I 117TH CONGRESS 1ST SESSION H. R. 1368 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 HOUSE OF REPRESENTATIVES FEBRUARY 25, 2021 Ms. PORTER (for herself, Ms. PRESSLEY, Ms. SCANLON, Mr. CA´RDENAS, Ms. MOORE of Wisconsin, Mr. TRONE, Mrs. BEATTY, Ms. SCHAKOWSKY, Mr. WELCH, Mr. CARSON, Mrs. NAPOLITANO, Mr. MOULTON, Mr. KHANNA, Mr. POCAN, Ms. PINGREE, Mr. HASTINGS, Mr. RYAN, Mr. FOSTER, Mr. LEVIN of California, Mr. LIEU, Mr. RASKIN, Mr. ESPAILLAT, Mr. CON- NOLLY, Mr. BLUMENAUER, Mr. JONES, Ms. WILD, Mr. DESAULNIER, Ms. MENG, Mr. MORELLE, Mr. GRIJALVA, Ms. CHU, Mr. RUSH, Ms. DEAN, Mr. MEEKS, Ms. VELA´ZQUEZ, Ms. JACOBS of California, Ms. OCASIO-CORTEZ, Mrs. CAROLYN B. MALONEY of New York, Mr. TORRES of New York, Mr. DEUTCH, Ms. DEGETTE, Mr. LOWENTHAL, Ms. OMAR, Ms. BUSH, Ms. TLAIB, Ms. WASSERMAN SCHULTZ, Ms. JAYAPAL, Mr. EVANS, Mr. MCGOVERN, Mr. NEGUSE, Ms. LEE of California, Ms. JACK- SON LEE, Ms. JOHNSON of Texas, Mr. JOHNSON of Georgia, Ms. SPEIER, Mrs. HAYES, Mrs. DEMINGS, and Mr. LAWSON of Florida) introduced the following bill; which was referred to the Committee on Energy and Com- merce, and in addition to the Committee on the Judiciary, for a period to be subsequently determined by the Speaker, in each case for consider- ation of such provisions as fall within the jurisdiction of the committee concerned A BILL To authorize the Secretary of Health and Human Services to award grants to States and political subdivisions of VerDate Sep 11 2014 02:02 Mar 22, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6652 E:\BILLS\H1368.IH H1368 pbinns on DSKJLVW7X2PROD with BILLS 2 •HR 1368 IH 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 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Mental Health Justice 4 Act of 2021’’. 5 SEC. 2. FINDINGS. 6 Congress finds the following: 7 (1) Needless institutionalization (including in 8 psychiatric hospitals) of people with disabilities is 9 generally a violation of the Americans with Disabil- 10 ities Act of 1990 (42 U.S.C. 12101 et seq.), and the 11 failure to provide sufficient community-based serv- 12 ices (such as supported housing, assertive commu- 13 nity treatment, mobile crisis, peer support, and sup- 14 ported employment) has resulted in needless institu- 15 tionalization as well as incarceration of persons with 16 mental illness or an intellectual or developmental 17 disability. 18 (2) In the landmark 1999 Supreme Court case 19 Olmstead v. L.C., the Supreme Court ruled that the 20 ‘‘unjustified institutional isolation of persons with 21 VerDate Sep 11 2014 02:02 Mar 22, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H1368.IH H1368 pbinns on DSKJLVW7X2PROD with BILLS 3 •HR 1368 IH disabilities is a form of discrimination’’ prohibited by 1 the Americans with Disabilities Act of 1990 (42 2 U.S.C. 12101 et seq.). 3 (3) Regulations promulgated by the Attorney 4 General in 1991 affirm that title II of the Ameri- 5 cans with Disabilities Act of 1990 (42 U.S.C. 12131 6 et seq.) requires public entities to ‘‘administer serv- 7 ices, programs, and activities in the most integrated 8 setting appropriate to the needs of qualified individ- 9 uals with disabilities’’ (28 C.F.R. 35.130(d)). The 10 regulation defines ‘‘the most integrated setting’’ as 11 one that ‘‘enables individuals with disabilities to 12 interact with nondisabled persons to the fullest ex- 13 tent possible’’ (28 C.F.R. pt. 35, App. B). 14 (4) Yet today, persons with a mental illness or 15 an intellectual or developmental disability are more 16 likely to be incarcerated and to be subject to exces- 17 sive use of force by law enforcement officers: 18 (A) One out of every four of the deaths 19 caused by law enforcement officers is a person 20 with mental illness. 21 (B) Persons with a mental illness or an in- 22 tellectual or developmental disability are often 23 charged with minor, nonviolent offenses. For 24 many of these persons, arrest and incarceration 25 VerDate Sep 11 2014 02:02 Mar 22, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H1368.IH H1368 pbinns on DSKJLVW7X2PROD with BILLS 4 •HR 1368 IH could have been avoided if they had access to 1 intensive community-based services and stable 2 housing. 3 (5) Many of the police encounters that lead to 4 the incarceration (and in too many cases, death) of 5 people with mental illness or an intellectual or devel- 6 opmental disability could be avoided by having in 7 place systems that ensure that calls to 911 or to law 8 enforcement result in dispatch of mental health pro- 9 fessionals, peer support workers, or others rather 10 than law enforcement officers. 11 (6) Many people who are incarcerated would be 12 better served in community services. If there were 13 sufficient community services, and persons with 14 mental illness or an intellectual or developmental 15 disability were connected to those services rather 16 than being arrested, thousands of people with men- 17 tal illness or an intellectual or developmental dis- 18 ability would avoid needless admissions to hospitals 19 or jails. Further, jails and hospitals would experi- 20 ence less crowding. 21 SEC. 3. GRANTS FOR MENTAL HEALTH PROFESSIONALS TO 22 ACT AS FIRST RESPONDERS. 23 (a) IN GENERAL.—The Secretary of Health and 24 Human Services (in this section referred to as the ‘‘Sec- 25 VerDate Sep 11 2014 02:02 Mar 22, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H1368.IH H1368 pbinns on DSKJLVW7X2PROD with BILLS 5 •HR 1368 IH retary’’), acting through the Assistant Secretary for Men- 1 tal Health and Substance Use and in consultation with 2 the Assistant Attorney General for the Civil Rights Divi- 3 sion of the Department of Justice (in this section referred 4 to as the ‘‘Assistant Attorney General’’), shall award 5 grants to States and political subdivisions of States— 6 (1) to hire, employ, train, and dispatch mental 7 health professionals to respond in lieu of law en- 8 forcement officers in emergencies in which— 9 (A) an individual calling 911, 988, or an- 10 other emergency hotline states that a person— 11 (i) is in a mental health crisis; or 12 (ii) may have a mental illness or an 13 intellectual or developmental disability; 14 (B) a law enforcement officer or other first 15 responder identifies a person as having (or pos- 16 sibly having) a mental illness or an intellectual 17 or developmental disability; or 18 (C) a law enforcement officer or other first 19 responder identifies a person as being (or pos- 20 sibly being) under the influence of a legal or il- 21 legal substance; 22 (2) to include in the training for mental health 23 professionals pursuant to paragraph (1) training 24 in— 25 VerDate Sep 11 2014 02:02 Mar 22, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H1368.IH H1368 pbinns on DSKJLVW7X2PROD with BILLS 6 •HR 1368 IH (A) the principles of deescalation and 1 antiracism; and 2 (B) age-appropriate techniques; 3 (3) to ensure that such mental health profes- 4 sionals link persons described in subparagraph (A), 5 (B), or (C) of paragraph (1) with voluntary commu- 6 nity-based services where appropriate; and 7 (4) to train the staff of dispatch centers regard- 8 ing the proper handling of a report of an emergency 9 described in paragraph (1), including training in the 10 principles of deescalation and antiracism referred to 11 in paragraph (2)(A). 12 (b) DELEGATION.—The Secretary shall delegate re- 13 sponsibility for carrying out the Secretary’s responsibil- 14 ities under this section and section 4 to the Director of 15 the Center for Mental Health Services of the Substance 16 Abuse and Mental Health Services Administration. 17 (c) ADDITIONAL AWARDS.—The Secretary shall 18 make an additional award of funds under this section each 19 fiscal year to grantees that demonstrate that their pro- 20 grams under this section resulted in— 21 (1) a notable reduction in the incarceration and 22 death of persons with mental illness or an intellec- 23 tual or developmental disability; or 24 VerDate Sep 11 2014 02:02 Mar 22, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H1368.IH H1368 pbinns on DSKJLVW7X2PROD with BILLS 7 •HR 1368 IH (2) a notable reduction in the use of force by 1 police and a notable increase in referrals of persons 2 with a mental illness or intellectual disability to com- 3 munity-based, voluntary support services (other than 4 institutionalization or carceral support services). 5 (d) PRIORITY.—In awarding grants under this sec- 6 tion, the Secretary shall give priority to States and polit- 7 ical subdivisions of States that— 8 (1) have high rates of arrests and incarceration 9 of persons with a mental illness or an intellectual or 10 developmental disability; 11 (2) commit to increasing resources for mental 12 health and community-based support services or so- 13 lutions for such persons; or 14 (3) include peer support specialists in their cur- 15 rent first responder model. 16 (e) REPORTING.— 17 (1) BY GRANTEES.—A recipient of a grant 18 under this section shall submit to the Secretary— 19 (A) a quarterly report on— 20 (i) the number and percentage of 21 emergencies where mental health profes- 22 sionals were dispatched in lieu of law en- 23 forcement officers pursuant to assistance 24 under this section; 25 VerDate Sep 11 2014 02:02 Mar 22, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H1368.IH H1368 pbinns on DSKJLVW7X2PROD with BILLS 8 •HR 1368 IH (ii) such other matters as the Sec- 1 retary may require for determining wheth- 2 er the recipient should receive an addi- 3 tional award under subsection (c); and 4 (iii) any increase or decrease, com- 5 pared to any previous quarter, in incarcer- 6 ation or institutionalization as a result of 7 dispatching mental health professionals 8 pursuant to assistance under this section, 9 disaggregated to include data specific to 10 persons with intellectual and developmental 11 disabilities and mental illnesses where 12 available, so as— 13 (I) to provide a critical baseline 14 analysis; and 15 (II) to ensure that mental health 16 practitioners are not simply funneling 17 individuals into other institutionalized 18 settings; and 19 (B) a final report on the use of such grant. 20 (2) BY SECRETARY.—Not later than 1 year 21 after awarding the first grant under this section, 22 and annually thereafter, the Secretary shall submit 23 to the Congress a report on the grant program 24 under this section. 25 VerDate Sep 11 2014 02:02 Mar 22, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H1368.IH H1368 pbinns on DSKJLVW7X2PROD with BILLS 9 •HR 1368 IH (3) DISAGGREGATION OF DATA.—The reporting 1 pursuant to paragraphs (1) and (2) shall, to the ex- 2 tent determined by the Secretary to be applicable, be 3 disaggregated by age, gender, race, and ethnicity. 4 (f) REVOCATION OF GRANT.—If the Secretary finds, 5 based on reporting under subsection (e) or other informa- 6 tion, that activities funded through a grant under this sec- 7 tion are leading to a significant increase in incarceration 8 or institutionalization— 9 (1) the Secretary shall revoke the grant; and 10 (2) the grantee shall repay to the Federal Gov- 11 ernment any amounts that the grantee— 12 (A) received through the grant; and 13 (B) has not obligated or expended. 14 (g) FUNDING.—To carry out this section, there are 15 authorized to be appropriated such sums as may be nec- 16 essary for fiscal year 2022 and each subsequent fiscal 17 year. 18 SEC. 4. TECHNICAL ASSISTANCE FOR POLITICAL SUBDIVI- 19 SIONS OF A STATE. 20 The Secretary of Health and Human Service, acting 21 through the Assistant Secretary for Mental Health and 22 Substance Use and in consultation with the Assistant At- 23 torney General for the Civil Rights Division of the Depart- 24 ment of Justice, shall provide technical assistance to 25 VerDate Sep 11 2014 02:02 Mar 22, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H1368.IH H1368 pbinns on DSKJLVW7X2PROD with BILLS 10 •HR 1368 IH grantees under section 3 (or other Federal law), other po- 1 litical subdivisions of States, and States to hire, employ, 2 train, and dispatch mental health professionals to respond 3 in lieu of law enforcement officers, as described in section 4 3. 5 SEC. 5. STUDY. 6 (a) IN GENERAL.—The Secretary of Health and 7 Human Services and the Assistant Attorney General for 8 the Civil Rights Division of the Department of Justice 9 shall conduct a study of the effectiveness of programs and 10 activities under sections 3 and 4. 11 (b) QUALITATIVE AND LONGITUDINAL EXAMINA- 12 TION.—The study under subsection (a) shall include a 13 qualitative and longitudinal study of— 14 (1) the number of persons diverted from ar- 15 rests; and 16 (2) short- and long-term outcomes for those 17 persons, including reduced recidivism, reduced 18 incidences of use of force, and reduced utilization of 19 resources. 20 (c) COMPLETION; REPORT.—Not later than 3 years 21 after the date of enactment of this Act, the Secretary of 22 Health and Human Services and the Assistant Attorney 23 General for the Civil Rights Division of the Department 24 of Justice shall— 25 VerDate Sep 11 2014 02:02 Mar 22, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H1368.IH H1368 pbinns on DSKJLVW7X2PROD with BILLS 11 •HR 1368 IH (1) complete the study under subsection (a); 1 (2) submit a report to the Congress on the re- 2 sults of such study; and 3 (3) publish such report. 4 Æ VerDate Sep 11 2014 02:02 Mar 22, 2021 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6301 E:\BILLS\H1368.IH H1368 pbinns on DSKJLVW7X2PROD with BILLS