II 118TH CONGRESS 1ST SESSION S. 1774 To amend the Social Security Act to provide for an increased Federal medical assistance percentage for State expenditures on certain behavioral health services furnished under the Medicaid program, and for other purposes. IN THE SENATE OF THE UNITED STATES MAY 31 (legislative day, MAY 30), 2023 Mr. WARNOCK (for himself, Ms. STABENOW, Mr. BOOKER, Mr. PADILLA, Mr. CARPER, Ms. WARREN, and Mr. FETTERMAN) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend the Social Security Act to provide for an increased Federal medical assistance percentage for State expendi- tures on certain behavioral health services furnished under the Medicaid program, 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 ‘‘Advancing Student 4 Services In Schools Today Act’’ or the ‘‘ASSIST Act’’. 5 VerDate Sep 11 2014 02:42 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1774.IS S1774 kjohnson on DSK79L0C42PROD with BILLS 2 •S 1774 IS SEC. 2. INCREASING THE APPLICABLE FMAP FOR STATE 1 EXPENDITURES ATTRIBUTABLE TO CERTAIN 2 BEHAVIORAL HEALTH SERVICES. 3 Section 1905 of the Social Security Act (42 U.S.C. 4 1396d) is amended— 5 (1) in subsection (b), by striking ‘‘and (ii)’’ and 6 inserting ‘‘(ii), and (jj)’’; and 7 (2) by adding at the end the following new sub- 8 section: 9 ‘‘(jj) INCREASED FMAP FOR MEDICAL ASSISTANCE 10 FOR SERVICES FURNISHED BY MENTAL HEALTH AND 11 SUBSTANCE USE DISORDER CARE PROVIDERS IN CER- 12 TAIN SCHOOL-BASED SETTINGS.— 13 ‘‘(1) IN GENERAL.—Notwithstanding any pre- 14 ceding provision of this section, with respect to State 15 expenditures for medical assistance consisting of 16 services provided by a mental health and substance 17 use disorder care provider (as defined in section 3 18 of the Advancing Student Services In Schools Today 19 Act) and furnished at a school or at a school-based 20 health center (as defined in section 399Z–1(a)(3) of 21 the Public Health Service Act) on or after the first 22 day of the first calendar quarter beginning on or 23 after the date that is 12 months after the date of 24 the enactment of this subsection, the Federal med- 25 ical assistance percentage otherwise determined 26 VerDate Sep 11 2014 02:42 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1774.IS S1774 kjohnson on DSK79L0C42PROD with BILLS 3 •S 1774 IS under subsection (b) shall, subject to paragraph (2), 1 be equal to 90 percent. 2 ‘‘(2) APPLICATION OF HIGHER MATCH.—Para- 3 graph (1) shall not apply in the case of State ex- 4 penditures described in such paragraph if applica- 5 tion of such paragraph would result in a lower Fed- 6 eral medical assistance percentage for such expendi- 7 tures than would otherwise apply without application 8 of such paragraph. 9 ‘‘(3) EXCLUSION OF EXPENDITURES FROM TER- 10 RITORIAL CAP.—Any payment made to a territory 11 for expenditures for medical assistance described in 12 paragraph (1) that are subject to the Federal med- 13 ical assistance percentage specified under such para- 14 graph shall not be taken into account for purposes 15 of applying payment limits under subsections (f) and 16 (g) of section 1108 to the extent that such payment 17 exceeds the amount of the payment that would have 18 been made to the territory for such expenditures 19 without regard to this subsection.’’. 20 VerDate Sep 11 2014 02:42 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1774.IS S1774 kjohnson on DSK79L0C42PROD with BILLS 4 •S 1774 IS SEC. 3. PROGRAM TO INCREASE MENTAL HEALTH AND 1 SUBSTANCE USE DISORDER CARE PRO- 2 VIDERS IN SCHOOLS AND SCHOOL-BASED 3 HEALTH CENTERS. 4 (a) FINDINGS.—Congress finds that the lack of ac- 5 cess to mental health and substance use disorder care in 6 schools and school-based health centers has a negative im- 7 pact on the health of children in the United States, includ- 8 ing children who are eligible for coverage under the Med- 9 icaid and Children’s Health Insurance Program. 10 (b) GRANT AUTHORITY.—Not later than 12 months 11 after the date of enactment of this Act, the Secretary of 12 Health and Human Services (referred to in this section 13 as the ‘‘Secretary’’), in consultation with the Adminis- 14 trator of the Centers for Medicare & Medicaid Services 15 and the Secretary of Education, shall award grants, con- 16 tracts, or cooperative agreements to eligible entities to in- 17 crease the number of mental health and substance use dis- 18 order care providers in schools and school-based health 19 centers served by such entities. 20 (c) APPLICATION.—An eligible entity seeking an 21 award under this section shall submit an application to 22 the Secretary at such time, in such manner, and con- 23 taining such information as the Secretary may require, in- 24 cluding a description of— 25 VerDate Sep 11 2014 02:42 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1774.IS S1774 kjohnson on DSK79L0C42PROD with BILLS 5 •S 1774 IS (1) the mental health and substance use dis- 1 order needs of the student population served by the 2 eligible entity; and 3 (2) with respect to the student population 4 served by the eligible entity, how the eligible entity 5 will ensure that the mental health and substance use 6 disorder care providers supported by the eligible en- 7 tity, and the services administered by such pro- 8 viders, are culturally competent and linguistically 9 appropriate. 10 (d) RESTRICTION.—No funds made available through 11 an award under this section may be used for a threat as- 12 sessment team. 13 (e) REPORTING.— 14 (1) ELIGIBLE ENTITY REPORTING.—Eligible 15 entities receiving an award under this section shall 16 submit an annual report to the Secretary accom- 17 panied by such information as the Secretary may re- 18 quire, including— 19 (A) the number of mental health and sub- 20 stance use disorder care providers working at 21 the schools or school-based health centers 22 served by the eligible entity, and the number of 23 such providers supported through the award; 24 VerDate Sep 11 2014 02:42 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1774.IS S1774 kjohnson on DSK79L0C42PROD with BILLS 6 •S 1774 IS (B) the types of services provided by the 1 mental health and substance use disorder care 2 providers and the efficacy of such services; 3 (C) the practices used by the schools or 4 school-based health centers served by the eligi- 5 ble entity to recruit and retain mental health 6 and substance use disorder care providers; and 7 (D) the rates of retention of mental health 8 and substance use disorder care providers at 9 the school or school-based health center. 10 (2) SECRETARY.—Not later than 18 months 11 after the date of enactment of this section, and every 12 5 years thereafter, the Secretary shall submit to 13 Congress a report on the effectiveness of the awards 14 under this section. 15 (f) DEFINITIONS.—In this section: 16 (1) ELIGIBLE ENTITY.—The term ‘‘eligible enti- 17 ty’’ means— 18 (A) a local educational agency, as defined 19 in section 8101 of the Elementary and Sec- 20 ondary Education Act of 1965 (20 U.S.C. 21 7801); 22 (B) an institution of higher education, as 23 defined in section 101 of the Higher Education 24 Act of 1965 (20 U.S.C. 1001); 25 VerDate Sep 11 2014 02:42 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1774.IS S1774 kjohnson on DSK79L0C42PROD with BILLS 7 •S 1774 IS (C) a school operated by the Bureau of In- 1 dian Affairs; or 2 (D) a school-based health center, as de- 3 fined in section 399Z–1(a)(3) of the Public 4 Health Service Act (42 U.S.C. 280h–5(a)(3)). 5 (2) MENTAL HEALTH AND SUBSTANCE USE 6 DISORDER CARE PROVIDER.—The term ‘‘mental 7 health and substance use disorder care provider’’ 8 means an individual who is licensed or credentialed 9 to provide mental health and substance use disorder 10 services, including— 11 (A) a school counselor; 12 (B) a school psychologist or any other psy- 13 chologist; 14 (C) a psychiatrist who specializes in child 15 or adolescent psychiatry; 16 (D) a school social worker; 17 (E) a peer support specialist or peer recov- 18 ery coach; 19 (F) a licensed clinical social worker; 20 (G) an addiction medicine specialist; and 21 (H) other providers, as the Secretary de- 22 termines appropriate. 23 Æ VerDate Sep 11 2014 02:42 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6301 E:\BILLS\S1774.IS S1774 kjohnson on DSK79L0C42PROD with BILLS