H.R. 5636 (111th): Community Mental Health and Addiction Safety Net Equity Act of 2010

111th Congress, 2009–2010. Text as of Jun 29, 2010 (Introduced).

Status & Summary | PDF | Source: GPO

I

111th CONGRESS

2d Session

H. R. 5636

IN THE HOUSE OF REPRESENTATIVES

June 29, 2010

(for herself and Mr. Engel) introduced the following bill; which was referred to the Committee on Energy and Commerce

A BILL

To establish Federally Qualified Behavioral Health Centers and to require Medicaid coverage for services provided by such Centers.

1.

Short title

This Act may be cited as the Community Mental Health and Addiction Safety Net Equity Act of 2010.

2.

Federally Qualified Behavioral Health Centers

Section 1913 of the Public Health Service Act (42 U.S.C. 300x–3) is amended—

(1)

in subsection (a)(2)(A), by striking community mental health services and inserting behavioral health services (of the type offered by federally qualified behavioral health centers consistent with subsection (c)(3));

(2)

in subsection (b)—

(A)

by striking paragraph (1) and inserting the following:

(1)

services under the plan will be provided only through appropriate, qualified community programs (which may include federally qualified behavioral health centers, child mental health programs, psychosocial rehabilitation programs, mental health peer-support programs, and mental health primary consumer-directed programs); and

; and

(B)

in paragraph (2), by striking community mental health centers and inserting federally qualified behavioral health centers; and

(3)

by striking subsection (c) and inserting the following:

(c)

Criteria for Federally Qualified Behavioral Health Centers

(1)

In general

The Administrator shall certify, and recertify at least every 5 years, federally qualified behavioral health centers as meeting the criteria specified in this subsection.

(2)

Regulations

Not later than 18 months after the date of the enactment of the Community Mental Health and Addiction Safety Net Equity Act of 2010, the Administrator shall issue final regulations for certifying non-profit or local government centers as centers under paragraph (1).

(3)

Criteria

The criteria referred to in subsection (b)(2) are that the center performs each of the following:

(A)

Provide services in locations that ensure services will be available and accessible promptly and in a manner which preserves human dignity and assures continuity of care.

(B)

Provide services in a mode of service delivery appropriate for the target population.

(C)

Provide individuals with a choice of service options where there is more than one efficacious treatment.

(D)

Employ a core staff of clinical staff that is multidisciplinary and culturally and linguistically competent.

(E)

Provide services, within the limits of the capacities of the center, to any individual residing or employed in the service area of the center, regardless of the ability of the individual to pay.

(F)

Provide, directly or through contract, to the extent covered for adults in the State Medicaid plan under title XIX of the Social Security Act and for children in accordance with section 1905(r) of such Act regarding early and periodic screening, diagnosis, and treatment, each of the following services:

(i)

Screening, assessment, and diagnosis, including risk assessment.

(ii)

Person-centered treatment planning or similar processes, including risk assessment and crisis planning.

(iii)

Outpatient clinic mental health services, including screening, assessment, diagnosis, psychotherapy, substance abuse counseling, medication management, and integrated treatment for mental illness and substance abuse which shall be evidence-based (including cognitive behavioral therapy and other such therapies which are evidence-based).

(iv)

Outpatient clinic primary care services, including screening and monitoring of key health indicators and health risk (including screening for diabetes, hypertension, and cardiovascular disease and monitoring of weight, height, body mass index (BMI), blood pressure, blood glucose or HbA1C, and lipid profile).

(v)

Crisis mental health services, including 24-hour mobile crisis teams, emergency crisis intervention services, and crisis stabilization.

(vi)

Targeted case management (services to assist individuals gaining access to needed medical, social, educational, and other services and applying for income security and other benefits to which they may be entitled).

(vii)

Psychiatric rehabilitation services including skills training, assertive community treatment, family psychoeducation, disability self-management, supported employment, supported housing services, therapeutic foster care services, and such other evidence-based practices as the Secretary may require.

(viii)

Peer support and counselor services and family supports.

(G)

Maintain linkages, and where possible enter into formal contracts with the following:

(i)

Inpatient psychiatric facilities and substance abuse detoxification and residential programs.

(ii)

Adult and youth peer support and counselor services.

(iii)

Family support services for families of children with serious mental disorders.

(iv)

Other community or regional services, supports, and providers, including schools, child welfare agencies, juvenile and criminal justice agencies and facilities, housing agencies and programs, employers, and other social services.

(v)

Onsite or offsite access to primary care services.

(vi)

Enabling services, including outreach, transportation, and translation.

(vii)

Health and wellness services, including services for tobacco cessation.

.

3.

Medicaid coverage and payment for federally qualified behavioral health center services

(a)

Payment for services provided by federally qualified behavioral health centers

Section 1902(bb) of the Social Security Act (42 U.S.C. 1396a(bb)) is amended—

(1)

in the heading, by striking and Rural Health Clinics and inserting , federally qualified behavioral health centers, and Rural Health Clinics;

(2)

in paragraph (1), by inserting (and beginning with fiscal year 2011 with respect to services furnished on or after January 1, 2011, and each succeeding fiscal year, for services described in section 1905(a)(2)(D) furnished by a federally qualified behavioral health center) after by a rural health clinic;

(3)

in paragraph (2)—

(A)

by striking the heading and inserting Initial fiscal year;

(B)

by inserting (or, in the case of services described in section 1905(a)(2)(D) furnished by a federally qualified behavioral health center, for services furnished on and after January 1, 2011, during fiscal year 2011) after January 1, 2001, during fiscal year 2001;

(C)

by inserting (or, in the case of services described in section 1905(a)(2)(D) furnished by a federally qualified behavioral health center, during fiscal years 2009 and 2010) after 1999 and 2000; and

(D)

by inserting (or, in the case of services described in section 1905(a)(2)(D) furnished by a federally qualified behavioral health center, during fiscal year 2011) before the period;

(4)

in paragraph (3)—

(A)

in the heading, by striking Fiscal year 2002 and succeeding and inserting Succeeding; and

(B)

by inserting (or, in the case of services described in section 1905(a)(2)(D) furnished by a federally qualified behavioral health center, for services furnished during fiscal year 2012 or a succeeding fiscal year) after 2002 or a succeeding fiscal year;

(5)

in paragraph (4)—

(A)

by inserting (or as a federally qualified behavioral health center after fiscal year 2010) after or rural health clinic after fiscal year 2000;

(B)

by striking furnished by the center or and inserting furnished by the federally qualified health center, services described in section 1905(a)(2)(D) furnished by the federally qualified behavioral health center, or;

(C)

in the second sentence, by striking or rural health clinic and inserting , federally qualified behavioral health center, or rural health clinic;

(6)

in paragraph (5), in each of subparagraphs (A) and (B), by striking or rural health clinic and inserting , federally qualified behavioral health center, or rural health clinic; and

(7)

in paragraph (6), by striking or to a rural health clinic and inserting , to a federally qualified behavioral health center for services described in section 1905(a)(2)(D), or to a rural health clinic.

(b)

Inclusion of federally qualified behavioral health center services in the term medical assistance

Section 1905(a)(2) of the Social Security Act (42 U.S.C. 1396d(a)(2)) is amended—

(1)

by striking and before (C); and

(2)

by inserting before the semicolon at the end the following: , and (D) federally qualified behavioral health center services (as defined in subsection (l)(4)).

(c)

Definition of federally qualified behavioral health center services

Section 1905(l) of the Social Security Act (42 U.S.C. 1396d(l)) is amended by adding at the end the following paragraph:

(4)
(A)

The term federally qualified behavioral health center services means services furnished to an individual at a federally qualified behavioral health center (as defined by subparagraph (B).

(B)

The term federally qualified behavioral health center means an entity that is certified under section 1913(c) of the Public Health Service Act as meeting the criteria described in paragraph (3) of such section.

.

4.

Mental health and addiction safety net studies

(a)

Paperwork reduction study

(1)

In general

Not later than 12 months after the date of the enactment of this Act, the Institute of Medicine shall submit to the appropriate committees of Congress a report that evaluates the combined paperwork burden of federally qualified behavioral health centers certified section 1913(c) of the Public Health Service Act, as inserted by section 2.

(2)

Scope

In preparing the report under paragraph (1), the Institute of Medicine shall examine licensing, certification, service definitions, claims payment, billing codes, and financial auditing requirements utilized by the Office of Management and Budget, the Centers for Medicare & Medicaid Services, the Health Resources and Services Administration, the Substance Abuse and Mental Health Services Administration, the Office of the Inspector General, State Medicaid agencies, State departments of health, State departments of education, and State and local juvenile justice and social services agencies to—

(A)

establish an estimate of the combined nationwide cost of complying with the requirements described in this paragraph, in terms of both administrative funding and staff time;

(B)

establish an estimate of the per capita cost to each federally qualified behavioral health center certified under section 1913(c) of the Public Health Service Act to comply with the requirements described in this paragraph, in terms of both administrative funding and staff time; and

(C)

make administrative and statutory recommendations to Congress, which may include a uniform methodology, to reduce the paperwork burden experienced by such federally qualified behavioral health centers.

(3)

Authorization of appropriations

There are authorized to be appropriated to carry out this subsection $550,000 for each of the fiscal years 2012 and 2013.

(b)

Wage study

(1)

In general

Not later than 12 months after the date of the enactment of this Act, the Institute of Medicine shall conduct a nationwide analysis, and submit a report to the appropriate committees of Congress, concerning the compensation structure of professional and paraprofessional personnel employed by federally qualified behavioral health centers certified under section 1913(c) of the Public Health Service Act, as inserted by section 2, as compared with the compensation structure of comparable health safety net providers and relevant private sector health care employers.

(2)

Scope

In preparing the report under paragraph (1), the Institute of Medicine shall examine compensation disparities, if such disparities are determined to exist, by type of personnel, type of provider or private sector employer, and by geographic region.

(3)

Authorization of appropriations

There are authorized to be appropriated to carry out this subsection, $550,000 for each of the fiscal years 2012 and 2013.