Sec. 301. Increasing uptake of the collaborative care model
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Section 520K of the Public Health Service Act ( 42 U.S.C. 290bb–42 ) is amended to read as follows: In this section: The term collaborative care model means the evidence-based, integrated behavioral health service delivery method that includes— care directed by the primary care team; structured care management; regular assessments of clinical status using developmentally appropriate, validated tools; and modification of treatment as appropriate. The term eligible entity means a State, or an appropriate State agency, in collaboration with— 1 or more qualified community programs as described in section 1913(b)(1); 1 or more health centers (as defined in section 330(a)), a rural health clinic (as defined in section 1961(aa) of the Social Security Act), or a Federally qualified health center (as defined in such section); or 1 or more primary health care practices.
The term integrated care means models or practices for coordinating and jointly delivering behavioral and physical health services, which may include practices that share the same space in the same facility. The term bidirectional integrated care means the integration of behavioral health care and specialty physical health care, as well as the integration of primary and physical health care with specialty behavioral health settings, including within primary health care settings.
The term primary health care provider means a provider who— provides health services related to family medicine, internal medicine, pediatrics, obstetrics, gynecology, or geriatrics; or is a doctor of medicine or osteopathy, physician assistant, or nurse practitioner, who is licensed to practice medicine by the State in which such physician, assistant, or practitioner primarily practices, including within primary health care settings. The term primary health care practice means a medical practice of primary health care providers, including a practice within a larger health care system.
The term special population , for an eligible entity that is collaborating with an entity described in subparagraph
(A)or
(B)of paragraph (3), means— adults with a serious mental illness who have a co-occurring physical health condition or chronic disease; children and adolescents with a mental illness who have a co-occurring physical health condition or chronic disease; individuals with a substance use disorder; or individuals with a mental illness who have a co-occurring substance use disorder. The Secretary may award grants and cooperative agreements to eligible entities to support the improvement of integrated care for physical and behavioral health care in accordance with paragraph (2). A grant or cooperative agreement awarded under this section shall be used— in the case of an eligible entity that is collaborating with an entity described in subparagraph
(A)or
(B)of subsection (a)(2)— to promote full integration and collaboration in clinical practices between physical and behavioral health care for special populations including each population listed in subsection (a)(7); to support the improvement of integrated care models for physical and behavioral health care to improve the overall wellness and physical health status of— adults with a serious mental illness or children with a serious emotional disturbance; and individuals with a substance use disorder; and to promote bidirectional integrated care services including screening, diagnosis, prevention, treatment, and recovery of mental and substance use disorders, and co-occurring physical health conditions and chronic diseases; and in the case of an eligible entity that is collaborating with a primary health care practice, to support the uptake of the collaborative care model, including by— hiring staff; identifying and formalizing contractual relationships with other health care providers, including providers who will function as psychiatric consultants and behavioral health care managers in providing behavioral health integration services through the collaborative care model; purchasing or upgrading software and other resources needed to appropriately provide behavioral health integration services through the collaborative care model, including resources needed to establish a patient registry and implement measurement-based care; and for such other purposes as the Secretary determines to be necessary. An eligible entity that is collaborating with an entity described in subparagraph
(A)or
(B)of subsection (a)(2) seeking a grant or cooperative agreement under subsection (b)(2)(A) shall submit an application to the Secretary at such time, in such manner, and accompanied by such information as the Secretary may require, including the contents described in paragraph (2). Any such application of an eligible entity described in subparagraph
(A)or
(B)of subsection (a)(2) shall include— a description of a plan to achieve fully collaborative agreements to provide bidirectional integrated care to special populations; a document that summarizes the policies, if any, that are barriers to the provision of integrated care, and the specific steps, if applicable, that will be taken to address such barriers; a description of partnerships or other arrangements with local health care providers to provide services to special populations; an agreement and plan to report to the Secretary performance measures necessary to evaluate patient outcomes and facilitate evaluations across participating projects; a description of how validated rating scales will be implemented to support the improvement of patient outcomes using measurement-based care, including those related to depression screening, patient follow-up, and symptom remission; and a plan for sustainability beyond the grant or cooperative agreement period under subsection (e). An eligible entity that is collaborating with a primary health care practice seeking a grant pursuant to subsection (b)(2)(B) shall submit an application to the Secretary at such time, in such manner, and accompanied by such information as the Secretary may require. The target amount that an eligible entity may receive for a year through a grant or cooperative agreement under this section shall be— $2,000,000 for an eligible entity described in subparagraph
(A)or
(B)of subsection (a)(2); or $100,000 or less for an eligible entity described in subparagraph
(C)of subsection (a)(2). The Secretary, taking into consideration the quality of an eligible entity’s application and the number of eligible entities that received grants under this section prior to the date of enactment of the Restoring Hope for Mental Health and Well-Being Act of 2022 , may adjust the target amount that an eligible entity may receive for a year through a grant or cooperative agreement under this section. An eligible entity that is collaborating with an entity described in subparagraph
(A)or
(B)of subsection (a)(2) receiving funding under this section— may not allocate more than 20 percent of the funds awarded to such eligible entity under this section to administrative functions; and shall allocate the remainder of such funding to health facilities that provide integrated care. A grant or cooperative agreement under this section shall be for a period not to exceed 5 years. An eligible entity receiving a grant or cooperative agreement under this section— that is collaborating with an entity described in subparagraph
(A)or
(B)of subsection (a)(2) shall submit an annual report to the Secretary that includes— the progress made to reduce barriers to integrated care as described in the entity’s application under subsection (c); and a description of outcomes with respect to each special population listed in subsection (a)(7), including outcomes related to education, employment, and housing; or that is collaborating with a primary health care practice shall submit an annual report to the Secretary that includes— the progress made to improve access; the progress made to improve patient outcomes; and the progress made to reduce referrals to specialty care. The Secretary may provide appropriate information, training, and technical assistance to eligible entities that are collaborating with an entity described in subparagraph
(A)or
(B)of subsection (a)(2) that receive a grant or cooperative agreement under this section, in order to help such entities meet the requirements of this section, including assistance with— development and selection of integrated care models; dissemination of evidence-based interventions in integrated care; establishment of organizational practices to support operational and administrative success; and other activities, as the Secretary determines appropriate. The Secretary shall provide appropriate information, training, and technical assistance to eligible entities that are collaborating with primary health care practices that receive funds under this section to help such entities implement the collaborative care model, including— developing financial models and budgets for implementing and maintaining a collaborative care model, based on practice size; developing staffing models for essential staff roles; providing strategic advice to assist practices seeking to utilize other clinicians for additional psychotherapeutic interventions; providing information technology expertise to assist with building the collaborative care model into electronic health records, including assistance with care manager tools, patient registry, ongoing patient monitoring, and patient records; training support for all key staff and operational consultation to develop practice workflows; establishing methods to ensure the sharing of best practices and operational knowledge among primary health care physicians and primary health care practices that provide behavioral health integration services through the collaborative care model; and providing guidance and instruction to primary health care physicians and primary health care practices on developing and maintaining relationships with community-based mental health and substance use disorder facilities for referral and treatment of patients whose clinical presentation or diagnosis is best suited for treatment at such facilities. In addition to providing the assistance described in paragraphs
(1)and
(2)to recipients of a grant or cooperative agreement under this section, the Secretary may also provide such assistance to other States and political subdivisions of States, Indian Tribes and Tribal organizations (as defined under the Federally Recognized Indian Tribe List Act of 1994), outpatient mental health and addiction treatment centers, community mental health centers that meet the criteria under section 1913(c), certified community behavioral health clinics described in section 223 of the Protecting Access to Medicare Act of 2014, primary care organizations such as Federally qualified health centers or rural health clinics as defined in section 1861(aa) of the Social Security Act, primary health care practices, other community-based organizations, and other entities engaging in integrated care activities, as the Secretary determines appropriate. To carry out this section, there is authorized to be appropriated $60,000,000 for each of fiscal years 2023 through 2027. .
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Sec. 301
Increasing uptake of the collaborative care model
Cite42 USC 290bb–42
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