21st Century Cures Act (Public Law 114-255)

A detailed overview of this bill is scheduled to be provided in the September Interim.

Summary:

The 21st Century Cures Act is a United States law enacted by the 114th United States Congress in

December 2016. It authorized $6.3 billion in funding. The bill included the Helping Families In Mental

Health Crisis Act, increases the availability of psychiatric hospital beds, establish a new assistant

secretary for mental health and substance use disorders in the Department of Health and Human

Services (HHS), and boost treatment for young mental health patients, among other provisions. This

mental health component was the most significant attempt at mental health reform in decades.

National Association of State Alcohol and Drug Abuse Directors (NASADAD) Synopsis can be found at:

http://nasadad.org/wp-content/uploads/2017/02/21st-Century-Cures-Section-by-Section.pdf

General Sections Section 6001: Assistant Secretary for Mental Health and Substance Use Section 6002: Strengthening Leadership of the Substance Abuse and Mental Health Services Administration Section 6003: Chief Medical Officer Section 6004: Improving the Quality of Behavioral Health Programs Section 6005: Strategic Plan by Sept 30, 2018 Section 6006: Biennial Report Concerning Activities and Progress Section 6007: Authorities of Centers for Mental Health Services, Substance Abuse Prevention, and Substance Abuse Treatment (adding requirements for collaboration with other related federal agencies NIMH, CSAP, NIDA, NIAAA, CDC, CSAT) Section 6008: Advisory Councils (Addition of new Members) Section 6009: Peer Review (review of Grants by professional experts) Section 6031: Interdepartmental Serious Mental Illness Coordinating Committee (research, evaluation focus on outcomes for Suicide, Crisis, homelessness, unemployment and quality of treatment) Section 7001: Encouraging Innovation and Evidence-Based Programs (establishes a National Mental Health and Substance Use Policy Laboratory. No later than January 1, 2018) Section 7002: Promoting Access to Information on Evidence-Based Programs and Practices Section 7003: Priority Mental Health Needs of Regional and National Significance Section 8001: Community Mental Health Services Block Grant (adding plan requirements for: community-based systems of care, quality/effectiveness/efficiency, evidence-based practice, case management, enhancing individual, family and caregiver communication, reducing high levels of care, Primary and mental health care integration, promoting recovery and recovery support services) Section 8004: Study of Distribution of Funds under the Substance Use Disorder Prevention and Treatment Block Grant and the Community Mental Health Service Block Grant Section 9001: Grants for Treatment and Recovery for Homeless Individuals (reduces funding from $50,000,000 to $41,304,000) *all budget changes yearly for FFY 2018-2022 Section 9002: Grants for Jail Diversion Programs (reduces funding from $10,000,000 to $4,269,000) Section 9003: Promoting Integration of Primary and Behavioral Health Care (Adds $51,878,000 in grants for Integration) Section 9004: Projects for Assistance in Transition from Homelessness (Adds $64,635,000 in grants) Section 9005: National Suicide Prevention Lifeline Program (appropriâtes $7,198,000)

Section 9006: Connecting Individuals and Families with Care (Nationwide informational telephone number connecting to local providers, searchable website) Section 9007: Strengthening Community Crisis Response Systems (Competitive Grants $12,500,000) Section 9008: Garrett Lee Smith Memorial Act Reauthorization (creates a Suicide Prevention Technical Assistance Center, $5,988,000, focused on high risk populations all ages) Section 9009: Adult Suicide Prevention (Grants authorized $30,000,000) Section 9010: Mental Health Awareness Training Grants (Focus on Teachers and School training grants youth mental health and crisis de-escalation, $14,693,000) Section 9011: Sense of Congress on Prioritizing Native American Youth and Suicide Prevention Programs Section 9012: Evidence-Based Practices for Older Adults Section 9013: National Violent Death Reporting System Section 9014: Assisted Outpatient Treatment ($15 million for each of fiscal years 2015-2017, $20 million for FY 2018, $19 million for each of fiscal years 2019 and 2020, and $18 million for each of fiscal years 2021 and 2022) *Utah Already awarded multi-year grant Section 9015: Assertive Community Treatment Grant Program (focus on reducing hospitalization, homelessness, and criminal justice involvement and improving health and social outcomes. $5,000,000) Higher Ed and Training – Workforce Development Section 9021: Mental and Behavioral Health Education and Training Grants (Higher Education and Professional Training grants, $50,000,000) Section 9022: Strengthening the Mental and Substance Use Disorders Workforce (Medical Resident Training/Education Higher Ed, $10,000,000) Section 9023: Clarification on Current Eligibility for Loan Repayment Programs Section 9024: Minority Fellowship Program Section 9025: Liability Protections for Health Professional Volunteers at Community Health Centers Section 9031: Mental Health and Substance Use Disorder Services on Campus (grants $7,000,000) Section 9032: Interagency Working Group on College Mental Health ($1,000,000) Section 9033: Improving Mental Health on College Campuses ($1,000,000) Children and Adolescents Section 10001: Programs for Children with a Serious Emotional Disturbance (Can now serve up to age 21, Grants $119,026,000) Section 10002: Increasing Access to Pediatric Mental Health Care (includes telehealth grants $9,000,000, 20% match requirement) Section 10003: Substance Use Disorder Treatment and Early Intervention Services for Children and Adolescents (early identification and treatment also for pregnant and parenting mothers, grants $29,605,000) Section 10004: Children’s Recovery from Trauma (grants $46,887,000) Section 10005: Screening and Treatment for Maternal Depression (high interest in Utah to apply for this grant when it is released, $5,000,000) Section 10006: Infant and Early Childhood Prevention, Intervention, and Treatment (grants $20,000,000) HIPAA Section 11002: Confidentiality of Records (convene relevant stakeholders to determine the effect of 42 CFR Part 2 regulations on patient care, outcomes, and privacy.) Section 11003: Clarification of Circumstances under Which Disclosure of Protected Health Information is Permitted (promulgate final regulations clarifying under which circumstances a healthcare provider or covered entity may disclose the protected health information of a patient with a mental illness)

Section 11004: Development and Dissemination of Model Training Programs (authorizes $4 million for FY 2018, $2 million for each of fiscal years 2019 and 2020, and $1 million for each of fiscal years 2021 and 2022) Medicaid Section 12001: Rule of Construction Related to Medicaid Coverage of Mental Health Services and Primary Care Services Furnished on the Same Day Section 12002: Study and Report Related to Medicaid Managed Care Regulation Section 12004: Study and Report on Medicaid Emergency Psychiatric Demonstration Project (Review/Study of Institutions for Mental Disease (IMDs)) Section 12005: Providing EPSDT Services to Children in IMDs (Early and periodic screening, diagnostic and treatment services) Mental Health Parity Section 13001: Enhanced Compliance with Mental Health and Substance Use Disorder Coverage Requirements Section 13002: Action Plan for Enhanced Enforcement of Mental Health and Substance Use Disorder Coverage Section 13003: Report on Investigation Regarding Parity in Mental Health and Substance Use Disorder Benefits Section 13004: GAO Study on Parity in Mental Health and Substance Use Disorder Benefits Section 13005: Information and Awareness on Eating Disorders Section 13006: Education and Training on Eating Disorders Section 13007: Clarification of Existing Parity Rules (Eating Disorders) Safe Communities / Law Enforcement Section 14001: Law Enforcement Grants for Crisis Intervention Teams, Mental Health Purposes (amends the Omnibus Crime Control and Safe Streets Act by adding “mental health programs and related law enforcement and corrections programs, including behavioral programs and crisis intervention teams”) Section 14002: Assisted Outpatient Treatment Programs (amends the Omnibus Crime Control and Safe Streets Act by amending the services for which mental health court grant funds can be used) Section 14003: Federal Drug and Mental Health Courts (Pilot Programs on Federal Level required) Section 14004: Mental Health in the Judicial System (Grant programs for pre-trial mental health programs and behavioral health screening and assessment in State and local criminal justice systems. No amount specified) Section 14005: Forensic Assertive Community Treatment Initiatives (amends the Omnibus Crime Control and Safe Streets Act of 1968 by adding a new program, Forensic Assertive Community Treatment (FACT)) Section 14006: Assistance for Individuals Transitioning Out of Systems (amends to include in the Omnibus Crime Control and Safe Streets Act of 1968) Section 14007: Co-occurring Substance Abuse and Mental Health Challenges in Drug Courts Section 14008: Mental Health Training for Federal Uniformed Services (mandates coordination of federal agencies and data systems on a federal level) Section 14009: Advancing Mental Health as Part of Offender Reentry (Omnibus Crime Control and Safe Streets Act amendment to prioritize Reentry) Section 14010: School Mental Health Crisis Intervention Teams (Amends VALOR Act in DOJ for safety training for law enforcement) Section 14011: Active Shooter Training for Law Enforcement

Section 14012: Co-occurring Substance Abuse and Mental Health Challenges in Substance Abuse Treatment Programs (Amends Omnibus Act refocusing Grant funds) Section 14013: Mental Health and Drug Treatment Alternatives to Incarceration Programs (Amends Omnibus Act refocusing Grant funds) Section 14014: National Criminal Justice and Mental Health Training and Technical Assistance (Amends Omnibus Act refocusing Grant funds) Section 14015: Improving Department of Justice Data Collection on Mental Illness Involved in Crime Section 14016: Reports on the Number of Mentally Ill Offenders in Prison Section 14021: Sequential Intercept Model (Amends Omnibus Act refocusing Grant funds) Section 14022: Prison and Jails (Amends Omnibus Act refocusing Grant funds) Section 14024: Law Enforcement Training (Amends Omnibus Act refocusing Grant funds)