Sec. 103. Reports
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Not later than 180 days after the enactment of this Act, and annually thereafter, the Administrator of the Centers for Medicare & Medicaid Services, in collaboration with the Assistant Secretary of Labor of the Employee Benefits Security Administration and the Secretary of the Treasury, and in consultation with the Assistant Secretary for Mental Health and Substance Use Disorders, shall submit to the Congress a report— identifying Federal investigations conducted or completed during the preceding 12-month period regarding compliance with parity in mental health and substance use disorder benefits, including benefits provided to persons with serious mental illness and substance use disorders, under 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 ); and summarizing the results of such investigations.
Subject to paragraph (3), each report under paragraph
(1)shall include the following information: The number of investigations opened and closed during the covered reporting period. The benefit classification or classifications examined by each investigation. The subject matter or subject matters of each investigation, including quantitative and nonquantitative treatment limitations. A summary of the basis of the final decision rendered for each investigation. Individually identifiable information shall be excluded from reports under paragraph
(1)consistent with Federal privacy protections. Not later than 1 year after the date of enactment of this Act, and biannually thereafter, the Assistant Secretary shall submit to the Congress and make publicly available a report on best practices and professional standards in States for— establishing and operating health care programs using peer-support specialists; and training and certifying peer-support specialists. In this subsection, the term peer-support specialist means an individual who— uses his or her lived experience of recovery from mental illness or substance abuse, plus skills learned in formal training, to facilitate support groups, and to work on a one-on-one basis, with individuals with a serious mental illness or a substance use disorder, in consultation with and under the supervision of a licensed mental health or substance use treatment professional; has been an active participant in mental health or substance use treatment for at least the preceding 2 years; does not provide direct medical services; and does not perform services outside of his or her area of training, expertise, competence, or scope of practice. Each report under this subsection shall include information on best practices and standards with regard to the following: Hours of formal work or volunteer experience related to mental health and substance use issues. Types of peer specialist exams required. Code of ethics. Additional training required prior to certification, including in areas such as— psychopharmacology; integrating physical medicine and mental health supportive services; ethics; scope of practice; crisis intervention; identification and treatment of mental health disorders; State confidentiality laws; Federal privacy protections, including under the Health Insurance Portability and Accountability Act of 1996; and other areas as determined by the Assistant Secretary. Requirements to explain what, where, when, and how to accurately complete all required documentation activities. Required or recommended skill sets, including— identifying consumer risk indicators, including individual stressors, triggers, and indicators of escalating symptoms; explaining basic de-escalation techniques; explaining basic suicide prevention concepts and techniques; identifying indicators that the consumer may be experiencing abuse or neglect; identifying and responding appropriately to personal stressors, triggers, and indicators; identifying the consumer’s current stage of change or recovery; explaining the typical process that should be followed to access or participate in community mental health and related services; and identifying circumstances when it is appropriate to request assistance from other professionals to help meet the consumer’s recovery goals. Requirements for continuing education credits annually. Not later than 1 year after the date of enactment of this Act, and not less than every 2 years thereafter, the Assistant Secretary shall submit to the Congress and make available to the public a report on the state of the States in mental health and substance use treatment, including the following: A detailed report on how Federal mental health and substance use treatment funds are used in each State including: The numbers of individuals with serious mental illness or substance use disorders who are served with Federal funds. The types of programs made available to individuals with serious mental illness or substance use disorders. A summary of best practice models in the States highlighting programs that are cost effective, provide evidence-based care, increase access to care, integrate physical, psychiatric, psychological, and behavioral medicine, and improve outcomes for individuals with mental illness or substance use disorders. A statistical report of outcome measures in each State, including— rates of suicide, suicide attempts, substance abuse, overdose, overdose deaths, emergency psychiatric hospitalizations, and emergency room boarding; and for those with mental illness, arrests, incarcerations, victimization, homelessness, joblessness, employment, and enrollment in educational or vocational programs. Outcome measures on State-assisted outpatient treatment programs, including— rates of keeping treatment appointments and compliance with prescribed medications; participants’ perceived effectiveness of the program; rates of the programs helping those with serious mental illness gain control over their lives; alcohol and drug abuse rates; incarceration and arrest rates; violence against persons or property; homelessness; and total treatment costs for compliance with the program. For States and counties with assisted outpatient treatment programs, the information reported under this subsection shall include a comparison of the outcomes of individuals with serious mental illness who participated in the programs versus the outcomes of individuals who did not participate but were eligible to do so by nature of their history. For States and counties without assisted outpatient treatment programs, the information reported under this subsection shall include data on individuals with mental illness who— have a history of violence, incarceration, and arrests; have a history of emergency psychiatric hospitalizations; are substantially unlikely to participate in treatment on their own; may be unable for reasons other than indigence, to provide for any of their basic needs such as food, clothing, shelter, health or safety; have a history of mental illness or condition that is likely to substantially deteriorate if the individual is not provided with timely treatment; and due to their mental illness, have a lack of capacity to fully understand or lack judgment, or diminished capacity to make informed decisions, regarding their need for treatment, care, or supervision. In this subsection, the term emergency room boarding means the practice of admitting patients to an emergency department and holding them in the department until inpatient psychiatric beds become available. The Assistant Secretary for Mental Health and Substance Use Disorders shall enter into an arrangement with the Institute of Medicine of the National Academies (or, if the Institute declines, another appropriate entity) under which, not later than 12 months after the date of enactment of this Act, the Institute will submit to the appropriate committees of Congress a report that evaluates the combined paperwork burden of— community mental health centers meeting the criteria specified in section 1913(c) of the Public Health Service Act ( 42 U.S.C. 300x–2 ), including such centers meeting such criteria as in effect on the day before the date of enactment of this Act; and federally qualified community mental health clinics certified pursuant to section 223 of the Protecting Access to Medicare Act of 2014 ( Public Law 113–93 ), as amended by section 505. In preparing the report under subsection (a), the Institute of Medicine (or, if applicable, other appropriate entity) shall examine licensing, certification, service definitions, claims payment, billing codes, and financial auditing requirements used 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 of the Department of Health and Human Services, State Medicaid agencies, State departments of health, State departments of education, and State and local juvenile justice and social service agencies to— establish an estimate of the combined nationwide cost of complying with such requirements, in terms of both administrative funding and staff time; establish an estimate of the per capita cost to each center or clinic described in subparagraph
(A)or
(B)of paragraph
(1)to comply with such requirements, in terms of both administrative funding and staff time; and make administrative and statutory recommendations to Congress (which recommendations may include a uniform methodology) to reduce the paperwork burden experienced by centers and clinics described in subparagraph
(A)or
(B)of paragraph (1).
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3 references not yet in our index
- Pub. L. 110-343
- 42 USC 300x–2
- Pub. L. 113-93
Citation graph
cites case law
Sec. 103
Reports
Pub. L.Pub. L. 110-343
Cite42 USC 300x–2
Pub. L.Pub. L. 113-93
Cites 3Cited by 0 across 0 sources