Senate Approves Bipartisan Safer Communities Act

June 24, 2022

On Thursday, June 23, the Senate approved—by 65-33 vote—the Bipartisan Safer Communities Act (S. 2938), which seeks to address firearm safety measures across the country, mental health, school safety, and telehealth. 

Important provisions that may be relevant to state and territorial health officials include funding for SAMHSA and HRSA mental health and training programs, improving telehealth services, and creating a clearinghouse on school safety evidence-based practices. 

In addition to the public health provisions, the bill enhances background checks, particularly for juveniles and firearm purchasers under the age of 21, assists states that are interested in implementing red flag laws that allow authorities to temporarily confiscate weapons from people who are deemed to be dangerous, and prohibits domestic abusers from purchasing firearms. 

View the bill text and summary.

Outlook

This bill is expected to become law. Considering the complexity of the bill, it is very likely that ASTHO’s analysis did not capture all relevant provisions. 

Summary 

Mental Health, Medicaid & School Safety

• Requires the coordination of the Secretary of Education, the Attorney General, and the Secretary of HHS to establish a federal clearinghouse on school safety evidence-based practices.
  • The purpose of the clearinghouse will be to serve as a federal resource to identify and publish online through SchoolSafety.gov, or any successor website, evidence-based practices and recommendations to improve school safety for use by state and local educational agencies, institutions of higher education, state and local law enforcement agencies, health professionals, and the general public. In identifying the evidence-based practices and recommendations for the clearinghouse, the Secretary is required to: 
    • Consult with appropriate federal, state, local, tribal, private sector, and non-governmental organizations, including civil rights and disability rights organizations. 
    • Consult with the Secretary of Education to ensure that evidence-based practices published by the clearinghouse align with evidence-based practices to support a positive and safe learning environment for all students.
    • Requires the Secretary of Education, Secretary of Homeland Security, Secretary of HHS, and the Attorney General to provide notification of the publication of the clearinghouse. Specifically for HHS, the Secretary is required to provide notification to: 
      • Every state health department of public health. 
      • Other HHS partners in the implementation of the evidence-based practices and recommendations of the clearinghouse, as determined appropriate by the Secretary of HHS.
• $100 million, to remain available until expended, is appropriated to meet additional resource needs of the National Instant Criminal Background Check System (NICS).
• $1.4 billion, to remain available until expended, is appropriated for grants to be administered by the Office of Justice Programs. This includes $750 million to be allocated for the Edward Byrne Memorial Justice Assistance Grant Program, $200 million for grants administered by the Bureau of Justice Assistance for purposes authorized under the STOP School Violence Act of 2018, $200 million for grants to states to upgrade criminal and mental health records for the NICS, and $250 million for a community violence intervention and prevention initiative. 
• $100 million to remain available until expended at $20 million per fiscal year from FY22-FY26 for competitive grants to be administered by the Community Oriented Policing Services Office. 
• $800 million, to remain available until September 30, 2025, is appropriated for health surveillance and program support within the Substance Abuse and Mental Health Services Administration (SAMHSA). This includes $250 million for the community mental health services block grant program, $40 million for the National Child Traumatic Stress Network, $240 million for activities and services under Project AWARE, $120 million for Mental Health Awareness Training, and $150 million for the National Suicide Prevention Lifeline for FY22. Specifically: 
  • $312.5 million is made available until December 31, 2022, for FY22. 
  • $162.5 million is made available until September 30, 2023, for FY23. 
  • $162.5 million is made available until September 30, 2024, for FY24.
  • $162.5 million is made available until September 30, 2025, for FY25.
• $190 million, to remain available until September 30, 2026, is appropriated for the Public Health and Social Services Emergency Fund. This includes $60 million for primary care training and enhancement to provide mental and behavioral health care training as part of the training for pediatricians and other primary care clinicians who plan to provide care for pediatric populations and other vulnerable populations to be transferred to the Health Resources and Services Administration (HRSA), $50 million to support state Medicaid agencies in the delivery of medical assistance to Medicaid and CHIP beneficiaries in school settings, and $80 million for pediatric mental health care access to be transferred to HRSA. Specifically: 
  • $82 million, to remain available until December 31, 2022, for FY22.  
  • $32 million, to remain available until September 30, 2023, for FY23.
  • $32 million, to remain available until September 30, 2024, for FY24. 
  • $32 million, to remain available until September 30, 2025, for FY25. 
  • $12 million, to remain available until September 30, 2026, for FY26.
• $1.05 billion, to remain available through September 30, 2025, is appropriated for school improvement programs specifically to increase support for the implementation of evidence-based practices intended to increase attendance and engagement of students in middle grades and high schools in community learning centers. 
• $1 billion, to remain available until December 31, 2026, is appropriated for Safe Schools and Citizenship Education. This includes $500 million for School-Based Mental Health Services Grants and $500 million for Mental Health Services Professional Demonstration Grants in equal amounts for each of the fiscal years 2022 through 2026. Specifically: 
  • $200 million, to remain available until March 31, 2023, for FY22.
  • $200 million, to remain available until December 31, 2023, for FY23.
  • $200 million, to remain available until December 31, 2024, for FY24.
  • $200 million, to remain available until December 31, 2025, for FY25,
  • $200 million, to remain available until December 31, 2026, for FY26.

Medicaid & Telehealth

• $40 million for FY23 to remain available until expended, is appropriated for award planning grants to states to develop proposals to participate in time-limited community mental health services demonstration programs that begin July 1, 2024, and every two years thereafter, up to 10 additional states may participate in the demonstration programs.
• Authorizes $50 million in FY22 for the Secretary to provide technical assistance and issue guidance to states on improving access to telehealth services for services covered under Medicaid and CHIP including: 
  • How states can adopt flexibilities under Medicaid and CHIP to expand access to covered services via telehealth, including when states may adopt such flexibilities without the need for the approval of a state plan amendment or waiver.
  • Best practices regarding billing for services, including recommended voluntary billing codes, modifiers, and place of service designations and how such billing codes, modifiers, and designations can be used to create consistent data sets.
  • Strategies for integrating telehealth services into value-based care models.
  • Best practices from states that have used Medicaid waivers and other Medicaid authorities to expand access to telehealth, including during the COVID-19 public health emergency.
  • Strategies to promote the delivery of accessible and culturally-competent care via telehealth, including addressing the needs of individuals with disabilities, medically-underserved urban and rural communities, racial and ethnic minorities such as American Indians and Alaska Natives, individuals with limited English proficiency, and individuals of different age groups including children, young adults, and seniors.
  • Strategies for training and providing resources to providers and patients on the use of telehealth, including working with interpreters to furnish health services and providing resources in multiple languages.
  • Integrating the use of existing video platforms that enable multi-person video calls.
  • Best practices to support the delivery of covered services under Medicaid and CHIP via telehealth in schools, including specifically for the provision of mental health and substance use disorder services in such settings.
  • Strategies for evaluating how the delivery of health services via telehealth affects quality, outcomes, and cost under Medicaid and CHIP.
  • Best practices for conveying information to beneficiaries regarding the availability of telehealth as an option to receive services covered under Medicaid and CHIP, including the availability of audio-only telehealth, the ability to receive such services from a patient’s home, and requirements related to in-person visits. 
• $8 million in FY22 is appropriated and available until expended to require the Secretary, in consultation with the Secretary of Education, to issue guidance to state Medicaid agencies, local education agencies, and school-based entities to support the delivery of medical assistance to Medicaid and CHIP beneficiaries. 
• $5 million, to remain available until expended for each fiscal year 2023 and fiscal year 2024, and $1 million for each fiscal year thereafter, is appropriated for the Secretary, no later than 24 months after the date of enactment of the bill, and every five years thereafter, to: 
  • Review state implementation of the requirements for providing Early and Periodic Screening, Diagnostic, and Treatment services under Medicaid.
  • Identify gaps and deficiencies concerning state compliance with such requirements.
  • Provide technical assistance to states to address such gaps and deficiencies. 
  • Issue guidance to state on the Medicaid coverage requirements of such services that include best practices for ensuring children have access to comprehensive health care services, including children without a mental health or substance use disorder diagnosis.
• $31 million, for each fiscal year 2023 through 2027, is appropriated to provide grants, information, consultative support, training, and technical assistance to pediatric primary care providers about available mental health services for children in communities. Eligible entities receiving this information also include emergency departments, state educational agencies, local educational agencies, tribal educational agencies, elementary schools, and secondary schools. 

Firearm Safety

• Amends federal statute related to the selling or disposal of a firearm or ammunition for buyers under 21 years of age to require more thorough background checks including contacts with state databases and local law enforcement. Also allows the National Instant Criminal Background Check System (NICS) additional time to investigate potentially disqualifying records.  
• Amends the underlying statue wherein the Attorney General may make grants available to states and units of local government to now include: 
  • Mental health courts
  • Drug courts 
  • Veterans courts 
  • Extreme risk protection order programs
• Amends anti-straw purchasing and firearms trafficking laws and clarifies that a purchase, or conspiracy to purchase any firearm affecting interstate or foreign commerce for, on behalf of, or at the request or demand of any other person, knowing or having reasonable cause to believe that such other person intends to:
  • Use, carry, possess, sell or otherwise dispose of the firearm in furtherance of a felony, a federal crime of terrorism, or a drug trafficking crime. 
  • Sell or otherwise dispose of the firearm to a person violates this law.
• Clarifies that it is unlawful for any person to: 
  • Ship, transport, transfer, cause to be transported, or otherwise dispose of any firearm to another person in or otherwise affecting interstate or foreign commerce if such person knows or has reasonable cause to believe that the use, carrying, or possession of a firearm by the recipient would constitute a felony.
  • Receive from another person any firearm in or otherwise affecting interstate or foreign commerce, if the recipient knows or has reasonable cause to believe that such receipt would constitute a felony. 
  • Attempt or conspire to commit the conduct described above.
• Clarifies that the bill does not restrict the sale or disposition of a firearm or ammunition to a licensed importer, licensed manufacturer, licensed dealer, or licensed collector is not precluded from dealing in firearms or ammunition, or to a person who has been granted relief from these provisions.
• Amends federal law to clarify that individuals who knowingly receive or transfer a firearm or ammunition, or attempt or conspire to do so, knowing or having reasonable cause to believe that such firearm or ammunition will be used to commit a felony, a federal crime of terrorism, or a drug trafficking crime are to be fined and or imprisoned.
• Amends federal law to clarify that an individual who smuggles or knowingly brings a firearm or ammunition into or out of the United States, or conspires to do so, with intent to engage in or promote conduct that constitutes a crime be fined and or imprisoned.
• Prohibits the transfer of firearms or ammunition to agents of drug cartels by the Department of Justice or other law enforcement coordinate agencies.
• $1 million, for each fiscal year 2023 through 2027, is authorized to be appropriated to continue and expand efforts with existing partners to educate persons licensed as an importer, manufacturers, or dealers of firearms.
• Adds convicted domestic violence abusers in dating relationships to the NICS. Creates a process for removal from NICS five years after the completion of the sentence, only if there are no intervening prohibited crimes or other crimes of violence.