42 U.S.C. § 294k — Training demonstration program

(a) In general: The Secretary must establish a training demonstration program awarding grants to support: (1) training medical residents and fellows to practice psychiatry and addiction medicine in underserved, community-based settings that combine primary care with mental health and substance use disorder prevention and treatment services; (2) training nurse practitioners, physician assistants, health service psychologists, counselors, nurses, and social workers — including people completing clinical training required for licensure — to provide mental health and substance use disorder services in similar underserved, community-based settings that combine primary care with those services, including settings serving children; and (3) establishing, maintaining, or improving academic units or programs that (A) train students or faculty, including through clinical experience and research, to better recognize, diagnose, and treat mental health and substance use disorders, with a special focus on addiction or on children, or (B) develop evidence-based practices or recommendations for how these units or programs should be designed, including curriculum content standards. (b) Activities: (1) Training for residents and fellows: A grantee under subsection (a)(1) (A) must use the funds (i) either to plan, develop, and run a training program for psychiatry medical residents and fellows in addiction medicine practicing at the eligible entities described in (c)(1), or to train new psychiatric residents and fellows in addiction medicine to expand access to integrated mental health and substance use disorder services; and (ii) to offer at least one training track that is (I) a virtual track with an in-person rotation at a teaching health center or community-based setting, followed by a virtual rotation continuing to support those patients using health information technology and telehealth, (II) an in-person track with a rotation at a teaching health center or community-based setting, or (III) an in-person track with a rotation at a community-based setting specializing in treating infants, children, adolescents, or pregnant or postpartum women; and (B) may also use funds to support program administration, or for projects to establish, maintain, or improve faculty development or the units needed to run the training. (2) Training for other providers: A grantee under subsection (a)(2) (A) must use the funds to plan, develop, or run a training program providing mental health and substance use disorder services in underserved, community-based settings, including those serving children, that combine primary care with those services; and (B) may also use funds to support program administration, or for faculty development or the units needed to run the program. (3) Academic units or programs: A grantee under subsection (a)(3) must partner with organizations such as an education accrediting body — for example the Liaison Committee on Medical Education, the Accreditation Council for Graduate Medical Education, the Commission on Osteopathic College Accreditation, the Accreditation Commission for Education in Nursing, the Commission on Collegiate Nursing Education, the Accreditation Council for Pharmacy Education, the Council on Social Work Education, the American Psychological Association Commission on Accreditation, or the Accreditation Review Commission on Education for the Physician Assistant — to carry out its activities under subsection (a)(3). (c) Eligible entities: (1) Training for residents and fellows: To be eligible for a grant under subsection (a)(1), an entity must (A) be a consortium made up of (i) at least one teaching health center, and (ii) the sponsoring institution (or parent institution) of either (I) an accredited psychiatry residency program, or (II) a fellowship in addiction medicine the Secretary considers appropriate; or (B) be that sponsoring institution itself, if it offers residents or fellows opportunities to train in community-based settings that combine primary care with mental health and substance use disorder services. (2) Training for other providers: To be eligible for a grant under subsection (a)(2), an entity must be (A) a teaching health center; (B) a federally qualified health center; (C) a community mental health center; (D) a rural health clinic; (E) a health center run by the Indian Health Service, a tribe, a tribal organization, or an urban Indian organization; or (F) another entity with a proven record of training nurse practitioners, physician assistants, health service psychologists, counselors, nurses, and social workers, including entities serving children. (3) Academic units or programs: To be eligible for a grant under subsection (a)(3), an entity must be a school of medicine or osteopathic medicine, a nursing school, a physician assistant training program, a school of pharmacy, a school of social work, an accredited public or nonprofit private hospital, an accredited medical residency program, or another qualified public or private nonprofit entity. (d) Priority: (1) In general: For grants under subsection (a)(1) or (a)(2), the Secretary must give priority to entities that (A) can train enough residents, fellows, psychologists, nurses, nurse practitioners, physician assistants, counselors, or social workers in addiction medicine each year to meet the needs of the area served; (B) have experience training providers in team-based care that combines mental health and substance use disorder services with primary care in community-based settings, including those serving children; (C) have experience using health information technology and telehealth to deliver these services and to help community health centers integrate care; or (D) can expand access to mental health and substance use disorder services in areas of demonstrated need, such as tribal, rural, or other underserved communities. (2) Academic units or programs: For grants under subsection (a)(3), the Secretary must give priority to entities that (A) have a record of training the most mental health and substance use disorder providers who stay in these fields or in integrated-care settings; (B) have a record of training people from underrepresented minorities, native populations, or rural or disadvantaged backgrounds; (C) train people to care — which may include trauma-informed care — for vulnerable groups such as infants, children, adolescents, pregnant and postpartum women, older adults, homeless individuals, abuse or trauma victims, people with disabilities, and other groups the Secretary defines; (D) teach trainees to provide interprofessional, integrated care through collaboration among health professionals; or (E) provide training in cultural competency and health literacy. (e) Duration: Grants awarded under this section last at least 5 years. (f) Study and report: (1) Study: (A) The Secretary, through the Health Resources and Services Administration, must study the results of this demonstration program. (B) Within 90 days after the end of the first year of a training program, and each following year the program is in effect, each grantee must send the Secretary the data needed for the report in paragraph (2). (2) Report to Congress: Within 1 year after receiving that data, the Secretary must report to Congress, including (A) an analysis of the program's effect on the quality, quantity, and distribution of mental health and substance use disorder services; (B) an analysis of the program's effect on untreated mental health and substance use disorders in the communities around participating health centers; and (C) recommendations on whether the program should be expanded. (g) Authorization of appropriations: Congress authorized $31,700,000 for each of fiscal years 2023 through 2027 to carry out this section.