by the Director.
(4) Coordination efforts.--The Strategy shall contain a
report on Federal efforts to consult, coordinate with,
facilitate joint efforts among, and support State, local, and
tribal governments, nongovernmental entities, and individuals
with mental illness, particularly serious mental illness, and
children and adolescents with a serious emotional disturbance,
including an evaluation of the effectiveness of those efforts.
(5) Guidance.--The Strategy shall contain research-based
guidance for assessing and improving the quality of mental
health services that is responsive to gaps identified in
community-based and other mental health services, particularly
for individuals with a serious mental illness and children and
adolescents with a serious emotional disturbance.
(6) Mental health advocates and perspectives.--The Strategy
shall contain the views and perspectives of individuals with
mental illness, particularly individuals with serious mental
illness and children and adolescents with a serious emotional
disturbance, with respect to mental health services as prepared
by the National Mental Health Advisory Board.
(7) Strategic plan.--The Strategy shall contain a plan to
achieve the goals and performance measures set for the year
with respect to which the Strategy applies, including the
following:
(A) Program and budget priorities necessary to
achieve the performance measures.
(B) Recommendations for improved Federal
interagency coordination, such as shared grant
application processes, grantee reporting requirements,
training and technical assistance efforts, definitions,
recipient eligibility requirements, research,
evaluation efforts, and data collection, and
recommendations for legislative changes necessary to
achieve such interagency coordination and to facilitate
the delivery of a comprehensive array of mental health
services.
(C) Recommendations for improved coordination
between the Federal Government and State, local, and
tribal governments, nongovernmental entities, and
individuals with mental illness, particularly
individuals with serious mental illness and children
and adolescents with a serious emotional disturbance.
(D) A strategic research, innovation, and
demonstration agenda to guide the use of Federal
research spending with respect to mental illness,
particularly serious mental illness.
(E) Recommendations to promote community
integration of individuals with mental illness,
consistent with the Americans with Disabilities Act of
1990, section 504 of the Rehabilitation Act of 1973,
and the Supreme Court's decision in Olmstead v. L.C.
(F) Recommendations to enhance prevention and early
intervention services for children and adolescents with
mental illness.
(G) Recommendations concerning ways to ensure
appropriate access to intensive community-based
services for Medicaid beneficiaries.
(8) Additional reports.--The Strategy shall contain
additional reports the Director determines necessary, such as
reports on the unmet needs of individuals with mental illness,
international comparisons of mental health services and
outcomes, or the status of implementation and enforcement of
mental health parity.
SEC. 104. COORDINATION WITH FEDERAL DEPARTMENTS AND AGENCIES.
(a) Federal Department and Agency Cooperation.--Each department or
agency of the Federal Government providing mental health services
shall--
(1) cooperate with the efforts of the Director under this
title;
(2) provide such assistance, statistics, studies, reports,
information, and advice as the Director may request, to the
extent permitted by law;
(3) adjust department or agency staff job descriptions and
performance measures to support collaboration and
implementation of the Strategy; and
(4) assign department or agency liaisons to the Office to
oversee and implement interagency coordination.
(b) Interagency Alignment.--The Director, in collaboration with the
heads of Federal departments and agencies providing mental health
services, shall strengthen the coordination of Federal mental health
services in order to maximize the access of individuals with mental
illness, particularly individuals with serious mental illness, to
community-based mental health services, strengthen the impact of mental
health services, and meet the comprehensive needs of individuals with
mental illness, particularly individuals with serious mental illness
and children and adolescents with a serious emotional disturbance, by,
where appropriate--
(1) facilitating the development of shared grant
application processes;
(2) offering joint training and technical assistance
efforts;
(3) improving opportunities for individuals with mental
illness to maintain services as they transition from systems of
care;
(4) aligning--
(A) grantee reporting requirements;
(B) definitions;
(C) eligibility requirements;
(D) research;
(E) evaluation efforts; and
(F) data collection;
(5) making recommendations with respect to the legislative
changes necessary to achieve the interagency alignment and
coordination necessary to facilitate the delivery of a
comprehensive array of mental health services; and
(6) taking other steps necessary to improve collaboration
between Federal departments and agencies providing mental
health services.
(c) Joint Funding and Coordination.--
(1) In general.--The Director, in consultation with the
heads of Federal departments and agencies, may oversee the
development and administration of initiatives involving
multiple Federal departments and agencies, including
initiatives that involve the integration of funding from
different Federal departments and agencies to the extent
permitted by law.
(2) Administration of funds.--With respect to an initiative
that involves the integration of funding from different Federal
departments and agencies, the Federal department or agency
principally involved in such an initiative, as determined by
the Director, may be designated by the Director to act for all
involved departments or agencies in administering funds for the
initiative to the extent permitted by law.
(3) Nongovernmental entities.--Initiatives developed under
this subsection may involve nongovernmental entities to the
extent permitted by law.
(d) National Mental Health Council.--
(1) Establishment.--There is established within the Office
the National Mental Health Council (hereinafter referred to in
this title as the ``Council'').
(2) Members and terms.--The members of the Council shall
include--
(A) the President;
(B) the Director;
(C) the Secretary of Health and Human Services;
(D) the Director of the National Institute of
Mental Health;
(E) the Attorney General of the United States;
(F) the Secretary of Veterans Affairs;
(G) the Assistant Secretary-Indian Affairs of the
Department of the Interior;
(H) the Director of the Centers for Disease Control
and Prevention;
(I) the Director of the National Institutes of
Health;
(J) the directors of such national research
institutes of the National Institutes of Health as the
Director determines appropriate;
(K) representatives, appointed by the Director, of
Federal agencies that are outside of the Department of
Health and Human Services and serve individuals with
mental illness, such as the Department of Education;
(L) the Administrator of Substance Abuse and Mental
Health Services Administration;
(M) the Secretary of Defense; and
(N) other Federal officials as directed by the
President.
(3) Chairperson.--The Chairperson of the Council shall be
the President.
(4) Designees.--Members of the Council may select a
designee to perform duties under this subsection, but it is the
sense of Congress that such members should refrain from doing
so whenever possible.
(5) Meetings.--
(A) In general.--The full membership of the Council
shall meet at the call of the Chairperson, but at least
once each year. The Chairperson may call additional
meetings composed of less than the full membership of
the Council as needed.
(B) First meeting.--The first meeting of the
Council shall be not more than four months after the
date of the enactment of this title.
(C) Inclusion of the national mental health
advisory board.--At least two meetings of the Council
each year shall be opened to the participation of
members of the National Mental Health Advisory Board.
(6) Responsibilities.--The Council shall--
(A) assist the Director to coordinate the mental
health services provided by Federal departments and
agencies and to coordinate Federal interagency mental
health services;
(B) assist the Director in the development,
coordination, implementation, evaluation, and
promulgation of the Strategy;
(C) assist the Director in soliciting and
documenting ongoing input and recommendations with
respect to mental health services and mental health
outcomes from State, local, and tribal governments,
nongovernmental entities, and individuals with mental
illness, particularly individuals with serious mental
illness and children and adolescents with a serious
emotional disturbance; and
(D) ensure that members of the Council oversee the
implementation of those sections of the Strategy for
which each such member's department or agency is
responsible, as determined by the Director, and to
report to the Director on such implementation and the
results thereof.
SEC. 105. NATIONAL MENTAL HEALTH ADVISORY BOARD.
(a) Establishment.--There is established within the Office the
National Mental Health Advisory Board (hereinafter referred to in this
title as the ``Board'').
(b) Members and Terms.--
(1) In general.--Except as provided in paragraph (3), each
member shall serve a two-year term. No member shall serve more
than three terms. The Board shall be composed of non-Federal
public members to be appointed by the Director, of which--
(A) at least eight such members, or \1/3\ of total
membership, whichever is greater, shall be individuals
with a diagnosis of serious mental illness;
(B) at least six such members, or \1/4\ of total
membership, whichever is greater, shall be a parent or
legal guardian of an individual with a serious mental
illness or a child or adolescent with a serious
emotional disturbance;
(C) at least one such member shall be a
representative of a leading research organization for
individuals with serious mental illness;
(D) at least one such member shall be a
representative of a leading advocacy organization for
individuals with serious mental illness;
(E) at least one such member shall be a
representative of a leading community service
organization for individuals with serious mental
illness;
(F) at least one member shall have served in a
senior position in a State mental health system;
(G) at least one member shall have served in a
senior position in a local mental health system;
(H) at least one member shall be a psychiatrist;
(I) at least one member shall be a clinical
psychologist;
(J) at least one member shall be a law enforcement
officer;
(K) at least one such member shall be a
representative of a leading veterans service
organization; and
(L) at least one such member shall be a child or
adolescent psychiatrist.
(2) Selection process for the initial membership of the
board.--The Director shall design an application and selection
process to fill the initial membership of the Board. Political
affiliation or views may not be taken into account in such
application and selection process and relatives of elected
officials shall not be eligible for membership.
(3) Selection process for membership of the board following
the initial membership.--The initial membership of the Board
shall design an application and selection process to fill the
membership of the Board for those terms following the term of
the initial membership. Such application and selection process
shall ensure that Board members select the membership that will
follow that Board membership's term and, notwithstanding the
two-year term requirement in paragraph (1), such application
process shall ensure that not more than half of the terms of
Board members expire in a given year.
(4) Chairperson.--The initial membership of the Board shall
elect two members as co-chairs of the Board. Co-chairs shall
serve a term of one year and the Board shall elect new co-
chairs as vacancies arise.
(c) Meetings.--The Board shall meet in person not fewer than four
times each year. The Director shall request senior Federal Government
officials to attend each of the four meetings, including requesting
that the Council attend one of the four meetings. The co-chairs of the
Board may call additional meetings online and by telephone as
determined necessary by the co-chairs.
(d) Duties.--The Board shall--
(1) advise the President, the heads of Federal departments
and agencies providing mental health services, and other senior
Federal Government officials on proposed and pending
legislation, budget expenditures, and other policy matters with
respect to mental illness, particularly serious mental illness
and children and adolescents with a serious emotional
disturbance;
(2) work in partnership with local organizations to solicit
the views and perspectives of individuals with mental illness,
particularly individuals with serious mental illness, and
parents or legal guardians of individuals with mental illness,
with respect to mental health services;
(3) prepare a section of the Strategy outlining the views
and perspectives of individuals with mental illness,
particularly individuals with serious mental illness and
children and adolescents with a serious emotional disturbance,
with respect to mental health services; and
(4) provide the Director evaluations of the staff support
and training and technical assistance the Board has received.
(e) Procedures.--The membership of the Board shall, in consultation
with the Director, determine the procedures of the Board.
TITLE II--STRENGTHENING AND INVESTING IN SAMHSA PROGRAMS
SEC. 201. COMMUNITY MENTAL HEALTH SERVICES BLOCK GRANT REAUTHORIZATION.
Section 1920(a) of the Public Health Service Act (42 U.S.C. 300x-
9(a)) is amended by striking ``$450,000,000 for fiscal year 2001, and
such sums as may be necessary for each of the fiscal years 2002 and
2003'' and inserting ``$483,744,000 for fiscal year 2015 and such sums
as may be necessary for each of fiscal years 2016 through 2019''.
SEC. 202. REPORTING REQUIREMENTS FOR BLOCK GRANTS REGARDING MENTAL
HEALTH AND SUBSTANCE USE DISORDERS.
Section 1942 of the Public Health Service Act (42 U.S.C. 300x-52)
is amended to read as follows:
``SEC. 1942. REQUIREMENT OF REPORTS AND AUDITS BY STATES.
``(a) Annual Report.--A funding agreement for a grant under section
1911 is that--
``(1) the State involved will prepare and submit to the
Secretary an annual report on the activities funded through the
grant; and
``(2) each such report shall be prepared by, or in
consultation with, the State agency responsible for community
mental health programs and activities.
``(b) Standardized Form; Contents.--In order to properly evaluate
and to compare the performance of different States assisted under
section 1911, reports under this section shall be in such standardized
form and contain such information as the Secretary determines (after
consultation with the States) to be necessary--
``(1) to secure an accurate description of the activities
funded through the grant under section 1911;
``(2) to determine the extent to which funds were expended
consistent with the State's application transmitted under
section 1917(a); and
``(3) to describe the extent to which the State has met the
goals and objectives it set forth in its State plan under
section 1912(b).
``(c) Minimum Contents.--Each report under this section shall, at a
minimum, include the following information:
``(1)(A) The number of individuals served by the State
under subpart I (by class of individuals).
``(B) The proportion of each class of such individuals
which has health coverage.
``(C) The types of services (as defined by the Secretary)
provided under subpart I to individuals within each such class.
``(D) The amounts spent under subpart I on each type of
service (by class of individuals served).
``(2) Information on the status of mental health in the
State, including information (by county and by racial and
ethnic group) on each of the following:
``(A) The proportion of adolescents with serious
emotional disturbances.
``(B) The proportion of adults with serious mental
illness (including major depression).
``(C) The proportion of individuals with co-
occurring mental health and substance use disorders.
``(D) The proportion of children and adolescents
with mental health disorders who seek and receive
treatment.
``(E) The proportion of adults with mental health
disorders who seek and receive treatment.
``(F) The proportion of individuals with co-
occurring mental health and substance use disorders who
seek and receive treatment.
``(G) The proportion of homeless adults with mental
health disorders who receive treatment.
``(H) The number of primary care facilities that
provide mental health screening and treatment services
onsite or by paid referral.
``(I) The number of primary care physician office
visits that include mental health screening services.
``(J) The number of juvenile residential facilities
that screen admissions for mental health disorders.
``(K) The number of deaths attributable to suicide.
``(3) Information on the number and type of health care
practitioners licensed in the State and providing mental
health-related services.
``(d) Availability of Reports.--The Secretary shall, upon request,
provide a copy of any report under this section to any interested
public agency.''.
SEC. 203. GARRETT LEE SMITH MEMORIAL ACT REAUTHORIZATION.
(a) Suicide Prevention Technical Assistance Center.--Section 520C
of the Public Health Service Act (42 U.S.C. 290bb-34) is amended--
(1) in the section heading, by striking the section heading
and inserting ``suicide prevention technical assistance
center.'';
(2) in subsection (a), by striking ``and in consultation
with'' and all that follows through the period at the end of
paragraph (2) and inserting ``shall establish a research,
training, and technical assistance resource center to provide
appropriate information, training, and technical assistance to
States, political subdivisions of States, federally recognized
Indian tribes, tribal organizations, institutions of higher
education, public organizations, or private nonprofit
organizations regarding the prevention of suicide among all
ages, particularly among groups that are at high risk for
suicide.'';
(3) by striking subsections (b) and (c);
(4) by redesignating subsection (d) as subsection (b);
(5) in subsection (b), as so redesignated--
(A) by striking the subsection heading and
inserting ``Responsibilities of the Center.'';
(B) in the matter preceding paragraph (1), by
striking ``The additional research'' and all that
follows through ``nonprofit organizations for'' and
inserting ``The center established under subsection (a)
shall conduct activities for the purpose of'';
(C) by striking ``youth suicide'' each place such
term appears and inserting ``suicide'';
(D) in paragraph (1)--
(i) by striking ``the development or
continuation of'' and inserting ``developing
and continuing''; and
(ii) by inserting ``for all ages,
particularly among groups that are at high risk
for suicide'' before the semicolon at the end;
(E) in paragraph (2), by inserting ``for all ages,
particularly among groups that are at high risk for
suicide'' before the semicolon at the end;
(F) in paragraph (3), by inserting ``and tribal''
after ``statewide'';
(G) in paragraph (5), by inserting ``and
prevention'' after ``intervention'';
(H) in paragraph (8), by striking ``in youth'';
(I) in paragraph (9), by striking ``and behavioral
health'' and inserting ``health and substance use
disorder''; and
(J) in paragraph (10), by inserting ``conducting''
before ``other''; and
(6) by striking subsection (e) and inserting the following:
``(c) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated $4,948,000
for each of fiscal years 2015 through 2019.''.
(b) Youth Suicide Early Intervention and Prevention Strategies.--
Section 520E of the Public Health Service Act (42 U.S.C. 290bb-36) is
amended--
(1) in paragraph (1) of subsection (a) and in subsection
(c), by striking ``substance abuse'' each place such term
appears and inserting ``substance use disorder'';
(2) in subsection (b)(2)--
(A) by striking ``each State is awarded only 1
grant or cooperative agreement under this section'' and
inserting ``a State does not receive more than 1 grant
or cooperative agreement under this section at any 1
time''; and
(B) by striking ``been awarded'' and inserting
``received''; and
(3) by striking subsection (m) and inserting the following:
``(m) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated $29,682,000
for each of fiscal years 2015 through 2019.''.
(c) Mental Health and Substance Use Disorder Services.--Section
520E-2 of the Public Health Service Act (42 U.S.C. 290bb-36b) is
amended--
(1) in the section heading, by striking ``and behavioral
health'' and inserting ``health and substance use disorder
services'';
(2) in subsection (a)--
(A) by striking ``Services,'' and inserting
``Services and'';
(B) by striking ``and behavioral health problems''
and inserting ``health or substance use disorders'';
and
(C) by striking ``substance abuse'' and inserting
``substance use disorders'';
(3) in subsection (b)--
(A) in the matter preceding paragraph (1), by
striking ``for--'' and inserting ``for one or more of
the following:''; and
(B) by striking paragraphs (1) through (6) and
inserting the following:
``(1) Educating students, families, faculty, and staff to
increase awareness of mental health and substance use
disorders.
``(2) The operation of hotlines.
``(3) Preparing informational material.
``(4) Providing outreach services to notify students about
available mental health and substance use disorder services.
``(5) Administering voluntary mental health and substance
use disorder screenings and assessments.
``(6) Supporting the training of students, faculty, and
staff to respond effectively to students with mental health and
substance use disorders.
``(7) Creating a network infrastructure to link colleges
and universities with health care providers who treat mental
health and substance use disorders.'';
(4) in subsection (c)(5), by striking ``substance abuse''
and inserting ``substance use disorder'';
(5) in subsection (d)--
(A) in the matter preceding paragraph (1), by
striking ``An institution of higher education desiring
a grant under this section'' and inserting ``To be
eligible to receive a grant under this section, an
institution of higher education'';
(B) in paragraph (1)--
(i) by striking ``and behavioral health''
and inserting ``health and substance use
disorder''; and
(ii) by inserting ``, including veterans
whenever possible and appropriate,'' after
``students''; and
(C) in paragraph (2), by inserting ``, which may
include, as appropriate and in accordance with
subsection (b)(7), a plan to seek input from relevant
stakeholders in the community, including appropriate
public and private entities, in order to carry out the
program under the grant'' before the period at the end;
(6) in subsection (e)(1), by striking ``and behavioral
health problems'' and inserting ``health and substance use
disorders'';
(7) in subsection (f)(2)--
(A) by striking ``and behavioral health'' and
inserting ``health and substance use disorder''; and
(B) by striking ``suicide and substance abuse'' and
inserting ``suicide and substance use disorders''; and
(8) in subsection (h), by striking ``$5,000,000 for fiscal
year 2005'' and all that follows through the period at the end
and inserting ``$4,858,000 for each of fiscal years 2015
through 2019.''.
SEC. 204. PRIORITY MENTAL HEALTH NEEDS OF REGIONAL AND NATIONAL
SIGNIFICANCE REAUTHORIZATION.
Section 520A(f)(1) of the Public Health Service Act (42 U.S.C.
290bb-32(f)(1)) is amended by striking ``$300,000,000 for fiscal year
2001, and such sums as may be necessary for each of the fiscal years
2002 and 2003'' and inserting ``$216,632,000 for fiscal year 2015 and
such sums as may be necessary for each of fiscal years 2016 through
2019''.
SEC. 205. GRANTS FOR JAIL DIVERSION PROGRAMS REAUTHORIZATION.
Section 520G(i) of the Public Health Service Act (42 U.S.C. 290bb-
38(i)) is amended by striking ``$10,000,000 for fiscal year 2001, and
such sums as may be necessary for fiscal years 2002 through 2003'' and
inserting ``$4,280,000 for fiscal year 2015 and such sums as may be
necessary for each of fiscal years 2016 through 2019''.
SEC. 206. PROJECTS FOR ASSISTANCE IN TRANSITION FROM HOMELESSNESS.
Section 535(a) of the Public Health Service Act (42 U.S.C. 29cc-
35(a)) is amended by striking ``$75,000,000 for each of the fiscal
years 2001 through 2003'' and inserting ``$64,800,000 for fiscal year
2015 and such sums as may be necessary for each of fiscal years 2016
through 2019''.
SEC. 207. COMPREHENSIVE COMMUNITY MENTAL HEALTH SERVICES FOR CHILDREN
WITH SERIOUS EMOTIONAL DISTURBANCES.
Section 565 of the Public Health Service Act (42 U.S.C. 290ff-4) is
amended--
(1) in subsection (b)(1), by striking ``receiving a grant
under section 561(a)'' and inserting ``(irrespective of whether
the public entity is in receipt of a grant under section
561(a))'';
(2) in subsection (b)(1)(B), by striking ``planning,
development, and operation of systems of care pursuant to
section 562'' and inserting ``planning, development, and
operation of systems of care described in section 562''; and
(3) in subsection (f)(1), by striking ``$100,000,000 for
fiscal year 2001, and such sums as may be necessary for each of
the fiscal years 2002 and 2003'' and inserting ``$117,315,000
for fiscal year 2015 and such sums as may be necessary for each
of fiscal years 2016 through 2019''.
SEC. 208. CHILDREN'S RECOVERY FROM TRAUMA.
Section 582 of the Public Health Service Act (42 U.S.C. 290hh-1) is
amended--
(1) in subsection (a), by striking ``developing programs''
and all that follows and inserting ``developing and maintaining
programs that provide for--
``(1) the continued operation of the National Child
Traumatic Stress Initiative (referred to in this section as the
`NCTSI'), which includes a coordinating center, that focuses on
the mental, behavioral, and biological aspects of psychological
trauma response; and
``(2) the development of knowledge with regard to evidence-
based practices for identifying and treating mental,
behavioral, and biological disorders of children and youth
resulting from witnessing or experiencing a traumatic event.'';
(2) in subsection (b)--
(A) by striking ``subsection (a) related'' and
inserting ``subsection (a)(2) (related'';
(B) by striking ``treating disorders associated
with psychological trauma'' and inserting ``treating
mental, behavioral, and biological disorders associated
with psychological trauma)''; and
(C) by striking ``mental health agencies and
programs that have established clinical and basic
research'' and inserting ``universities, hospitals,
mental health agencies, and other programs that have
established clinical expertise and research'';
(3) by redesignating subsections (c) through (g) as
subsections (g) through (k), respectively;
(4) by inserting after subsection (b), the following:
``(c) Child Outcome Data.--The NCTSI coordinating center shall
collect, analyze, and report NCTSI-wide child treatment process and
outcome data regarding the early identification and delivery of
evidence-based treatment and services for children and families served
by the NCTSI grantees.
``(d) Training.--The NCTSI coordinating center shall facilitate the
coordination of training initiatives in evidence-based and trauma-
informed treatments, interventions, and practices offered to NCTSI
grantees, providers, and partners.
``(e) Dissemination.--The NCTSI coordinating center shall, as
appropriate, collaborate with the Secretary in the dissemination of
evidence-based and trauma-informed interventions, treatments, products
and other resources to appropriate stakeholders.
``(f) Review.--The Secretary shall, consistent with the peer review
process, ensure that NCTSI applications are reviewed by appropriate
experts in the field as part of a consensus review process. The
Secretary shall include review criteria related to expertise and
experience in child trauma and evidence-based practices.'';
(5) in subsection (g) (as so redesignated), by striking
``with respect to centers of excellence are distributed
equitably among the regions of the country'' and inserting
``are distributed equitably among the regions of the United
States'';
(6) in subsection (i) (as so redesignated), by striking
``recipient may not exceed 5 years'' and inserting ``recipient
shall not be less than 4 years, but shall not exceed 5 years'';
and
(7) in subsection (j) (as so redesignated), by striking
``$50,000,000'' and all that follows through ``2006'' and
inserting ``$45,714,000 for each of fiscal years 2015 through
2019''.
SEC. 209. PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS
REAUTHORIZATION.
Section 117 of the Protection and Advocacy for Individuals with
Mental Illness Act (42 U.S.C. 10827) is amended by striking
``$19,500,000 for fiscal year 1992, and such sums as may be necessary
for each of the fiscal years 1993 through 2003'' and inserting
``$36,238,000 for fiscal year 2015 and such sums as may be necessary
for each of fiscal years 2016 through 2019''.
SEC. 210. MENTAL HEALTH AWARENESS TRAINING GRANTS.
Section 520J of the Public Health Service Act (42 U.S.C. 290bb-41)
is amended--
(1) in the section heading, by inserting ``mental health
awareness'' before ``training''; and
(2) in subsection (b)--
(A) in the subsection heading, by striking
``Illness'' and inserting ``Health'';
(B) in paragraph (1), by inserting ``, and other
categories of individuals listed in paragraph (2),''
after ``emergency services personnel''; and
(C) by striking paragraph (2) and inserting the
following:
``(2) Categories of individuals to be trained.--The
categories of individuals listed in this paragraph are the
following:
``(A) Emergency services personnel and other first
responders.
``(B) Police officers and other law enforcement
personnel.
``(C) Teachers and school administrators.
``(D) Human resources professionals.
``(E) Faith community leaders.
``(F) Nurses and other primary care personnel.
``(G) Students enrolled in an elementary school, a
secondary school, or an institution of higher
education.
``(H) The parents of students described in
subparagraph (G).
``(I) Veterans.
``(J) Other individuals, audiences, or training
populations as determined appropriate by the
Secretary.'';
(D) in paragraph (5)--
(i) in the matter preceding subparagraph
(A), by striking ``to'' and inserting ``for
evidence-based programs for the purpose of'';
and
(ii) by striking subparagraphs (A) through
(C) and inserting the following:
``(A) recognizing the signs and symptoms of mental
illness; and
``(B)(i) providing education to personnel regarding
resources available in the community for individuals
with a mental illness and other relevant resources; or
``(ii) the safe de-escalation of crisis situations
involving individuals with a mental illness.''; and
(E) in paragraph (7), by striking ``, $25,000,000''
and all that follows through the period at the end and
inserting ``$20,000,000 for each of fiscal years 2014
through 2018''.
SEC. 211. NATIONAL MEDIA CAMPAIGN TO REDUCE THE STIGMA ASSOCIATED WITH
MENTAL ILLNESS.
Subpart 3 of part B of title V of the Public Health Service Act (42
U.S.C. 290bb-31 et seq.) is amended by adding at the end the following
new section:
``SEC. 520L. NATIONAL MEDIA CAMPAIGN TO REDUCE THE STIGMA ASSOCIATED
WITH MENTAL ILLNESS.
``(a) Scope of the Campaign.--The Secretary, acting through the
Administrator of the Substance Abuse and Mental Health Services
Administration, shall provide for the production, broadcasting, and
evaluation of a national media public service campaign to reduce the
stigma associated with mental illness. Such campaign shall seek to
reach as wide and diverse an audience as possible and shall
particularly target the population between the ages of 16 and 24 years
of age.
``(b) Report.--The Secretary shall provide a report to the Congress
annually detailing--
``(1) the production, broadcasting, and evaluation of the
campaign under subsection (a); and
``(2) the effectiveness of the campaign in reducing the
stigma associated with mental illness, as measured using such
methods as public attitude surveys and mental health services
utilization statistics.
``(c) Consultation Requirement.--In carrying out this section, the
Secretary shall ensure that mental health professionals and patient
advocates are consulted in carrying out the media campaign under this
section. The progress of this consultative process is to be covered in
the report under subsection (b).
``(d) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section, $10,000,000 for each of the
fiscal years 2015 through 2019.''.
SEC. 212. SAMHSA AND HRSA INTEGRATION OF BEHAVIORAL HEALTH SERVICES
INTO PRIMARY CARE SETTINGS.
Title V of the Public Health Service Act is amended by inserting
after section 520K (42 U.S.C. 290bb-42) the following:
``SEC. 520K-1. AWARDS FOR CO-LOCATING BEHAVIORAL HEALTH SERVICES IN
PRIMARY CARE SETTINGS.
``(a) Program Authorized.--The Secretary, acting through the
Administrators of the Substance Abuse and Mental Health Services
Administration and the Health Resources and Services Administration,
shall award grants, contracts, and cooperative agreements to eligible
entities for the provision of coordinated and integrated behavioral
health services and primary health care.
``(b) Eligible Entities.--To be eligible to seek a grant, contract,
or cooperative agreement this section, an entity shall be a public or
nonprofit entity.
``(c) Use of Funds.--An eligible entity receiving an award under
this section shall use the award for the provision of coordinated and
integrated behavioral health services and primary health care through--
``(1) the co-location of behavioral health services in
primary care settings;
``(2) the use of care management services to facilitate
coordination between behavioral health and primary care
providers;
``(3) the use of information technology (such as
telemedicine)--
``(A) to facilitate coordination between behavioral
health and primary care providers; or
``(B) to expand the availability of behavioral
health services; or
``(4) the provision of training and technical assistance to
improve the delivery, effectiveness, and integration of
behavioral health services into primary care settings.
``(d) Authorization of Appropriations.--To carry out this section--
``(1) there are authorized to be appropriated such sums as
may be necessary for fiscal years 2015 through 2019; and
``(2) such sums as necessary are authorized to be
transferred from the Substance Abuse and Mental Health Services
Administration to the Health Resources and Services
Administration.''.
SEC. 213. GERIATRIC MENTAL HEALTH DISORDERS.
Section 520A(e) of the Public Health Service Act (42 U.S.C. 290bb-
32(e)) is amended by adding at the end the following:
``(3) Geriatric mental health disorders.--The Secretary
shall, as appropriate, provide technical assistance to grantees
regarding evidence-based practices for the prevention and
treatment of geriatric mental health disorders, as well as
disseminate information about such evidence-based practices to
States and nongrantees throughout the United States.''.
SEC. 214. ASSESSING BARRIERS TO BEHAVIORAL HEALTH INTEGRATION.
(a) In General.--Not later than 2 years after the date of enactment
of this Act, the Comptroller General of the United States shall submit
a report to the Committee on Health, Education, Labor, and Pensions of
the Senate and the Committee on Energy and Commerce of the House of
Representatives concerning Federal requirements that impact access to
treatment of mental health and substance use disorders related to
integration with primary care, administrative and regulatory issues,
quality measurement and accountability, and data sharing.
(b) Contents.--The report submitted under subsection (a) shall
include the following:
(1) An evaluation of the administrative or regulatory
burden on behavioral health care providers.
(2) The identification of outcome and quality measures
relevant to integrated health care, evaluation of the data
collection burden on behavioral health care providers, and any
alternative methods for evaluation.
(3) An analysis of the degree to which electronic data
standards, including interoperability and meaningful use
includes behavioral health measures, and an analysis of
strategies to address barriers to health information exchange
posed by part 2 of title 42, Code of Federal Regulations.
(4) An analysis of the degree to which Federal rules and
regulations for behavioral and physical health care are
aligned, including recommendations to address any identified
barriers.
SEC. 215. ACUTE CARE BED REGISTRY GRANT FOR STATES.
(a) In General.--The Secretary of Health and Human Services, acting
through Administrator of the Substance Abuse and Mental Health Services
Administration, shall award grants to State mental health agencies to
develop and administer a Web-based acute psychiatric bed registry to
collect, aggregate, and display information about available acute beds
in public and private inpatient psychiatric facilities and public and
private residential crisis stabilization units to facilitate the
identification and designation of facilities for the temporary
treatment of individuals in psychiatric crisis.
(b) Registry Requirements.--An acute psychiatric bed registry
funded under this section shall--
(1) include descriptive information for every public and
private inpatient psychiatric facility and every public and
private residential crisis stabilization unit in the State
involved, including contact information for the facility or
unit;
(2) provide real-time information about the number of beds
available at each facility or unit and, for each available bed,
the type of patient that may be admitted, the level of security
provided, and any other information that may be necessary to
allow for the proper identification of appropriate facilities
for treatment of individuals in psychiatric crisis; and
(3) allow employees and designees of community mental
health service providers, employees of inpatient psychiatric
facilities or public and private residential crisis
stabilization units, and health care providers working in an
emergency room of a hospital or clinic or other facility
rendering emergency medical care to perform searches of the
registry to identify available beds that are appropriate for
the treatment of individuals in psychiatric crisis.
(c) Authorization of Appropriations.--To carry out this section,
there are authorized to be appropriated such sums as may be necessary
for fiscal years 2015 through 2019.
SEC. 216. AWARDS FOR CO-LOCATING PRIMARY AND SPECIALTY CARE IN
COMMUNITY-BASED MENTAL HEALTH SETTINGS.
Section 520K(f) of the Public Health Service Act (42 U.S.C. 290bb-
42(f)) is amended by striking ``$50,000,000 for fiscal year 2010 and
such sums as may be necessary for each of fiscal years 2011 through
2014'' and inserting ``$50,000,000 for fiscal year 2015 and such sums
as may be necessary for each of fiscal years 2016 through 2019''.
SEC. 217. GRANTS FOR THE BENEFIT OF HOMELESS INDIVIDUALS.
Section 506(e) of the Public Health Service Act (42 U.S.C. 290aa-
5(e)) is amended by striking ``$50,000,000 for fiscal year 2001, and
such sums as may be necessary for each of the fiscal years 2002 and
2003'' and inserting ``$____for fiscal year 2015 and such sums as may
be necessary for each of fiscal years 2016 through 2019''.
TITLE III--IMPROVING MEDICAID AND MEDICARE MENTAL HEALTH SERVICES
SEC. 301. ACCESS TO MENTAL HEALTH PRESCRIPTION DRUGS UNDER MEDICARE.
Section 1860D-4(b)(3)(G)(ii)(I) of the Social Security Act (42
U.S.C. 1395w-104(b)(3)(G)(ii)(I)) is amended by adding at the end the
following: ``Notwithstanding the previous sentence, categories and
classes of drugs specified in subclauses (II) and (IV) of clause (iv)
shall be identified under this subclause.''.
SEC. 302. MEDICAID COVERAGE OF MENTAL HEALTH SERVICES AND PRIMARY CARE
SERVICES FURNISHED ON THE SAME DAY.
(a) In General.--Not later than one year after the date of the
enactment of this Act, the Secretary of Health and Human Services shall
issue guidance to clarify that payment under a State plan is not
prohibited for a mental health service or primary care service
furnished to an individual at a community mental health center that
meets the criteria specified in section 1913(c) of the Public Health
Service Act (42 U.S.C. 300x-2(c)) or a federally qualified health
center (as defined in section 1861(aa)(3) of the Social Security Act
(42 U.S.C. 1395x(aa)(3))) for which payment would otherwise be payable
under the plan, with respect to such individual, if such service were
not a same-day qualifying service.
(b) Same-Day Qualifying Service Defined.--In this section, the term
``same-day qualifying service'' means--
(1) a primary care service furnished to an individual by a
provider at a facility on the same day a mental health service
is furnished to such individual by such provider (or another
provider) at the facility; and
(2) a mental health service furnished to an individual by a
provider at a facility on the same day a primary care service
is furnished to such individual by such provider (or another
provider) at the facility.
SEC. 303. ELIMINATION OF 190-DAY LIFETIME LIMIT ON INPATIENT
PSYCHIATRIC HOSPITAL SERVICES.
(a) In General.--Section 1812 of the Social Security Act (42 U.S.C.
1395d) is amended--
(1) in subsection (b)--
(A) in paragraph (1), by adding ``or'' at the end;
(B) in paragraph (2), by striking ``; or'' at the
end and inserting a period; and
(C) by striking paragraph (3); and
(2) in subsection (c), by striking ``or in determining the
190-day limit under subsection (b)(3)''.
(b) Effective Date.--The amendments made by subsection (a) shall
apply to items and services furnished on or after January 1, 2016.
SEC. 304. EXPANDING THE MEDICAID HOME AND COMMUNITY-BASED SERVICES
WAIVER TO INCLUDE YOUTH IN NEED OF SERVICES PROVIDED IN A
PSYCHIATRIC RESIDENTIAL TREATMENT FACILITY.
(a) In General.--Section 1915(c) of the Social Security Act (42
U.S.C. 1396n(c)) is amended--
(1) in paragraph (1)--
(A) by striking ``a hospital or a nursing facility
or intermediate care facility for the mentally
retarded'' and inserting ``a hospital, a nursing
facility, an intermediate care facility for the
intellectually disabled, or a psychiatric residential
treatment facility,''; and
(B) by striking ``a hospital, nursing facility, or
intermediate care facility for the mentally retarded''
and inserting ``a hospital, nursing facility,
intermediate care facility for the intellectually
disabled, or psychiatric residential treatment
facility'';
(2) in paragraph (2)(B), by striking ``or services in an
intermediate care facility for the mentally retarded'' each
place it appears and inserting ``services in an intermediate
care facility for the intellectually disabled, or services in a
psychiatric residential treatment facility'';
(3) in paragraph (2)(C)--
(A) by striking ``or intermediate care facility for
the mentally retarded'' and inserting ``intermediate
care facility for the intellectually disabled, or
psychiatric residential treatment facility''; and
(B) by striking ``or services in an intermediate
care facility for the mentally retarded'' and inserting
``services in an intermediate care facility for the
intellectually disabled, or services in a psychiatric
residential treatment facility'';
(4) in paragraph (7)(A), by striking ``or intermediate care
facilities for the mentally retarded,'' and inserting
``intermediate care facilities for the intellectually disabled,
or psychiatric residential treatment facilities,''; and
(5) by adding at the end the following new paragraph:
``(11) For purposes of this subsection, the term `psychiatric
residential treatment facility' means a facility other than a hospital
that is certified as meeting the requirements specified in regulations
promulgated for such facilities under section 1905(h)(1) and that
provides psychiatric services in an inpatient setting to individuals
under age 21 for which medical assistance is available under a State
plan under this title.''.
(b) Waiver Limitation.--Section 1915(c) of such Act, as amended by
subsection (a), is further amended--
(1) in paragraph (2)--
(A) in subparagraph (D), by striking ``; and'' and
inserting a semicolon;
(B) in subparagraph (E), by striking the period at
the end and inserting a semicolon; and
(C) by adding at the end the following new
subparagraphs:
``(F) under the waiver, the total number of Medicaid
inpatient bed days at psychiatric residential treatment
facilities during each fiscal year within the waiver period
will not exceed the total number of Medicaid inpatient bed days
at such facilities for the previous fiscal year as increased by
the estimated percentage increase (if any) in the population of
individuals under age 21 residing in the State over the
preceding 12-month period; and
``(G) the State will provide to the Secretary annually,
subject to such requirements as the Secretary determines
appropriate, relevant information and evidence as to the manner
in which the State will satisfy the requirements described in
subparagraph (F).''; and
(2) by adding at the end the following new paragraph:
``(12) For purposes of paragraph (2)(F), an individual who is under
age 21 and is an inpatient in a bed in a psychiatric residential
treatment facility for a single day shall be counted as one inpatient
bed day.''.
SEC. 305. APPLICATION OF ROSA'S LAW FOR INDIVIDUALS WITH INTELLECTUAL
DISABILITIES.
(a) References in the Social Security Act.--
(1) In general.--With the exception of section 1930(b) of
the Social Security Act (42 U.S.C. 1396u(b)), as amended by
section 305, such Act is further amended--
(A) by striking, wherever it appears, ``State
mental retardation or developmental disability
authority'' and inserting ``State intellectual
disability or developmental disability authority'';
(B) by striking, wherever it appears, ``mental
retardation'' and inserting ``intellectual
disabilities''; and
(C) by striking, wherever it appears, ``mentally
retarded'' and inserting ``intellectually disabled''.
(2) Conforming amendment.--
(A) In general.--Section 1902(e)(14)(F) of such Act
is amended by striking ``mentally retarded'' and
inserting ``intellectually disabled''.
(B) Effective date.--The amendment made under
subparagraph (A) shall take effect on January 2, 2015.
(b) References.--
(1) In general.--For purposes of each provision amended by
this section, issuing or amending regulations to carry out a
provision amended by this section, or issuing any publication
or other official communication in regards to any provision of
the Social Security Act--
(A) a reference to an intellectual disability shall
mean a condition previously referred to as mental
retardation, or a variation of such term, and shall
have the same meaning with respect to programs, or
qualifications for such programs, for individuals with
such a condition;
(B) a reference to an individual who is
intellectually disabled shall mean an individual who
was previously referred to as an individual who is
mentally retarded, an individual with mental
retardation, or variations of such terms;
(C) a reference to an intermediate care facility
for the intellectually disabled shall mean a facility
that was previously referred to as an intermediate care
facility for the mentally retarded; and
(D) a reference to a State intellectual disability
or developmental disability authority shall mean an
entity that was previously referred to as a State
mental retardation or developmental disability
authority.
(2) Regulations.--For purposes of amending regulations to
carry out this section, a Federal agency shall ensure that the
regulations clearly state--
(A) that an intellectual disability was formerly
termed mental retardation;
(B) that individuals with intellectual disabilities
were formerly termed individuals who are mentally
retarded;
(C) that an intermediate care facility for the
intellectually disabled was formerly termed an
intermediate care facility for the mentally retarded;
and
(D) that a State intellectual disability or
developmental disability authority was formerly termed
a State mental retardation or developmental disability
authority.
(c) Rule of Construction.--This section shall be construed to make
amendments to provisions of Federal law to substitute the term
``intellectual disability'' for ``mental retardation'' or any variation
of such term without any intent to--
(1) change the coverage, eligibility, rights,
responsibilities, or definitions referred to in the amended
provisions; or
(2) compel States to change terminology in State laws for
individuals covered by a provision amended by this section.
SEC. 306. COMPLETE APPLICATION OF MENTAL HEALTH AND SUBSTANCE USE
PARITY RULES UNDER MEDICAID AND CHIP.
Not later than January 1, 2015, the Secretary of Health and Human
Services shall issue a final rule to carry out the following provisions
of law:
(1) Section 1932(b)(8) of the Social Security Act (42
U.S.C. 1396u-2(b)(8)) (requiring Medicaid managed care
organizations to comply with the mental health and substance
use requirements under certain provisions of part A of title
XXVII of the Public Health Service Act (42 U.S.C. 300gg et
seq.)).
(2) Section 1937(b)(6) of such Act (42 U.S.C. 1396u-
7(b)(6)) (requiring benchmark benefit packages or benchmark
equivalent coverage to comply with the mental health and
substance use parity requirements under section 2705(a) of the
Public Health Service Act (42 U.S.C. 300gg-4)).
(3) Section 2103(c)(6) of such Act (42 U.S.C. 1937cc(c)(6))
(requiring State child health plans to comply with mental
health and substance use parity requirements under section
2705(a) of the Public Health Service Act (42 U.S.C. 300gg-4)).
SEC. 307. COVERAGE OF MARRIAGE AND FAMILY THERAPIST SERVICES AND MENTAL
HEALTH COUNSELOR SERVICES UNDER PART B OF THE MEDICARE
PROGRAM.
(a) Coverage of Services.--
(1) In general.--Section 1861(s)(2) of the Social Security
Act (42 U.S.C. 1395x(s)(2)) is amended--
(A) in subparagraph (EE), by striking ``and'' after
the semicolon at the end;
(B) in subparagraph (FF), by inserting ``and''
after the semicolon at the end; and
(C) by adding at the end the following new
subparagraph:
``(GG) marriage and family therapist services (as defined
in subsection (iii)(1)) and mental health counselor services
(as defined in subsection (iii)(3));''.
(2) Definitions.--Section 1861 of the Social Security Act
(42 U.S.C. 1395x) is amended by adding at the end the following
new subsection:
``Marriage and Family Therapist Services; Marriage and Family
Therapist; Mental Health Counselor Services; Mental Health Counselor
``(iii)(1) The term `marriage and family therapist services' means
services performed by a marriage and family therapist (as defined in
paragraph (2)) for the diagnosis and treatment of mental illnesses,
which the marriage and family therapist is legally authorized to
perform under State law (or the State regulatory mechanism provided by
State law) of the State in which such services are performed, as would
otherwise be covered if furnished by a physician or as an incident to a
physician's professional service, but only if no facility or other
provider charges or is paid any amounts with respect to the furnishing
of such services.
``(2) The term `marriage and family therapist' means an individual
who--
``(A) possesses a master's or doctoral degree which
qualifies for licensure or certification as a marriage and
family therapist pursuant to State law;
``(B) after obtaining such degree has performed at least 2
years of clinical supervised experience in marriage and family
therapy; and
``(C) is licensed or certified as a marriage and family
therapist in the State in which marriage and family therapist
services are performed.
``(3) The term `mental health counselor services' means services
performed by a mental health counselor (as defined in paragraph (4))
for the diagnosis and treatment of mental illnesses which the mental
health counselor is legally authorized to perform under State law (or
the State regulatory mechanism provided by the State law) of the State
in which such services are performed, as would otherwise be covered if
furnished by a physician or as incident to a physician's professional
service, but only if no facility or other provider charges or is paid
any amounts with respect to the furnishing of such services.
``(4) The term `mental health counselor' means an individual who--
``(A) possesses a master's or doctoral degree in mental
health counseling or a related field;
``(B) after obtaining such a degree has performed at least
2 years of supervised mental health counselor practice; and
``(C) in the case of an individual performing services in a
State that provides for licensure or certification of mental
health counselors or professional counselors, is licensed or
certified as a mental health counselor or professional
counselor in such State.''.
(3) Provision for payment under part b.--Section
1832(a)(2)(B) of the Social Security Act (42 U.S.C.
1395k(a)(2)(B)) is amended by adding at the end the following
new clause:
``(v) marriage and family therapist
services (as defined in section 1861(iii)(1))
and mental health counselor services (as
defined in section 1861(iii)(3));''.
(4) Amount of payment.--
(A) In general.--Section 1833(a)(1) of the Social
Security Act (42 U.S.C. 1395l(a)(1)) is amended--
(i) by striking ``and (Z)'' and inserting
``(Z)''; and
(ii) by inserting before the semicolon at
the end the following: ``, and (AA) with
respect to marriage and family therapist
services and mental health counselor services
under section 1861(s)(2)(GG), the amounts paid
shall be 80 percent of the lesser of the actual
charge for the services or 75 percent of the
amount determined for payment of a psychologist
under subparagraph (L)''.
(B) Development of criteria with respect to
consultation with a health care professional.--The
Secretary of Health and Human Services shall, taking
into consideration concerns for patient
confidentiality, develop criteria with respect to
payment for marriage and family therapist services for
which payment may be made directly to the marriage and
family therapist under part B of title XVIII of the
Social Security Act (42 U.S.C. 1395j et seq.) under
which such a therapist must agree to consult with a
patient's attending or primary care physician or nurse
practitioner in accordance with such criteria.
(5) Exclusion of marriage and family therapist services and
mental health counselor services from skilled nursing facility
prospective payment system.--Section 1888(e)(2)(A)(ii) of the
Social Security Act (42 U.S.C. 1395yy(e)(2)(A)(ii)) is amended
by inserting ``marriage and family therapist services (as
defined in section 1861(iii)(1)), mental health counselor
services (as defined in section 1861(iii)(3)),'' after
``qualified psychologist services,''.
(6) Inclusion of marriage and family therapists and mental
health counselors as practitioners for assignment of claims.--
Section 1842(b)(18)(C) of the Social Security Act (42 U.S.C.
1395u(b)(18)(C)) is amended by adding at the end the following
new clauses:
``(vii) A marriage and family therapist (as defined in
section 1861(iii)(2)).
``(viii) A mental health counselor (as defined in section
1861(iii)(4)).''.
(b) Coverage of Certain Mental Health Services Provided in Certain
Settings.--
(1) Rural health clinics and federally qualified health
centers.--Section 1861(aa)(1)(B) of the Social Security Act (42
U.S.C. 1395x(aa)(1)(B)) is amended by striking ``or by a
clinical social worker (as defined in subsection (hh)(1))'' and
inserting ``, by a clinical social worker (as defined in
subsection (hh)(1)), by a marriage and family therapist (as
defined in subsection (iii)(2)), or by a mental health
counselor (as defined in subsection (iii)(4))''.
(2) Hospice programs.--Section 1861(dd)(2)(B)(i)(III) of
the Social Security Act (42 U.S.C. 1395x(dd)(2)(B)(i)(III)) is
amended by inserting ``(and may, in addition, include a
marriage and family therapist and mental health counselor)''
after ``social worker''.
(c) Authorization of Marriage and Family Therapists and Mental
Health Counselors To Develop Discharge Plans for Post-Hospital
Services.--Section 1861(ee)(2)(G) of the Social Security Act (42 U.S.C.
1395x(ee)(2)(G)) is amended by inserting ``, including a marriage and
family therapist and a mental health counselor who meets qualification
standards established by the Secretary'' before the period at the end.
(d) Effective Date.--The amendments made by this section shall
apply with respect to services furnished on or after the date that is
one year after the date of the enactment of this Act.
TITLE IV--DEVELOPING THE BEHAVIORAL HEALTH WORKFORCE
SEC. 401. NATIONAL HEALTH SERVICE CORPS SCHOLARSHIP AND LOAN REPAYMENT
FUNDING FOR BEHAVIORAL AND MENTAL HEALTH PROFESSIONALS.
Section 338H of the Public Health Service Act (42 U.S.C. 254q) is
amended--
(1) by redesignating subsections (b) and (c) as subsections
(c) and (d), respectively; and
(2) by inserting after subsection (a) the following:
``(b) Additional Funding for Behavioral and Mental Health
Professionals.--In addition to the amounts authorized to be
appropriated under subsection (a), and in addition to the amounts
appropriated under section 10503 of Public Law 111-148, there are
authorized to be appropriated such sums as may be necessary for fiscal
years 2015 through 2019 for scholarships and loan repayments under this
subpart for ensuring, as described in sections 338A(a) and 338B(a), an
adequate supply of behavioral and mental health professionals.''.
SEC. 402. REAUTHORIZATION OF HRSA'S MENTAL AND BEHAVIORAL HEALTH
EDUCATION AND TRAINING PROGRAM.
Subsection (e) of section 756 of the Public Health Service Act (42
U.S.C. 294e-1) is amended to read as follows:
``(e) Authorization of Appropriations.--To carry out this section,
there are authorized to be appropriated such sums as may be necessary
for fiscal years 2015 through 2019.''.
SEC. 403. SAMHSA GRANT PROGRAM FOR DEVELOPMENT AND IMPLEMENTATION OF
CURRICULA FOR CONTINUING EDUCATION ON SERIOUS MENTAL
ILLNESS.
Title V of the Public Health Service Act is amended by inserting
after section 520I (42 U.S.C. 290bb-40) the following:
``SEC. 520I-1. CURRICULA FOR CONTINUING EDUCATION ON SERIOUS MENTAL
ILLNESS.
``(a) Grants.--The Secretary may award grants to eligible entities
for the development and implementation of curricula for providing
continuing education and training to health care professionals on
identifying, referring, and treating individuals with serious mental
illness.
``(b) Eligible Entities.--To be eligible to seek a grant under this
section, an entity shall be a public or nonprofit entity that--
``(1) provides continuing education or training to health
care professionals; or
``(2) applies for the grant in partnership with another
entity that provides such education and training.
``(c) Preference.--In awarding grants under this section, the
Secretary shall give preference to eligible entities proposing to
develop and implement curricula for providing continuing education and
training to--
``(1) health care professionals in primary care
specialities; or
``(2) health care professionals who are required, as a
condition of State licensure, to participate in continuing
education or training specific to mental health.
``(d) Authorization of Appropriations.--To carry out this section,
there are authorized to be appropriated such sums as may be necessary
for fiscal years 2015 through 2019.''.
SEC. 404. DEMONSTRATION GRANT PROGRAM TO RECRUIT, TRAIN, DEPLOY, AND
PROFESSIONALLY SUPPORT PSYCHIATRIC PHYSICIANS IN INDIAN
HEALTH PROGRAMS.
(a) Short Title.--This section may be cited as the ``Native
American Psychiatric and Mental Health Care Improvement Act''.
(b) Demonstration Grant Program To Recruit, Train, Deploy, and
Professionally Support Psychiatric Physicians in Indian Health
Programs.--
(1) Establishment.--The Secretary of Health and Human
Services (in this subsection referred to as the ``Secretary''),
in consultation with the Director of the Indian Health Service
and demonstration programs established under section 123 of the
Indian Health Care Improvement Act (25 U.S.C. 1616p), shall
award one 5-year grant to one eligible entity to carry out a
demonstration program (in this Act referred to as the
``Program'') under which the eligible entity shall carry out
the activities described in paragraph (2).
(2) Activities to be carried out by recipient of grant
under program.--Under the Program, the grant recipient shall--
(A) create a nationally replicable workforce model
that identifies and incorporates best practices for
recruiting, training, deploying, and professionally
supporting Native American and non-Native American
psychiatric physicians to be fully integrated into
medical, mental, and behavioral health systems in
Indian health programs;
(B) recruit to participate in the Program Native
American and non-Native American psychiatric physicians
who demonstrate interest in providing specialty health
care services (as defined in section 313(a)(3) of the
Indian Health Care Improvement Act (25 U.S.C.
1638g(a)(3))) and primary care services to American
Indians and Alaska Natives;
(C) provide such psychiatric physicians
participating in the Program with not more than 1 year
of supplemental clinical and cultural competency
training to enable such physicians to provide such
specialty health care services and primary care
services in Indian health programs;
(D) with respect to such psychiatric physicians who
are participating in the Program and trained under
subparagraph (C), deploy such physicians to practice
specialty care or primary care in Indian health
programs for a period of not less than 2 years and
professionally support such physicians for such period
with respect to practicing such care in such programs;
and
(E) not later than 1 year after the last day of the
5-year period for which the grant is awarded under
paragraph (1), submit to the Secretary and to the
appropriate committees of Congress a report that shall
include--
(i) the workforce model created under
subparagraph (A);
(ii) strategies for disseminating the
workforce model to other entities with the
capability of adopting it; and
(iii) recommendations for the Secretary and
Congress with respect to supporting an
effective and stable psychiatric and mental
health workforce that serves American Indians
and Alaska Natives.
(3) Eligible entities.--
(A) Requirements.--To be eligible to receive the
grant under this section, an entity shall--
(i) submit to the Secretary an application
at such time, in such manner, and containing
such information as the Secretary may require;
(ii) be a department of psychiatry within a
medical school in the United States that is
accredited by the Liaison Committee on Medical
Education or a public or private nonprofit
entity affiliated with a medical school in the
United States that is accredited by the Liaison
Committee on Medical Education; and
(iii) have in existence, as of the time of
submission of the application under
subparagraph (A), a relationship with Indian
health programs in at least two States with a
demonstrated need for psychiatric physicians
and provide assurances that the grant will be
used to serve rural and non-rural American
Indian and Alaska Native populations in at
least two States.
(B) Priority in selecting grant recipient.--In
awarding the grant under this section, the Secretary
shall give priority to an eligible entity that
satisfies each of the following:
(i) Demonstrates sufficient infrastructure
in size, scope, and capacity to undertake the
supplemental clinical and cultural competency
training of a minimum of 5 psychiatric
physicians, and to provide ongoing professional
support to psychiatric physicians during the
deployment period to an Indian health program.
(ii) Demonstrates a record in successfully
recruiting, training, and deploying physicians
who are American Indians and Alaska Natives.
(iii) Demonstrates the ability to establish
a program advisory board, which may be
primarily composed of representatives of
federally recognized tribes, Alaska Natives,
and Indian health programs to be served by the
Program.
(4) Eligibility of psychiatric physicians to participate in
the program.--
(A) In general.--To be eligible to participate in
the Program, as described in paragraph (2), a
psychiatric physician shall--
(i) be licensed or eligible for licensure
to practice in the State to which the physician
is to be deployed under paragraph (2)(D); and
(ii) demonstrate a commitment beyond the
one year of training described in paragraph
(2)(C) and two years of deployment described in
paragraph (2)(D) to a career as a specialty
care physician or primary care physician
providing mental health services in Indian
health programs.
(B) Preference.--In selecting physicians to
participate under the Program, as described in
paragraph (2)(B), the grant recipient shall give
preference to physicians who are American Indians and
Alaska Natives.
(5) Loan forgiveness.--Under the Program, any psychiatric
physician accepted to participate in the Program shall,
notwithstanding the provisions of subsection (b) of section 108
of the Indian Health Care Improvement Act (25 U.S.C. 1616a) and
upon acceptance into the Program, be deemed eligible and
enrolled to participate in the Indian Health Service Loan
Repayment Program under such section 108. Under such Loan
Repayment Program, the Secretary shall pay on behalf of the
physician for each year of deployment under the Program under
this section up to $35,000 for loans described in subsection
(g)(1) of such section 108.
(6) Deferral of certain service.--The starting date of
required service of individuals in the National Health Service
Corps Service Program under title II of the Public Health
Service Act (42 U.S.C. 202 et seq.) who are psychiatric
physicians participating under the Program under this section
shall be deferred until the date that is 30 days after the date
of completion of the participation of such a physician in the
Program under this section.
(7) Definitions.--For purposes of this Act:
(A) American indians and alaska natives.--The term
``American Indians and Alaska Natives'' has the meaning
given the term ``Indian'' in section 447.50(b)(1) of
title 42, Code of Federal Regulations, as in existence
as of the date of the enactment of this Act.
(B) Indian health program.--The term ``Indian
health program'' has the meaning given such term in
section 104(12) of the Indian Health Care Improvement
Act (25 U.S.C. 1603(12)).
(C) Professionally support.--The term
``professionally support'' means, with respect to
psychiatric physicians participating in the Program and
deployed to practice specialty care or primary care in
Indian health programs, the provision of compensation
to such physicians for the provision of such care
during such deployment and may include the provision,
dissemination, or sharing of best practices, field
training, and other activities deemed appropriate by
the recipient of the grant under this section.
(D) Psychiatric physician.--The term ``psychiatric
physician'' means a medical doctor or doctor of
osteopathy in good standing who has successfully
completed four-year psychiatric residency training or
who is enrolled in four-year psychiatric residency
training in a residency program accredited by the
Accreditation Council for Graduate Medical Education.
(8) Authorization of appropriations.--There is authorized
to be appropriated to carry out this section $1,000,000 for
each of the fiscal years 2015 through 2019.
SEC. 405. INCLUDING OCCUPATIONAL THERAPISTS AS BEHAVIORAL AND MENTAL
HEALTH PROFESSIONALS FOR PURPOSES OF THE NATIONAL HEALTH
SERVICE CORPS.
(a) Inclusion of Occupational Therapist.--Section 331(a)(3)(E)(i)
of the Public Health Service Act (42 U.S.C. 254d(a)(3)(E)(i)) is
amended by inserting ``subject to section 405(b)(2) of the
Strengthening Mental Health in Our Communities Act of 2014,
occupational therapists,'' after ``psychiatric nurse specialists;''.
(b) Effective Date; Contingent Implementation.--
(1) Effective date.--Subject to paragraph (2), the
amendment made by subsection (a) shall apply beginning on
October 1, 2014.
(2) Contingent implementation.--The amendment made by
subsection (a) shall apply with respect to obligations entered
into for a fiscal year after fiscal year 2014 only if the total
amount made available for the purpose of carrying out subparts
II and III of part D of title III of the Public Health Service
Act (42 U.S.C. 254d et seq.) for such fiscal year is greater
than the total amount made available for such purpose for
fiscal year 2014.
SEC. 406. EXTENSION OF CERTAIN HEALTH CARE WORKFORCE LOAN REPAYMENT
PROGRAMS THROUGH FISCAL YEAR 2019.
Section 775(e) of the Public Health Service Act (42 U.S.C. 295f(e))
is amended--
(1) by striking ``2014'' and inserting ``2019''; and
(2) by striking ``2013'' and inserting ``2019''.
TITLE V--IMPROVING MENTAL HEALTH RESEARCH AND COORDINATION
SEC. 501. NATIONAL INSTITUTE OF MENTAL HEALTH RESEARCH PROGRAM ON
SERIOUS MENTAL ILLNESS AND SUICIDE PREVENTION.
(a) Purpose of Institute.--Section 464R(a) of the Public Health
Service Act (42 U.S.C. 285p(a)) is amended by inserting ``serious
mental illness research,'' after ``biomedical and behavioral
research,''.
(b) Research Program.--Section 464R(b) of the Public Health Service
Act (42 U.S.C. 285p(b)) is amended--
(1) by striking ``The research program'' and inserting the
following:
``(1) In general.--The research program'';
(2) by striking ``to further the treatment and prevention
of mental illness'' and inserting ``to further the treatment
and prevention of mental illness (including serious mental
illness)''; and
(3) by adding at the end the following:
``(2) Research with respect to serious mental illness.--As
part of the research program established under this subpart,
the Director of the Institute shall conduct or support research
on serious mental illness, including with respect to--
``(A) the causes, prevention, and treatment of
serious mental illness; and
``(B) interventions to improve early identification
of individuals with serious mental illness.
``(3) Research with respect to violence associated with
mental illness.--As part of the research program established
under this subpart, the Director of the Institute shall conduct
or support research on self-directed and other-directed
violence associated with mental illness, including with respect
to--
``(A) the causes of such violence; and
``(B) interventions to reduce the risk of self-
harm, suicide, and interpersonal violence, including in
rural and other underserved communities.''.
(c) Biennial Report.--Section 403(a)(5) of the Public Health
Service Act (42 U.S.C. 283(a)(5)) is amended--
(1) by redesignating subparagraph (L) as subparagraph (M);
and
(2) by inserting after subparagraph (K) the following:
``(L) Serious mental illness.''.
(d) Authorization of Appropriations.--Section 464R of the Public
Health Service Act (42 U.S.C. 285p) is amended by adding at the end the
following:
``(f) Authorization of Appropriations.--In addition to amounts
otherwise made available to the National Institute of Mental Health,
including amounts appropriated pursuant to section 402A(a), there are
authorized to be appropriated to such Institute $40,000,000 for each of
fiscal years 2015 through 2019 to carry out subsection (b)(3) (relating
to research with respect to violence associated with mental
illness).''.
SEC. 502. YOUTH MENTAL HEALTH RESEARCH NETWORK.
(a) Youth Mental Health Research Network.--
(1) Network.--The Director of the National Institutes of
Health may provide for the establishment of a Youth Mental
Health Research Network for the conduct or support of--
(A) youth mental health research; and
(B) youth mental health intervention services.
(2) Collaboration by institutes and centers.--The Director
of NIH shall carry out this Act acting--
(A) through the Director of the National Institute
of Mental Health; and
(B) in collaboration with other appropriate
national research institutes and national centers that
carry out activities involving youth mental health
research.
(3) Mental health research.--
(A) In general.--In carrying out paragraph (1), the
Director of NIH may award cooperative agreements,
grants, and contracts to State, local, and tribal
governments and private nonprofit entities for--
(i) conducting, or entering into consortia
with other entities to conduct--
(I) basic, clinical, behavioral, or
translational research to meet unmet
needs for youth mental health research;
or
(II) training for researchers in
youth mental health research
techniques;
(ii) providing, or partnering with non-
research institutions or community-based groups
with existing connections to youth to provide,
youth mental health intervention services; and
(iii) collaborating with the National
Institute of Mental Health to make use of, and
build on, the scientific findings and clinical
techniques of the Institute's earlier programs,
studies, and demonstration projects.
(B) Research.--The Director of NIH shall ensure
that--
(i) each recipient of an award under
subparagraph (A)(i) conducts or supports at
least one category of research described in
subparagraph (A)(i)(I) and collectively such
recipients conduct or support all such
categories of research; and
(ii) one or more such recipients provide
training described in subparagraph (A)(i)(II).
(C) Number of award recipients.--The Director of
NIH may make awards under this paragraph for not more
than 70 entities.
(D) Supplement, not supplant.--Any support received
by an entity under subparagraph (A) shall be used to
supplement, and not supplant, other public or private
support for activities authorized to be supported under
this paragraph.
(E) Duration of support.--Support of an entity
under subparagraph (A) may be for a period of not to
exceed 5 years. Such period may be extended by the
Director of NIH for additional periods of not more than
5 years.
(4) Coordination.--The Director of NIH shall--
(A) as appropriate, provide for the coordination of
activities (including the exchange of information and
regular communication) among the recipients of awards
under this subsection; and
(B) require the periodic preparation and submission
to the Director of reports on the activities of each
such recipient.
(b) Intervention Services for, and Research on, Serious Emotional
Disturbance.--
(1) In general.--In making awards under subsection (a)(3),
the Director of NIH shall ensure that an appropriate number of
such awards are awarded to entities that agree to--
(A) focus primarily on the early detection of and
interventions for serious emotional disturbances in
children and adolescents;
(B) conduct or coordinate one or more multisite
clinical trials of therapies for, or approaches to, the
prevention, diagnosis, or treatment of early serious
emotional disturbance in a community setting;
(C) rapidly and efficiently disseminate scientific
findings resulting from such trials; and
(D) adhere to the guidelines, protocols, and
practices used in the North American Prodrome
Longitudinal Study (NAPLS) and the Recovery After an
Initial Schizophrenia Episode (RAISE) initiative.
(2) Data coordinating center.--
(A) Establishment.--In connection with awards to
entities described in paragraph (1), the Director of
NIH shall establish a data coordinating center for the
following purposes:
(i) To distribute the scientific findings
referred to in paragraph (1)(C).
(ii) To provide assistance in the design
and conduct of collaborative research projects
and the management, analysis, and storage of
data associated with such projects.
(iii) To organize and conduct multisite
monitoring activities.
(iv) To provide assistance to the Centers
for Disease Control and Prevention in the
establishment of patient registries.
(B) Reporting.--The Director of NIH shall--
(i) require the data coordinating center
established under subparagraph (A) to provide
regular reports to the Director of NIH on
research conducted by entities described in
paragraph (1), including information on
enrollment in clinical trials and the
allocation of resources with respect to such
research; and
(ii) as appropriate, incorporate
information reported under clause (i) into the
Director's biennial reports under section 403
of the Public Health Service Act (42 U.S.C.
283).
(c) Definitions.--In this Act, the terms ``Director of NIH'',
``national center'', and ``national research institute'' have the
meanings given to such terms in section 401 of the Public Health
Service Act (42 U.S.C. 281).
(d) Authorization of Appropriations.--To carry out this Act, there
is authorized to be appropriated $25,000,000 for each of fiscal years
2015 through 2019.
SEC. 503. NATIONAL VIOLENT DEATH REPORTING SYSTEM.
The Secretary of Health and Human Services, acting through the
Director of the Centers for Disease Control and Prevention, shall
improve, particularly through the inclusion of additional States, the
National Violent Death Reporting System, as authorized by title III of
the Public Health Service Act (42 U.S.C. 241 et seq.). Participation in
the system by the States shall be voluntary.
TITLE VI--EDUCATION AND YOUTH
SEC. 601. SCHOOL-BASED MENTAL HEALTH PROGRAMS.
(a) Purposes.--It is the purpose of this section to--
(1) revise, increase funding for, and expand the scope of
the Safe Schools-Healthy Students program in order to provide
access to more comprehensive school-based mental health
services and supports;
(2) increase access to school employed mental health
professionals;
(3) provide for comprehensive staff development for school
and community service personnel working in the school; and
(4) provide for comprehensive training for children with
mental health disorders, for parents, siblings, and other
family members of such children, and for concerned members of
the community.
(b) Amendments to the Public Health Service Act.--
(1) Technical amendments.--The second part G (relating to
services provided through religious organizations) of title V
of the Public Health Service Act (42 U.S.C. 290kk et seq.) is
amended--
(A) by redesignating such part as part J; and
(B) by redesignating sections 581 through 584 as
sections 596 through 596C, respectively.
(2) School-based mental health and children and violence.--
Section 581 of the Public Health Service Act (42 U.S.C. 290hh)
is amended to read as follows:
``SEC. 581. SCHOOL-BASED MENTAL HEALTH AND CHILDREN AND VIOLENCE.
``(a) In General.--The Secretary, in collaboration with the
Secretary of Education and in consultation with the Attorney General,
shall, directly or through grants, contracts, or cooperative agreements
awarded to States, assist local communities and schools in applying a
public health approach to mental health services both in schools and in
the community. Such an approach should provide comprehensive, age-
appropriate services and supports, be linguistically and culturally
appropriate, be trauma-informed, and incorporate age appropriate
strategies of positive behavioral interventions and supports.
``(b) Activities.--Under the program under subsection (a), the
Secretary may--
``(1) provide financial support to enable local communities
to implement a comprehensive culturally and linguistically
appropriate, trauma-informed, and age-appropriate, school
mental health program that incorporates positive behavioral
interventions, client treatment, and supports to foster the
health and development of children;
``(2) provide technical assistance to local communities
with respect to the development of programs described in
paragraph (1);
``(3) provide assistance to local communities in the
development of policies to address child and adolescent trauma
and mental health issues and violence when and if it occurs;
``(4) facilitate community partnerships among families,
students, law enforcement agencies, education systems, school-
based health centers, mental health and substance use disorder
service systems, family-based mental health service systems,
welfare agencies, health care service systems (including
physicians), faith-based programs, trauma networks, and other
community-based systems; and
``(5) establish mechanisms for children and adolescents to
report incidents of violence or plans by other children,
adolescents, or adults to commit violence.
``(c) Requirements.--
``(1) In general.--To be eligible for a grant, contract, or
cooperative agreement under subsection (a), an entity shall--
``(A) be a State, in partnership with at least
three local education agencies; and
``(B) submit an application, that is endorsed by
all members of the partnership, that contains the
assurances described in paragraph (2).
``(2) Required assurances.--An application under paragraph
(1) shall contain assurances as follows:
``(A) That the applicant will ensure that, in
carrying out activities under this section, the local
educational agency involved will enter into a
memorandum of understanding--
``(i) with, at least one, public or private
mental health entity, health care entity, law
enforcement or juvenile justice entity, child
welfare agency, family-based mental health
entity, family or family organization, trauma
network, or other community-based entity; and
``(ii) that clearly states--
``(I) how school employed mental
health professionals will be utilized
for carrying out such responsibilities;
``(II) the responsibilities of each
partner with respect to the activities
to be carried out;
``(III) how each such partner will
be accountable for carrying out such
responsibilities; and
``(IV) the amount of non-Federal
funding or in-kind contributions that
each such partner will contribute in
order to sustain the program.
``(B) That the comprehensive school-based mental
health program carried out under this section supports
the flexible use of funds to address--
``(i) the promotion of the social,
emotional, and behavioral health of all
students in an environment that is conducive to
learning;
``(ii) the reduction in the likelihood of
at-risk students developing social, emotional,
behavioral health problems, or substance use
disorders;
``(iii) the early identification of social,
emotional, behavioral problems, or substance
use disorders and the provision of early
intervention services;
``(iv) the treatment or referral for
treatment of students with existing social,
emotional, behavioral health problems, or
substance use disorders; and
``(v) the development and implementation of
programs to assist children in dealing with
trauma and violence.
``(C) That the comprehensive school-based mental
health program carried out under this section will
provide for in-service training of all school
personnel, including ancillary staff and volunteers,
in--
``(i) the techniques and supports needed to
identify early children with trauma histories
and children with, or at risk of, mental
illness;
``(ii) the use of referral mechanisms that
effectively link such children to appropriate
treatment and intervention services in the
school and in the community and to follow up
when services are not available;
``(iii) strategies that promote a school-
wide positive environment;
``(iv) strategies for promoting the social,
emotional, mental, and behavioral health of all
students; and
``(v) strategies to increase the knowledge
and skills of school and community leaders
about the impact of trauma and violence and on
the application of a public health approach to
comprehensive school-based mental health
programs.
``(D) That the comprehensive school-based mental
health program carried out under this section will
include comprehensive training for parents, siblings,
and other family members of children with mental health
disorders, and for concerned members of the community
in--
``(i) the techniques and supports needed to
identify early children with trauma histories,
and children with, or at risk of, mental
illness;
``(ii) the use of referral mechanisms that
effectively link such children to appropriate
treatment and intervention services in the
school and in the community and follow up when
such services are not available; and
``(iii) strategies that promote a school-
wide positive environment.
``(E) That the comprehensive school-based mental
health program carried out under this section will
demonstrate the measures to be taken to sustain the
program after funding under this section terminates.
``(F) That the local educational agency partnership
involved is supported by the State educational and
mental health system to ensure that the sustainability
of the program is established after funding under this
section terminates.
``(G) That the comprehensive school-based mental
health program carried out under this section will be
based on trauma-informed and evidence-based practices.
``(H) That the comprehensive school-based mental
health program carried out under this section will be
coordinated with early intervening activities carried
out under the Individuals with Disabilities Education
Act.
``(I) That the comprehensive school-based mental
health program carried out under this section will be
trauma-informed and culturally and linguistically
appropriate.
``(J) That the comprehensive school-based mental
health program carried out under this section will
include a broad needs assessment of youth who drop out
of school due to policies of `zero tolerance' with
respect to drugs, alcohol, or weapons and an inability
to obtain appropriate services.
``(K) That the mental health services provided
through the comprehensive school-based mental health
program carried out under this section will be provided
by qualified mental and behavioral health professionals
who are certified or licensed by the State involved and
practicing within their area of expertise.
``(3) Coordinator.--Any entity that is a member of a
partnership described in paragraph (1)(A) may serve as the
coordinator of funding and activities under the grant if all
members of the partnership agree.
``(4) Compliance with hipaa.--A grantee under this section
shall be deemed to be a covered entity for purposes of
compliance with the regulations promulgated under section
264(c) of the Health Insurance Portability and Accountability
Act of 1996 with respect to any patient records developed
through activities under the grant.
``(d) Geographical Distribution.--The Secretary shall ensure that
grants, contracts, or cooperative agreements under subsection (a) will
be distributed equitably among the regions of the country and among
urban and rural areas.
``(e) Duration of Awards.--With respect to a grant, contract, or
cooperative agreement under subsection (a), the period during which
payments under such an award will be made to the recipient shall be 6
years. An entity may receive only one award under this section, except
that an entity that is providing services and supports on a regional
basis may receive additional funding after the expiration of the
preceding grant period.
``(f) Evaluation and Measures of Outcomes.--
``(1) Development of process.--The Administrator shall
develop a fiscally appropriate process for evaluating
activities carried out under this section. Such process shall
include--
``(A) the development of guidelines for the
submission of program data by grant, contract, or
cooperative agreement recipients;
``(B) the development of measures of outcomes (in
accordance with paragraph (2)) to be applied by such
recipients in evaluating programs carried out under
this section; and
``(C) the submission of annual reports by such
recipients concerning the effectiveness of programs
carried out under this section.
``(2) Measures of outcomes.--
``(A) In general.--The Administrator shall develop
measures of outcomes to be applied by recipients of
assistance under this section, and the Administrator,
in evaluating the effectiveness of programs carried out
under this section. Such measures shall include student
and family measures as provided for in subparagraph (B)
and local educational measures as provided for under
subparagraph (C).
``(B) Student and family measures of outcomes.--The
measures of outcomes developed under paragraph (1)(B)
relating to students and families shall, with respect
to activities carried out under a program under this
section, at a minimum include provisions to evaluate
whether the program is effective in--
``(i) increasing social and emotional
competency;
``(ii) increasing academic competency (as
defined by Secretary);
``(iii) reducing disruptive and aggressive
behaviors;
``(iv) improving child functioning;
``(v) reducing substance use disorders;
``(vi) reducing suspensions, truancy,
expulsions and violence;
``(vii) increasing graduation rates (as
defined in section 1111(b)(2)(C)(vi) of the
Elementary and Secondary Education Act of
1965); and
``(viii) improving access to care for
mental health disorders.
``(C) Local educational outcomes.--The outcome
measures developed under paragraph (1)(B) relating to
local educational systems shall, with respect to
activities carried out under a program under this
section, at a minimum include provisions to evaluate--
``(i) the effectiveness of comprehensive
school mental health programs established under
this section;
``(ii) the effectiveness of formal
partnership linkages among child and family
serving institutions, community support
systems, and the educational system;
``(iii) the progress made in sustaining the
program once funding under the grant has
expired;
``(iv) the effectiveness of training and
professional development programs for all
school personnel that incorporate indicators
that measure cultural and linguistic
competencies under the program in a manner that
incorporates appropriate cultural and
linguistic training;
``(v) the improvement in perception of a
safe and supportive learning environment among
school staff, students, and parents;
``(vi) the improvement in case-finding of
students in need of more intensive services and
referral of identified students to early
intervention and clinical services;
``(vii) the improvement in the immediate
availability of clinical assessment and
treatment services within the context of the
local community to students posing a danger to
themselves or others;
``(viii) the increased successful
matriculation to postsecondary school; and
``(ix) reduced referrals to juvenile
justice.
``(3) Submission of annual data.--An entity that receives a
grant, contract, or cooperative agreement under this section
shall annually submit to the Administrator a report that
includes data to evaluate the success of the program carried
out by the entity based on whether such program is achieving
the purposes of the program. Such reports shall utilize the
measures of outcomes under paragraph (2) in a reasonable manner
to demonstrate the progress of the program in achieving such
purposes.
``(4) Evaluation by administrator.--Based on the data
submitted under paragraph (3), the Administrator shall annually
submit to Congress a report concerning the results and
effectiveness of the programs carried out with assistance
received under this section.
``(5) Limitation.--A grantee shall use not to exceed 10
percent of amounts received under a grant under this section to
carry out evaluation activities under this subsection.
``(g) Information and Education.--The Secretary shall establish
comprehensive information and education programs to disseminate the
findings of the knowledge development and application under this
section to the general public and to health care professionals.
``(h) Amount of Grants and Authorization of Appropriations.--
``(1) Amount of grants.--A grant under this section shall
be in an amount that is not more than $1,000,000 for each of
grant years 2015 through 2019. The Secretary shall determine
the amount of each such grant based on the population of
children up to age 21 of the area to be served under the grant.
``(2) Authorization of appropriations.--There is authorized
to be appropriated to carry out this section, $200,000,000 for
each of fiscal years 2015 through 2019.''.
(3) Conforming amendment.--Part G of title V of the Public
Health Service Act (42 U.S.C. 290hh et seq.), as amended by
this section, is further amended by striking the part heading
and inserting the following:
``PART G--SCHOOL-BASED MENTAL HEALTH''.
SEC. 602. EXAMINING MENTAL HEALTH CARE FOR CHILDREN.
(a) In General.--Not later than 1 year after the date of enactment
of this Act, the Comptroller General of the United States shall conduct
an independent evaluation, and submit to the Committee on Health,
Education, Labor, and Pensions of the Senate and the Committee on
Energy and Commerce of the House of Representatives, a report
concerning the utilization of mental health services for children,
including the usage of psychotropic medications.
(b) Content.--The report submitted under subsection (a) shall
review and assess--
(1) the ways in which children access mental health care,
including information on whether children are screened and
treated by primary care or specialty physicians or other health
care providers, what types of referrals for additional care are
recommended, and any barriers to accessing this care;
(2) the extent to which children prescribed psychotropic
medications in the United States face barriers to more
comprehensive or other mental health services, interventions,
and treatments;
(3) the extent to which children are prescribed
psychotropic medications in the United States including the
frequency of concurrent medication usage; and
(4) the tools, assessments, and medications that are
available and used to diagnose and treat children with mental
health disorders.
TITLE VII--JUSTICE AND MENTAL HEALTH COLLABORATION
SEC. 701. ASSISTING VETERANS.
(a) Redesignation.--Section 2991 of the Omnibus Crime Control and
Safe Streets Act of 1968 (42 U.S.C. 3797aa) is amended by redesignating
subsection (i) as subsection (l).
(b) Assisting Veterans.--Section 2991 of the Omnibus Crime Control
and Safe Streets Act of 1968 (42 U.S.C. 3797aa) is amended by inserting
after subsection (h) the following:
``(i) Assisting Veterans.--
``(1) Definitions.--In this subsection:
``(A) Peer-to-peer services or programs.--The term
`peer-to-peer services or programs' means services or
programs that connect qualified veterans with other
veterans for the purpose of providing support and
mentorship to assist qualified veterans in obtaining
treatment, recovery, stabilization, or rehabilitation.
``(B) Qualified veteran.--The term `qualified
veteran' means a preliminarily qualified offender who--
``(i) has served on active duty in any
branch of the Armed Forces, including the
National Guard and reserve components; and
``(ii) was discharged or released from such
service under conditions other than
dishonorable.
``(C) Veterans treatment court program.--The term
`veterans treatment court program' means a court
program involving collaboration among criminal justice,
veterans, and mental health and substance abuse
agencies that provides qualified veterans with--
``(i) intensive judicial supervision and
case management, which may include random and
frequent drug testing where appropriate;
``(ii) a full continuum of treatment
services, including mental health services,
substance abuse services, medical services, and
services to address trauma;
``(iii) alternatives to incarceration; and
``(iv) other appropriate services,
including housing, transportation, mentoring,
employment, job training, education, and
assistance in applying for and obtaining
available benefits.
``(2) Veterans assistance program.--
``(A) In general.--The Attorney General, in
consultation with the Secretary of Veterans Affairs,
may award grants under this subsection to applicants to
establish or expand--
``(i) veterans treatment court programs;
``(ii) peer-to-peer services or programs
for qualified veterans;
``(iii) practices that identify and provide
treatment, rehabilitation, legal, transitional,
and other appropriate services to qualified
veterans who have been incarcerated; and
``(iv) training programs to teach criminal
justice, law enforcement, corrections, mental
health, and substance abuse personnel how to
identify and appropriately respond to incidents
involving qualified veterans.
``(B) Priority.--In awarding grants under this
subsection, the Attorney General shall give priority to
applications that--
``(i) demonstrate collaboration between and
joint investments by criminal justice, mental
health, substance abuse, and veterans service
agencies;
``(ii) promote effective strategies to
identify and reduce the risk of harm to
qualified veterans and public safety; and
``(iii) propose interventions with
empirical support to improve outcomes for
qualified veterans.''.
SEC. 702. CORRECTIONAL FACILITIES.
Section 2991 of the Omnibus Crime Control and Safe Streets Act of
1968 (42 U.S.C. 3797aa) is amended by inserting after subsection (i),
as so added by section 701, the following:
``(j) Correctional Facilities.--
``(1) Definitions.--
``(A) Correctional facility.--The term
`correctional facility' means a jail, prison, or other
detention facility used to house people who have been
arrested, detained, held, or convicted by a criminal
justice agency or a court.
``(B) Eligible inmate.--The term `eligible inmate'
means an individual who--
``(i) is being held, detained, or
incarcerated in a correctional facility; and
``(ii) manifests obvious signs of a mental
illness or has been diagnosed by a qualified
mental health professional as having a mental
illness.
``(2) Correctional facility grants.--The Attorney General
may award grants to applicants to enhance the capabilities of a
correctional facility--
``(A) to identify and screen for eligible inmates;
``(B) to plan and provide--
``(i) initial and periodic assessments of
the clinical, medical, and social needs of
inmates; and
``(ii) appropriate treatment and services
that address the mental health and substance
abuse needs of inmates;
``(C) to develop, implement, and enhance--
``(i) post-release transition plans for
eligible inmates that, in a comprehensive
manner, coordinate health, housing, medical,
employment, and other appropriate services and
public benefits;
``(ii) the availability of mental health
care services and substance abuse treatment
services; and
``(iii) alternatives to solitary
confinement and segregated housing and mental
health screening and treatment for inmates
placed in solitary confinement or segregated
housing; and
``(D) to train each employee of the correctional
facility to identify and appropriately respond to
incidents involving inmates with mental health or co-
occurring mental health and substance abuse
disorders.''.
SEC. 703. HIGH UTILIZERS.
Section 2991 of the Omnibus Crime Control and Safe Streets Act of
1968 (42 U.S.C. 3797aa) is amended by inserting after subsection (j),
as added by section 702, the following:
``(k) Demonstration Grants Responding to High Utilizers.--
``(1) Definition.--In this subsection, the term `high
utilizer' means an individual who--
``(A) manifests obvious signs of mental illness or
has been diagnosed by a qualified mental health
professional as having a mental illness; and
``(B) consumes a significantly disproportionate
quantity of public resources, such as emergency,
housing, judicial, corrections, and law enforcement
services.
``(2) Demonstration grants responding to high utilizers.--
``(A) In general.--The Attorney General may award
not more than 6 grants per year under this subsection
to applicants for the purpose of reducing the use of
public services by high utilizers.
``(B) Use of grants.--A recipient of a grant
awarded under this subsection may use the grant--
``(i) to develop or support
multidisciplinary teams that coordinate,
implement, and administer community-based
crisis responses and long-term plans for high
utilizers;
``(ii) to provide training on how to
respond appropriately to the unique issues
involving high utilizers for public service
personnel, including criminal justice, mental
health, substance abuse, emergency room, health
care, law enforcement, corrections, and housing
personnel;
``(iii) to develop or support alternatives
to hospital and jail admissions for high
utilizers that provide treatment,
stabilization, and other appropriate supports
in the least restrictive, yet appropriate,
environment; or
``(iv) to develop protocols and systems
among law enforcement, mental health, substance
abuse, housing, corrections, and emergency
medical service operations to provide
coordinated assistance to high utilizers.
``(C) Report.--Not later than the last day of the
first year following the fiscal year in which a grant
is awarded under this subsection, the recipient of the
grant shall submit to the Attorney General a report
that--
``(i) measures the performance of the grant
recipient in reducing the use of public
services by high utilizers; and
``(ii) provides a model set of practices,
systems, or procedures that other jurisdictions
can adopt to reduce the use of public services
by high utilizers.''.
SEC. 704. ACADEMY TRAINING.
Section 2991(h) of the Omnibus Crime Control and Safe Streets Act
of 1968 (42 U.S.C. 3797aa(h)) is amended--
(1) in paragraph (1), by adding at the end the following:
``(F) Academy training.--To provide support for
academy curricula, law enforcement officer orientation
programs, continuing education training, and other
programs that teach law enforcement personnel how to
identify and respond to incidents involving individuals
with mental illness or co-occurring mental illness and
substance abuse disorders.''; and
(2) by adding at the end the following:
``(4) Priority consideration.--The Attorney General, in
awarding grants under this subsection, shall give priority to
programs that law enforcement personnel and members of the
mental health and substance abuse professions develop and
administer cooperatively.''.
SEC. 705. EVIDENCE-BASED PRACTICES.
Section 2991(c) of the Omnibus Crime Control and Safe Streets Act
of 1968 (42 U.S.C. 3797aa(c)) is amended--
(1) in paragraph (3), by striking ``or'' at the end;
(2) by redesignating paragraph (4) as paragraph (6); and
(3) by inserting after paragraph (3), the following:
``(4) propose interventions that have been shown by
empirical evidence to reduce recidivism;
``(5) when appropriate, use validated assessment tools to
target preliminarily qualified offenders with a moderate or
high risk of recidivism and a need for treatment and services;
or''.
SEC. 706. SAFE COMMUNITIES.
(a) In General.--Section 2991(a) of the Omnibus Crime Control and
Safe Streets Act of 1968 (42 U.S.C. 3797aa(a)) is amended by striking
paragraph (9) and inserting the following:
``(9) Preliminarily qualified offender.--
``(A) In general.--The term `preliminarily
qualified offender' means an adult or juvenile accused
of an offense who--
``(i)(I) previously or currently has been
diagnosed by a qualified mental health
professional as having a mental illness or co-
occurring mental illness and substance abuse
disorders;
``(II) manifests obvious signs of mental
illness or co-occurring mental illness and
substance abuse disorders during arrest or
confinement or before any court; or
``(III) in the case of a veterans treatment
court provided under subsection (i), has been
diagnosed with, or manifests obvious signs of,
mental illness or a substance abuse disorder or
co-occurring mental illness and substance abuse
disorder; and
``(ii) has been unanimously approved for
participation in a program funded under this
section by, when appropriate, the relevant--
``(I) prosecuting attorney;
``(II) defense attorney;
``(III) probation or corrections
official;
``(IV) judge; and
``(V) a representative from the
relevant mental health agency described
in subsection (b)(5)(B)(i).
``(B) Determination.--In determining whether to
designate an individual as a preliminarily qualified
offender, the relevant prosecuting attorney, defense
attorney, probation or corrections official, judge, and
mental health or substance abuse agency representative
shall take into account--
``(i) whether the participation of the
individual in the program would pose a
substantial risk of violence to the community;
``(ii) the criminal history of the
individual and the nature and severity of the
offense for which the individual is charged;
``(iii) the views of any relevant victims
to the offense;
``(iv) the extent to which the individual
would benefit from participation in the
program;
``(v) the extent to which the community
would realize cost savings because of the
individual's participation in the program; and
``(vi) whether the individual satisfies the
eligibility criteria for program participation
unanimously established by the relevant
prosecuting attorney, defense attorney,
probation or corrections official, judge and
mental health or substance abuse agency
representative.''.
(b) Technical and Conforming Amendment.--Section 2927(2) of the
Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C. 3797s-
6(2)) is amended by striking ``has the meaning given that term in
section 2991(a).'' and inserting ``means an offense that--
``(A) does not have as an element the use,
attempted use, or threatened use of physical force
against the person or property of another; or
``(B) is not a felony that by its nature involves a
substantial risk that physical force against the person
or property of another may be used in the course of
committing the offense.''.
SEC. 707. REAUTHORIZATION OF APPROPRIATIONS.
Subsection (l) of section 2991 of the Omnibus Crime Control and
Safe Streets Act of 1968 (42 U.S.C. 3797aa), as redesignated in section
701(a), is amended--
(1) in paragraph (1)--
(A) in subparagraph (B), by striking ``and'' at the
end;
(B) in subparagraph (C), by striking the period and
inserting ``; and''; and
(C) by adding at the end the following:
``(D) $40,000,000 for each of fiscal years 2015
through 2019.''; and
(2) by adding at the end the following:
``(3) Limitation.--Not more than 20 percent of the funds
authorized to be appropriated under this section may be used
for purposes described in subsection (i) (relating to
veterans).''.
TITLE VIII--BEHAVIORAL HEALTH INFORMATION TECHNOLOGY
SEC. 801. EXTENSION OF HEALTH INFORMATION TECHNOLOGY ASSISTANCE FOR
BEHAVIORAL AND MENTAL HEALTH AND SUBSTANCE ABUSE.
Section 3000(3) of the Public Health Service Act (42 U.S.C.
300jj(3)) is amended by inserting before ``and any other category'' the
following: ``behavioral and mental health professionals (as defined in
section 331(a)(3)(E)(i)), a substance abuse professional, a psychiatric
hospital (as defined in section 1861(f) of the Social Security Act), a
community mental health center meeting the criteria specified in
section 1913(c), a residential or outpatient mental health or substance
abuse treatment facility,''.
SEC. 802. EXTENSION OF ELIGIBILITY FOR MEDICARE AND MEDICAID HEALTH
INFORMATION TECHNOLOGY IMPLEMENTATION ASSISTANCE.
(a) Payment Incentives for Eligible Professionals Under Medicare.--
Section 1848 of the Social Security Act (42 U.S.C. 1395w-4) is
amended--
(1) in subsection (a)(7)--
(A) in subparagraph (E), by adding at the end the
following new clause:
``(iv) Additional eligible professional.--
The term `additional eligible professional'
means a clinical psychologist providing
qualified psychologist services (as defined in
section 1861(ii)).''; and
(B) by adding at the end the following new
subparagraph:
``(F) Application to additional eligible
professionals.--The Secretary shall apply the
provisions of this paragraph with respect to an
additional eligible professional in the same manner as
such provisions apply to an eligible professional,
except in applying subparagraph (A)--
``(i) in clause (i), the reference to 2015
shall be deemed a reference to 2019;
``(ii) in clause (ii), the references to
2015, 2016, and 2017 shall be deemed references
to 2019, 2020, and 2021, respectively; and
``(iii) in clause (iii), the reference to
2018 shall be deemed a reference to 2022.'';
and
(2) in subsection (o)--
(A) in paragraph (5), by adding at the end the
following new subparagraph:
``(D) Additional eligible professional.--The term
`additional eligible professional' means a clinical
psychologist providing qualified psychologist services
(as defined in section 1861(ii)).''; and
(B) by adding at the end the following new
paragraph:
``(6) Application to additional eligible professionals.--
The Secretary shall apply the provisions of this subsection
with respect to an additional eligible professional in the same
manner as such provisions apply to an eligible professional,
except in applying--
``(A) paragraph (1)(A)(ii), the reference to 2016
shall be deemed a reference to 2020;
``(B) paragraph (1)(B)(ii), the references to 2011
and 2012 shall be deemed references to 2015 and 2016,
respectively;
``(C) paragraph (1)(B)(iii), the references to 2013
shall be deemed references to 2017;
``(D) paragraph (1)(B)(v), the references to 2014
shall be deemed references to 2018; and
``(E) paragraph (1)(E), the reference to 2011 shall
be deemed a reference to 2015.''.
(b) Eligible Hospitals.--Section 1886 of the Social Security Act
(42 U.S.C. 1395ww) is amended--
(1) in subsection (b)(3)(B)(ix), by adding at the end the
following new subclause:
``(V) The Secretary shall apply the
provisions of this subsection with
respect to an additional eligible
hospital (as defined in subsection
(n)(6)(C)) in the same manner as such
provisions apply to an eligible
hospital, except in applying--
``(aa) subclause (I), the
references to 2015, 2016, and
2017 shall be deemed references
to 2019, 2020, and 2021,
respectively; and
``(bb) subclause (III), the
reference to 2015 shall be
deemed a reference to 2019.'';
and
(2) in subsection (n)--
(A) in paragraph (6), by adding at the end the
following new subparagraph:
``(C) Additional eligible hospital.--The term
`additional eligible hospital' means an inpatient
hospital that is a psychiatric hospital (as defined in
section 1861(f)).''; and
(B) by adding at the end the following new
paragraph:
``(7) Application to additional eligible hospitals.--The
Secretary shall apply the provisions of this subsection with
respect to an additional eligible hospital in the same manner
as such provisions apply to an eligible hospital, except in
applying paragraph (2)--
``(A) the Secretary shall adjust the base amount
specified in subparagraph (B) of such paragraph, in a
manner specified by the Secretary, to reflect the
smaller size of such additional eligible hospitals
relative to eligible hospitals;
``(B) the Secretary shall adjust the discharge
related amount specified in subparagraph (C) of such
paragraph for each 12-month period selected by the
Secretary under such subparagraph, in a manner
specified by the Secretary, to reflect the smaller size
such additional hospitals relative to eligible
hospitals, including by adjusting the ranges of
discharges specified in such subparagraph and the
amount specified in such subparagraph for each
discharge within such a specified range;
``(C) the references in subparagraph (E)(ii) of
such paragraph to 2013 and 2015 shall be deemed
references to 2017 and 2019, respectively; and
``(D) the reference in subparagraph (G)(i) of such
paragraph to 2011 shall be deemed a reference to
2015.''.
(c) Medicaid Providers.--Section 1903(t) of the Social Security Act
(42 U.S.C. 1396b(t)) is amended--
(1) in paragraph (2)(B)--
(A) in clause (i), by striking ``, or'' and
inserting a semicolon;
(B) in clause (ii), by striking the period and
inserting a semicolon; and
(C) by adding after clause (ii) the following new
clauses:
``(iii) a public hospital that is
principally a psychiatric hospital (as defined
in section 1861(f));
``(iv) a private hospital that is
principally a psychiatric hospital (as defined
in section 1861(f)) and that has at least 10
percent of its patient volume (as estimated in
accordance with a methodology established by
the Secretary) attributable to individuals
receiving medical assistance under this title;
``(v) a community mental health center
meeting the criteria specified in section
1913(c) of the Public Health Service Act; or
``(vi) a residential or outpatient mental
health or substance abuse treatment facility
that--
``(I) is accredited by the Joint
Commission on Accreditation of
Healthcare Organizations, the
Commission on Accreditation of
Rehabilitation Facilities, the Council
on Accreditation, or any other national
accrediting agency recognized by the
Secretary; and
``(II) has at least 10 percent of
its patient volume (as estimated in
accordance with a methodology
established by the Secretary)
attributable to individuals receiving
medical assistance under this title.'';
(2) in paragraph (3)(B)--
(A) in clause (iv), by striking ``and'' after the
semicolon;
(B) in clause (v), by striking the period and
inserting ``; and''; and
(C) by adding at the end the following new clause:
``(vi) clinical psychologist providing
qualified psychologist services (as defined in
section 1861(ii)), if such clinical
psychologist is practicing in an outpatient
clinic that--
``(I) is led by a clinical
psychologist; and
``(II) is not otherwise receiving
payment under paragraph (1) as a
Medicaid provider described in
paragraph (2)(B).''; and
(3) in paragraph (5)(B), by adding at the end the following
new sentence: ``For purposes of this subparagraph in computing
the amounts under section 1886(n)(2)(C) for payment years after
2015, with respect to a Medicaid provider described in clause
(iii), (iv), (v), or (vi) of paragraph (2)(B), in order to
reflect the smaller size of Medicaid providers described in
such clauses relative to Medicaid providers described in
clauses (i) and (ii) of such paragraph (2)(B), the Secretary
shall, in a manner specified by the Secretary, adjust the base
amount specified in subparagraph (B) of section 1886(n)(2) and
the discharge related amount calculated under subparagraph (C)
of such section, including by adjusting the ranges of
discharges specified in such subparagraph (C) and the amount
specified in such subparagraph (C) for each discharge within
such a specified range.''.
(d) Medicare Advantage Organizations.--Section 1853 of the Social
Security Act (42 U.S.C. 1395w-23) is amended--
(1) in subsection (l)--
(A) in paragraph (1)--
(i) by inserting ``or additional eligible
professionals (as described in paragraph (9))''
after ``paragraph (2)''; and
(ii) by inserting ``and additional eligible
professionals'' before ``under such sections'';
(B) in paragraph (3)(B)--
(i) in clause (i) in the matter preceding
subclause (I), by inserting ``or an additional
eligible professional described in paragraph
(9)'' after ``paragraph (2)''; and
(ii) in clause (ii)--
(I) in the matter preceding
subclause (I), by inserting ``or an
additional eligible professional
described in paragraph (9)'' after
``paragraph (2)''; and
(II) in subclause (I), by inserting
``or an additional eligible
professional, respectively,'' after
``eligible professional'';
(C) in paragraph (3)(C), by inserting ``and
additional eligible professionals'' after ``all
eligible professionals'';
(D) in paragraph (4)(D), by adding at the end the
following new sentence: ``In the case that a qualifying
MA organization attests that not all additional
eligible professionals of the organization are
meaningful EHR users with respect to an applicable
year, the Secretary shall apply the payment adjustment
under this paragraph based on the proportion of all
such additional eligible professionals of the
organization that are not meaningful EHR users for such
year.'';
(E) in paragraph (6)(A), by inserting ``and, as
applicable, each additional eligible professional
described in paragraph (9)'' after ``paragraph (2)'';
(F) in paragraph (6)(B), by inserting ``and, as
applicable, each additional eligible hospital described
in paragraph (9)'' after ``subsection (m)(1)'';
(G) in paragraph (7)(A), by inserting ``and, as
applicable, additional eligible professionals'' after
``eligible professionals'';
(H) in paragraph (7)(B), by inserting ``and, as
applicable, additional eligible professionals'' after
``eligible professionals'';
(I) in paragraph (8)(B), by inserting ``and
additional eligible professionals described in
paragraph (9)'' after ``paragraph (2)''; and
(J) by adding at the end the following new
paragraph:
``(9) Additional eligible professional described.--With
respect to a qualifying MA organization, an additional eligible
professional described in this paragraph is an additional
eligible professional (as defined for purposes of section
1848(o)) who--
``(A)(i) is employed by the organization; or
``(ii)(I) is employed by, or is a partner of, an
entity that through contract with the organization
furnishes at least 80 percent of the entity's Medicare
patient care services to enrollees of such
organization; and
``(II) furnishes at least 80 percent of the
professional services of the additional eligible
professional covered under this title to enrollees of
the organization; and
``(B) furnishes, on average, at least 20 hours per
week of patient care services.''; and
(2) in subsection (m)--
(A) in paragraph (1)--
(i) by inserting ``or additional eligible
hospitals (as described in paragraph (7))''
after ``paragraph (2)''; and
(ii) by inserting ``and additional eligible
hospitals'' before ``under such sections'';
(B) in paragraph (3)(A)(i), by inserting ``or
additional eligible hospital'' after ``eligible
hospital'';
(C) in paragraph (3)(A)(ii), by inserting ``or an
additional eligible hospital'' after ``eligible
hospital'' in each place it occurs;
(D) in paragraph (3)(B)--
(i) in clause (i), by inserting ``or an
additional eligible hospital described in
paragraph (7)'' after ``paragraph (2)''; and
(ii) in clause (ii)--
(I) in the matter preceding
subclause (I), by inserting ``or an
additional eligible hospital described
in paragraph (7)'' after ``paragraph
(2)''; and
(II) in subclause (I), by inserting
``or an additional eligible hospital,
respectively,'' after ``eligible
hospital'';
(E) in paragraph (4)(A), by inserting ``or one or
more additional eligible hospitals (as defined in
section 1886(n)), as appropriate,'' after ``section
1886(n)(6)(A))'';
(F) in paragraph (4)(D), by adding at the end the
following new sentence: ``In the case that a qualifying
MA organization attests that not all additional
eligible hospitals of the organization are meaningful
EHR users with respect to an applicable period, the
Secretary shall apply the payment adjustment under this
paragraph based on the methodology specified by the
Secretary, taking into account the proportion of such
additional eligible hospitals, or discharges from such
hospitals, that are not meaningful EHR users for such
period.'';
(G) in paragraph (5)(A), by inserting ``and, as
applicable, each additional eligible hospital described
in paragraph (7)'' after ``paragraph (2)'';
(H) in paragraph (5)(B), by inserting ``and
additional eligible hospitals, as applicable,'' after
``eligible hospitals'';
(I) in paragraph (6)(B), by inserting ``and
additional eligible hospitals described in paragraph
(7)'' after ``paragraph (2)''; and
(J) by adding at the end the following new
paragraph:
``(7) Additional eligible hospital described.--With respect
to a qualifying MA organization, an additional eligible
hospital described in this paragraph is an additional eligible
hospital (as defined in section 1886(n)(6)(C)) that is under
common corporate governance with such organization and serves
individuals enrolled under an MA plan offered by such
organization.''.
TITLE IX--SERVICEMEMBERS AND VETERANS MENTAL HEALTH
SEC. 901. PRELIMINARY MENTAL HEALTH ASSESSMENTS.
(a) In General.--Chapter 31 of title 10, United States Code, is
amended by adding at the end the following new section:
``SEC. 520D. PRELIMINARY MENTAL HEALTH ASSESSMENTS.
``(a) Provision of Mental Health Assessment.--Before any individual
enlists in an Armed Force or is commissioned as an officer in an Armed
Force, the Secretary concerned shall provide the individual with a
mental health assessment. The Secretary shall use such results as a
baseline for any subsequent mental health examinations, including such
examinations provided under sections 1074f and 1074m of this title.
``(b) Use of Assessment.--The Secretary may not consider the
results of a mental health assessment conducted under subsection (a) in
determining the assignment or promotion of a member of the Armed
Forces.
``(c) Application of Privacy Laws.--With respect to applicable laws
and regulations relating to the privacy of information, the Secretary
shall treat a mental health assessment conducted under subsection (a)
in the same manner as the medical records of a member of the Armed
Forces.''.
(b) Clerical Amendment.--The table of sections at the beginning of
such chapter is amended by adding after the item relating to section
520c the following new item:
``520d. Preliminary mental health assessments.''.
(c) Report.--
(1) In general.--Not later than 180 days after the date of
the enactment of this Act, the Secretary of Defense shall
submit to Congress a report on preliminary mental health
assessments of members of the Armed Forces.
(2) Matters included.--The report under paragraph (1) shall
include the following:
(A) Recommendations with respect to establishing a
preliminary mental health assessment of members of the
Armed Forces to bring mental health screenings to
parity with physical screenings of members.
(B) Recommendations with respect to the composition
of the mental health assessment, best practices, and
how to track assessment changes relating to traumatic
brain injuries, post-traumatic stress disorder, and
other conditions.
(3) Coordination.--The Secretary shall carry out paragraph
(1) in coordination with the Secretary of Veterans Affairs, the
Uniformed Services University of the Health Sciences, the
surgeons general of the military departments, and other
relevant experts.
SEC. 902. UNLIMITED ELIGIBILITY FOR HEALTH CARE FOR MENTAL ILLNESSES
FOR VETERANS OF COMBAT SERVICE DURING CERTAIN PERIODS OF
HOSTILITIES AND WAR.
(a) Eligibility.--Section 1710(e)(1) of title 38, United States
Code, is amended by adding at the end the following new subparagraph:
``(G) Notwithstanding paragraphs (2) and (3), a
veteran who served on active duty in a theater of
combat operations (as determined by the Secretary in
consultation with the Secretary of Defense) during
World War II, the Korean conflict, the Vietnam Era, the
Persian Gulf war, Operation Iraqi Freedom, Operation
Enduring Freedom, or any other period of war after the
Persian Gulf war, or in combat against a hostile force
during a period of hostilities (as defined in section
1712A(a)(2)(B) of this title), is eligible for hospital
care, medical services, and nursing home care under
subsection (a)(2)(F) for any mental illness,
notwithstanding that there is insufficient medical
evidence to conclude that such illness is attributable
to such service.''.
(b) Effective Date.--Subparagraph (G) of section 1710(e)(1) of
title 38, United States Code, as added by subsection (a), shall apply
with respect to hospital care, medical services, and nursing home care
provided on or after the date of the enactment of this Act.
SEC. 903. TIMELINE FOR IMPLEMENTING INTEGRATED ELECTRONIC HEALTH
RECORDS.
(a) Establishment of Timeline.--Section 1635 of the Wounded Warrior
Act (10 U.S.C. 1071 note) is amended by adding at the end the following
new subsection:
``(k) Timeline.--In carrying out this section, the Secretary of
Defense and the Secretary of Veterans Affairs shall ensure that--
``(1) the creation of a health data authoritative source is
achieved by not later than 180 days after the date of the
enactment of this subsection;
``(2) the ability of patients of both the Department of
Defense and the Department of Veterans Affairs to download the
medical records of the patient (commonly referred to as the
`Blue Button Initiative') is achieved by not later than 365
days after the date of the enactment of this subsection;
``(3) the seamless integration of personal health care
information between the Departments is achieved by not later
than 365 days after the date of the enactment of this
subsection;
``(4) the standardization of health care data of the
Departments is achieved by not later than 365 days after the
date of the enactment of this subsection;
``(5) the acceleration of the exchange of real-time data
between the Departments is achieved by not later than 365 days
after the date of the enactment of this subsection;
``(6) the upgrade of the graphical user interface to
display the new standardized health care data of the
Departments is achieved by not later than 365 days after the
date of the enactment of this subsection;
``(7) each incoming member of the Armed Forces and the
dependent of such a member may elect to receive an electronic
copy of the health care record of the individual beginning not
later than October 1, 2014; and
``(8) each current member of the Armed Forces and the
dependent of such a member may elect to receive an electronic
copy of the health care record of the individual beginning not
later than October 1, 2015.''.
(b) Cloud Storage.--Section 1635 of such Act is further amended by
adding at the end the following new subsection:
``(l) Cloud Storage.--The Secretary of Defense and the Secretary of
Veterans Affairs shall study the feasibility of establishing a secure,
remote, network-accessible computer storage system (commonly referred
to as `cloud storage') to--
``(1) provide members of the Armed Forces and veterans the
ability to upload the health care records of the member or
veteran if the member or veteran elects to do so; and
``(2) allow medical providers of the Department of Defense
and the Department of Veterans Affairs to access such records
in the course of providing care to the member or veteran.''.
(c) Conforming Amendments.--Section 1635 of such Act is further
amended--
(1) in subsection (a), by striking ``The Secretary'' and
inserting ``In accordance with the timeline described in
subsection (k), the Secretary''; and
(2) in the matter preceding paragraph (1) of subsection
(e), by inserting ``in accordance with subsection (k)'' after
``under this section''.
SEC. 904. PILOT PROGRAM FOR REPAYMENT OF EDUCATIONAL LOANS FOR CERTAIN
PSYCHIATRISTS OF VETERANS HEALTH ADMINISTRATION.
(a) Pilot Program.--
(1) Establishment.--The Secretary of Veterans Affairs shall
carry out a pilot program to repay a loan of an individual
described in paragraph (2) that--
(A) was used by the individual to finance education
regarding psychiatric medicine, including education
leading to an undergraduate degree and education
leading to the degree of doctor of medicine or of
doctor of osteopathy; and
(B) was obtained from a governmental entity,
private financial institution, school, or other
authorized entity, as determined by the Secretary.
(2) Eligible individuals.--To be eligible to obtain a loan
repayment under this subsection, an individual shall--
(A) either--
(i) be licensed or eligible for licensure
to practice psychiatric medicine in the
Veterans Health Administration of the
Department of Veterans Affairs; or
(ii) be enrolled in the final year of a
residency program leading to a specialty
qualification in psychiatric medicine that is
approved by the Accreditation Council for
Graduate Medical Education; and
(B) as determined appropriate by the Secretary,
demonstrate a commitment to a long-term career as a
psychiatrist in the Veterans Health Administration,
including by requiring a set number of years of
obligated service.
(3) Selection.--The Secretary shall select not less than 10
individuals described in paragraph (2) to participate in the
pilot program for each year in which the Secretary carries out
the pilot program.
(4) Loan repayments.--
(A) Amounts.--Subject to the limits established by
subparagraph (B), a loan repayment under this
subsection may consist of payment of the principal,
interest, and related expenses of a loan obtained by an
individual described in paragraph (2) for all
educational expenses (including tuition, fees, books,
and laboratory expenses) relating to a degree described
in paragraph (1)(A).
(B) Limit.--For each year of obligated service that
an individual agrees to serve in an agreement described
in paragraph (2)(B), the Secretary may pay not more
than $60,000 on behalf of the individual.
(5) Breach.--
(A) Liability.--An individual who participates in
the pilot program under paragraph (1) who fails to
satisfy the commitment described in paragraph (2)(B)
shall be liable to the United States, in lieu of any
service obligation arising from such participation, for
the amount which has been paid or is payable to or on
behalf of the individual under the program, reduced by
the proportion that the number of days served for
completion of the service obligation bears to the total
number of days in the period of obligated service of
the individual.
(B) Repayment period.--Any amount of damages which
the United States is entitled to recover under this
paragraph shall be paid to the United States within the
one-year period beginning on the date of the breach of
the agreement.
(6) Prohibition on simultaneous eligibility.--An individual
who is participating in any other program of the Federal
Government that repays the educational loans of the individual
may not participate in the pilot program under paragraph (1).
(7) Report.--Not later than 90 days after the date on which
the pilot program terminates under paragraph (7), the Secretary
shall submit to the Committees on Veterans' Affairs of the
House of Representatives and the Senate a report on the pilot
program. The report shall include the overall effect of the
pilot program on the psychiatric workforce shortage of the
Veterans Health Administration, the long-term stability of such
workforce, and overall workforce strategies of the Veterans
Health Administration that seek to promote the physical and
mental resiliency of all veterans.
(8) Regulations.--The Secretary shall prescribe regulations
to carry out this subsection, including standards for qualified
loans and authorized payees and other terms and conditions for
the making of loan repayments.
(9) Termination.--The authority to carry out the pilot
program shall expire on the date that is three years after the
date on which the Secretary commences the pilot program.
(b) Comptroller General Study on Pay Disparities of Psychiatrists
of Veterans Health Administration.--
(1) Study.--Not later than one year after the date of the
enactment of this Act, the Comptroller General of the United
States shall conduct a study of pay disparities among
psychiatrists of the Veterans Health Administration of the
Department of Veterans Affairs. The study shall include--
(A) an examination of laws, regulations, practices,
and policies, including salary flexibilities, that
contribute to such disparities; and
(B) recommendations with respect to legislative or
regulatory actions to improve equity in pay among such
psychiatrists.
(2) Report.--Not later than one year after the date on
which the Comptroller General completes the study under
paragraph (1), the Comptroller General shall submit to the
Committees on Veterans' Affairs of the House of Representatives
and the Senate a report containing the results of the study.
TITLE X--MAKING PARITY WORK
SEC. 1001. GAO STUDY ON MENTAL HEALTH AND SUBSTANCE USE DISORDER PARITY
ENFORCEMENT EFFORTS.
Not later than one year after the date of enactment of this Act,
the Comptroller General of the United States, in consultation with the
Secretary of Health and Human Services and the Secretary of Labor,
shall submit to Congress a report detailing the enforcement efforts of
the responsible departments and agencies in implementing the Paul
Wellstone and Pete Domenici Mental Health Parity and Addiction Equity
Act (subtitle B of title V of division C of Public Law 110-343),
including--
(1) the number of investigations that have been conducted
into potential parity violations; and
(2) details on the investigation or enforcement action that
was carried out as a result of such investigations that would
not identify the subject of such investigation or enforcement.
SEC. 1002. REPORT TO CONGRESS ON FEDERAL ASSISTANCE TO STATE INSURANCE
REGULATORS REGARDING MENTAL HEALTH PARITY ENFORCEMENT.
Not later than one year after the date of enactment of this Act,
the Secretary of Health and Human Services shall submit to Congress a
report detailing--
(1) the ways in which State governments and State insurance
regulators are either empowered or required to enforce the Paul
Wellstone and Pete Domenici Mental Health Parity and Addiction
Equity Act of 2008 (subtitle B of title V of division C of
Public Law 110-343);
(2) their capability to carry out these enforcement powers
or requirements; and
(3) any technical assistance to State government and State
insurance regulators that has been communicated by the
Department of Health and Human Services.
SEC. 1003. ANNUAL REPORT TO CONGRESS BY SECRETARIES OF LABOR AND HEALTH
AND HUMAN SERVICES.
Not later than one year after the date of enactment of this Act,
and annually thereafter, the Secretary of Labor, in coordination with
the Secretary of Health and Human Services, shall submit to Congress a
report--
(1) describing the actions taken by the Federal Government
and the States to ensure compliance with the Paul Wellstone and
Pete Domenici Mental Health Parity and Addiction Equity Act of
2008 (subtitle B of title V of division C of Public Law 110-
343);
(2) including a collection and classification of inquiries
and complaints regarding the implementation or enforcement of
such Act;
(3) including a transparent de-identified report of all
Federal and State actions to enforce such Act; and
(4) include a compliance guide that includes--
(A) detailed answers to relevant questions raised
during the previous year concerning implementation or
enforcement of such Act; and
(B) specific guidelines providing clear
interpretations of such Act and the regulations
thereunder.
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