Sec. 301. Operating grants for community behavioral health clinics
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Part D of title III of the Public Health Service Act ( 42 U.S.C. 254b et seq. ) is amended by adding at the end the following: In this subpart: The term certified community behavioral health clinic has the meaning given the term in section 1905(jj)(2)) of the Social Security Act. The term certified community behavioral health services has the meaning given the term in section 1905(jj)(1) of the Social Security Act. Not later than 180 days after the date of enactment of the Ensuring Excellence in Mental Health Act , the Secretary, after public notice and opportunity for comment, shall publish in the Federal Register criteria for a clinic to be certified as a community behavioral health clinic for purposes of section 1905(jj)(2)(D)(ii) of the Social Security Act.
The criteria published under subsection
(a)shall include criteria with respect to the following: Staffing requirements, including criteria that staff have diverse disciplinary backgrounds, have necessary State-required license and accreditation, and are culturally and linguistically trained to serve the needs of the patient populations of the community behavioral health clinic. Availability and accessibility of services, including crisis management services that are available and accessible 24 hours a day, the use of a sliding scale for payment, and no rejection for services or limiting of services on the basis of a patient's ability to pay or a place of residence. Care coordination, including requirements to coordinate care across settings and providers to ensure seamless transitions for patients across the full spectrum of health services including acute, chronic, and behavioral health needs. Care coordination requirements shall include partnerships or formal contracts with the following: Federally-qualified health centers (as defined in section 1905(l) of the Social Security Act) and, as applicable, rural health clinics (as so defined), to provide Federally-qualified health center services (as so defined) and, as applicable, rural health clinic services (as so defined), to the extent such services are not provided directly through the community behavioral health clinic. Inpatient psychiatric facilities and substance use detoxification, post-detoxification step-down services, and residential programs. Other community or regional services, supports, and providers, including schools, child welfare agencies, juvenile and criminal justice agencies and facilities, Indian Health Service youth regional treatment centers, State-licensed and nationally accredited child placing agencies for therapeutic foster care service, and other social and human services. Medical centers, outpatient clinics, and drop-in centers of the Department of Veterans Affairs and other facilities of the Department (as defined in section 1701 of title 38, United States Code). Inpatient acute care hospitals and hospital outpatient clinics. Provision (in a manner reflecting person-centered care) of the full array of certified community behavioral health services which, if not available directly through the community behavioral health clinic, are provided or referred through formal relationships with other providers. Requirements relating to development by the community behavioral health clinic of an effective procedure for compiling and reporting to the Secretary such statistics and other information as the Secretary may require relating to— the costs of its operations; the patterns of use of its services, including the reporting of encounter data, clinical outcomes data, quality data, and such other data as the Secretary may require; the availability, accessibility, and acceptability of its services; and such other matters relating to operations of the applicant as the Secretary may require. Requirements that a community behavioral health clinic be— a nonprofit entity; part of a local government behavioral health authority; operated under the authority of the Indian Health Service; operated by an Indian Tribe or Tribal organization pursuant to a contract, grant, cooperative agreement, or compact with the Indian Health Service pursuant to the Indian Self-Determination and Education Assistance Act ; or operated by an urban Indian organization pursuant to a grant or contract with the Indian Health Service under title V of the Indian Health Care Improvement Act. The Secretary shall establish a grant program under which the Secretary shall award grants to eligible community behavioral health clinics to provide (in a manner reflecting person-centered care) the full array of certified community behavioral health services. To be eligible to receive a grant under subsection (a), a community behavioral health clinic shall be— a certified community behavioral health clinic; or a community behavioral health clinic that indicates in the grant application that the clinic will use the grant funds to meet the criteria described in section 340J–1(a). A community behavioral health clinic that receives a grant under subsection (a)— shall use the grant funds— to provide the services described in subsection (a); and in the case of a community behavioral health clinic described in subsection (b)(2), to meet the criteria described in section 340J–1(a); and may use the grant funds— to carry out other activities that— reduce costs associated with the provision of certified community behavioral health services; improve access to, and availability of, certified community behavioral health services provided to individuals served by the community behavioral health clinic; enhance the quality and coordination of certified community behavioral health services; or improve the health status of communities; and to pay for— the costs of acquiring and leasing buildings and equipment (including the costs of amortizing the principal of, and paying interest on, loans); costs relating to the purchase or lease of equipment, including data and information systems and behavioral health information technology to facilitate data reporting and other purposes; the costs of in-service staff training and other operational or infrastructure costs identified by the Secretary; and costs associated with expanding and modernizing existing buildings or constructing new buildings (including the costs of amortizing the principal of, and paying the interest on, loans), if such costs are specifically allowed for in the grant opportunity published by the Secretary. Grants awarded under subsection
(a)shall be for a period of not more than 5 years. The Secretary shall not make a grant to an applicant under subsection
(a)unless the applicant provides assurances to the Secretary that within 120 days of receiving grant funding for the operation of the clinic, the applicant will submit for approval by the Secretary an implementation plan that describes how the applicant will— provide the services described in subsection (a); and in the case of a community behavioral health clinic described in subsection (b)(2), meet the criteria described in section 340J–1(a). Subject to paragraph (2), the amount of a grant made in any fiscal year to a community behavioral health clinic under subsection
(a)shall be determined by the Secretary based on information provided by the community behavioral health clinic, but may not exceed an amount equal to the difference obtained by subtracting— the sum obtained by adding— the total State, local, and other operational funding provided to the clinic for such fiscal year; and the fees, premiums, and third-party reimbursements that the clinic reasonably expects to receive for its operations in such fiscal year; from the costs of operating the clinic to meet the purposes and requirements of the grant program under this section during such fiscal year. In determining the costs described in paragraph (1)(B), the Secretary may estimate the anticipated costs of the grant recipient in— providing the services described in subsection (a), including the anticipated costs of providing any individual certified community behavioral health service that the applicant entity does not have cost experience providing at the time of submitting an application for such grant; and if applicable, meeting the criteria described in section 340J–1(a). The Secretary shall base the estimate of anticipated costs under subparagraph
(A)on an estimate of anticipated costs provided by the applicable community behavioral health clinic. The Secretary may— award grants under subsection (a)— in advance or through reimbursement; and in installments; make adjustments to account for overpayments or underpayments. In selecting grant recipients under this section, the Secretary may take into account whether an applicant community behavioral health clinic is accredited under section 340J–5(a). In determining whether a community behavioral health clinic receiving a grant under this section is providing the services described in subsection
(a)and, if applicable, meeting the criteria described in section 340J–1(a), the Secretary may take into account whether the community behavioral health clinic is accredited under section 340J–5(a). There is authorized to be appropriated to carry out this section, $552,500,000 for each of fiscal years 2024 through 2028. The amount made available under paragraph
(1)shall supplement (and not supplant) any other Federal funding made available for community behavioral health clinics. Not later than 180 days after the date of enactment of the Ensuring Excellence in Mental Health Act , the Secretary shall establish programs through which the Secretary shall provide (either through the Department of Health and Human Services or by grant or contract) technical assistance and other assistance to any of the following: Entities that receive a grant under section 340J–2. Entities participating in a Medicaid demonstration program under section 223(d) of the Protecting Access to Medicare Act. Certified community behavioral health clinics (as defined in sections 1861(aa)(8) and 1905(jj)(2) of the Social Security Act), furnishing services under title XVIII or title XIX of such Act. Health or social service provider organizations pursuing or considering certified community behavioral health clinic status or partnering with certified community behavioral health clinics. Other stakeholders, for the purpose of facilitating successful implementation of the certified community behavioral health clinic model. Assistance provided by the Secretary under subsection
(a)may include technical and nonfinancial assistance, including— fiscal and program management assistance; operational and administrative support; and the provision of information to the entities about the variety of resources available under this part and how those resources can be best used to meet the health and behavioral health needs of the communities served by the entities. There is authorized to be appropriated to carry out this section $6,000,000 for each of fiscal years 2024 through 2028. Not later than 180 days after the date of enactment of the Ensuring Excellence in Mental Health Act , the Secretary shall establish a system under which the Secretary shall collect and analyze data on community behavioral health clinics. The system established under subsection
(a)shall be used by the Secretary to collect and analyze data from— entities that receive a grant under section 340J–2; and organizations that provide services, or have applied to provide services, under title XVIII of the Social Security Act, as described in section 1861(aa)(8) of such Act, or under a State Medicaid program in accordance with section 1905(jj) of such Act. There is authorized to be appropriated to carry out this section $51,000,000 for each of fiscal years 2024 through 2028. A community behavioral health clinic may be accredited if the entity— meets the standards of an approved accreditation body; and authorizes the accreditation body to submit to the Secretary (or such agency as the Secretary may designate) such records or other information as the Secretary may require. The Secretary may approve a private nonprofit organization to be an accreditation body for the accreditation of community behavioral health clinics under subsection
(a)if— using inspectors qualified to evaluate quality of care in a behavioral health service setting, the accreditation body agrees to inspect the clinic with such frequency as is determined by the Secretary; the standards applied by the body in determining whether or not to accredit a clinic correspond to the criteria described in section 340J–1(a), and are not less restrictive than such criteria; there is adequate provision for assuring that the standards of the accreditation body continue to be met by the clinic; in the case of any clinic previously accredited by the body which has had its accreditation denied, suspended, withdrawn, or revoked or which has had any other action taken against it by the accrediting body, the accrediting body agrees to submit to the Secretary the name of such clinic within 30 days of the action taken; and if the accreditation body has its approval withdrawn by the Secretary, the body agrees to notify each clinic accredited by the body of the withdrawal within 10 days of the withdrawal. .
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Sec. 301
Operating grants for community behavioral health clinics
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