Mental Health and Aging Act of 1988

Mental Health and Aging Act of 1988 - Title I: Public Health Service Act Amendments - Amends the Public Health Service Act to authorize appropriations for FY 1989 through 1991 for alcohol and drug abuse and mental health services block grants to States. Requires that specified portions of grants for community mental health services be allotted for programs serving severely disturbed children and adolescents, and individuals at or over 65 years who are not in mental institutions. Directs States to implement programs for assuring the quality and effectiveness of such services.

Sets forth a community mental health services consumer's bill of rights which includes provisions addressing the right to: (1) receive appropriate treatment in a safe and humane setting pursuant to an individualized, written, treatment plan; (2) exercise personal liberties; (3) make or participate in informed decisions regarding the course of treatment; (4) be notified regarding changes in treatment eligibility status and, upon discharge, referred as appropriate to other mental health service providers; and (5) be informed regarding charges and coverage for such services.

Authorizes the Secretary of Health and Human Services to make grants to States, localities, and nonprofit private agencies for mental health services demonstration projects for the planning, coordination, and improvement of community services (including outreach and self-help services) for elderly individuals and for rural residents, and for the conduct of research concerning such services. Authorizes appropriations for such projects for FY 1989 and 1990.

Reserves specified amounts of appropriations to the National Institute of Mental Health and to the National Institute on Aging for FY 1989 through 1991, which are in excess of FY 1988 appropriations, for programs of clinical training, research training, and career development regarding the mental health of the elderly. Amends the Older Americans Act of 1965 to authorize appropriations for FY 1989 through 1991 for the education and training of personnel concerned with the mental health of the elderly.

Amends the Public Health Service Act to reserve specified amounts of appropriations to the National Institute of Mental Health and to the National Institute on Aging for FY 1989 through 1991, which are in excess of FY 1988 appropriations, for research on the mental health and psycho-social well-being of elderly individuals. Amends the Older Americans Act of 1965 to authorize appropriations for FY 1989 through 1991 for research, development, and demonstration projects regarding the mental health of elderly individuals.

Directs the Secretary to establish a National Mental Health Education Program to encourage research, training, and education and collect and disseminate information regarding mental health problems. Authorizes appropriations for such Program for FY 1989 through 1991.

Requires the Secretary to enter into a contract with the Institute of Medicine of the National Academy of Sciences for the conduct of a study to determine methods for measuring and assuring the quality and effectiveness of mental health services and alcohol and drug abuse treatment services. Requires that the Institute complete such study and report to the Congress. Authorizes appropriations for FY 1989.

Directs the Secretary to provide for and report to the Congress by January 1, 1990, on additional studies: (1) comparing mental health services under Medicare (title XVIII of the Social Security Act) and non-Medicare prepaid health plans, and in settings other than prepaid health plans; (2) examining mechanisms for ensuring the quality of, and access to, mental health services delivered by State, local, and independent mental health facilities; (3) examining minority access to community mental health centers; (4) examining the adequacy and optimal utilization of mental health manpower; and (5) examining the adequacy of minority mental health manpower and training. Authorizes the Secretary to conduct demonstration projects to determine methods of increasing minority access to community mental health centers. Authorizes appropriations for such studies and projects.

Title II: Medicare and Medicaid Program Changes - Amends part A (Hospital Insurance) of title XVIII (Medicare) of the Social Security Act to cover inpatient psychiatric hospital services furnished to an individual for up to 60 days in a calendar year, with extensions of such limit permissible upon a review and determination of the necessity of such services. (Currently, such coverage is provided for up to 190 days in an individual's lifetime.)

Amends part B (Supplementary Medical Insurance) of the Medicare program to cover up to 20 physician visits per year to an outpatient suffering from mental disorders if the main purpose of such visits is to assess the individual's status and drug plan, and to perform necessary lab tests. Permits the extension of such limit upon a determination of the necessity of such visits. Covers, under the Medicare and Medicaid (title XIX of the Act) programs, outpatient mental health services furnished in a community mental health center or by a physician, clinical psychologist, clinical social worker, or psychiatric nurse specialist, provided such services would otherwise be covered if furnished by a physician.

Provides Medicare coverage of in-home care for up to 120 hours per year for a chronically dependent individual. (Currently, up to 80 hours of such coverage is provided after an individual has incurred catastrophic expenses.)

Amends the Medicaid program to define an institution for mental diseases as an institution that has more than 16 beds and: (1) is under the jurisdiction of the State mental health authority; (2) advertises itself as primarily specializing in treating individuals with mental disease; or (3) is made up, for the most part, of patients who do not have a physical condition which in itself requires the level of services provided in a skilled nursing facility.

Amends the Medicare and Medicaid programs to require nursing facilities to provide access to medically necessary mental health services.

Directs the Secretary to ensure the reasonableness of levels of reimbursement of nursing facilities under the Medicare and Medicaid programs for their provision of mental health services.

Requires that Medicare payments for outpatient mental health services be made on an assignment-related basis. Requires Medicare carriers and fiscal intermediaries to provide for reviews to assure appropriate utilization of services covered by this Act. Prohibits charges for covered outpatient mental health services from increasing by more than the average percentage increase of the Consumer Price Index and the Medicare Economic Index. Directs the Secretary to develop a prospective payment system for Medicare outpatient mental health services and report to the Congress regarding such system by January 1, 1990.

Amends part A (General Provisions) of title XI of the Act to impose additional conditions on mental health providers' participation in the Medicare and Medicaid programs. Includes among such conditions the requirements that each provider: (1) comply with the consumer bill of rights; (2) provide each consumer with written grievance procedures and written notice of the services to be provided; (3) have the capacity to identify potential clients, provide mental health services, and coordinate their services with those provided by others; and (4) engage in consumer needs assessment and care and discharge planning activities. Requires health maintenance organizations to ensure access to, and the quality of, the outpatient mental health services they provide.

Requires peer review organization review of the mental health services for which payment is made under the Medicare or Medicaid program.