Crisis Care Improvement and Suicide Prevention Act of 2020

II 116TH CONGRESS 2D SESSION S. 4282 To amend the Community Mental Health Service Block Grant to authorize a set-aside for crisis care services, and for other purposes. IN THE SENATE OF THE UNITED STATES JULY 22, 2020 Mr. MANCHIN (for himself and Mr. GARDNER) introduced the following bill; which was read twice and referred to the Committee on Health, Edu- cation, Labor, and Pensions A BILL To amend the Community Mental Health Service Block Grant to authorize a set-aside for crisis care services, and for other purposes. 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 ‘‘Crisis Care Improve- 4 ment and Suicide Prevention Act of 2020’’. 5 SEC. 2. FINDINGS AND SENSE OF CONGRESS. 6 (a) FINDINGS.—Congress finds the following: 7 (1) Fragmentation of mental health services 8 and limited access to crisis services complicates and 9 VerDate Sep 11 2014 05:14 Aug 07, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S4282.IS S4282 SSpencer on DSK126QN23PROD with BILLS 2 •S 4282 IS elongates mental health patient stays in emergency 1 departments and under the custody of law enforce- 2 ment. 3 (2) Emergency departments and the criminal 4 justice system do not have the capacity with existing 5 resources and health care professional shortages to 6 address the needs of the rapidly growing number of 7 individuals with mental health conditions, increasing 8 the risk of adverse patient outcomes. 9 (3) In 2017, 150,000 individuals in the United 10 States died from alcohol and drug-induced fatalities 11 and suicides. Nearly 1⁄3, or more than 47,000 were 12 suicides. 13 (4) From 2016 to 2018, more than 1⁄4 of hos- 14 pital emergency department ‘‘frequent users’’ in Illi- 15 nois were patients with presenting or underlying 16 mental health conditions, underscoring the need for 17 additional funding, continued access to real-time 18 care and connection to long-term treatment options. 19 (5) Fifteen percent of men and 30 percent of 20 women in custody of county jails have severe mental 21 illnesses. 22 (6) Use of appropriate crisis facilities and inter- 23 ventions in Maricopa County, Arizona, have saved 24 emergency departments an estimated $37,000,000 in 25 VerDate Sep 11 2014 05:14 Aug 07, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S4282.IS S4282 SSpencer on DSK126QN23PROD with BILLS 3 •S 4282 IS 2016 and saved the equivalent of 37 police officer 1 full-time equivalent salaries. 2 (b) SENSE OF CONGRESS.—It is the sense of Con- 3 gress that— 4 (1) for patients with mental health issues, co- 5 ordination of physical and mental health services 6 and cooperation with law enforcement are essential 7 to ensure timely, appropriate care; and 8 (2) crisis care networks established at State 9 and local levels have saved resources and shown im- 10 proved outcomes for patients in crisis. 11 SEC. 3. EVIDENCE-BASED CRISIS CARE PROGRAMS. 12 (a) IN GENERAL.—Section 1912(b)(1) of the Public 13 Health Service Act (42 U.S.C. 300x–1(b)(1))— 14 (1) in subparagraph (A)— 15 (A) by redesignating clauses (vi) and (vii) 16 as clauses (vii) and (viii), respectively; and 17 (B) by inserting after clause (v), the fol- 18 lowing: 19 ‘‘(vi) include a description of how the 20 State supports evidenced-based programs 21 that address the crisis care needs of indi- 22 viduals with serious mental disorders, and 23 children with serious mental and emotional 24 disturbances, that include at least one of 25 VerDate Sep 11 2014 05:14 Aug 07, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S4282.IS S4282 SSpencer on DSK126QN23PROD with BILLS 4 •S 4282 IS the core components specified in subpara- 1 graph (F); ’’; and 2 (2) by adding at the end the following: 3 ‘‘(F) CORE COMPONENTS FOR CRISIS CARE 4 SERVICES.—The core components of a program 5 referred to in subparagraph (A)(vi) include the 6 following: 7 ‘‘(i) Crisis call centers. 8 ‘‘(ii) 24/7 mobile crisis services. 9 ‘‘(iii) Crisis stabilization programs of- 10 fering acute care or sub-acute care in a 11 hospital or appropriately licensed facility, 12 with referrals to inpatient or outpatient 13 care, as determined by the Assistant Sec- 14 retary for Mental Health and Substance 15 Use.’’. 16 (b) SET-ASIDE FOR EVIDENCE-BASED CRISIS CARE 17 SERVICES.—Section 1920 of the Public Health Service 18 Act (42 U.S.C. 300x–9) is amended by adding at the end 19 the following: 20 ‘‘(d) CRISIS CARE.— 21 ‘‘(1) IN GENERAL.—Except as provided in para- 22 graph (3), a State shall expend at least 5 percent of 23 the allotment of the State pursuant to a funding 24 agreement under section 1911 for each fiscal year to 25 VerDate Sep 11 2014 05:14 Aug 07, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S4282.IS S4282 SSpencer on DSK126QN23PROD with BILLS 5 •S 4282 IS support programs described in section 1 1912(b)(1)(A)(vi). 2 ‘‘(2) STATE FLEXIBILITY.—In lieu of expending 3 5 percent of the State’s allotment for a fiscal year 4 as required by paragraph (1), a State may elect to 5 expend not less than 10 percent of such amount by 6 the end of 2 consecutive fiscal years. 7 ‘‘(3) FUNDING CONTINGENCY.—Paragraph (1) 8 shall not apply with respect to a fiscal year unless 9 the amount made available to carry out this section 10 for that fiscal year exceeds the amount appropriated 11 to carry out this section for fiscal year 2020 by at 12 least $35,000,000.’’. 13 Æ VerDate Sep 11 2014 05:14 Aug 07, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6301 E:\BILLS\S4282.IS S4282 SSpencer on DSK126QN23PROD with BILLS