Crisis Response Continuum of Care
[Pub. L. 117–328, div. FF, title I, § 1102], Dec. 29, 2022, [136 Stat. 5635], provided that:“(a)
In General.—
The Secretary, acting through the Assistant Secretary for Mental Health and Substance Use, shall facilitate the identification and publication of best practices for a crisis response continuum of care related to mental health and substance use disorders for use by health care providers, crisis services administrators, and crisis services providers in responding to individuals (including children and adolescents) experiencing mental health crises, substance-related crises, and crises arising from co-occurring disorders.
“(b)
Best Practices.—
“(1)
In general.—
The best practices published under subsection (a) shall, as appropriate, address best practices related to crisis response services for the range of entities that furnish such services, taking into consideration such services that—
“(A)
do not require prior authorization from an insurance provider or group health plan nor a referral from a health care provider prior to the delivery of services;
“(B)
provide for serving all individuals regardless of age or ability to pay;
“(C)
provide for operating 24 hours a day, 7 days a week;
“(D)
provide for care and support through resources described in paragraph (2)(A) until the individual has been stabilized or transferred to the next level of crisis care; and
“(E)
address psychiatric stabilization, including for—
“(i)
individuals screened over the phone, text, and chat; and
“(ii)
individuals stabilized on the scene by mobile teams.
“(2)
Identification of functions.—
The best practices published under subsection (a) shall consider the functions of the range of services in the crisis response continuum, including the following:
“(A)
Identification of resources for referral and enrollment in continuing mental health, substance use, or other human services relevant for the individual in crisis where necessary.
“(B)
A description of access and entry points to services within the crisis response continuum.
“(C)
Identification, as appropriate and consistent with State laws, of any protocols and agreements for the transfer and receipt of individuals to and from other segments of the crisis response continuum segments as needed, and from outside referrals, including health care providers, first responders (including law enforcement, paramedics, and firefighters), education institutions, and community-based organizations.
“(D)
Description of the qualifications of the range of crisis services staff, including roles for physicians, licensed clinicians, case managers, and peers (in accordance with State licensing requirements or requirements applicable to Tribal health professionals).
“(E)
The convening of collaborative meetings of relevant crisis response system partners, such as crisis response service providers, first responders (including law enforcement, paramedics, and firefighters), and community partners (including the National Suicide Prevention Lifeline or 9–8–8 call centers, 9–1–1 public service answering points, and local mental health and substance use disorder treatment providers), operating in a common region for the discussion of case management, best practices, and general performance improvement.
“(3)
Service capacity and quality best practices.—
The best practices under subsection (a) may include recommendations on—
“(A)
the volume of services to meet population need;
“(B)
appropriate timely response; and
“(C)
capacity to meet the needs of different patient populations that may experience a mental health or substance use crisis, including children, families, and all age groups, racial and ethnic minorities, veterans, individuals with co-occurring mental health and substance use disorders, individuals with disabilities, and individuals with chronic illness.
“(4)
Implementation timeframe.—
The Secretary shall—
“(A)
not later than 1 year after the date of enactment of this section [Dec. 29, 2022], publish and maintain the best practices required by subsection (a); and
“(B)
after 3 years, facilitate the identification of any updates to such best practices, as appropriate.
“(5)
Evaluations.—
Not later than 3 years after the date of enactment of this Act, the Comptroller General of the United States shall submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives, an assessment of relevant programs related to mental health and substance use disorder crises authorized under title V of the Public Health Service Act (
42 U.S.C. 290aa et seq.) in order to assess the extent to which such programs meet objectives and performance metrics, as determined by the Secretary. Such evaluation may, as appropriate, include data on—
“(A)
the type and variety of services provided when responding to mental health and substance use-related crises;
“(B)
the impact on emergency department facility use and length of stay, including for patients who require further psychiatric care;
“(C)
the impact on access to crisis care centers and crisis bed services;
“(D)
the impact on linkage to appropriate post-crisis care; and
“(E)
the use of best practices and recommendations identified under this section.”