[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[S. 464 Introduced in Senate (IS)]







106th CONGRESS
  1st Session
                                 S. 464

   To meet the mental health and substance abuse treatment needs of 
                    incarcerated children and youth.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           February 24, 1999

 Mr. Wellstone (for himself, Mr. Kennedy, and Ms. Landrieu) introduced 
the following bill; which was read twice and referred to the Committee 
               on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
   To meet the mental health and substance abuse treatment needs of 
                    incarcerated children and youth.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Mental Health Juvenile Justice 
Act''.

SEC. 2. BLOCK GRANT FUNDING FOR TREATMENT AND DIVERSION PROGRAMS.

    Subpart 3 of part B of title V of the Public Health Service Act (42 
U.S.C. 290bb-31 et seq.) is amended by adding at the end the following:

``SEC. 520C. GRANTS FOR STATE PARTNERSHIPS.

    ``(a) In General.--The Attorney General and the Secretary shall 
make grants to partnerships between State and local juvenile justice 
agencies and State and local mental health authorities (or appropriate 
children service agencies) in accordance with this section.
    ``(b) Use of Funds.--A partnership described in subsection (a) that 
receives a grant under this section shall use such amounts for the 
establishment and implementation of programs that address the service 
needs of juveniles who come into contact with the justice system 
(including facilities contracted for operation by State or local 
juvenile authorities) who have mental health or substance abuse 
problems, by requiring the following:
            ``(1) Diversion.--Appropriate diversion of those juveniles 
        from incarceration--
                    ``(A) at imminent risk of being taken into custody;
                    ``(B) at the time they are initially taken into 
                custody;
                    ``(C) after they are charged with an offense or act 
                of juvenile delinquency;
                    ``(D) after they are adjudicated delinquent but 
                prior to case disposition; and
                    ``(E) after they are released from a juvenile 
                facility for the purpose of attending after-care 
                programs.
            ``(2) Treatment.--
                    ``(A) Screening and assessment of juveniles.--
                            ``(i) In general.--Initial mental health 
                        screening shall be completed for all juveniles 
                        immediately upon entering the juvenile justice 
                        system or a juvenile facility. Screening shall 
                        be conducted by qualified health and mental 
                        health professionals or by staff who have been 
                        trained by qualified health, mental health, and 
                        substance abuse professionals. In the case of 
                        screening by staff, the screening results 
                        should be reviewed by qualified health and 
                        mental health professionals not later than 24 
                        hours after the screening.
                            ``(ii) Acute mental illness.--Juveniles who 
                        suffer from acute mental disorders, who are 
                        suicidal, or in need of detoxification shall be 
                        placed in or immediately transferred to an 
                        appropriate medical or mental health facility. 
                        They shall be admitted to a secure correctional 
                        facility only with written medical clearance.
                            ``(iii) Comprehensive assessment.--All 
                        juveniles entering the juvenile justice system 
                        shall have a comprehensive assessment conducted 
                        and an individualized treatment plan written 
                        and implemented within 2 weeks. This assessment 
                        shall be conducted within 1 week for juveniles 
                        incarcerated in secure facilities. Assessments 
                        shall be completed by qualified health, mental 
                        health, and substance abuse professionals.
                    ``(B) Treatment.--
                            ``(i) In general.--If the need for 
                        treatment is indicated by the assessment of a 
                        juvenile, the juvenile shall be referred to or 
                        treated by a qualified professional. A juvenile 
                        who is currently receiving treatment for a 
                        mental or emotional disorder shall have 
                        treatment continued.
                            ``(ii) Period.--Treatment shall continue 
                        until additional mental health assessment 
                        determines that the juvenile is no longer in 
                        need of treatment. Treatment plans shall be 
reevaluated at least every 30 days.
                            ``(iii) Discharge plan.--An incarcerated 
                        juvenile shall have a discharge plan prepared 
                        when the juvenile enters the correctional 
                        facility in order to integrate the juvenile 
                        back into the family and/or the community. This 
                        plan shall be updated in consultation with the 
                        juvenile's family or guardian before the 
                        juvenile leaves the facility. Discharge plans 
                        shall address the provision of aftercare 
                        services.
                            ``(iv) Medication.--Any juvenile receiving 
                        psychotropic medications shall be under the 
                        care of a licensed psychiatrist. Psychotropic 
                        medications shall be monitored regularly by 
                        trained staff for their efficacy and side 
                        effects.
                            ``(v) Specialized treatment.--Specialized 
                        treatment and services shall be continually 
                        available to a juvenile who--
                                    ``(I) has a history of mental 
                                health problems or treatment;
                                    ``(II) has a documented history of 
                                sexual offenses or sexual abuse, as a 
                                victim or perpetrator;
                                    ``(III) has substance abuse 
                                problems, health problems, learning 
                                disabilities, or histories of family 
                                abuse or violence; or
                                    ``(IV) has developmental 
                                disabilities.
                    ``(C) Medical and mental health emergencies.--All 
                correctional facilities shall have written policies and 
                procedures on suicide prevention. All staff working in 
                correctional facilities shall be trained and certified 
                annually in suicide prevention. Facilities shall have 
                written arrangements with a hospital or other facility 
                for providing emergency medical and mental health care. 
                Physical and mental health services shall be available 
                to an incarcerated juvenile 24 hours per day, 7 days 
                per week.
                    ``(D) Classification of juveniles.--
                            ``(i) In general.--Juvenile facilities 
                        shall classify and house juveniles in living 
                        units according to a plan that includes age, 
                        gender, offense, special medical or mental 
                        health condition, size, and vulnerability to 
                        victimization. Younger, smaller, weaker, and 
                        more vulnerable juveniles shall not be placed 
                        in housing units with older, more aggressive 
                        juveniles.
                            ``(ii) Boot camps.--juveniles who are under 
                        13 years old or who have serious medical 
                        conditions or mental illness shall not be 
                        placed in paramilitary boot camps.
                    ``(E) Confidentiality of records.--Mental health 
                and substance abuse treatment records of juveniles 
                shall be treated as confidential and shall be excluded 
                from the records that States require to be routinely 
                released to other correctional authorities and school 
                officials.
                    ``(F) Mandatory reporting.--States shall keep 
                records of the incidence and types of mental health and 
                substance abuse disorders in their juvenile justice 
                populations, the range and scope of services provided, 
                and barriers to service. The State shall submit an 
                analysis of this information yearly to the Department 
                of Justice.
                    ``(G) Staff ratios for correctional facilities.--
                Each secure correctional facility shall have a minimum 
                ratio of no fewer than 1 mental health counselor to 
                every 50 juveniles. Mental health counselors shall be 
                professionally trained and certified or licensed. Each 
                secure correctional facility shall have a minimum ratio 
                of 1 clinical psychologist for every 100 juveniles. 
                Each secure correctional facility shall have a minimum 
                ratio of 1 licensed psychiatrist for every 100 
                juveniles receiving psychiatric care.
                    ``(H) Use of force.--
                            ``(i) Written guidelines.--All juvenile 
                        facilities shall have a written behavioral 
                        management system based on incentives and 
                        rewards to reduce misconduct and to decrease 
                        the use of restraints and seclusion by staff.
                            ``(ii) Limitations on restraint.--Control 
                        techniques such as restraint, seclusion, 
                        chemical sprays, and room confinement shall be 
                        used only in response to extreme threats to 
                        life or safety. Use of these techniques shall 
                        be approved by the facility superintendent or 
                        chief medical officer and documented in the 
                        juvenile's file along with the justification 
for use and the failure of less restrictive alternatives.
                            ``(iii) Limitation on isolation.--Isolation 
                        and seclusion shall be used only for immediate 
                        and short-term security or safety reasons. No 
                        juvenile shall be placed in isolation without 
                        approval of the facility superintendent or 
                        chief medical officer or their official staff 
                        designee. All cases shall be documented in the 
                        juvenile's file along with the justification. A 
                        juvenile shall be in isolation only the amount 
                        of time necessary to achieve security and 
                        safety of the juvenile and staff. Staff shall 
                        monitor each juvenile in isolation once every 
                        15 minutes and conduct a professional review of 
                        the need for isolation at least every 4 hours. 
                        Any juvenile held in seclusion for 24 hours 
                        shall be examined by a physician or licensed 
                        psychologist.
                    ``(I) IDEA and rehabilitation act.--All juvenile 
                facilities shall abide by all mandatory requirements 
                and time lines set forth under the Individuals with 
                Disabilities Education Act and section 504 of the 
                Rehabilitation Act of 1973.
                    ``(J) Advocacy assistance.--
                            ``(i) In general.--The Secretary of Health 
                        and Human Services shall make grants to the 
                        systems established under part C of the 
                        Developmental Disabilities Assistance and Bill 
                        of Rights Act (42 U.S.C. 6041 et seq.) to 
                        monitor the mental health and special education 
                        services provided by grantees to juveniles 
                        under subparagraphs (A), (B), (C), (H), and 
                        (I), and to advocate on behalf of juveniles to 
                        assure that such services are properly 
                        provided.
                            ``(ii) Appropriation.--The Secretary of 
                        Health and Human Services will reserve no less 
                        than 3 percent of the funds appropriated under 
                        this section for the purposes set forth in 
                        clause (i).
    ``(c) Partnerships.--
            ``(1) In general.--Any partnership desiring to receive a 
        grant under this section shall submit an application at such 
        time, in such manner, and containing such information as the 
        Attorney General and the Secretary may prescribe.
            ``(2) Contents.--In accordance with guidelines established 
        by the Attorney General and the Secretary, each application 
        submitted under paragraph (1) shall--
                    ``(A) set forth a program or activity for carrying 
                out one or more of the purposes specified in this 
                section and specifically identify each such purpose 
                such program or activity is designed to carry out;
                    ``(B) provide that such program or activity shall 
                be administered by or under the supervision of the 
                applicant;
                    ``(C) provide for the proper and efficient 
                administration of such program or activity;
                    ``(D) provide for regular evaluation of such 
                program or activity;
                    ``(E) provide an assurance that the proposed 
                program or activity will supplement, not supplant, 
                similar programs and activities already available in 
                the community; and
                    ``(F) provide for such fiscal control and fund 
                accounting procedures as may be necessary to ensure 
                prudent use, proper disbursement, and accurate 
                accounting of funds receiving under this section.
    ``(d) Authorization of Appropriations.--
            ``(1) In general.--There are authorized to be appropriated 
        from the Violent Crime Reduction Trust Fund, $500,000,000 for 
        fiscal years 1999, 2000, 2001, 2002, and 2003 to carry out this 
        section.
            ``(2) Allocation.--Of amounts appropriated under paragraph 
        (1)--
                    ``(A) 35 percent shall be used for diversion 
                programs under subsection (b)(1); and
                    ``(B) 65 percent shall be used for treatment 
                programs under subsection (b)(2).
            ``(3) Incentives.--The Attorney General and the Secretary 
        shall give preference under subsection (b)(2) to partnerships 
        that integrate treatment programs to serve juveniles with co-
        occurring mental health and substance abuse disorders.
            ``(4) Waivers.--The Attorney General and the Secretary may 
        grant a waiver of requirements under subsection (b)(2) for good 
        cause.''.

SEC. 3. INITIATIVE FOR COMPREHENSIVE, INTERSYSTEM PROGRAMS.

    Subpart 3 of part B of title V of the Public Health Service Act (42 
U.S.C. 290bb-31 et seq.) is amended by adding at the end the following:

``SEC. 520D. INITIATIVE FOR COMPREHENSIVE, INTERSYSTEM PROGRAMS.

    ``(a) In General.--The Attorney General and the Secretary, acting 
through the Director of the Center for Mental Health Services, shall 
award competitive grants to eligible entities for programs that address 
the service needs of juveniles and juveniles with serious mental 
illnesses by requiring the State or local juvenile justice system, the 
mental health system, and the substance abuse treatment system to work 
collaboratively to ensure--
            ``(1) the appropriate diversion of such juveniles and 
        juveniles from incarceration;
            ``(2) the provision of appropriate mental health and 
        substance abuse services as an alternative to incarceration and 
        for those juveniles on probation or parole; and
            ``(3) the provision of followup services for juveniles who 
        are discharged from the juvenile justice system.
    ``(b) Eligibility.--To be eligible to receive a grant under this 
section an entity shall--
            ``(1) be a State or local juvenile justice agency, mental 
        health agency, or substance abuse agency;
            ``(2) prepare and submit to the Secretary an application at 
        such time, in such manner, and containing such information as 
        the Secretary may require, including--
                    ``(A) an assurance that the applicant has the 
                consent of all entities described in paragraph (1) in 
                carrying out and coordinating activities under the 
                grant; and
                    ``(B) with respect to services for juveniles, an 
                assurance that the applicant has collaborated with the 
                State or local educational agency and the State or 
                local welfare agency in carrying out and coordinating 
                activities under the grant;
            ``(3) be given priority if it is a joint application 
        between juvenile justice and substance abuse or mental health 
        agencies; and
            ``(4) ensure that funds from non-Federal sources are 
        available to match amounts provided under the grant in an 
        amount that is not less than--
                    ``(A) with respect to the first 3 years under the 
                grant, 25 percent of the amount provided under the 
                grant; and
                    ``(B) with respect to the fourth and fifth years 
                under the grant, 50 percent of the amount provided 
                under the grant.
    ``(c) Use of Funds.--
            ``(1) Initial year.--An entity that receives a grant under 
        this section shall, in the first fiscal year in which amounts 
        are provided under the grant, use such amounts to develop a 
        collaborative plan--
                    ``(A) for how the guarantee will institute a system 
                to provide intensive community services--
                            ``(i) to prevent high-risk juveniles from 
                        coming in contact with the justice system; and
                            ``(ii) to meet the mental health and 
                        substance abuse treatment needs of juveniles on 
                        probation or recently discharged from the 
                        justice system; and
                    ``(B) providing for the exchange by agencies of 
                information to enhance the provision of mental health 
                or substance abuse services to juveniles.
            ``(2) 2-5th years.--With respect to the second through 
        fifth fiscal years in which amounts are provided under the 
        grant, the grantee shall use amounts provided under the grant--
                    ``(A) to furnish services, such as assertive 
                community treatment, wrap-around services for 
                juveniles, multisystemic therapy, outreach, integrated 
                mental health and substance abuse treatment, case 
                management, health care, and transitional and 
                independent living services, mentoring programs, home-
                based services, and provision of appropriate after 
                school and summer programing;
                    ``(B) to establish a network of boundary spanners 
                to conduct regular meetings with judges, provide 
                liaison with mental health and substance abuse workers, 
                share and distribute information, and coordinate with 
                mental health and substance abuse treatment providers, 
                and probation or parole officers concerning provision 
                of appropriate mental health and drug and alcohol 
                addiction services for individuals on probation or 
                parole;
                    ``(C) to provide cross-system training among 
                police, corrections, and mental health and substance 
abuse providers with the purpose of enhancing collaboration and the 
effectiveness of all systems;
                    ``(D) to provide coordinated and effective 
                aftercare programs for juveniles with emotional or 
                mental disorders who are discharged from jail, prison, 
                or juvenile facilities;
                    ``(E) to purchase technical assistance to achieve 
                the grant project's goals; and
                    ``(F) to furnish services, to train personnel in 
                collaborative approaches, and to enhance intersystem 
                collaboration.
            ``(3) Definition.--In paragraph (2)(B), the term `boundary 
        spanners' means professionals who act as case managers for 
        juveniles with mental disorders and substance abuse addictions, 
        within both justice agency facilities and community mental 
        health programs and who have full authority from both systems 
        to act as problem-solvers and advocates on behalf of 
        individuals targeted for service under this program.
    ``(d) Area Served by the Project.--An entity receiving a grant 
under this section shall conduct activities under the grant to serve at 
least a single political jurisdiction.
    ``(e) Authorization of Appropriations.--There shall be made 
available to carry out the section, not less than 10 percent of the 
amount appropriated under section 1935(a) for each of the fiscal years 
1999 through 2003.''.

SEC. 4. INTERAGENCY RESEARCH, TRAINING, AND TECHNICAL ASSISTANCE 
              CENTERS.

    (a) Grants or Contracts.--The Secretary of Health and Human 
Services, acting through the Substance Abuse and Mental Health Services 
Administration and in consultation with the Juvenile Justice and 
Delinquency Prevention Office and the Justice Assistance Bureau, shall 
award grants and contracts for the establishment of 4 research, 
training, and technical assistance centers to carry out the activities 
described in subsection (c).
    (b) Eligibility.--To be eligible to receive a grant or contract 
under subsection (a), an entity shall--
            (1) be a public or nonprofit private entity; and
            (2) prepare and submit to the Secretary of Health and Human 
        Services an application, at such time, in such manner, and 
        containing such information as the Secretary may require.
    (c) Activities.--A center established under a grant or contract 
under subsection (a) shall--
            (1) provide training with respect to state-of-the-art 
        mental health and justice-related services and successful 
        mental health and substance abuse-justice collaborations, to 
        public policymakers, law enforcement administrators, public 
        defenders, police, probation officers, judges, parole 
        officials, jail administrators and mental health and substance 
        abuse providers and administrators;
            (2) engage in research and evaluations concerning State and 
        local justice and mental health systems, including system 
        redesign initiatives, and disseminate information concerning 
        the results of such evaluations;
            (3) provide direct technical assistance, including 
        assistance provided through toll-free telephone numbers, 
        concerning issues such as how to accommodate individuals who 
        are being processed through the courts under the Americans with 
        Disabilities Act of 1990 (42 U.S.C. 12101 et seq.), what types 
        of mental health or substance abuse service approaches are 
        effective within the judicial system, and how community-based 
        mental health or substance abuse services can be more 
        effective, including relevant regional, ethnic, and gender-
        related considerations; and
            (4) provide information, training, and technical assistance 
        to State and local governmental officials to enhance the 
        capacity of such officials to provide appropriate services 
        relating to mental health or substance abuse.
    (d) Authorization of Appropriations.--There is authorized to be 
appropriated, $4,000,000 for each fiscal year to carry out this 
section.
                                 <all>