II 

118TH CONGRESS 

1ST SESSION S. 3388 

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. 

IN THE SENATE OF THE UNITED STATES 

DECEMBER 4, 2023 

Ms. WARREN (for herself, Ms. SMITH, 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 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. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Mental Health Justice 

3 Act of 2023’’. 

4 SEC. 2. GRANTS FOR MENTAL HEALTH PROFESSIONALS TO 

5 ACT AS FIRST RESPONDERS. 

6 Subpart 3 of part B of title V of the Public Health 

7 Service Act (42 U.S.C. 290bb–31 et seq.) is amended by 

8 adding at the end the following: 

9 ‘‘SEC. 520O. GRANTS FOR MENTAL HEALTH PROFES10 SIONALS TO ACT AS FIRST RESPONDERS. 

11 ‘‘(a) IN GENERAL.—The Secretary, acting through 

12 the Assistant Secretary, and in consultation with the As13 sistant Attorney General for the Civil Rights Division of 

14 the Department of Justice, shall award grants to States, 

15 Indian Tribes, Tribal organizations, and political subdivi16 sions thereof to establish or expand programs— 

17 ‘‘(1) to hire, employ, train, and dispatch mental 

18 health professionals to respond in lieu of law en19 forcement officers in emergencies in which— 

20 ‘‘(A) an individual calling 911, 988, or an21 other emergency hotline states that a person— 

22 ‘‘(i) is in a mental health crisis; 

23 ‘‘(ii) may have a mental illness, a sub24 stance use disorder, a co-occurring mental 

25 illness and substance use disorder, or an 

26 intellectual or developmental disability; or 


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1 ‘‘(iii) otherwise appears to need the 

2 immediate support of mental health profes3 sionals; 

4 ‘‘(B) a law enforcement officer or other 

5 first responder identifies a person as having (or 

6 possibly having) a mental illness or an intellec7 tual or developmental disability (or otherwise 

8 appears to need the support of mental health 

9 professionals); or 

10 ‘‘(C) a law enforcement officer or other 

11 first responder identifies a person as being (or 

12 possibly being) under the influence of a legal or 

13 illegal substance; 

14 ‘‘(2) to include in the training for mental health 

15 professionals pursuant to paragraph (1) training 

16 in— 

17 ‘‘(A) the principles of deescalation; and 

18 ‘‘(B) developmentally appropriate tech19 niques; 

20 ‘‘(3) to ensure that such mental health profes21 sionals link persons described in subparagraph (A), 

22 (B), or (C) of paragraph (1) with voluntary commu23 nity-based services where appropriate; 

24 ‘‘(4) to train the staff of dispatch centers re25 garding the proper handling of a report of an emerVerDate Sep 11 2014 02:08 Dec 08, 2023 Jkt 049200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S3388.IS S3388

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1 gency described in paragraph (1), including training 

2 in the principles and techniques referred to in sub3 paragraphs (A) and (B) of paragraph (2); and 

4 ‘‘(5) to coordinate with first responder agencies. 

5 ‘‘(b) ADDITIONAL AWARDS.—The Secretary shall 

6 make an additional award of funds under this section each 

7 fiscal year to grantees that— 

8 ‘‘(1) are in compliance with all conditions of 

9 their awards under this section, including the condi10 tions specified in subsections (a) and (d); and 

11 ‘‘(2) demonstrate that their programs under 

12 this section resulted in— 

13 ‘‘(A) a notable reduction in the incarcer14 ation and death of persons with mental illness 

15 or an intellectual or developmental disability; or 

16 ‘‘(B) a notable reduction in the use of 

17 force by police and a notable increase in refer18 rals of persons with a mental illness or intellec19 tual disability to community-based, voluntary 

20 support services (other than institutionalization 

21 or carceral support services). 

22 ‘‘(c) PRIORITY.—In awarding grants under this sec23 tion, the Secretary shall give priority to States, Indian 

24 Tribes, Tribal organizations, and political subdivisions 

25 thereof that— 


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1 ‘‘(1) have high rates of arrests and incarcer2 ation of persons with a mental illness, a substance 

3 use disorder, a co-occurring mental health and sub4 stance use disorder, or an intellectual or develop5 mental disability; 

6 ‘‘(2) commit to increasing resources for mental 

7 health and community-based support services or so8 lutions for such persons; or 

9 ‘‘(3) include peer support specialists in their 

10 current first responder model. 

11 ‘‘(d) 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 profes17 sionals were dispatched in lieu of law en18 forcement officers pursuant to assistance 

19 under this section; 

20 ‘‘(ii) such other matters as the Sec21 retary may require for determining wheth22 er the recipient should receive an addi23 tional award under subsection (b); and 

24 ‘‘(iii) any increase or decrease, com25 pared to any previous quarter, in incarcerVerDate Sep 11 2014 02:08 Dec 08, 2023 Jkt 049200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S3388.IS S3388

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1 ation or institutionalization as a result of 

2 dispatching mental health professionals 

3 pursuant to assistance under this section, 

4 disaggregated to include data specific to 

5 persons with intellectual and developmental 

6 disabilities and mental illnesses where 

7 available and permitted to be disclosed 

8 under applicable privacy law, so as— 

9 ‘‘(I) to provide a critical baseline 

10 analysis; and 

11 ‘‘(II) to ensure that mental 

12 health practitioners are not simply 

13 funneling individuals into other insti14 tutionalized settings; and 

15 ‘‘(B) a final report on the use of such 

16 grant. 

17 ‘‘(2) BY SECRETARY.—Not later than 1 year 

18 after awarding the first grant under this section, 

19 and annually thereafter, the Secretary shall submit 

20 to Congress a report on the grant program under 

21 this section. 

22 ‘‘(3) DISAGGREGATION OF DATA.—The report23 ing pursuant to paragraphs (1) and (2) shall, to the 

24 extent determined by the Secretary to be applicable, 


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1 be disaggregated by age, sex, gender, race, and eth2 nicity. 

3 ‘‘(e) REVOCATION OF GRANT.—If the Secretary 

4 finds, based on reporting under subsection (d) or other 

5 information, that activities funded through a grant under 

6 this section are leading to a significant increase in incar7 ceration or institutionalization— 

8 ‘‘(1) the Secretary shall revoke the grant; and 

9 ‘‘(2) the grantee shall repay to the Federal 

10 Government any amounts that the grantee— 

11 ‘‘(A) received through the grant; and 

12 ‘‘(B) has not obligated or expended. 

13 ‘‘(f) TECHNICAL ASSISTANCE.—The Secretary, act14 ing through the Assistant Secretary, and in consultation 

15 with the Assistant Attorney General for the Civil Rights 

16 Division of the Department of Justice, shall provide tech17 nical assistance to grantees under this section (or other 

18 Federal law), and to other States, Indian Tribes, Tribal 

19 organizations, and political subdivisions thereof, to hire, 

20 employ, train, and dispatch mental health professionals to 

21 respond in lieu of law enforcement officers, as described 

22 in subsection (a). 

23 ‘‘(g) DEFINITIONS.—In this section: 

24 ‘‘(1) The term ‘first responder’ means an indi25 vidual who, in the course of such individual’s profesVerDate Sep 11 2014 02:08 Dec 08, 2023 Jkt 049200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S3388.IS S3388

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1 sional duties, is dispatched to respond to fire, med2 ical, public safety, or mental health emergencies. 

3 ‘‘(2) The terms ‘Indian Tribe’ and ‘Tribal orga4 nization’ have the meanings given to the terms ‘In5 dian tribe’ and ‘tribal organization’, respectively, in 

6 section 4 of the Indian Health Care Improvement 

7 Act. 

8 ‘‘(3) The term ‘peer support specialist’ means 

9 an individual who— 

10 ‘‘(A) has lived experience of a mental 

11 health condition, a substance use disorder, or a 

12 co-occurring mental health and substance use 

13 disorder; and 

14 ‘‘(B) specializes in supporting individuals 

15 with mental health conditions, substance use 

16 disorders, or co-occurring mental health and 

17 substance use disorders. 

18 ‘‘(h) FUNDING.—To carry out this section, there is 

19 authorized to be appropriated $250,000,000 for the period 

20 of the 5 fiscal years following the date of enactment of 

21 this section.’’. 

22 SEC. 3. STUDY. 

23 (a) IN GENERAL.—The Secretary of Health and 

24 Human Services and the Assistant Attorney General for 

25 the Civil Rights Division of the Department of Justice 


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1 shall conduct a study on the effectiveness of programs and 

2 activities under section 520O of the Public Health Service 

3 Act, as added by section 2. 

4 (b) QUALITATIVE AND LONGITUDINAL EXAMINA5 TION.—The study under subsection (a) shall include a 

6 qualitative and longitudinal study of— 

7 (1) the number of persons diverted from ar8 rests; and 

9 (2) short- and long-term outcomes for those 

10 persons, including reduced incarceration or institu11 tionalization, reduced incidences of use of force, and 

12 reduced utilization of resources. 

13 (c) COMPLETION; REPORT.—Not later than 3 years 

14 after the date of enactment of this Act, the Secretary of 

15 Health and Human Services and the Assistant Attorney 

16 General for the Civil Rights Division of the Department 

17 of Justice shall— 

18 (1) complete the study under subsection (a); 

19 (2) submit a report to the Congress on the re20 sults of such study; and 

21 (3) publish such report. 

22 SEC. 4. BEST PRACTICES. 

23 (a) IN GENERAL.—The Secretary of Health and 

24 Human Services, acting in consultation with the Assistant 

25 Attorney General for Civil Rights, shall develop and pubVerDate Sep 11 2014 02:08 Dec 08, 2023 Jkt 049200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S3388.IS S3388

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1 lish best practices relating to the deployment of mental 

2 health professionals acting as first responders. 

3 (b) CONTENTS.—The best practices under subsection 

4 (a) shall— 

5 (1) be informed by lessons learned from the 

6 grant program under section 520O of the Public 

7 Health Service Act, as added by section 2; and 

8 (2) include best practices for the proper han9 dling and dispatch of a report of an emergency de10 scribed in each of subparagraphs (A), (B), and (C) 

11 of section 520O(a)(1) of the Public Health Service 

12 Act, as added by section 2, including best practices 

13 for training in— 

14 (A) the principles and techniques in proc15 essing calls for persons who— 

16 (i) are experiencing a mental health 

17 crisis; 

18 (ii) may have a mental illness, a sub19 stance use disorder, a co-occurring mental 

20 health and substance use disorder, or an 

21 intellectual or developmental disability; or 

22 (iii) otherwise appear to need the im23 mediate support of mental health profes24 sionals; 

25 (B) the principles of deescalation; and 


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1 (C) developmentally appropriate tech2 niques. 

3 (c) TIMELINE; UPDATES.—The Secretary of Health 

4 and Human Services shall— 

5 (1) not later than 1 year after the date of en6 actment of this Act, develop and publish initial best 

7 practices under this section; and 

8 (2) not less than every 5 years thereafter, de9 velop and publish updated best practices under this 

10 section. 

11 (d) DEFINITION.—In this section, the term ‘‘first re12 sponder’’ has the meaning given to such term in section 

13 520O of the Public Health Service Act, as added by sec14 tion 2. 

15 SEC. 5. RULES OF CONSTRUCTION. 

16 (a) HIRING OF LAW ENFORCEMENT OFFICERS.— 

17 Nothing in this Act (or the amendments made by this Act) 

18 shall be construed to remove, supplant, alter, or limit the 

19 authority of States, public agencies, or municipalities from 

20 hiring or recruiting career law enforcement officers (as de21 fined in section 1709 of the Omnibus Crime Control and 

22 Safe Streets Act of 1968 (34 U.S.C. 10389)) to engage 

23 in or supervise the prevention, detection, or investigation 

24 of violations of criminal laws when appropriate. 


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1 (b) CIRCUMSTANCES OF IMMINENT OR IMMEDIATE

2 DANGER.—Nothing in this Act (or the amendments made 

3 by this Act) shall be construed to impede, supplant, alter, 

4 or limit the use of career law enforcement officers during 

5 emergencies— 

6 (1) which such career law enforcement officers 

7 may be best suited to handle; and 

8 (2) in which a person poses a direct threat to 

9 the health and safety of others that cannot be elimi10 nated by a modification of policies, practices or pro11 cedures, or by the provision of auxiliary aids or serv12 ices. 

13 (c) NONDISCRIMINATION.—Nothing in this Act (or 

14 the amendments made by this Act) shall be construed to 

15 limit or alter the protections and requirements of applica16 ble Federal and State civil rights laws and regulations. 

17 (d) DEFINITIONS.—In this section, the term ‘‘direct 

18 threat’’ has the meaning given to such term in sections 

19 35.139 and 35.104 of title 28, Code of Federal Regula20 tions (as in effect on the date of enactment of this Act). 

Æ 


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