Mental Health Justice Act of 2021

II 117TH CONGRESS 1ST SESSION S. 515 To authorize the Secretary of Health and Human Services to award grants to States and political subdivisions of States to hire, employ, train, and dispatch mental health professionals to respond in lieu of law en- forcement officers in emergencies involving one or more persons with a mental illness or an intellectual or developmental disability, and for other purposes. IN THE SENATE OF THE UNITED STATES MARCH 1, 2021 Ms. WARREN (for herself, Ms. KLOBUCHAR, and Mr. BOOKER) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To authorize the Secretary of Health and Human Services to award grants to States and political subdivisions of States to hire, employ, train, and dispatch mental health professionals to respond in lieu of law enforcement offi- cers in emergencies involving one or more persons with a mental illness or an intellectual or developmental dis- ability, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 VerDate Sep 11 2014 05:51 Mar 31, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S515.IS S515 pbinns on DSKJLVW7X2PROD with BILLS 2 •S 515 IS SECTION 1. SHORT TITLE. 1 This Act may be cited as the ‘‘Mental Health Justice 2 Act of 2021’’. 3 SEC. 2. FINDINGS. 4 Congress finds the following: 5 (1) Needless institutionalization (including in 6 psychiatric hospitals) of people with disabilities is 7 generally a violation of the Americans with Disabil- 8 ities Act of 1990 (42 U.S.C. 12101 et seq.), and the 9 failure to provide sufficient community-based serv- 10 ices (such as supported housing, assertive commu- 11 nity treatment, mobile crisis, peer support, and sup- 12 ported employment) has resulted in needless institu- 13 tionalization as well as incarceration of persons with 14 mental illness or an intellectual or developmental 15 disability. 16 (2) In the landmark 1999 Supreme Court case 17 Olmstead v. L.C., the Supreme Court ruled that the 18 ‘‘unjustified institutional isolation of persons with 19 disabilities is a form of discrimination’’ prohibited by 20 the Americans with Disabilities Act of 1990 (42 21 U.S.C. 12101 et seq.). 22 (3) Regulations promulgated by the Attorney 23 General in 1991 affirm that title II of the Ameri- 24 cans with Disabilities Act of 1990 (42 U.S.C. 12131 25 et seq.) requires public entities to ‘‘administer serv- 26 VerDate Sep 11 2014 05:51 Mar 31, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S515.IS S515 pbinns on DSKJLVW7X2PROD with BILLS 3 •S 515 IS ices, programs, and activities in the most integrated 1 setting appropriate to the needs of qualified individ- 2 uals with disabilities’’ (28 C.F.R. 35.130(d)). The 3 regulation defines ‘‘the most integrated setting’’ as 4 one that ‘‘enables individuals with disabilities to 5 interact with nondisabled persons to the fullest ex- 6 tent possible’’ (28 C.F.R. pt. 35, App. B). 7 (4) Yet today, persons with a mental illness or 8 an intellectual or developmental disability are more 9 likely to be incarcerated and to be subject to exces- 10 sive use of force by law enforcement officers: 11 (A) One out of every 4 of the deaths 12 caused by law enforcement officers is a person 13 with mental illness. 14 (B) Persons with a mental illness or an in- 15 tellectual or developmental disability are often 16 charged with minor, nonviolent offenses. For 17 many of these persons, arrest and incarceration 18 could have been avoided if they had access to 19 intensive community-based services and stable 20 housing. 21 (5) Many of the police encounters that lead to 22 the incarceration (and in too many cases, death) of 23 people with mental illness or an intellectual or devel- 24 opmental disability could be avoided by having in 25 VerDate Sep 11 2014 05:51 Mar 31, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S515.IS S515 pbinns on DSKJLVW7X2PROD with BILLS 4 •S 515 IS place systems that ensure that calls to 911 or to law 1 enforcement result in dispatch of mental health pro- 2 fessionals, peer support workers, or others rather 3 than law enforcement officers. 4 (6) Many people who are incarcerated would be 5 better served in community services. If there were 6 sufficient community services, and persons with 7 mental illness or an intellectual or developmental 8 disability were connected to those services rather 9 than being arrested, thousands of people with men- 10 tal illness or an intellectual or developmental dis- 11 ability would avoid needless admissions to hospitals 12 or jails. Further, jails and hospitals would experi- 13 ence less crowding. 14 SEC. 3. GRANTS FOR MENTAL HEALTH PROFESSIONALS TO 15 ACT AS FIRST RESPONDERS. 16 (a) IN GENERAL.—The Secretary of Health and 17 Human Services (in this section referred to as the ‘‘Sec- 18 retary’’), acting through the Assistant Secretary for Men- 19 tal Health and Substance Use and in consultation with 20 the Assistant Attorney General for the Civil Rights Divi- 21 sion of the Department of Justice (in this section referred 22 to as the ‘‘Assistant Attorney General’’), shall award 23 grants to States and political subdivisions of States— 24 VerDate Sep 11 2014 05:51 Mar 31, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S515.IS S515 pbinns on DSKJLVW7X2PROD with BILLS 5 •S 515 IS (1) to hire, employ, train, and dispatch mental 1 health professionals to respond in lieu of law en- 2 forcement officers in emergencies in which— 3 (A) an individual calling 911, 988, or an- 4 other emergency hotline states that a person— 5 (i) is in a mental health crisis; or 6 (ii) may have a mental illness or an 7 intellectual or developmental disability; 8 (B) a law enforcement officer or other first 9 responder identifies a person as having (or pos- 10 sibly having) a mental illness or an intellectual 11 or developmental disability; or 12 (C) a law enforcement officer or other first 13 responder identifies a person as being (or pos- 14 sibly being) under the influence of a legal or il- 15 legal substance; 16 (2) to include in the training for mental health 17 professionals pursuant to paragraph (1) training 18 in— 19 (A) the principles of de-escalation and 20 anti-racism; and 21 (B) age-appropriate mechanisms for car- 22 rying out the professionals’ responsibilities; 23 (3) to ensure that such mental health profes- 24 sionals link persons described in subparagraph (A), 25 VerDate Sep 11 2014 05:51 Mar 31, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S515.IS S515 pbinns on DSKJLVW7X2PROD with BILLS 6 •S 515 IS (B), or (C) of paragraph (1) with voluntary commu- 1 nity-based services where appropriate; and 2 (4) to train the staff of dispatch centers regard- 3 ing the proper handling of a report of an emergency 4 described in paragraph (1), including training in the 5 principles of de-escalation and anti-racism referred 6 to in paragraph (2)(A). 7 (b) DELEGATION.—The Secretary shall delegate re- 8 sponsibility for carrying out the Secretary’s responsibil- 9 ities under this section and section 4 to the Director of 10 the Center for Mental Health Services of the Substance 11 Abuse and Mental Health Services Administration. 12 (c) ADDITIONAL AWARDS.—The Secretary shall 13 make an additional award of funds under this section each 14 fiscal year to grantees that demonstrate that their pro- 15 grams under this section resulted in— 16 (1) a notable reduction in the incarceration and 17 death of persons with mental illness or an intellec- 18 tual or developmental disability; or 19 (2) a notable reduction in the use of force by 20 police and a notable increase in referrals of persons 21 with a mental illness or intellectual disability to com- 22 munity-based, voluntary support services (other than 23 institutionalization or carceral support services). 24 VerDate Sep 11 2014 05:51 Mar 31, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S515.IS S515 pbinns on DSKJLVW7X2PROD with BILLS 7 •S 515 IS (d) PRIORITY.—In awarding grants under this sec- 1 tion, the Secretary shall give priority to States and polit- 2 ical subdivisions of States that— 3 (1) have high rates of arrests and incarceration 4 of persons with a mental illness or an intellectual or 5 developmental disability; 6 (2) commit to increasing resources for mental 7 health and community-based support services or so- 8 lutions for such persons; or 9 (3) include peer support specialists in their cur- 10 rent first responder model. 11 (e) REPORTING.— 12 (1) BY GRANTEES.—A recipient of a grant 13 under this section shall submit to the Secretary— 14 (A) a quarterly report on— 15 (i) the number and percentage of 16 emergencies where mental health profes- 17 sionals were dispatched in lieu of law en- 18 forcement officers pursuant to assistance 19 under this section; 20 (ii) such other matters as the Sec- 21 retary may require for determining wheth- 22 er the recipient should receive an addi- 23 tional award under subsection (c); and 24 VerDate Sep 11 2014 05:51 Mar 31, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S515.IS S515 pbinns on DSKJLVW7X2PROD with BILLS 8 •S 515 IS (iii) any increase or decrease, com- 1 pared to any previous quarter, in incarcer- 2 ation or institutionalization as a result of 3 dispatching mental health professionals 4 pursuant to assistance under this section, 5 disaggregated to include data specific to 6 persons with intellectual and developmental 7 disabilities and mental illnesses where 8 available, so as— 9 (I) to provide a critical baseline 10 analysis; and 11 (II) to ensure that mental health 12 practitioners are not simply funneling 13 individuals into other institutionalized 14 settings; and 15 (B) a final report on the use of such grant. 16 (2) BY SECRETARY.—Not later than 1 year 17 after awarding the first grant under this section, 18 and annually thereafter, the Secretary shall submit 19 to Congress a report on the grant program under 20 this section. 21 (3) DISAGGREGATION OF DATA.—The reporting 22 pursuant to paragraphs (1) and (2) shall be 23 disaggregated by age, gender, race, and ethnicity, to 24 the extent the Secretary determines appropriate. 25 VerDate Sep 11 2014 05:51 Mar 31, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S515.IS S515 pbinns on DSKJLVW7X2PROD with BILLS 9 •S 515 IS (f) REVOCATION OF GRANT.—If the Secretary finds, 1 based on reporting under subsection (e) or other informa- 2 tion, that activities funded through a grant under this sec- 3 tion are leading to a significant increase in incarceration 4 or institutionalization— 5 (1) the Secretary shall revoke the grant; and 6 (2) the grantee shall repay to the Federal Gov- 7 ernment any amounts that the grantee— 8 (A) received through the grant; and 9 (B) has not obligated or expended. 10 SEC. 4. TECHNICAL ASSISTANCE FOR POLITICAL SUBDIVI- 11 SIONS OF A STATE. 12 The Secretary of Health and Human Services, acting 13 through the Assistant Secretary for Mental Health and 14 Substance Use and in consultation with the Assistant At- 15 torney General for the Civil Rights Division of the Depart- 16 ment of Justice, shall provide technical assistance to 17 grantees under section 3 (or other Federal law), other po- 18 litical subdivisions of States, and States to hire, employ, 19 train, and dispatch mental health professionals to respond 20 in lieu of law enforcement officers, as described in section 21 3. 22 SEC. 5. STUDY. 23 (a) IN GENERAL.—The Secretary of Health and 24 Human Services and the Assistant Attorney General for 25 VerDate Sep 11 2014 05:51 Mar 31, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S515.IS S515 pbinns on DSKJLVW7X2PROD with BILLS 10 •S 515 IS the Civil Rights Division of the Department of Justice 1 shall conduct a study of the effectiveness of programs and 2 activities under sections 3 and 4. 3 (b) QUALITATIVE AND LONGITUDINAL EXAMINA- 4 TION.—The study under subsection (a) shall include a 5 qualitative and longitudinal study of— 6 (1) the number of persons diverted from ar- 7 rests; and 8 (2) short- and long-term outcomes for those 9 persons, including reduced recidivism, reduced 10 incidences of use of force, and reduced utilization of 11 resources. 12 (c) COMPLETION; REPORT.—Not later than 3 years 13 after the date of enactment of this Act, the Secretary of 14 Health and Human Services and the Assistant Attorney 15 General for the Civil Rights Division of the Department 16 of Justice shall— 17 (1) complete the study under subsection (a); 18 (2) submit a report to Congress on the results 19 of such study; and 20 (3) publish such report. 21 VerDate Sep 11 2014 05:51 Mar 31, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S515.IS S515 pbinns on DSKJLVW7X2PROD with BILLS 11 •S 515 IS SEC. 6. FUNDING. 1 To carry out this legislation, there are authorized to 2 be appropriated such sums as may be necessary for fiscal 3 year 2021 and each subsequent fiscal year. 4 Æ VerDate Sep 11 2014 05:51 Mar 31, 2021 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6301 E:\BILLS\S515.IS S515 pbinns on DSKJLVW7X2PROD with BILLS