[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 4312 Introduced in Senate (IS)]
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118th CONGRESS
2d Session
S. 4312
To establish a United States Senate Commission on Mental Health for the
purpose of providing to Congress and the President independent, expert
policy recommendations to improve access to and affordability of mental
health care services.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
May 9, 2024
Mr. Fetterman (for himself and Ms. Smith) introduced the following
bill; which was read twice and referred to the Committee on Health,
Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To establish a United States Senate Commission on Mental Health for the
purpose of providing to Congress and the President independent, expert
policy recommendations to improve access to and affordability of mental
health care services.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``United States Senate Commission on
Mental Health Act of 2024''.
SEC. 2. PURPOSES.
The purposes of this section are as follows:
(1) To establish the United States Senate Commission on
Mental Health to review available data, research, policies, and
other pertinent information regarding mental health care
services and delivery.
(2) To facilitate discussion among relevant stakeholders,
including Federal agencies, to understand what policies have
successfully improved mental health care services and delivery
and to develop recommendations for congressional and executive
action to improve access to, and affordability of, mental
health care services.
SEC. 3. ESTABLISHMENT OF UNITED STATES SENATE COMMISSION ON MENTAL
HEALTH.
(a) Establishment.--There is established a United States Senate
Commission on Mental Health (referred to in this Act as the
``Commission'').
(b) Purposes.--The purpose of the Commission is to provide Congress
and the President independent, expert policy recommendations to improve
mental health care services, including improving equitable access and
affordability.
(c) Membership.--
(1) In general.--The Commission shall be composed of 8
members, as follows:
(A) Six shall be Members of the Senate appointed by
the President of the Senate, of which--
(i) 3 shall be selected, after consultation
with the majority leader of the Senate, from
the majority party; and
(ii) 3 shall be selected, after
consultation with the minority leader of the
Senate, from the minority party.
(B) Two shall be experts with a demonstrated
academic and professional background in mental health
care, selected by the majority leader of the Senate,
after consultation with the minority leader of the
Senate.
(2) Period of appointment.--Each member of the Commission
shall be appointed for a term of 2 years.
(3) Chair and vice chair.--On the commencement of each 2-
year period of appointment of the members of the Commission,
the members of the Commission shall select a Chair from among
the members appointed under paragraph (1)(A)(i), and a Vice
Chair from among the members appointed under paragraph
(1)(A)(ii).
(4) No compensation.--The members of the Commission shall
serve without compensation for their work on the Commission.
(5) Travel expenses.--A member of the Commission shall be
allowed travel expenses, including per diem in lieu of
subsistence, at rates authorized for employees of agencies
under subchapter I of chapter 57 of title 5, United States
Code, while away from their homes or regular places of business
in the performance of services for the Commission.
(d) Retention of Support.--The Commission shall retain and make use
of such staff, materials, and infrastructure of the Senate as is
necessary to carry out the duties of the Commission.
(e) Meetings.--The Commission shall conduct meetings, not less
frequently than every 90 days, with relevant stakeholders across the
United States, including mental health care providers (such as
physicians, psychiatrists, psychologists, counselors, and therapists),
patients, and individuals representing advocacy groups, academic and
research institutions, nonprofit organizations, industry, and other
relevant stakeholders, as determined by the Commission.
(f) Vacancies.--A vacancy in the Commission--
(1) shall not affect the powers of the Commission; and
(2) shall be filled in the same manner as the original
appointment.
SEC. 4. DUTIES OF THE COMMISSION.
(a) In General.--The Commission shall study relevant issues
regarding mental health care services and delivery and issue reports,
as required under subsection (b).
(b) Topics Studied.--
(1) In general.--Each calendar year, the Commission shall
study specific topics relating to improving mental health care
services and delivery, including improving equitable access and
affordability with respect to such services, in accordance with
paragraphs (2) and (3), including by convening meetings
described in section 3(e).
(2) Initial topics.--In the first year following the
establishment of the Commission, the Commission shall consider
the following topics:
(A) Mental health care services coverage, including
mental health parity requirements, under the Medicare
program under title XVIII of the Social Security Act
(42 U.S.C. 1395 et seq.), the Medicaid program under
title XIX of such Act (42 U.S.C. 1396 et seq.), the
State Children's Health Insurance Program under title
XXI of such Act (42 U.S.C. 1397aa et seq.), and, as the
Commission determines appropriate, other health
programs administered by the Federal Government,
including--
(i) the extent to which mental health care
services are covered under such programs; and
(ii) the extent to which mental health
parity requirements applicable to such programs
are effective in meeting the mental health care
needs of patients.
(B) Reimbursement rates for mental health care
services with respect to mental health care providers,
including--
(i) the extent to which reimbursement rates
under the programs described in subparagraph
(A)(i), impact the affordability,
accessibility, and availability of mental
health care services;
(ii) how reimbursement rates for all mental
health care services differ from reimbursement
rates for physical health care services under
such programs; and
(iii) the probable impact of increasing the
rates of mental health reimbursement rates
under such programs, including the cost to the
Federal Government and the number of providers
and patients who would be impacted.
(C) Workforce challenges with respect to mental
health care providers, including--
(i) challenges and barriers that prevent
individuals, including students, from entering
mental health care professions;
(ii) challenges and barriers that students
enrolled in mental health care professional
training programs face while pursuing their
degrees;
(iii) the challenges and barriers
professors and staff in such training programs
face;
(iv) challenges and barriers mental health
care providers face; and
(v) factors that contribute to mental
health care providers leaving the field.
(3) Topics in subsequent years.--After the submission of
the first report under subsection (c) that addresses the topics
described in paragraph (2), the Commission shall consider such
topics each year as the Commission determines appropriate.
(4) Definition.--In this subsection, the term ``mental
health parity'' means--
(A) with respect to the Medicare program under
title XVIII of the Social Security Act (42 U.S.C. 1395
et seq.), and other applicable plans administered by
the Federal Government, efforts to ensure that
reimbursement rates for mental health care services are
equivalent to reimbursement rates for physical health
care services under such program or such plans; and
(B) with respect to the Medicaid program under
title XIX of such Act (42 U.S.C. 1396 et seq.) and the
State Children's Health Insurance Program under title
XXI of such Act (42 U.S.C. 1397aa et seq.), the
requirements set forth in the rule titled ``Medicaid
and Children's Health Insurance Programs; Mental Health
Parity and Addiction Equity Act of 2008; the
Application of Mental Health Parity Requirements to
Coverage Offered by Medicaid Managed Care
Organizations, the Children's Health Insurance Program
(CHIP), and Alternative Benefit Plans'' (81 Fed. Reg.
18390).
(c) Annual Report.--
(1) In general.--Not later than January 1 each year,
beginning with the first year that begins at least 2 years
after the date of enactment of this Act, the Commission shall
submit to Congress, the Secretary of Health and Human Services,
and, as appropriate, the heads of other relevant Federal
agencies a report, based on the studies carried out under
subsection (b), regarding the state of mental health care
services and delivery, including a needs and gap assessment
across the continuum of mental health care. Each report shall
include--
(A) an analysis of the current barriers to
accessing affordable and equitable mental health care
services, challenges facing the mental health care
workforce, and successful efforts by State, local, or
Tribal entities to improve mental health care services
and delivery; and
(B) policy recommendations for legislative and
administrative actions to address issues identified
through the report.
(2) Contents of report.--Each report submitted under
paragraph (1) shall include a discussion of the topics
considered under subsection (b) for the applicable year and the
following:
(A) The most current and comprehensive data and
research on the state of mental health care in the
United States, including barriers to accessing mental
health care.
(B) A comprehensive needs and gap assessment across
the continuum of mental health care services, using
disaggregated data, for--
(i) different age groups, such as for
children, adolescents, adults, and older
adults;
(ii) student status, for each of the
primary, secondary, and postsecondary levels;
(iii) people with disabilities;
(iv) individuals with co-morbidities,
including substance use;
(v) racial and ethnic minorities;
(vi) LGBTQ+ individuals;
(vii) individuals residing in rural
communities; and
(viii) members of Tribal communities.
(C) Prioritizing health equity through building and
maintaining a culturally competent and diverse mental
health care workforce across the continuum of care.
SEC. 5. TERMINATION OF COMMISSION.
The Commission shall terminate 10 years after the date of enactment
of this Act.
SEC. 6. AUTHORIZATION OF APPROPRIATIONS.
To carry out this Act, there is authorized to be appropriated such
sums as may be necessary for each of fiscal years 2025 through 2034.
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