1.
This Act may be cited as the
Keeping Families Together
Act
.
2.
It is the purpose of this Act
to assist States in eliminating the practice of parents giving custody of their
seriously emotionally disturbed children to State agencies for the purpose of
securing mental health care for those children.
3.
Title V of the
Public Health Service Act
(42 U.S.C.
290aa et seq.) is amended—
(1)
by redesignating the second
part G (relating to services provided through religious organizations) as part
J;
(2)
by redesignating sections 581
through 584 of part J (as so redesignated) as sections 596 through 596C,
respectively; and
(3)
by adding at the end the
following:
K
597.
(a)
The Secretary, acting
through the Administrator and in consultation with the task force established
under section 597A, is authorized to award competitive grants to States to
enable such States to establish systems of care to treat and provide services
to all eligible children and youth. The Secretary shall ensure that the amount
awarded to each grantee is sufficient to enable the grantee to accomplish the
purposes of the grant.
(b)
To be eligible for a grant
under subsection (a) a State shall—
(1)
have laws or policies in
effect to ensure that children receive appropriate mental health services so
that parents do not have to relinquish legal custody of such children;
(2)
submit to the Secretary an
application from the Governor in accordance with subsection (c);
(3)
provide assurances that the
State will provide matching funds in accordance with subsection (e); and
(4)
meet such other
requirements as the Secretary determines appropriate.
(c)
(1)
An application submitted
for a grant under this section shall include—
(A)
a brief description of the
system of care that the State intends to establish with amounts received under
the grant to ensure that eligible children and youth and their families receive
the appropriate individualized mental health treatment and family support
services necessary to keep such families together;
(B)
a description of the
process by which the State will formulate a State plan that meets the
requirements of paragraph (2), including participants, timelines, and any
previous or ongoing efforts related to the establishment of a statewide
system;
(C)
an estimate of the number
of eligible children and youth in the State, and the number of eligible
children and youth who will be served under the grant;
(D)
a description of existing
systems of care in the State (including systems funded under section 561) and
existing interagency collaboration that demonstrates a foundation on which the
State can build a system of care under a grant under this section;
(E)
a brief description of the
manner in which services for all eligible children and youth are expected to be
funded under the system established by the State under the grant;
(F)
a description of children’s
mental health services capacity in the State and the steps that will be taken,
if necessary, to ensure that adequate capacity exists to implement the proposed
system of care;
(G)
a description of the source
of the State matching funds; and
(H)
other information as
required by the Secretary.
(2)
Prior to receiving funds
under the grant for the second grant year, a State shall submit to the
Secretary and the Secretary shall approve, a State plan that—
(A)
is developed through a
collaborative process that includes the required State partners as represented
by senior officials with policymaking authority, the required private partners,
and other entities that the governor of the State determines
appropriate;
(B)
contains a description and
assessment of the effectiveness of the laws or policies that the State has in
effect to ensure that children receive appropriate mental health services and
that parents do not have to relinquish legal custody of such children in order
to obtain such services;
(C)
contains a description of
the services to be provided to eligible children and youth and the sources of
such services, including the extent to which the State will build upon existing
systems of care within the State;
(D)
contains a description of
the procedures to be implemented for the early identification, assessment, and
referral, by health care providers, mental health agencies, other child-serving
entities, child welfare, corrections, and juvenile justice systems, of all
eligible children and youth for appropriate care and for coordinating services
among child welfare, juvenile justice, and child mental health agencies,
including co-location of services as appropriate;
(E)
describes any legislative
changes that are required to implement the State plan;
(F)
describes how the State
screens children and youth entering the juvenile justice and child welfare
systems for mental health problems, including the State’s mental health
screening procedures as part of the early and periodic screening, diagnostic,
and treatment services described in section 1905(r) of the
Social Security Act that are provided
under the medicaid programs;
(G)
contains a description of
the plan of the State for ensuring that there will be adequate capacity to
serve all eligible children;
(H)
contains a description of
the plan of the State for financing the system of care developed under the
grant, including—
(i)
the manner in which the
State will use—
(I)
contributions from State
agencies;
(II)
State eligibility options
or waivers authorized with respect to the State medicaid program such as those
authorized under sections 1902(e)(3) and 1915(c) of the
Social Security Act;
(III)
the State Children’s Health
Insurance Program under title XXI of the Social
Security Act (including an assurance that grant funds will not be
used as a State match under the medicaid or SCHIP programs); and
(IV)
other public health
insurance mechanisms; and
(ii)
how Federal grant dollars
will be used to enable the State to achieve a sustainable system of care to
serve all eligible children and youth;
(I)
contains a description of
how the State will provide outreach services to families, provide for public
educational activities, and involve families; and
(J)
establishes a method for
tracking and reporting the number of children and youth entering child welfare
and juvenile justice systems with significant mental health problems.
(3)
In awarding grants under
this section, the Secretary shall give priority to States—
(A)
that have a history of
developing and supporting local or statewide systems care and of successful
interagency collaboration;
(B)
that have taken steps to
broaden access to community-based services for children with serious emotional
disturbances;
(C)
that have provided
reasonable estimates of the numbers of eligible children and youth;
(D)
that have sufficient mental
health service capacity or specific plans for sufficiently increasing mental
health services capacity to successfully implement the proposed system of
care;
(E)
in which the governor’s
office will play a leading role in the formulation of the State plan required
under paragraph (2); and
(F)
that will involve State
juvenile and family court judges in the planning and oversight of the system of
care.
(d)
A State shall use amounts
received under a grant under this section to—
(1)
establish State- and
local-level infrastructure to allow for interagency cooperation and cross
system financing to—
(A)
support the purchase and
delivery of a comprehensive array of community-based mental health and family
support services to all eligible children and youth and their families;
(B)
decrease categorical
funding structures and eliminate inter-agency fragmentation of services;
and
(C)
increase the capacity of
agencies to share public resources and improve parental access to services for
children with mental health needs to eliminate the need to relinquish custody
in order to receive treatment;
(2)
expand public health
insurance programs to cover a comprehensive array of community-based mental
health and family support services for eligible children and youth and their
families that will be sustainable after the grant has expired;
(3)
deliver mental health care
and family support services to eligible children and youth and their families
as part of a transition to a sustainable system of care for such children and
youth;
(4)
provide outreach and public
education concerning programs and activities funded under this section;
(5)
provide training and
professional development for personnel who work with eligible children and
youth as required to successfully implement the State plan; and
(6)
carry out other
administrative activities related to the programs and activities carried out
under the grant, including the development and maintenance of data
systems.
(e)
(1)
A State that receives a
grant under this section shall, with respect to the costs to be incurred by the
State in carrying out the purpose for which the grant is awarded, make
available non-Federal contributions toward such costs in an amount that—
(A)
for the third fiscal year
for which the entity receives payments from a grant under such subsection, is
not less than $1 for each $2 of Federal funds provided in the grant;
(B)
for the fourth such fiscal
year, is not less than $1 for each $1 of Federal funds provided in the grant;
and
(C)
for the fifth and sixth
such fiscal years, is not less than $2 for each $1 of Federal funds provided in
the grant.
(2)
Determination of amount contributed
Non-Federal contributions
required in paragraph (1) may be in cash or in kind, fairly evaluated,
including plant, equipment, or services. Amounts provided by the Federal
Government, or services assisted or subsidized to any significant extent by the
Federal Government, may not be included in determining the amount of such
non-Federal contributions.
(3)
With respect to a State
that complies with the requirement of paragraph (2) through the provision of
in-kind contributions, such State shall provide the Secretary with an
accounting that describes the value of such in-kind contributions.
(f)
Limitation on use for administrative costs
Not more than 5 percent of
the amount that a State receives under a grant under this section shall be used
for administrative costs.
(g)
Grants under this section
shall be payable over a 6-year period.
(h)
(1)
Secretary, acting through
the Administrator and in consultation with the task force established under
section 597A, shall require States to report information that is appropriate to
permit an assessment to be made of the success of States in the implementation
of programs under this section. Such information shall, at a minimum,
include—
(A)
the number of eligible
children and youth in foster care;
(B)
the number of eligible
children and youth in residential treatment centers;
(C)
appropriate information
concerning the participation and academic progress of eligible children and
youth in school;
(D)
measures of the contacts of
eligible children and youth with juvenile justice systems;
(E)
measures of the clinical
improvement of eligible children and youth; and
(F)
information concerning the
level of satisfaction of eligible children and youth and their families with
services received.
(2)
Beginning with the second
fiscal year in which a State receives funding under a grant under this section,
the State shall annually report to the Secretary on the success of the programs
and activities carried out by the State under the grant. Such reports shall
include the information specified in paragraph (1) and other information
required by the Secretary.
(3)
(A)
Not later than 3 years
after the date of enactment of this part, the Secretary shall submit to
Congress a report on the success of States in using grants under this section
to eliminate children and youth custody relinquishment solely to obtain mental
health care. Such report shall include recommendations to strengthen the
program under this section.
(B)
Not later than 6 years
after the date of enactment of this part, the Secretary shall submit to
Congress a final report on the success of States in using grants under this
section to eliminate children and youth custody relinquishment solely to obtain
mental health care.
(i)
The Secretary, in
consultation with the task force established under section 597A, may provide
technical assistance to States in carrying out programs and activities under
this section. The Secretary shall use not more than 20 percent of the amount
appropriate for each fiscal year, not to exceed $5,000,000 in any such fiscal
year, to carry out this subsection and shall coordinate technical assistance
under this section with other technical assistance programs as
appropriate.
(j)
In this section:
(1)
Eligible children and youth
The term eligible
children and youth means children and youth under the age of 21 years
who are in the custody of the State for the purpose of receiving mental health
services or at-risk of entering into the custody of the State for the purpose
of receiving mental health services.
(2)
The term family
support services means individualized services that are designed with
input from the family and provided to eligible children and youth and their
families to promote the mental health of an eligible child or youth, to
strengthen the ability of family members to care for an eligible child or
youth, or to enable an eligible child or youth to take advantage of other
treatment and family support services.
(3)
Required private partners
The term required
private partners includes—
(A)
representatives of families
of seriously emotionally disturbed children;
(B)
representatives of mental
health care providers;
(C)
representatives of private
health insurers; and
(D)
representatives of
hospitals and residential care facilities.
(4)
The term required
State partners with respect to a State includes—
(A)
the State agency
responsible for children’s mental health;
(B)
the State child welfare
agency;
(C)
the State juvenile justice
agency;
(D)
the State Medicaid
agency;
(E)
the State education
agency;
(F)
the State substance abuse
agency;
(G)
the State bureau of
insurance; and
(H)
the office of the Governor
of the State.
(5)
The term State
includes, in addition to the several States, the District of Columbia, the
Commonwealth of Puerto Rico, the Commonwealth of the Northern Mariana Islands,
the Virgin Islands, Guam, American Samoa, the Trust Territory of the Pacific
Islands, and Indian tribes.
(k)
Authorization of appropriations
There are authorized to be
appropriated to carry out this section, $4,500,000 for fiscal year 2006,
$6,500,000 for fiscal year 2007, and $11,000,000 for each of fiscal years 2008
through 2010.
597A.
(a)
The Administrator, in
conjunction with the Director of the Office of Juvenile Justice and Delinquency
Prevention, the Administrator of the Administration for Children and Families,
the Administrator of the Centers for Medicare & Medicaid Services, and the
Assistant Secretary of Education for Special Education, shall establish and
staff a task force to examine problems of mental health in the child welfare
and juvenile justice systems and issues with respect to access by children and
youth to mental health services, and the role of their agencies in promoting
access by children and youth to mental health services.
(b)
The task force established
under subsection (a) shall—
(1)
work with mental health and
child advocates, representatives of families of eligible children and youth,
and representatives of State systems of care to make recommendations to
Congress concerning strategies to improve the delivery of mental health
services, including prevention services, to children and youth with serious
emotional disturbances, including those who are at risk of dropping out of
school or at risk of coming in contact with child welfare and juvenile justice
systems;
(2)
work with mental health and
child advocates, representatives of families of eligible children and youth,
and representatives of State systems of care to develop improved reporting
requirements for States concerning the number of children and youth entering
child welfare and juvenile justice systems solely to access mental health
services;
(3)
in consultation with States
and appropriate stakeholders, create standard definitions for the categories of
data to be collected on such children and youth;
(4)
foster interagency
cooperation to eliminate the practice of custody relinquishment;
(5)
provide advice to the
Administrator in implementation of the family support grant programs under
section 597;
(6)
coordinate and deliver
technical assistance to States and State agencies to help implement programs
under such grant program;
(7)
make recommendations to
break down barriers to coordination in existing Federal programs and to allow
for more effective integration across agencies and programs; and
(8)
provide a biannual report
to Congress on its recommendations and its progress in carrying out its duties,
ending the practice of parents relinquishing legal custody of their children
with serious emotional disturbances in order to obtain mental health services,
and improving the delivery of mental health services to children with serious
emotional disturbances.
(c)
Authorization of appropriations
There are authorized to be
appropriated to carry out this section, $1,000,000 for each of fiscal years
2006 through 2010. Of the amount appropriate for each fiscal year under this
subsection, 60 percent of such amount shall be made available to the Secretary,
20 percent of such amount shall be made available to the Attorney General, and
20 percent of such amount shall be made available to the Secretary of
Education.
.
4.
Treatment of inpatient psychiatric hospital services for
individuals under age 21 in home or community-based services waivers
(a)
Section
1915(c) of the Social Security
Act (42 U.S.C. 1396n(c)) is
amended—
(1)
in paragraph (1)—
(A)
in the first sentence, by
inserting , or would require inpatient psychiatric hospital services for
individuals under age 21,
after intermediate care facility for
the mentally retarded
; and
(B)
in the second sentence, by
inserting , or would require inpatient psychiatric hospital services for
individuals under age 21
before the period;
(2)
in paragraph (2)(B), by
striking or services in an intermediate care facility for the mentally
retarded
each place it appears and inserting services in an
intermediate care facility for the mentally retarded, or inpatient psychiatric
hospital services for individuals under age 21
;
(3)
in paragraph (2)(C)—
(A)
by inserting , or who
are determined to be likely to require inpatient psychiatric hospital services
for individuals under age 21,
after , or intermediate care
facility for the mentally retarded
; and
(B)
by striking or
services in an intermediate care facility for the mentally retarded
and
inserting services in an intermediate care facility for the mentally
retarded, or inpatient psychiatric hospital services for individuals under age
21
; and
(4)
in paragraph (7)(A)—
(A)
by inserting or would
require inpatient psychiatric hospital services for individuals under age
21,
after intermediate care facility for the mentally
retarded,
; and
(B)
by inserting or who
would require inpatient psychiatric hospital services for individuals under age
21
before the period.
(b)
The amendments made by
subsection (a) apply with respect to medical assistance provided on or after
January 1, 2006.