[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 3402 Introduced in Senate (IS)]
<DOC>
119th CONGRESS
1st Session
S. 3402
To amend titles XVIII and XIX of the Social Security Act and the Public
Health Service Act to improve the certified community behavioral health
clinic program, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
December 9, 2025
Mr. Cornyn (for himself, Ms. Smith, Mr. Tillis, and Ms. Cortez Masto)
introduced the following bill; which was read twice and referred to the
Committee on Finance
_______________________________________________________________________
A BILL
To amend titles XVIII and XIX of the Social Security Act and the Public
Health Service Act to improve the certified community behavioral health
clinic program, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,

b6be911a42295aaa411c86f4344c3a677b39fb134d83fdec1e14e0bdd1fd0b26

(a) Short Title.--This Act may be cited as the ``Ensuring
Excellence in Mental Health Act''.
(b) Table of Contents.--The table of contents for this Act is as
follows:

05b0dc459296550286bd48d89047a41dd6f84c6ce9eb907528493607b6ab0d43

COMMUNITY BEHAVIORAL HEALTH CLINICS IN THE MEDICAID PROGRAM

26b7d5419cf7f167cf616880d8dd0b5a3708c63e85ebc5d28fcf304140838ef9

health services with community behavioral
health clinics operating grant program;
community behavioral health clinics
accreditation option.

d2dd05debf7d2cc9a626940e920d8ffb67532eb6cb643f8e8a7df98487deef04

TITLE I

-STRENGTHENING AND PROVIDING COST-RELATED PAYMENT FOR CERTIFIED

certified community behavioral health
clinics.

3786ed6fec33610c6372f383c020789bb9c75ebbd5eaae7473cd5df8fd3d8956

services within Medicaid demonstration
program.

a71a4315498efc6af4cc2076057fff407bd3d690d9b675a13dfc5846b9bf82dd

services covered under the Medicaid State
plan.
SERVICES UNDER THE MEDICARE PROGRAM

bb3a4d1f423b8f7b109bbfade1f1dd3f4ac731d38b8019a6ebf4794b2371f88a

520e1e61e36d87eb19120c0e5ab218530ee81af04041f44ef0485e3ce610d27b

TITLE II

-COVERAGE OF CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC

community behavioral health clinic
services.

73f04830163272b081c7bb42df058e698ad956d2f561c4f913945ab6cec98247

9965e4fdd4ed9391e9a98e27a146df84f408d7f12aae6440473cc5d0ddf5dc04

of certified community behavioral health
clinic coinsurance.

12a3163debf730975421cd8b5c2d4f8b9a024aaf3815ca7326c221f9b6d83ad5

a3b283da15094b6b444dae07da6db09a7a445861c031799a269e32d2531eea5b

TITLE III

-COMMUNITY BEHAVIORAL HEALTH CLINICS

clinicians in certified community
behavioral health clinics.
COMMUNITY BEHAVIORAL HEALTH CLINICS IN THE MEDICAID PROGRAM

3bf54f831ce7fa5092b1582fae4742d4bcd3f06e56257f68831b56524665f94e

TITLE IV

-LIABILITY PROTECTION FOR CERTIFIED COMMUNITY BEHAVIORAL

HEALTH SERVICES WITH COMMUNITY BEHAVIORAL HEALTH CLINICS
OPERATING GRANT PROGRAM; COMMUNITY BEHAVIORAL HEALTH
CLINICS ACCREDITATION OPTION.
Section 1905(jj) of the Social Security Act (42 U.S.C. 1396d(jj))
is amended--
(1) in paragraph (2)(C), by inserting before the period at
the end ``and including any such data as the State, by
agreement with the Secretary, shall access via the system
described in section 340J-3 of the Public Health Service
Act.''; and
(2) by adding at the end the following new paragraph:
``(3) Accreditation.--In the case of services furnished on
or after January 1, 2026, at the option of the State, a State
may determine that an organization does not meet such criteria
as the Secretary may establish for certified community
behavioral health clinics pursuant to section 223 of the
Protecting Access to Medicare Act unless the organization has
received accreditation by an accreditation body approved under
section 340J-4 of the Public Health Service Act. An election by
a State under the preceding sentence shall not relieve a State
of the requirement to certify an organization under paragraph
(2)(A).''.

121d13e49fd15f8bdbe2a0a0fa047b309b32595e1e44c9d462c453ff6337ec92

CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINICS.
Section 1902 of the Social Security Act (42 U.S.C. 1396a) is
amended by adding at the end the following new subsection:
``(yy) Payment for Services Provided by Certified Community
Behavioral Health Clinics.--
``(1) In general.--Beginning with fiscal year 2026, with
respect to services furnished on or after January 1, 2026, and
each succeeding fiscal year, a State that has elected in its
State plan under this title to furnish the services described
in section 1905(a)(31) shall provide under the plan for payment
for services furnished by a certified community behavioral
health clinic described in section 1905(jj)(2) (in this
subsection referred to as a `clinic') in accordance with the
provisions of this subsection.
``(2) Payment for services in initial year.--
``(A) In general.--Subject to subparagraphs (B) and
(C) and the succeeding provisions of this subsection,
and in accordance with paragraph (1), for services
furnished by a clinic in the first fiscal year
beginning after September 30, 2025, for which a State
elects to provide for payment for services described in
section 1905(a)(31), the State shall provide for
payment for such services in an amount (calculated on
the basis of daily visits or unduplicated monthly
visits, at the State's election) that is equal to 100
percent of the average costs of the clinic which are
reasonable and related to the furnishing such services
during a base year corresponding to the fiscal year
preceding such initial fiscal year.
``(B) Additional payment considerations.--
``(i) In general.--A State may elect in its
State plan to carry out any of the following,
consistent with the methodology described in
guidance issued under the authority of section
223(b) of the Protecting Access to Medicare
Act:
``(I) Establishing separate
prospective payment system rates for
special populations.
``(II) Using a system of outlier
payments for a portion of costs of
furnishing the covered benefit.
``(III) With respect to the crisis
services included within the benefit
described in section 1905(a)(31)--
``(aa) requiring that
clinics, in their cost reports,
segregate costs relating to
mobile crisis teams, emergency
crisis intervention services,
or crisis stabilization as
components of the covered
benefit described in section
1905(a)(31); and
``(bb) providing for a
prospective payment system rate
for any or all of such crisis
services, distinct from the
rate encompassing the remainder
of the services described in
section 1905(a)(31).
``(ii) States with pama demonstration
programs.--If a State electing to furnish
services described in section 1905(a)(31) under
its State plan, as of the year prior to the
initial fiscal year described above, operated a
demonstration program under section 223 of the
Protecting Access to Medicare Act, such State
may elect under the State plan to establish as
its initial rate under this paragraph, for any
clinic that participated in such demonstration,
the rate that would otherwise have applied
under the demonstration.
``(iii) Use of estimated or projected
data.--In the absence of complete actual cost
data representing the provision of the full
covered benefit in such base year, the State
may provide in its State plan amendment to
allow clinics to use estimated or projected
data relating to specific services for which
they lack cost experience.
``(C) Inflation adjustment.--The per-unit rate
derived from the cost data described in subparagraph
(A) shall be annually adjusted by the inflationary
factor described in section 1834(aa)(2)(C), and shall
be adjusted to take into account any increase or
decrease in the scope of such services furnished by the
clinic in the fiscal year involved.
``(3) Payment for services in subsequent fiscal years.--
Subject to the succeeding provisions of this subsection, for
services described in section 1905(a)(31) furnished by a clinic
after the initial fiscal year described in paragraph (2), the
State plan shall provide for payment for such services in an
amount (calculated on the basis of daily visits or unduplicated
monthly visits, at the State's election) that is equal to the
amount calculated under this subsection for such services and
clinic for the preceding fiscal year--
``(A) increased by the percentage increase in the
inflationary factor described in section 1834(aa)(2)(C)
for such fiscal year; and
``(B) adjusted to take into account any increase or
decrease in the scope of such services furnished by the
clinic during the fiscal year involved.
``(4) Establishment of initial fiscal year payment for new
clinics.--
``(A) In general.--In any case in which an entity
first qualifies as a certified community behavioral
health clinic in a year after the first fiscal year in
which the State first provides for payment for the
services described in section 1905(a)(31) in accordance
with paragraph (1), the State plan shall provide for
payment for such services in the first fiscal year in
which the clinic so qualifies in an amount (calculated
on the basis of daily visits or unduplicated monthly
visits, at the State's election) that is equal to the
rates established under this subsection for other such
clinics located in the same or adjacent area with a
similar case load, or in the absence of any such
clinic, based on the reasonable projected costs per
visit of the clinic.
``(B) Additional requirement.--Not later than the
second fiscal year in which a clinic described in
subparagraph (A) furnishes services described in
section 1905(a)(31)--
``(i) the State shall establish a unique
payment rate for the clinic based on the
methodology described in paragraph (2), using
reasonable and related costs from the clinic's
first fiscal year of operation as the basis for
establishing such rates; and
``(ii) in any year following the
establishment of an initial rate under this
subparagraph, the State plan shall provide for
the payment amount to be adjusted in accordance
with paragraph (3) and (as applicable)
reestablished in accordance with paragraph (5).
``(5) Optional periodic rebase of pps rates.--
Notwithstanding the preceding paragraphs, a State may elect in
its State plan amendment to establish a new prospective payment
system rate for clinics on a periodic basis. Under such an
election, periodically (but not less frequently than every 3rd
fiscal year) after the initial year, as described in paragraph
(2), in which the State first furnishes the services described
in section 1905(a)(31), the State shall set a new rebased rate
for each clinic whose rate was initially set pursuant to
paragraph (2), except that costs from the fiscal year preceding
such rebasing year, rather than costs from the base year
described in paragraph (2), shall be used in establishing a new
cost-related rate for each clinic. States electing this option
shall also follow this methodology and schedule in periodically
establishing new rates for those clinics whose initial rates
were set as described in paragraph (4).
``(6) Administration in the case of managed care.--
``(A) In general.--In the case of services
furnished by a certified community behavioral health
clinic pursuant to a contract between the clinic and a
managed care entity (as defined in section
1932(a)(1)(B)), the State plan shall provide for
payment to the clinic by the State of a supplemental
payment equal to the amount (if any) by which the
amount determined under the preceding paragraphs of
this subsection or as applicable, paragraph (7),
exceeds the amount of payments under the contract, with
such supplemental payment being made pursuant to a
payment schedule agreed to by the State and the
certified community behavioral health clinic, but not
less frequently than every 3 months.
``(B) Option to delegate pps payment to managed
care entities through an alternative payment
methodology.--
``(i) In general.--Notwithstanding
subparagraph (A), nothing in this subsection
shall be interpreted to preclude a State from
amending its State plan to provide for an
alternative payment methodology in accordance
with paragraph (7), under which the State may
delegate to a managed care entity (as defined
in section 1932(a)(1)(B)) the responsibility to
pay the clinic at least the rate determined
under the preceding subparagraphs or as
applicable, paragraph (7).
``(ii) Requirements.--In making a
delegation under clause (i), a State shall
ensure that it complies with the requirements
described in paragraph (7) and shall use
reconciliation and oversight processes to
ensure that each clinic is paid at least the
amounts required under the preceding paragraphs
of this subsection.
``(7) Alternative payment methodologies.--Notwithstanding
any other provision of this subsection, a State plan may
provide for payment in any year to a certified community
behavioral health clinic for services described in section
1905(a)(31) in an amount which is determined under an
alternative payment methodology that--
``(A) is agreed to by the State and the clinic; and
``(B) results in payment to the clinic of an amount
which is not less than the amount otherwise required to
be paid to the clinic under this subsection.''.

d234704655e9f391059eb31f1d8aaa62730df9dfd7035461043922747dc9db88

SERVICES WITHIN MEDICAID DEMONSTRATION PROGRAM.
(a) Additional Services Within Demonstration Program.--
(1) In general.--Section 223(a)(2)(D) of the Protecting
Access to Medicare Act of 2014 (42 U.S.C. 1396a note), is
amended to read as follows:
``(D) Scope of services.--Provision (in a manner
reflecting person-centered care) of at least the
following required services described in clause (i),
which may be furnished either directly or, if not
available directly, through formal relationships with
other providers, and at the discretion of the certified
community behavioral health clinic, at least 1 of the
following additional services described in clause (ii)
furnished directly by the clinic:
``(i) Required services.--
``(I) Crisis mental health
services, including 24-hour mobile
crisis teams, emergency crisis
intervention services, and crisis
stabilization.
``(II) Screening, assessment, and
diagnosis, including risk assessment.
``(III) Patient-centered treatment
planning or similar processes,
including risk assessment and crisis
planning.
``(IV) Outpatient mental health and
substance use services.
``(V) Outpatient clinic primary
care screening and monitoring of key
health indicators and health risk.
``(VI) Targeted case management.
``(VII) Psychiatric rehabilitation
services.
``(VIII) Peer support and counselor
services and family supports.
``(IX) Intensive, community-based
mental health care for members of the
Armed Forces and veterans, particularly
those members and veterans located in
rural areas, provided the care is
consistent with minimum clinical mental
health guidelines promulgated by the
Veterans Health Administration
including clinical guidelines contained
in the Uniform Mental Health Services
Handbook of such Administration.
``(ii) Additional services.--The additional
services described in this clause are--
``(I) services not described in
clause (i); and
``(II) services that are
appropriate to meet the health needs of
the population served, including any of
the primary health services described
in section 330(b)(1)(A) of the Public
Health Service Act.''.
(2) Additional amendments.--Section 223 of the Protecting
Access to Medicare Act of 2014 (42 U.S.C. 1396a note), is
amended--
(A) in subsection (b)(1), by striking ``mental
health services'' and inserting ``certified community
behavioral health clinic services'';
(B) in subsection (d)(5)(D)--
(i) by inserting ``(including such State's
prior use under such demonstration of a
supplemental payment or `wraparound' framework
for payments for services furnished under
contract with a managed care entity)'' after
``established under subsection (c)''; and
(ii) by striking the period at the end and
inserting the following: ``, and
notwithstanding any Federal regulation
concerning prohibition of additional payments
for services covered under a contract with a
managed care entity, a prepaid inpatient health
plan, or a prepaid ambulatory health plan.'';
and
(C) in subsection (e)--
(i) by redesignating paragraphs (1) through
(4) as paragraphs (2) through (5); and
(ii) by inserting before paragraph (2) the
following new paragraph:
``(1) Certified community behavioral health clinic
services.--The term `certified community behavioral health
clinic services' means any services required under clause (i)
of subsection (a)(2)(D) and any additional services described
in clause (ii) of such subsection to the extent that a
certified community behavioral health clinic elects to furnish
such services.''.
(b) Effective Date.--The amendments made by this section shall
apply with respect to services furnished on or after October 1, 2026.

7fd1776dc51e51edb74404b36d0f1613ec6adb48306fccb7876f504555902794

SERVICES COVERED UNDER THE MEDICAID STATE PLAN.
(a) Additional Services Within Certified Community Behavioral
Health Clinic Benefit.--Section 1905(jj)(1) of the Social Security Act
(42 U.S.C. 1396d(jj)(1)) is amended to read as follows:
``(1) In general.--The term `certified community behavioral
health services' means the following required services
described in subparagraph (A), which may be furnished either
directly or, if not available directly, through formal
relationships with other providers, and at the discretion of
the certified community behavioral health clinic, at least 1 of
the following additional services described in subparagraph (B)
furnished directly by the clinic:
``(A) Required services.--
``(i) Crisis mental health services,
including 24-hour mobile crisis teams,
emergency crisis intervention services, and
crisis stabilization.
``(ii) Screening, assessment, and
diagnosis, including risk assessment.
``(iii) Patient-centered treatment planning
or similar processes, including risk assessment
and crisis planning.
``(iv) Outpatient mental health and
substance use services.
``(v) Outpatient clinic primary care
screening and monitoring of key health
indicators and health risk.
``(vi) Targeted case management.
``(vii) Psychiatric rehabilitation
services.
``(viii) Peer support and counselor
services and family supports.
``(ix) Intensive, community-based mental
health care for members of the Armed Forces and
veterans who are eligible for medical
assistance, particularly such members and
veterans located in rural areas, provided the
care is consistent with minimum clinical mental
health guidelines promulgated by the Veterans
Health Administration, including clinical
guidelines contained in the Uniform Mental
Health Services Handbook of such
Administration.
``(B) Additional services.--The additional services
described in this subparagraph are--
``(i) services not described in
subparagraph (A); and
``(ii) services that are appropriate to
meet the health needs of the population served,
including any of the primary health services
described in section 330(b)(1)(A) of the Public
Health Service Act.''.
(b) Effective Date.--The amendments made by this section shall
apply with respect to services furnished on or after October 1, 2026.
SERVICES UNDER THE MEDICARE PROGRAM

b1ea430c82fa238d7acc186457567cf5cb3ddc2cfd154e68481287f22730c40d

SERVICES UNDER THE MEDICARE PROGRAM.
(a) Coverage.--Section 1861(s)(2) of the Social Security Act (42
U.S.C. 1395x(s)(2)) is amended--
(1) in subparagraph (JJ), by inserting ``and'' at the end;
and
(2) by adding at the end the following new subparagraph:
``(KK) certified community behavioral health clinic
services (as defined in subsection (aa)(8)) furnished on or
after January 1, 2027.''.
(b) Definitions.--Section 1861(aa) of the Social Security Act (42
U.S.C. 1395x) is amended--
(1) in the heading, by striking ``and Federally Qualified
Health Center Services'' and inserting ``, Federally Qualified
Health Center Services, and Certified Community Behavioral
Health Clinic Services''; and
(2) by adding at the end the following new paragraph:
``(8) The terms `certified community behavioral health clinic
services' and `certified community behavioral health clinic' have the
meaning given those terms in paragraphs (1) and (2), respectively, of
section 1905(jj).''.

eaa13d5bf524e71873fa91e2594b72b1b2f6e2283664beb18d0cf74ce5417b51

SERVICES UNDER THE MEDICARE PROGRAM.
(a) In General.--Section 1833(a)(1) of the Social Security Act (42
U.S.C. 1395l(a)(1)) is amended--
(1) by striking ``and (HH)'' and inserting ``(HH)''; and
(2) by inserting before the semicolon at the end the
following: ``, and (II) with respect to certified community
behavioral health clinic services for which payment is made
under section 1834(aa), the amounts paid shall be equal to 80
percent of the lesser of the actual charge or the amount
determined under such section''.
(b) Development and Implementation of Prospective Payment System.--
Section 1834 of the Social Security Act (42 U.S.C. 1395m) is amended by
adding at the end the following new subsection:
``(aa) Development and Implementation of Prospective Payment System
for Certified Community Behavioral Health Clinics.--
``(1) Development.--
``(A) In general.--The Secretary shall develop a
prospective payment system for payment for community
behavioral health clinic services (as defined in
section 1861(aa)(8)) furnished by certified community
behavioral health clinics (as defined in such section)
under this title.
``(B) Considerations and adjustments.--In
developing the system described in subparagraph (A),
the Secretary--
``(i) shall--
``(I) take into account the type,
intensity, and duration of services
furnished by certified community
behavioral health clinics; and
``(II) consider an appropriate unit
of service and a general system design
that provides for continued access to
quality services; and
``(ii) may include adjustments, including
geographic adjustments, as determined
appropriate by the Secretary.
``(2) Implementation.--
``(A) In general.--For cost reporting periods
beginning on or after January 1, 2027, the Secretary
shall provide for payments of prospective payment rates
for certified community behavioral health clinic
services furnished by certified community behavioral
health clinics under this title in accordance with the
prospective payment system developed by the Secretary
under paragraph (1).
``(B) Initial payments.--
``(i) In general.--Subject to clause (ii),
in the first year that such prospective payment
system is implemented, the Secretary shall
implement such system to reflect the national
average allowable service costs of certified
community behavioral health clinics on the
basis of the most current audited cost report
data for the 2 most recent fiscal years
available to the Secretary. Initial payments
shall be established without the application of
a per visit limit or productivity screen and
shall be based on national average costs per
unit of service, updated as appropriate by the
inflationary adjustment described in
subparagraph (C).
``(ii) Absence of data.--In the absence of
complete cost report data described in clause
(i), certified community behavioral health
clinics may, at the Secretary's discretion,
submit estimated or projected data relating to
specific services.
``(C) Payments in subsequent years.--Payment rates
in years after the year of implementation of such
system shall be the payment rates in the previous year
increased--
``(i) in the first year after
implementation of such system, by the
percentage increase in the MEI (as defined in
section 1842(i)(3)); and
``(ii) in subsequent years--
``(I) by the percentage increase in
a market basket of certified community
behavioral health clinic services,
designed by the Secretary; or
``(II) if such an index is not
available, by the percentage increase
in the Federally qualified health
center market basket (as described in
section 1834(o)(2)(B)(ii)(II)) for the
year involved.
``(3) Periodic reevaluation of rates.--The Secretary may
periodically adjust the amounts that would otherwise be
applicable under paragraph (2) by a percentage determined
appropriate by the Secretary to reflect such factors as changes
in the intensity of certified community behavioral health
clinic services furnished within a unit of service, the average
cost of providing care per unit of service, and other factors
that the Secretary considers to be appropriate. Such adjustment
shall be made before the update under clause (i) or (ii) of
paragraph (2)(C) has been applied for the year.''.

e03f78fac678eb8f3ec7cede5d39c28e8ea7d4f0df4b952a29dc3424cec396cc

COMMUNITY BEHAVIORAL HEALTH CLINIC SERVICES.
Section 1833(b)(4) of the Social Security Act (42 U.S.C.
1395l(b)(4)) is amended by inserting ``or certified community
behavioral health clinic services'' before the comma at the end.

d410c616a61eba7e1775cdfb03bdddb6b7451e38f2763f0bbeede98c1d603c06

COST REPORTS.
Section 1878(j) of the Social Security Act (42 U.S.C. 1395oo(j)) is
amended by striking ``and a Federally qualified health center'' and
inserting ``, a Federally qualified health center, and a certified
community behavioral health clinic''.

7efd918020313ddbd9a334610c34e6399e812fbb305c928fe1c0a3b7c1a431e6

OF CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC
COINSURANCE.
Section 1128B(b)(3)(D) of the Social Security Act (42 U.S.C. 1320a-
7b(b)(3)(D)) is amended by inserting ``or a certified community
behavioral health clinic'' after ``Federally qualified health care
center''.

6c168a72457621eece8b552eff4050404704450570465a60a89040cc053a6776

The amendments made by this title shall apply with respect to
services furnished on or after January 1, 2027.

ae73bd49f47c9ea7bc31b58f451a80d6427cd35f8521eac15f644b2858e26efa

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:
``Subpart XIII--Community Behavioral Health Clinics
``SEC. 340J. DEFINITIONS.
``In this subpart:
``(1) Certified community behavioral health clinic.--The
term `certified community behavioral health clinic' has the
meaning given the term in section 1905(jj)(2) of the Social
Security Act.
``(2) Certified community behavioral health services.--The
term `certified community behavioral health services' has the
meaning given the term in section 1905(jj)(1) of the Social
Security Act.
``SEC. 340J-1. OPERATING GRANTS FOR COMMUNITY BEHAVIORAL HEALTH
CLINICS.
``(a) In General.--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.
``(b) Eligibility.--To be eligible to receive a grant under
subsection (a), an entity shall be--
``(1) a certified community behavioral health clinic; or
``(2) a community behavioral health clinic that--
``(A) indicates in the grant application that--
``(i) it will use the grant funds to meet
such criteria required to be a certified
community behavioral health clinic; and
``(ii) agrees to seek accreditation under
section 340J-4(a), as the Secretary may
require; and
``(B) demonstrates how it can ensure access to care
for all individuals in the community through referral
or other formal arrangements with other providers of
services, in the case of an entity that specializes in
services to children or youth or to veterans.
``(c) Use of Funds.--A community behavioral health clinic that
receives a grant under subsection (a)--
``(1) shall use the grant funds--
``(A) to provide the services described in
subsection (a); and
``(B) in the case of a community behavioral health
clinic described in subsection (b)(2), to attain
certification and accreditation as described in
subsection (b)(2)(A); and
``(2) may use the grant funds--
``(A) to carry out other activities that--
``(i) reduce costs associated with the
provision of certified community behavioral
health services;
``(ii) improve access to, and availability
of, certified community behavioral health
services provided to individuals served by the
community behavioral health clinic;
``(iii) enhance the quality and
coordination of certified community behavioral
health services; or
``(iv) improve the health status of
communities; and
``(B) to pay for--
``(i) the costs of acquiring and leasing
buildings and equipment (including the costs of
amortizing the principal of, and paying
interest on, loans);
``(ii) 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;
``(iii) the costs of in-service staff
training and other operational or
infrastructure costs identified by the
Secretary; and
``(iv) 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.
``(d) Use of Nongrant Funds.--Nongrant funds described in
subsection (g)(1)(B), including any such funds in excess of those
originally expected, shall be used as permitted under this section, and
may be used for such other purposes as are not specifically prohibited
under this section if such use furthers the objectives of the project.
``(e) Term.--Grants awarded under subsection (a) shall be for a
period of not more than 5 years.
``(f) Condition on Receipt of Funds.--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--
``(1) provide the services described in subsection (a); and
``(2) in the case of a community behavioral health clinic
described in subsection (b)(2), attain certification and
accreditation as described in subsection (b)(2)(A).
``(g) Amount of Grant.--
``(1) In general.--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 between--
``(A) the costs of operating the clinic to meet the
purposes and requirements of the grant program under
this section during such fiscal year; and
``(B) the sum obtained by adding--
``(i) the total State, local, and other
operational funding provided to the clinic for
such fiscal year; and
``(ii) the fees, premiums, and third-party
reimbursements that the clinic reasonably
expects to receive for its operations in such
fiscal year.
``(2) Requirement.--In determining the costs described in
paragraph (1)(A) with respect to a community behavioral health
clinic, the Secretary may estimate, based on an estimate of
anticipated costs provided by the applicable community
behavioral health clinic, the anticipated costs of such clinic
in--
``(A) 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
experience providing at the time of submitting an
application for such grant; and
``(B) if applicable, attain certification and
accreditation as described in subsection (b)(2)(A).
``(3) Payments.--The Secretary may--
``(A) disperse funds awarded under subsection (a)--
``(i) in advance or through reimbursement;
and
``(ii) in installments;
``(B) make adjustments to such disbursements to
account for overpayments or underpayments.
``(h) Use of Accreditation in Monitoring Grant Progress.--
Regardless of whether the Secretary elects to use accreditation under
section 340J-4(a) as a condition for award of an operating grant as
described in subsection (b)(2)(A)(ii), the Secretary may take such
accreditation into account in determining if an entity receiving a
grant under this section is providing the services described in
subsection (a) and, if applicable, meeting the criteria for
certification described in subsection (b)(2)(A)(i).
``(i) Authorization of Appropriations.--
``(1) In general.--There is authorized to be appropriated
to carry out this section, $552,500,000 for each of fiscal
years 2026 through 2030.
``(2) Maintenance of funding.--The amount made available
under paragraph (1) shall supplement (and not supplant) any
other Federal funding made available for certified community
behavioral health clinics.
``(j) Study of Clinics Serving Specialized Populations.--Not later
than 1 year after the date of enactment of this section, the Secretary
shall publish guidance clarifying how clinics that focus on distinct
populations, such as children or youth and veterans, may meet any
relevant requirement to furnish appropriate treatment to individuals
across the lifespan. Such guidance shall not affect clinics'
qualification to participate in the demonstration program under section
223(a)(1) of the Protecting Access to Medicare Act of 2014 or to
furnish the services described in section 1905(a)(31) of the Social
Security Act.''.
``SEC. 340J-2. TECHNICAL ASSISTANCE.
``(a) In General.--Not later than 180 days after the date of
enactment of this section, the Secretary shall establish a program or
programs through which the Secretary shall provide (directly or by
grant or contract) technical assistance and other assistance to any of
the following:
``(1) Entities that receive a grant under section 340J-1.
``(2) Entities participating in a Medicaid demonstration
program under section 223(d) of the Protecting Access to
Medicare Act.
``(3) Certified community behavioral health clinics
furnishing services under title XVIII or title XIX of the
Social Security Act.
``(4) Health or social service provider organizations
pursuing or considering seeking status as a certified community
behavioral health clinic or partnering with certified community
behavioral health clinics.
``(5) Other stakeholders, including demonstration planning
grant recipients and State Medicaid or behavioral health
officials, for the purpose of facilitating successful
implementation of the certified community behavioral health
clinic model.
``(b) Inclusions.--Assistance provided by the Secretary under
subsection (a) may include technical and nonfinancial assistance,
including--
``(1) fiscal and program management assistance;
``(2) operational and administrative support; and
``(3) information about the variety of resources available
under this part and how such resources best can be used to meet
the health and behavioral health needs of the communities
served by the entities.
``(c) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $8,000,000 for each of fiscal
years 2026 through 2030.''.
``SEC. 340J-3. DATA INFRASTRUCTURE FOR COMMUNITY BEHAVIORAL HEALTH
CLINIC REPORTING.
``(a) In General.--Not later than 180 days after the date of
enactment of this part, the Secretary shall establish a system under
which the Secretary collects and analyzes data on community behavioral
health clinics.
``(b) Scope of Data Collection.--The system established under
subsection (a) shall be used by the Secretary to collect and analyze
data from--
``(1) entities that receive a grant under section 340J-1;
and
``(2) organizations that provide certified community
behavioral health services, or have applied to provide such
services, under the Medicare program under title XVIII of the
Social Security Act or the Medicaid program under title XIX of
such Act.
``(c) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $51,000,000 for each of fiscal
years 2026 through 2030.''.
``SEC. 340J-4. CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC
ACCREDITATION.
``(a) Accreditation Standards.--A clinic may be accredited as a
certified community behavioral health clinic if the clinic--
``(1) meets the standards of an approved accreditation
body; and
``(2) 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.
``(b) Approval of Accreditation Bodies.--
``(1) In general.--The Secretary may approve a private
nonprofit organization to be an accreditation body for the
accreditation of certified community behavioral health clinics
under subsection (a) if--
``(A) 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;
``(B) the standards applied by the body in
determining whether or not to accredit a clinic
correspond to such criteria as are described in section
340J-1(b)(2), pursuant to the determination of the
Secretary, and are not less restrictive than such
criteria;
``(C) there is adequate provision for assuring that
the standards of the accreditation body continue to be
met by the clinic;
``(D) in the case of any clinic accredited, within
the prior 3 years, 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
``(E) 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.''.
HEALTH CLINIC CLINICIANS

bc9c0b33331f7ccbe3afb3b9d38a67bf5ca9d3bb5ed43c36b75b66e89e051166

CLINICIANS IN CERTIFIED COMMUNITY BEHAVIORAL HEALTH
CLINICS.
Section 224(g)(4) of the Public Health Service Act (42 U.S.C. 233)
is amended by adding at the end the following: ``or certified community
behavioral health clinic as defined in section 1905(jj)(2) of the
Social Security Act''.
<all>

94bf85140eabe860520ba637d400f80337092d4c4a552b04492ce58356d4f5b7

Ensuring Excellence in Mental Health Act — S. 3402

Other Sections

TITLE I

TITLE II

TITLE III

TITLE IV

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