Mental Health Systems Act

(Measure passed House, amended, roll call #483 (277-15))

Mental Health Systems Act - =Title I: Community Mental Health Services= - Authorizes the Secretary of Health and Human Services to make preparation grants to public or nonprofit private entities recommended by the State mental health authority for projects to: (1) assess mental health service needs; (2) design programs; (3) obtain financial and professional assistance; and (4) encourage community involvement. Prohibits: (1) any grant from exceeding $75,000; (2) a mental health service area from receiving more than one such grant; and (3) any service area from receiving a grant if it has previously received a planning grant under the Community Mental Health Centers Act. Authorizes appropriations for each of fiscal years 1982-1984.

Authorizes the Secretary to make grants to public and nonprofit private community mental health centers (CMHCs) for nonconstruction expenses. Limits eligibility to CMHCs that: (1) are State-operated; or (2) have been approved by the State mental health authority. Requires applications to be accompanied by assurances from such authority that the grant and all other funding sources the applicant CMHC may reasonably be expected to receive will cover the operating expenses for the year in which the grant is to be made. Limits grant eligibility to the first eight years of a CMHC's operation. Permits a rollover of unused funds to the next fiscal year. Provides that the amount of the grant shall be the lesser of: (1) the amount equal to the amount by which a CMHC's annual operating costs exceed its revenues; or (2) a decreasing annual percentage of operating costs. Authorizes appropriations for fiscal years 1982-1984. Authorizes appropriations for fiscal years 1982-1991 for CMHC continuation grants.

Authorizes the Secretary to make grants to State mental health authorities, CMHCs, and other public and nonprofit private entities for services to the chronically mentally ill, including: (1) case management; (2) access to mental, medical, rehabilitation, and dental services; and (3) access to employment, housing, and other support services. Directs the Secretary to give special consideration to projects which supplement existing community services. Sets forth the following order of applicant priority for such projects: (1) State mental health authorities; (2) CMHCs; and (3) public and nonprofit private entities in areas without CMHCs. Authorizes appropriations for fiscal years 1982-1984.

Authorizes the Secretary to make grants to State mental health authorities, CMHCs, and other public and nonprofit private entities for mental health and support services for severely mentally disturbed children and adolescents and members of their families. Prohibits such a grant to be made to a nonprofit private or a public (other than a State mental health authority) entity in an area served by a CMHC. Sets forth the following order of applicant priority: (1) State mental health authorities; (2) CMHCs; and (3) public and nonprofit private entities in areas without CMHCs. Authorizes appropriations for fiscal years 1982-1984.

Authorizes the Secretary to make grants to public or nonprofit private entities to provide mental health services to unserved or underserved priority populations. States that applications for such grants shall only be approved if: (1) the State mental health authority has recommended approval; (2) the application contains assurances of increased services to such populations and of their opportunities to comment on the proposed project and on its later performance; and (3) the applicant will provide outpatient mental services and two of six other specified related services during the first three years that it receives a grant, and has a plan for the provision of all such services upon the expiration of such first three years. Prohibits approval of an application of an entity which has received a three-year grant unless the applicant is providing outpatient services and all of the specified six related services. Prohibits: (1) more than two grants in any single mental health service area during the same fiscal year; (2) more than ten grants to any such area; and (3) more than five grants for service for the same group. Directs the Secretary to determine grant amounts. Stipulates that the fourth and fifth grants may not exceed 60 percent and 30 percent, respectively, of the project's costs. Authorizes appropriations for fiscal years 1982-1984.

Authorizes the Secretary to make grants to CMHCs for consultation and education services, followup services, and program administration. Limits eligibility to those CMHCs which have received community health center grants under this Act or under the Community Mental Health Centers Act, but are no longer eligible (because of limitations on number of grants or period of eligibility) for such assistance. States that as of fiscal year 1984, such eligibility shall be further limited to State-run or State-recommended CMHCs. Prohibits any single CMHC from receiving more than five grants. Directs the Secretary to determine grant amounts. Stipulates that any such grant may not exceed $1.00 per capita for the population of the mental health service area. Authorizes appropriations for fiscal years 1982-1984.

Authorizes the Secretary to make grants for the provision of mental health services to: (1) public or nonprofit private ambulatory health care centers; and (2) public or nonprofit private entities which provide emergency and outpatient mental services and consultation and education services. Requires an application to include an affiliation agreement between a provider of ambulatory care services and a provider of mental health services. Authorizes appropriations for fiscal years 1982-1984.

Authorizes the Indian Health Service, upon the request of any tribe or urban Indian organization, to apply to the Secretary for any grant under this title. Provides that such a grant: (1) shall be made on the same terms and conditions that apply to non-Federal entities; and (2) shall be made even though the project to be funded serves residents of two or more mental health service areas of a State. Exempts such Service from specified preliminary State grant reviews.

Authorizes the Secretary to make grants to public and nonprofit private entities for: (1) employment services and training for employees adversely affected by changes in mental health services delivery systems; and (2) innovative mental health projects. Authorizes up to five percent of the funds appropriated under this title for such projects. Stipulates that at least 50 percent of such funds shall be used for training and employment projects.

=Title II: State Programs= - Authorizes the Secretary to make grants to State mental health authorities for: (1) data collection and analysis; (2) planning and administration; (3) performance standards and evaluation; and (4) other appropriate mental health services improvement projects. Authorizes appropriations for fiscal years 1982-1984.

Authorizes the Secretary to enter into agreements with State mental health authorities under which such authorities will: (1) disburse Federal funds under this Act; (2) review projects funded under this Act; and (3) perform other functions as agreed upon by the Secretary and State mental health authority. States that the Secretary, as determined by such agreements, shall make grants to such authorities to meet their costs in carrying out the agreements. Authorizes appropriations for fiscal years 1982-1984.

=Title III: Prevention= - Authorizes the Secretary to make grants to public and nonprofit private entities to demonstrate and evaluate the effectiveness of intervention techniques and mental health promotion activities in the prevention of mental illness. Authorizes appropriations for fiscal years 1982-1984.

=Title IV: General Provisions= - States that before any entity in a State may be eligible to receive funds under this Act such State must have in effect a mental health services plan which: (1) has been approved by the Secretary; (2) is consistent with the State health plan prepared in accordance with the Public Health Service Act; and (3) has been prepared by the requisite State agency and submitted to the Secretary through the Governor.

Authorizes the Secretary, after giving notice and opportunity for a hearing to the State agency, to discontinue funds to any entity for noncompliance.

States that a State mental health services plan shall consist of an administrative part and a services part. Requires the administrative part to provide for: (1) a State agency to administer the plan; (2) an advisory council to consult with such agency; (3) periodic reports to the Secretary and recordkeeping; (4) statistics collection; (5) periodic plan review and modification; and (6) personnel standards on a merit basis. Requires the services part to: (1) identify the State's mental health service areas; (2) identify the needs and the adequacy of resources to meet such needs; (3) describe the proposed allocation of resources; (4) describe proposals to coordinate State and local services; (5) describe the legal rights of mentally ill persons; and (6) provide for emphasis of outpatient mental health services, including protections for employees adversely affected by such programs.

Prohibits a grant to be made under this Act unless such application is approved by the Secretary. Sets forth the contents of such an application, including: (1) a budget, which shows funding sources and allocation, activities to be conducted, and target populations; (2) a statement of objectives; (3) in the case of any project to be assisted under title I of this Act under which health services are to be provided, assurances that the applicant: (a) has prepared a schedule of fees and discounts and has made reasonable effort to secure payment and reimbursement for services; (b) will provide that all fees will be paid to the center and all services provided by health professionals will be performed only at the center; and (c) will require that all patients be under professional staff supervision and that a member of such staff will be available to provide emergency mental health care; (4) arrangements, when necessary, for serving populations with limited English-speaking ability; (5) a system to assure that an employee who reports the applicant's failure to comply with applicable Federal or State law or regulations will not be discharged or discriminated against because of such report; (6) assurances that facilities meet State fire and safety codes; (7) assurances of reporting and recordkeeping accessibility; (8) assurances that funds under this Act will not supplant non-Federal funds; and (9) assurances that the project is consistent with the State mental health services plan.

Authorizes the Secretary to obligate up to two percent of the total appropriations under titles I and II of this Act for any fiscal year for technical assistance to any grant recipient.

Prohibits any single mental health service area from receiving more than ten grants under specified sections of this Act and the Community Mental Health Centers Act.

Requires the Secretary to: (1) prescribe grantee performance standards; and (2) consider any prior performance under this Act by an applicant in determining whether or not to approve a new application. Provides that: (1) with the Secretary's approval, a grantee may use a portion of the grant for project evaluation; and (2) the Secretary may obligate in a fiscal year up to one percent of appropriations under this Act to monitor grantees.

Defines "community mental health center" as a legal entity providing mental health service principally to individuals residing or employed in a mental health service area, regardless of such individuals' finances, past health condition, or any other factor. Sets forth services required to be provided by such CMHCs, including: (1) inpatient, outpatient, and emergency services; (2) assistance to courts and other public agencies in screening persons for inpatient mental health care; (3) where appropriate, treatment as an alternative to inpatient care; (4) education and counseling; (5) follow-up care for discharged patients; (6) specialized services for children and for the elderly; (7) transitional half-way house services; and (8) alcohol and drug abuse programs. Requires each CMHC to have: (1) a quality assurance program; (2) a medical records system; (3) a professional advisory board; and (4) an administrative unit responsible for providing education and consultation services (unless waived by the Secretary).

Authorizes the indirect provision of services by a CMHC through satellite facilities or through arrangements with other entities or health professionals.

Limits the Secretary's contract authority in any fiscal year to the extent or in such amounts as provided in advance by appropriation Acts.

=Title V: Minority Concerns= - Establishes as of October 1, 1980, the position of Associate Director for Minority Concerns within the National Institute of Mental Health. Authorizes grant and contract programs in the areas of: (1) mental health services delivery to minorities; (2) mental health problems of minorities; and (3) increased minority representation in the mental health fields.

=Title VI: Rape Services Support Program= - Authorizes the Secretary to make grants to and contract with public and nonprofit private entities for services to rape victims, including: (1) counseling and follow-up counseling; (2) assistance in securing mental health, legal, medical, and social services; and (3) rape prevention and victim assistance projects. Directs the Secretary to: (1) determine grant amounts, but prohibits any such grant from exceeding 90 percent of the project's cost; (2) establish a grant review panel; and (3) coordinate such activities with other similar Federal programs. Prohibits disclosure of personally identifiable information by a grant or contract recipient except for the purpose for which such information was obtained or with the consent of the person supplying the information. Authorizes appropriations for fiscal years 1981-1984. Prohibits the Secretary from obligating in any fiscal year more than ten percent of appropriated funds for technical assistance to assist in application development.

=Title VII: Extension of Community Mental Health Centers Act= - Amends the Community Mental Health Centers Act to extend through fiscal year 1981 grant authority for: (1) program planning; (2) initial operation costs; (3) consultation and education services; (4) financial distress; and (5) rape prevention. Increases the maximum number of financial distress grants to a CMHC from five to six. Extends the waiver period for CMHC's which do not meet certain requirements from fiscal year 1980 to fiscal year 1981.

=Title VIII: Miscellaneous= - Amends the Public Health Service Act to require an individual who has received a clinical traineeship in psychology, psychiatry, nursing, or social work that was not of a limited duration or experimental nature to serve in a State mental institution, a health manpower shortage area, or other area designated by the Secretary. States that: (1) such service shall be at the rate of one year for each year of traineeship; (2) failure to fulfill such service shall obligate the individual to repay three times the cost of the traineeship plus interest; and (3) such service may not be used to concurrently repay obligations owed under this Act and under the National Research Service Award and the National Health Service Corps Scholarships programs.

Requires that commissioned medical and dental officers of the Public Health Service Corps receive special pay at the same rate as similar officers in the Armed Forces.

States that there are shortages in the mental health care specialties.

Makes technical and conforming amendments to this Act.