42 U.S. Code § 290bb–42 - Integration incentive grants and cooperative agreements

(a) Definitions

In this section:

(1) Eligible entity

The term “eligible entity” means a State, or other appropriate State agency, in collaboration with 1 or more qualified community programs as described in section 300x–2(b)(1) of this title or 1 or more community health centers as described in section 254b of this title.

(2) Integrated care

The term “integrated care” means collaborative models or practices offering mental and physical health services, which may include practices that share the same space in the same facility.

(3) Special population

The term “special population” means—

(A) adults with a mental illness who have co-occurring physical health conditions or chronic diseases;

(B) adults with a serious mental illness who have co-occurring physical health conditions or chronic diseases;

(C) children and adolescents with a serious emotional disturbance with co-occurring physical health conditions or chronic diseases; or

(D) individuals with a substance use disorder.

(b) Grants and cooperative agreements

(1) In general

The Secretary may award grants and cooperative agreements to eligible entities to support the improvement of integrated care for primary care and behavioral health care in accordance with paragraph (2).

(2) Purposes

A grant or cooperative agreement awarded under this section shall be designed to—

(A) promote full integration and collaboration in clinical practices between primary and behavioral health care;

(B) support the improvement of integrated care models for primary care and behavioral health care to improve the overall wellness and physical health status of adults with a serious mental illness or children with a serious emotional disturbance; and

(C) promote integrated care services related to screening, diagnosis, prevention, and treatment of mental and substance use disorders, and co-occurring physical health conditions and chronic diseases.

(c) Applications

(1) In general

An eligible entity seeking a grant or cooperative agreement under this section shall submit an application to the Secretary at such time, in such manner, and accompanied by such information as the Secretary may require, including the contents described in paragraph (2).

(2) Contents

The contents described in this paragraph are—

(A) a description of a plan to achieve fully collaborative agreements to provide services to special populations;

(B) a document that summarizes the policies, if any, that serve as barriers to the provision of integrated care, and the specific steps, if applicable, that will be taken to address such barriers;

(C) a description of partnerships or other arrangements with local health care providers to provide services to special populations;

(D) an agreement and plan to report to the Secretary performance measures necessary to evaluate patient outcomes and facilitate evaluations across participating projects; and

(E) a plan for sustainability beyond the grant or cooperative agreement period under subsection (e).

(d) Grant and cooperative agreement amounts

(1) Target amount

The target amount that an eligible entity may receive for a year through a grant or cooperative agreement under this section shall be $2,000,000.

(2) Adjustment permitted

The Secretary, taking into consideration the quality of the application and the number of eligible entities that received grants under this section prior to December 13, 2016, may adjust the target amount that an eligible entity may receive for a year through a grant or cooperative agreement under this section.

(3) Limitation

An eligible entity receiving funding under this section may not allocate more than 10 percent of funds awarded under this section to administrative functions, and the remaining amounts shall be allocated to health facilities that provide integrated care.

(e) Duration

A grant or cooperative agreement under this section shall be for a period not to exceed 5 years.

(f) Report on program outcomes

An eligible entity receiving a grant or cooperative agreement under this section shall submit an annual report to the Secretary that includes—

(1) the progress made to reduce barriers to integrated care as described in the entity’s application under subsection (c); and

(2) a description of functional outcomes of special populations, including—

(A) with respect to adults with a serious mental illness, participation in supportive housing or independent living programs, attendance in social and rehabilitative programs, participation in job training opportunities, satisfactory performance in work settings, attendance at scheduled medical and mental health appointments, and compliance with prescribed medication regimes;

(B) with respect to individuals with co-occurring mental illness and physical health conditions and chronic diseases, attendance at scheduled medical and mental health appointments, compliance with prescribed medication regimes, and participation in learning opportunities related to improved health and lifestyle practices; and

(C) with respect to children and adolescents with a serious emotional disturbance who have co-occurring physical health conditions and chronic diseases, attendance at scheduled medical and mental health appointments, compliance with prescribed medication regimes, and participation in learning opportunities at school and extracurricular activities.

(g) Technical assistance for primary-behavioral health care integration

(1) In general

The Secretary may provide appropriate information, training, and technical assistance to eligible entities that receive a grant or cooperative agreement under this section, in order to help such entities meet the requirements of this section, including assistance with—

(A) development and selection of integrated care models;

(B) dissemination of evidence-based interventions in integrated care;

(C) establishment of organizational practices to support operational and administrative success; and

(D) other activities, as the Secretary determines appropriate.

(2) Additional dissemination of technical information

The information and resources provided by the Secretary under paragraph (1) shall, as appropriate, be made available to States, political subdivisions of States, Indian tribes or tribal organizations (as defined in section 5304 of title 25), outpatient mental health and addiction treatment centers, community mental health centers that meet the criteria under section 300x–2(c) of this title, certified community behavioral health clinics described in section 223 of the Protecting Access to Medicare Act of 2014, primary care organizations such as Federally qualified health centers or rural health clinics as defined in section 1395x(aa) of this title, other community-based organizations, or other entities engaging in integrated care activities, as the Secretary determines appropriate.

(h) Authorization of appropriations

To carry out this section, there are authorized to be appropriated $51,878,000 for each of fiscal years 2018 through 2022.

(July 1, 1944, ch.373, title V, § 520K, as added Pub. L. 111–148, title V, § 5604, Mar. 23, 2010, 124 Stat. 679; amended Pub. L. 114–255, div. B, title IX, § 9003, Dec. 13, 2016, 130 Stat. 1235.)

References in Text

Section 223 of the Protecting Access to Medicare Act of 2014, referred to in subsec. (g)(2), is section 223 of Pub. L. 113–93, which is set out as a note under section 1396a of this title.

Amendments

2016—Pub. L. 114–255 amended section generally. Prior to amendment, section related to awards for co-locating primary and specialty care in community-based mental health settings.