Improving Mental Health Access from the Emergency Department

II 116TH CONGRESS 1ST SESSION S. 1334 Authorizing a program to promote innovative approaches to securing prompt access to appropriate care for individuals presenting at emergency depart- ments with acute mental health illness. IN THE SENATE OF THE UNITED STATES MAY 6, 2019 Mrs. CAPITO (for herself and Ms. HASSAN) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL Authorizing a program to promote innovative approaches to securing prompt access to appropriate care for individ- uals presenting at emergency departments with acute mental health illness. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Improving Mental 4 Health Access from the Emergency Department’’. 5 VerDate Sep 11 2014 00:41 May 11, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 \\ALPHA3\E\BILLS\S1334.IS S1334 kjohnson on DSK79L0C42 with BILLS 2 •S 1334 IS SEC. 2. PROGRAM TO SUPPORT ACCESS TO APPROPRIATE 1 CARE FOR INDIVIDUALS PRESENTING AT 2 EMERGENCY DEPARTMENTS WITH ACUTE 3 MENTAL HEALTH ILLNESS. 4 Subpart 3 of part B of title V of the Public Health 5 Service Act (42 U.S.C. 290bb–31 et seq.) is amended by 6 adding at the end the following: 7 ‘‘SEC. 520N. SECURING APPROPRIATE CARE FOR ACUTE 8 MENTAL HEALTH ILLNESS FOLLOWING AN 9 EMERGENCY DEPARTMENT ENCOUNTER. 10 ‘‘(a) IN GENERAL.—The Secretary, acting through 11 the Director of the Center for Mental Health Services, 12 may award grants on a competitive basis to eligible enti- 13 ties to implement innovative approaches to securing 14 prompt access to appropriate follow-on care for individuals 15 experiencing acute mental health episodes and presenting 16 for care in emergency departments. 17 ‘‘(b) ELIGIBLE ENTITIES.—To be eligible to receive 18 a grant under this section, an entity shall be a health care 19 facility licensed under applicable law that— 20 ‘‘(1) has an emergency department; 21 ‘‘(2) is staffed by medical personnel (which may 22 include emergency physicians, psychiatrists, psy- 23 chiatric registered nurses, mental health technicians, 24 clinical social workers, psychologists, and therapists) 25 capable of providing treatment focused on stabilizing 26 VerDate Sep 11 2014 00:41 May 11, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 \\ALPHA3\E\BILLS\S1334.IS S1334 kjohnson on DSK79L0C42 with BILLS 3 •S 1334 IS acute mental health conditions and assisting individ- 1 uals to access resources to continue treatment in the 2 least restrictive appropriate setting; and 3 ‘‘(3) has arrangements in place with other pro- 4 viders of care that can provide a full range of medi- 5 cally appropriate, evidence-based services for the 6 treatment of acute mental health episodes. 7 ‘‘(c) USE OF FUNDS.—An entity receiving a grant 8 under this section shall use funds received under such 9 grant to create, support, or expand programs or projects 10 intended to assist individuals who are treated at its emer- 11 gency department for acute mental health episodes and 12 to expeditiously transition such individuals to an appro- 13 priate facility or setting for follow-on care. Such uses may 14 include any of the following: 15 ‘‘(1) Emergency department evaluation, treat- 16 ment, stabilization, observation, and referral (includ- 17 ing implementation of validated screening tools). 18 ‘‘(2) Expediting placement in appropriate facili- 19 ties through activities such as expanded coordination 20 with regional service providers, assessment, peer 21 navigators, bed availability tracking and manage- 22 ment, transfer protocol development, networking in- 23 frastructure development, and transportation serv- 24 ices. 25 VerDate Sep 11 2014 00:41 May 11, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 \\ALPHA3\E\BILLS\S1334.IS S1334 kjohnson on DSK79L0C42 with BILLS 4 •S 1334 IS ‘‘(3) Increasing the supply of inpatient psy- 1 chiatric beds and alternative care settings such as 2 regional emergency psychiatric facilities. 3 ‘‘(4) Use of alternative approaches to providing 4 psychiatric care in the emergency department set- 5 ting, including through tele-psychiatric support and 6 other remote psychiatric consultation, implementa- 7 tion of peak period crisis clinics, or creation of psy- 8 chiatric emergency service units. 9 ‘‘(5) Such other activities as the Secretary may 10 determine appropriate. 11 ‘‘(d) APPLICATION.—An eligible entity desiring a 12 grant under this section shall prepare and submit an ap- 13 plication to the Secretary at such time and in such manner 14 as the Secretary may require. At a minimum, the applica- 15 tion shall include the following: 16 ‘‘(1) A description of identified need for acute 17 mental health services in the entity’s service area. 18 ‘‘(2) A description of the existing efforts of the 19 entity to meet the need for acute mental health serv- 20 ices in the service area, and identified gaps in the 21 provision of such services. 22 ‘‘(3) A description of the proposed use of funds 23 to meet the needs and gaps identified under para- 24 graph (2). 25 VerDate Sep 11 2014 00:41 May 11, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 \\ALPHA3\E\BILLS\S1334.IS S1334 kjohnson on DSK79L0C42 with BILLS 5 •S 1334 IS ‘‘(4) A description of how the entity will coordi- 1 nate its efforts with Federal, State, local, and pri- 2 vate entities within the service area. 3 ‘‘(5) A description of program objectives, how 4 the objectives are proposed to be met, and how the 5 provider will evaluate outcomes relative to objectives. 6 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—For the 7 purpose of carrying out this section, there are authorized 8 to be appropriated $15,000,000 for each of fiscal years 9 2021 through 2025.’’. 10 Æ VerDate Sep 11 2014 00:41 May 11, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6301 \\ALPHA3\E\BILLS\S1334.IS S1334 kjohnson on DSK79L0C42 with BILLS