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<dc:title>118 HR 6451 IH: Mental Health Justice Act of 2023</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
<dc:date>2023-11-17</dc:date>
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<distribution-code display="yes">I</distribution-code><congress display="yes">118th CONGRESS</congress><session display="yes">1st Session</session><legis-num display="yes">H. R. 6451</legis-num><current-chamber>IN THE HOUSE OF REPRESENTATIVES</current-chamber><action display="yes"><action-date date="20231117">November 17, 2023</action-date><action-desc><sponsor name-id="P000618">Ms. Porter</sponsor> (for herself, <cosponsor name-id="P000617">Ms. Pressley</cosponsor>, <cosponsor name-id="C001097">Mr. Cárdenas</cosponsor>, <cosponsor name-id="S001205">Ms. Scanlon</cosponsor>, <cosponsor name-id="F000466">Mr. Fitzpatrick</cosponsor>, <cosponsor name-id="D000399">Mr. Doggett</cosponsor>, <cosponsor name-id="P000607">Mr. Pocan</cosponsor>, <cosponsor name-id="C001117">Mr. Casten</cosponsor>, <cosponsor name-id="B001296">Mr. Boyle of Pennsylvania</cosponsor>, <cosponsor name-id="G000598">Mr. Robert Garcia of California</cosponsor>, <cosponsor name-id="P000597">Ms. Pingree</cosponsor>, <cosponsor name-id="N000179">Mrs. Napolitano</cosponsor>, <cosponsor name-id="T000472">Mr. Takano</cosponsor>, <cosponsor name-id="P000096">Mr. Pascrell</cosponsor>, <cosponsor name-id="R000305">Ms. Ross</cosponsor>, <cosponsor name-id="W000822">Mrs. Watson Coleman</cosponsor>, <cosponsor name-id="T000468">Ms. Titus</cosponsor>, <cosponsor name-id="E000296">Mr. Evans</cosponsor>, <cosponsor name-id="M001188">Ms. Meng</cosponsor>, <cosponsor name-id="G000586">Mr. García of Illinois</cosponsor>, <cosponsor name-id="R000617">Mrs. Ramirez</cosponsor>, <cosponsor name-id="C001068">Mr. Cohen</cosponsor>, <cosponsor name-id="T000483">Mr. Trone</cosponsor>, <cosponsor name-id="M001160">Ms. Moore of Wisconsin</cosponsor>, <cosponsor name-id="J000032">Ms. Jackson Lee</cosponsor>, <cosponsor name-id="N000147">Ms. Norton</cosponsor>, <cosponsor name-id="J000305">Ms. Jacobs</cosponsor>, <cosponsor name-id="J000309">Mr. Jackson of Illinois</cosponsor>, <cosponsor name-id="C001125">Mr. Carter of Louisiana</cosponsor>, <cosponsor name-id="C001134">Ms. Caraveo</cosponsor>, <cosponsor name-id="J000298">Ms. Jayapal</cosponsor>, <cosponsor name-id="C001078">Mr. Connolly</cosponsor>, <cosponsor name-id="S001145">Ms. Schakowsky</cosponsor>, <cosponsor name-id="S001226">Ms. Salinas</cosponsor>, <cosponsor name-id="F000454">Mr. Foster</cosponsor>, <cosponsor name-id="O000173">Ms. Omar</cosponsor>, <cosponsor name-id="B001278">Ms. Bonamici</cosponsor>, <cosponsor name-id="W000797">Ms. Wasserman Schultz</cosponsor>, <cosponsor name-id="T000486">Mr. Torres of New York</cosponsor>, <cosponsor name-id="G000551">Mr. Grijalva</cosponsor>, <cosponsor name-id="M000687">Mr. Mfume</cosponsor>, <cosponsor name-id="K000385">Ms. Kelly of Illinois</cosponsor>, <cosponsor name-id="C001080">Ms. Chu</cosponsor>, <cosponsor name-id="M001143">Ms. McCollum</cosponsor>, <cosponsor name-id="J000288">Mr. Johnson of Georgia</cosponsor>, <cosponsor name-id="W000826">Ms. Wild</cosponsor>, <cosponsor name-id="P000616">Mr. Phillips</cosponsor>, <cosponsor name-id="S001218">Ms. Stansbury</cosponsor>, <cosponsor name-id="L000551">Ms. Lee of California</cosponsor>, <cosponsor name-id="W000788">Ms. Williams of Georgia</cosponsor>, <cosponsor name-id="C001072">Mr. Carson</cosponsor>, and <cosponsor name-id="L000593">Mr. Levin</cosponsor>) introduced the following bill; which was referred to the <committee-name committee-id="HIF00">Committee on Energy and Commerce</committee-name>, and in addition to the Committee on <committee-name committee-id="HJU00">the Judiciary</committee-name>, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned</action-desc></action><legis-type>A BILL</legis-type><official-title display="yes">To amend the Public Health Service Act to authorize grants to States, Indian Tribes, Tribal organizations, and political subdivisions thereof to hire, employ, train, and dispatch mental health professionals to respond in lieu of law enforcement officers in emergencies involving one or more persons with a mental illness or an intellectual or developmental disability, and for other purposes.</official-title></form><legis-body id="HEA12DF63034841FC894C8D8C717921E6" style="OLC"><section id="H581EF490436742299D925D862B9DA6D1" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Mental Health Justice Act of 2023</short-title></quote>.</text></section><section id="H0BD9EF74131B4587A15101237C1F588E"><enum>2.</enum><header>Grants for mental health professionals to act as first responders</header><text display-inline="no-display-inline">Subpart 3 of part B of title V of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290bb-31">42 U.S.C. 290bb–31 et seq.</external-xref>) is amended by adding at the end the following:</text><quoted-block style="OLC" id="H4529223FF91544B9BAD0549EECBD3E9D" display-inline="no-display-inline"><section id="H1425CEDC08B7445ABBE3401447FDDB23"><enum>520O.</enum><header>Grants for mental health professionals to act as first responders</header><subsection id="H051C818A7AE84F998BF7F135B848AC20"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary, acting through the Assistant Secretary, and in consultation with the Assistant Attorney General for the Civil Rights Division of the Department of Justice, shall award grants to States, Indian Tribes, Tribal organizations, and political subdivisions thereof to establish or expand programs—</text><paragraph id="H7AC71252B6564AEE895629C54429247E"><enum>(1)</enum><text>to hire, employ, train, and dispatch mental health professionals to respond in lieu of law enforcement officers in emergencies in which—</text><subparagraph id="H566AF608E4544E30987492AC394073E4"><enum>(A)</enum><text>an individual calling 911, 988, or another emergency hotline states that a person—</text><clause id="HEAF8E32DFA1E4F1DB7B42B2402B6B320"><enum>(i)</enum><text>is in a mental health crisis;</text></clause><clause id="HAE74016FEE934472986A422B6D57C10C"><enum>(ii)</enum><text display-inline="yes-display-inline">may have a mental illness, a substance use disorder, a co-occurring mental illness and substance use disorder, or an intellectual or developmental disability; or</text></clause><clause id="H45290D45C2584E04B6DD3AEE319B9C3E"><enum>(iii)</enum><text display-inline="yes-display-inline">otherwise appears to need the immediate support of mental health professionals;</text></clause></subparagraph><subparagraph id="HE9E78AEC136C4A84A4FE4493CB7866AE"><enum>(B)</enum><text display-inline="yes-display-inline">a law enforcement officer or other first responder identifies a person as having (or possibly having) a mental illness or an intellectual or developmental disability (or otherwise appears to need the support of mental health professionals); or</text></subparagraph><subparagraph id="H4AD8F23C7BCB44FAB2904055605F2129"><enum>(C)</enum><text display-inline="yes-display-inline">a law enforcement officer or other first responder identifies a person as being (or possibly being) under the influence of a legal or illegal substance;</text></subparagraph></paragraph><paragraph id="HCFC230F2896A42CB8F0F7358285ACC5A"><enum>(2)</enum><text>to include in the training for mental health professionals pursuant to paragraph (1) training in—</text><subparagraph id="HB86391B94DF04AD7B98CC8729B3000C4"><enum>(A)</enum><text>the principles of deescalation; and</text></subparagraph><subparagraph id="H0951EAD367B640CEA7BB281F77C876FA"><enum>(B)</enum><text>developmentally appropriate techniques;</text></subparagraph></paragraph><paragraph id="H724BA427A74E4DD9ACC07FB15109C545"><enum>(3)</enum><text display-inline="yes-display-inline">to ensure that such mental health professionals link persons described in subparagraph (A), (B), or (C) of paragraph (1) with voluntary community-based services where appropriate;</text></paragraph><paragraph id="H8A2EAEBEF8F14196827273C65A414711"><enum>(4)</enum><text>to train the staff of dispatch centers regarding the proper handling of a report of an emergency described in paragraph (1), including training in the principles and techniques referred to in subparagraphs (A) and (B) of paragraph (2); and</text></paragraph><paragraph id="H3C44BAEDEB744123BCA0EC4C2FD40C72"><enum>(5)</enum><text display-inline="yes-display-inline">to coordinate with first responder agencies.</text></paragraph></subsection><subsection id="H92C3257A86124C80AB073CD0ABF0E583"><enum>(b)</enum><header>Additional awards</header><text display-inline="yes-display-inline">The Secretary shall make an additional award of funds under this section each fiscal year to grantees that—</text><paragraph id="H959366D975D545B68E6606E2BB069A65"><enum>(1)</enum><text display-inline="yes-display-inline">are in compliance with all conditions of their awards under this section, including the conditions specified in subsections (a) and (d); and</text></paragraph><paragraph id="H408265190D2843D58F686646467AC24B"><enum>(2)</enum><text>demonstrate that their programs under this section resulted in—</text><subparagraph id="HEFFA0E0B9F724F72B5B70DF6D6FB04B8"><enum>(A)</enum><text>a notable reduction in the incarceration and death of persons with mental illness or an intellectual or developmental disability; or</text></subparagraph><subparagraph id="H68264D77241341AA859D1EB9A46ACBEE"><enum>(B)</enum><text display-inline="yes-display-inline">a notable reduction in the use of force by police and a notable increase in referrals of persons with a mental illness or intellectual disability to community-based, voluntary support services (other than institutionalization or carceral support services).</text></subparagraph></paragraph></subsection><subsection id="HDCBF52E4A64B4CF4B1E9B35EA28208F0"><enum>(c)</enum><header>Priority</header><text display-inline="yes-display-inline">In awarding grants under this section, the Secretary shall give priority to States, Indian Tribes, Tribal organizations, and political subdivisions thereof that—</text><paragraph id="H1B73F15D029649C39142B0897D0E67DC"><enum>(1)</enum><text display-inline="yes-display-inline">have high rates of arrests and incarceration of persons with a mental illness, a substance use disorder, a co-occurring mental health and substance use disorder, or an intellectual or developmental disability;</text></paragraph><paragraph id="H4D598C3B7C604138939B1D655E82F959"><enum>(2)</enum><text>commit to increasing resources for mental health and community-based support services or solutions for such persons; or</text></paragraph><paragraph id="H56101C224E2148DAA285F279431D3852"><enum>(3)</enum><text>include peer support specialists in their current first responder model.</text></paragraph></subsection><subsection id="HE65BE140B6A848AAA8617E96C412B007"><enum>(d)</enum><header>Reporting</header><paragraph id="H7E43983B2A9B4AA788A462DA7ACFC2FA"><enum>(1)</enum><header>By grantees</header><text>A recipient of a grant under this section shall submit to the Secretary—</text><subparagraph id="HEB80A02821EC4A27BEC885C55E48721C"><enum>(A)</enum><text display-inline="yes-display-inline">a quarterly report on—</text><clause id="H75E8129743EE473CAFCD65E97A394CC6"><enum>(i)</enum><text>the number and percentage of emergencies where mental health professionals were dispatched in lieu of law enforcement officers pursuant to assistance under this section;</text></clause><clause id="H2A6A2A043B1541EEBCFECAF2E71AFFB4"><enum>(ii)</enum><text>such other matters as the Secretary may require for determining whether the recipient should receive an additional award under subsection (b); and</text></clause><clause id="H5B83B5D1D40349EE9997E074099A80C3"><enum>(iii)</enum><text display-inline="yes-display-inline">any increase or decrease, compared to any previous quarter, in incarceration or institutionalization as a result of dispatching mental health professionals pursuant to assistance under this section, disaggregated to include data specific to persons with intellectual and developmental disabilities and mental illnesses where available and permitted to be disclosed under applicable privacy law, so as—</text><subclause id="HE62874AEDA134E92B280D6F15ACF0608"><enum>(I)</enum><text>to provide a critical baseline analysis; and</text></subclause><subclause id="H4B14B8A4D3AD40B5A6ABB65E381CAB68"><enum>(II)</enum><text>to ensure that mental health practitioners are not simply funneling individuals into other institutionalized settings; and</text></subclause></clause></subparagraph><subparagraph id="H6E7184A93F3B4E12B54B5AF228FB8FAE"><enum>(B)</enum><text>a final report on the use of such grant.</text></subparagraph></paragraph><paragraph id="H3C7D7628CD584ED289636DD3DEBA987D"><enum>(2)</enum><header>By Secretary</header><text>Not later than 1 year after awarding the first grant under this section, and annually thereafter, the Secretary shall submit to the Congress a report on the grant program under this section.</text></paragraph><paragraph id="HCDB469D904CF47D4A2E84FA6E98008D2"><enum>(3)</enum><header>Disaggregation of data</header><text display-inline="yes-display-inline">The reporting pursuant to paragraphs (1) and (2) shall, to the extent determined by the Secretary to be applicable, be disaggregated by age, sex, gender, race, and ethnicity.</text></paragraph></subsection><subsection id="H73FCA4952B5746589F057E68BA3D1642"><enum>(e)</enum><header>Revocation of grant</header><text display-inline="yes-display-inline">If the Secretary finds, based on reporting under subsection (d) or other information, that activities funded through a grant under this section are leading to a significant increase in incarceration or institutionalization—</text><paragraph id="HFD405B91E97F435A987D77B181234019"><enum>(1)</enum><text>the Secretary shall revoke the grant; and</text></paragraph><paragraph id="HE019FF3B6C3D40F994F1263999A8A634"><enum>(2)</enum><text>the grantee shall repay to the Federal Government any amounts that the grantee—</text><subparagraph id="HFD204285E30C4FEBB1186ED7FE0A3F4F"><enum>(A)</enum><text>received through the grant; and</text></subparagraph><subparagraph id="H64E5DEB0316C4B6892070B973DED47AA"><enum>(B)</enum><text>has not obligated or expended.</text></subparagraph></paragraph></subsection><subsection id="HC4468DB2DCB04EE296C8836D7B66A3A9"><enum>(f)</enum><header>Technical assistance</header><text display-inline="yes-display-inline">The Secretary, acting through the Assistant Secretary, and in consultation with the Assistant Attorney General for the Civil Rights Division of the Department of Justice, shall provide technical assistance to grantees under this section (or other Federal law), and to other States, Indian Tribes, Tribal organizations, and political subdivisions thereof, to hire, employ, train, and dispatch mental health professionals to respond in lieu of law enforcement officers, as described in subsection (a).</text></subsection><subsection id="H1E66E87264B8420EB9F98D2C9383BE6E"><enum>(g)</enum><header>Definitions</header><text>In this section:</text><paragraph id="H44FD6A3A2FA44D66BA4C0E38804F34ED"><enum>(1)</enum><text display-inline="yes-display-inline">The term <term>first responder</term> means an individual who, in the course of such individual’s professional duties, is dispatched to respond to fire, medical, public safety, or mental health emergencies.</text></paragraph><paragraph id="HE34B1954BD9944788A001E1529ACABDF"><enum>(2)</enum><text>The terms <term>Indian Tribe</term> and <term>Tribal organization</term> have the meanings given to the terms <term>Indian tribe</term> and <term>tribal organization</term>, respectively, in section 4 of the Indian Health Care Improvement Act.</text></paragraph><paragraph id="H6C483E7F8B4D4E0E8BACDCB02501C09D"><enum>(3)</enum><text display-inline="yes-display-inline">The term <term>peer support specialist</term> means an individual who—</text><subparagraph id="H560B8B6ADB5843B48D7E264872334A9F"><enum>(A)</enum><text display-inline="yes-display-inline">has lived experience of a mental health condition, a substance use disorder, or a co-occurring mental health and substance use disorder; and</text></subparagraph><subparagraph id="HE029E614A28148D1900DAAFBAAC44E88"><enum>(B)</enum><text display-inline="yes-display-inline">specializes in supporting individuals with mental health conditions, substance use disorders, or co-occurring mental health and substance use disorders.</text></subparagraph></paragraph></subsection><subsection id="H661DA18F201D4075B7F04E0FBE7532BB"><enum>(h)</enum><header>Funding</header><text display-inline="yes-display-inline">To carry out this section, there is authorized to be appropriated $250,000,000 for the period of the five fiscal years following the date of enactment of this section.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></section><section id="H63C4F394F78E419D8B6E60233948D256"><enum>3.</enum><header>Study</header><subsection id="H7DE306E8E8F84BCFAD62381ED84D2E66"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary of Health and Human Services and the Assistant Attorney General for the Civil Rights Division of the Department of Justice shall conduct a study on the effectiveness of programs and activities under section 520O of the Public Health Service Act, as added by section 2.</text></subsection><subsection id="H133B52882EDB4D85AD25D4D156A00F4B"><enum>(b)</enum><header>Qualitative and longitudinal examination</header><text>The study under subsection (a) shall include a qualitative and longitudinal study of—</text><paragraph id="H1D1EEB21691C4A52A59BFE7FA591FE73"><enum>(1)</enum><text>the number of persons diverted from arrests; and</text></paragraph><paragraph id="H0E6BC79071D44655BF8AFE675E903F4F"><enum>(2)</enum><text display-inline="yes-display-inline">short- and long-term outcomes for those persons, including reduced incarceration or institutionalization, reduced incidences of use of force, and reduced utilization of resources.</text></paragraph></subsection><subsection id="HF3248B683D13487B9DD4538CA5979073"><enum>(c)</enum><header>Completion; report</header><text>Not later than 3 years after the date of enactment of this Act, the Secretary of Health and Human Services and the Assistant Attorney General for the Civil Rights Division of the Department of Justice shall—</text><paragraph id="H85A0A2B8C2ED49EF8C28AC11F9CC45DF"><enum>(1)</enum><text>complete the study under subsection (a);</text></paragraph><paragraph id="HC53E2FD2AA1D4FD99AA684723313D55C"><enum>(2)</enum><text>submit a report to the Congress on the results of such study; and</text></paragraph><paragraph id="H2926D115EFE742BE91AC4A8DB841A8B2"><enum>(3)</enum><text>publish such report.</text></paragraph></subsection></section><section id="HA28DF917E49D49DDAB5BD5F8A8D31AD0"><enum>4.</enum><header>Best practices</header><subsection id="HE0B7CF35E5F445AA975945002F49D308"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary of Health and Human Services, acting in consultation with the Assistant Attorney General for Civil Rights, shall develop and publish best practices relating to the deployment of mental health professionals acting as first responders.</text></subsection><subsection id="H2D5DEC7910404A488775B4C52A592890"><enum>(b)</enum><header>Contents</header><text display-inline="yes-display-inline">The best practices under subsection (a) shall—</text><paragraph id="H620F7EBDD831461B9B7F6FAB455E37BE"><enum>(1)</enum><text display-inline="yes-display-inline">be informed by lessons learned from the grant program under section 520O of the Public Health Service Act, as added by section 2; and</text></paragraph><paragraph id="H6A05C3CFC2924CC39CEC54DABD85BFD6"><enum>(2)</enum><text>include best practices for the proper handling and dispatch of a report of an emergency described in each of subparagraphs (A), (B), and (C) of section 520O(a)(1) of the Public Health Service Act, as added by section 2, including best practices for training in—</text><subparagraph id="HDAF42AB215134374ABE431AC6930FC53"><enum>(A)</enum><text>the principles and techniques in processing calls for persons who—</text><clause id="H7D63AA15361D48D39E23D53644A2BE53"><enum>(i)</enum><text>are experiencing a mental health crisis;</text></clause><clause id="H3587668805764D74B623C5D3E7B713E5"><enum>(ii)</enum><text display-inline="yes-display-inline">may have a mental illness, a substance use disorder, a co-occurring mental health and substance use disorder, or an intellectual or developmental disability; or</text></clause><clause id="H5A8B80EBD26C42B7A661A9EA53CA62EB"><enum>(iii)</enum><text display-inline="yes-display-inline">otherwise appear to need the immediate support of mental health professionals;</text></clause></subparagraph><subparagraph id="H551C3F2694EA4642BC43A155339DC186"><enum>(B)</enum><text>the principles of deescalation; and</text></subparagraph><subparagraph id="H3ADD674D637F419AB1F1A3599F866914"><enum>(C)</enum><text>developmentally appropriate techniques.</text></subparagraph></paragraph></subsection><subsection id="H391105827A214799AFA24751DF313567"><enum>(c)</enum><header>Timeline; updates</header><text>The Secretary of Health and Human Services shall—</text><paragraph id="HA4FE171053EC4D2B88F4956D44DA3A02"><enum>(1)</enum><text>not later than 1 year after the date of enactment of this Act, develop and publish initial best practices under this section; and</text></paragraph><paragraph id="H327C14EA2D3A4A37B245A6A7A98ACF7E"><enum>(2)</enum><text>not less than every 5 years thereafter, develop and publish updated best practices under this section.</text></paragraph></subsection><subsection id="H6D5F8C38409E4085BF8FFEEFA9A35EF2"><enum>(d)</enum><header>Definition</header><text display-inline="yes-display-inline">In this section, the term <term>first responder</term> has the meaning given to such term in section 520O of the Public Health Service Act, as added by section 2.</text></subsection></section><section id="H26459E536F354EA7A8C6034D710CF0C6"><enum>5.</enum><header>Rules of construction</header><subsection id="H847E3C31D5EB49C48845A7A3DE6EA1D4"><enum>(a)</enum><header>Hiring of law enforcement officers</header><text display-inline="yes-display-inline">Nothing in this Act (or the amendments made by this Act) shall be construed to remove, supplant, alter, or limit the authority of States, public agencies, or municipalities from hiring or recruiting career law enforcement officers (as defined in section 1709 of the Omnibus Crime Control and Safe Streets Act of 1968 (<external-xref legal-doc="usc" parsable-cite="usc/34/10389">34 U.S.C. 10389</external-xref>)) to engage in or supervise the prevention, detection, or investigation of violations of criminal laws when appropriate.</text></subsection><subsection id="HA48534F3021D4C5EAE80D64CA140B06C"><enum>(b)</enum><header>Circumstances of imminent or immediate danger</header><text display-inline="yes-display-inline">Nothing in this Act (or the amendments made by this Act) shall be construed to impede, supplant, alter, or limit the use of career law enforcement officers during emergencies—</text><paragraph id="H2C8B65761F5945FF85CCC9B240557AAF"><enum>(1)</enum><text display-inline="yes-display-inline">which such career law enforcement officers may be best suited to handle; and</text></paragraph><paragraph id="HF14FFB9D77C2454AA49A21671A38DD7E"><enum>(2)</enum><text>in which a person poses a direct threat to the health and safety of others that cannot be eliminated by a modification of policies, practices or procedures, or by the provision of auxiliary aids or services.</text></paragraph></subsection><subsection id="H9238F1E9BA0649F7AF2746B3B1E5CC0C"><enum>(c)</enum><header>Nondiscrimination</header><text display-inline="yes-display-inline">Nothing in this Act (or the amendments made by this Act) shall be construed to limit or alter the protections and requirements of applicable Federal and State civil rights laws and regulations.</text></subsection><subsection id="H3FA89B05BE094E4283B0CA3146358F35"><enum>(d)</enum><header>Definitions</header><text display-inline="yes-display-inline">In this section, the term <term>direct threat</term> has the meaning given to such term in sections 35.139 and 35.104 of title 28, Code of Federal Regulations (as in effect on the date of enactment of this Act).</text></subsection></section></legis-body></bill> 

