Community Mental Health Services Improvement Act of 1991

Community Mental Health Services Improvement Act of 1991 - Title I: Community Mental Health Services Block Grant - Amends title XIX (Block Grants) of the Public Health Service Act to replace provisions relating to State comprehensive mental health services plans with provisions directing the Secretary of Health and Human Services, through the Director of the National Institute of Mental Health, to make a grant to each State each year for providing, through community mental health centers, comprehensive community mental health services to adults with a serious mental illness and to children with a serious emotional disturbance.

Includes in the comprehensive package health, mental health, rehabilitation, employment, housing, educational, dental, and other support services. Requires, for such children, a system of integrated social, educational, juvenile, substance abuse, health, and mental health services. Requires plans for service delivery to rural residents. Sets forth criteria for the centers, including providing: (1) 24-hour-a-day emergency services; and (2) day treatment or other partial hospitalization services, or psychosocial rehabilitation services.

Requires States to establish and maintain a State mental health planning council to: (1) serve as an advocate for individuals with mental illnesses or emotional problems; and (2) review the allocation and adequacy of mental health services in the State.

Authorizes appropriations to carry out: (1) this title; and (2) provisions requiring annual data collection on mental illness.

Provides, with regard to existing alcohol and drug abuse and mental health services block grant provisions and the provisions added by this title, for: (1) annual independent peer review to assess the quality and appropriateness of treatment services; (2) a single consolidated application for States to request funds; (3) considering programs or activities funded in whole or in part with funds under such provisions as programs or activities receiving Federal financial assistance for purposes of specified civil rights laws; (4) a prohibition of discrimination in such programs or activities on the basis of sex or religion; and (5) a prohibition of the Secretary delegating to the States the primary responsibility for interpreting governing provisions.

Title II: Comprehensive Mental Health Services for Children with Serious Emotional Disturbances - Directs the Secretary, through the Director of the National Institute of Mental Health, to make grants to public entities for comprehensive community mental health services to seriously emotionally disturbed children. Allows such grants only to those already receiving payments under existing alcohol and drug abuse and mental health services block grant provisions.

Requires, in making the grants, special consideration for an entity which agrees to provide non-Federal contributions greater than required. Requires non-Federal contributions in a specified ratio.

Requires grantees to establish and operate, through grants and contracts, one system to provide specified mental health services to children under 22 years old, including 24-hour-a-day emergency services, home-based services, day treatment, respite care, and therapeutic foster care. Requires a memorandum of understanding, to facilitate the availability of services, with providers of medical, educational, vocational counseling, vocational rehabilitation, and mental health protection and advocacy services. Prohibits using grant funds or non-Federal contributions made with respect to the grant for such linked non-mental health services.

Requires that the system: (1) enter into a memorandum of understanding regarding facilitation of services available under programs such as title XIX (Medicaid) of the Social Security Act and specified provisions of the Individuals with Disabilities Education Act; (2) provide case management services; and (3) develop and implement an individualized plan of services for each child admitted to the system.

Mandates submission by the States and approval by the Secretary of a system plan. Limits fees for system services. Limits grants to five years.

Authorizes appropriations.

Title III: Mental Health Research - Transfers provisions relating to service research on community-based mental health treatment programs from portions of the Public Health Service Act relating to State comprehensive mental health services plans to portions relating to mental health research.

Requires a set-aside of a specified percentage of funds appropriated under the Act for mental health research to carry out the transferred provisions.

Replaces, in the transferred provisions, references to the Administrator of the Alcohol, Drug Abuse, and Mental Health Administration with references to the Director of the National Institute of Mental Health.

Allows grants for certain community mental health services demonstration projects to be for five (currently, three) consecutive one-year periods.

Establishes in the National Institute of Mental Health the Office of Rural Mental Health. Mandates grants for demonstration projects to improve the availability of mental health services by providing such services in the same facilities as other health or social services.

Title IV: Protection and Advocacy for Mentally Ill Individuals - Amends the Protection and Advocacy for Mentally Ill Individuals Act of 1986 to authorize appropriations to carry out provisions of the Act relating to protection and advocacy systems.

Title V: Conforming Amendments - Amends the Public Health Service Act to conform to changes made by this Act.

Authorizes appropriations to carry out provisions relating to demonstration projects for individuals with positive tests for the etiologic agent for acquired immune deficiency syndrome.

Title VI: Federal Accountability - Declares ineffective any rule or regulation of the Department of Health and Human Services inconsistent with the amendments made by this Act, including a specified regulation recognizing that, under the block grant programs, the States are primarily responsible for interpreting the governing statutory provisions.

Title VII: General Provisions - Sets forth the effective date of this Act and the amendments made by this Act.