II

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.

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

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Mental Health Juve5 nile Justice Act’’.

6 SEC. 2. BLOCK GRANT FUNDING FOR TREATMENT AND DI7 VERSION PROGRAMS.

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

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

10 adding at the end the following:
2

•S 464 IS

1 ‘‘SEC. 520C. GRANTS FOR STATE PARTNERSHIPS.

2 ‘‘(a) IN GENERAL.—The Attorney General and the

3 Secretary shall make grants to partnerships between State

4 and local juvenile justice agencies and State and local

5 mental health authorities (or appropriate children service

6 agencies) in accordance with this section.

7 ‘‘(b) USE OF FUNDS.—A partnership described in

8 subsection (a) that receives a grant under this section

9 shall use such amounts for the establishment and imple10 mentation of programs that address the service needs of

11 juveniles who come into contact with the justice system

12 (including facilities contracted for operation by State or

13 local juvenile authorities) who have mental health or sub14 stance abuse problems, by requiring the following:

15 ‘‘(1) DIVERSION.—Appropriate diversion of

16 those juveniles from incarceration—

17 ‘‘(A) at imminent risk of being taken into

18 custody;

19 ‘‘(B) at the time they are initially taken

20 into custody;

21 ‘‘(C) after they are charged with an of22 fense or act of juvenile delinquency;

23 ‘‘(D) after they are adjudicated delinquent

24 but prior to case disposition; and
3

•S 464 IS

1 ‘‘(E) after they are released from a juve2 nile facility for the purpose of attending after3 care programs.

4 ‘‘(2) TREATMENT.—

5 ‘‘(A) SCREENING AND ASSESSMENT OF JU6 VENILES.—

7 ‘‘(i) IN GENERAL.—Initial mental

8 health screening shall be completed for all

9 juveniles immediately upon entering the ju10 venile justice system or a juvenile facility.

11 Screening shall be conducted by qualified

12 health and mental health professionals or

13 by staff who have been trained by qualified

14 health, mental health, and substance abuse

15 professionals. In the case of screening by

16 staff, the screening results should be re17 viewed by qualified health and mental

18 health professionals not later than 24

19 hours after the screening.

20 ‘‘(ii) ACUTE MENTAL ILLNESS.—Juve21 niles who suffer from acute mental dis22 orders, who are suicidal, or in need of de23 toxification shall be placed in or imme24 diately transferred to an appropriate medi25 cal or mental health facility. They shall be
4

•S 464 IS

1 admitted to a secure correctional facility

2 only with written medical clearance.

3 ‘‘(iii) COMPREHENSIVE ASSESS4 MENT.—All juveniles entering the juvenile

5 justice system shall have a comprehensive

6 assessment conducted and an individual7 ized treatment plan written and imple8 mented within 2 weeks. This assessment

9 shall be conducted within 1 week for juve10 niles incarcerated in secure facilities. As11 sessments shall be completed by qualified

12 health, mental health, and substance abuse

13 professionals.

14 ‘‘(B) TREATMENT.—

15 ‘‘(i) IN GENERAL.—If the need for

16 treatment is indicated by the assessment of

17 a juvenile, the juvenile shall be referred to

18 or treated by a qualified professional. A ju19 venile who is currently receiving treatment

20 for a mental or emotional disorder shall

21 have treatment continued.

22 ‘‘(ii) PERIOD.—Treatment shall con23 tinue until additional mental health assess24 ment determines that the juvenile is no

25 longer in need of treatment. Treatment
5

•S 464 IS

1 plans shall be reevaluated at least every 30

2 days.

3 ‘‘(iii) DISCHARGE PLAN.—An incar4 cerated juvenile shall have a discharge plan

5 prepared when the juvenile enters the cor6 rectional facility in order to integrate the

7 juvenile back into the family and/or the

8 community. This plan shall be updated in

9 consultation with the juvenile’s family or

10 guardian before the juvenile leaves the fa11 cility. Discharge plans shall address the

12 provision of aftercare services.

13 ‘‘(iv) MEDICATION.—Any juvenile re14 ceiving psychotropic medications shall be

15 under the care of a licensed psychiatrist.

16 Psychotropic medications shall be mon17 itored regularly by trained staff for their

18 efficacy and side effects.

19 ‘‘(v) SPECIALIZED TREATMENT.—Spe20 cialized treatment and services shall be

21 continually available to a juvenile who—

22 ‘‘(I) has a history of mental

23 health problems or treatment;
6

•S 464 IS

1 ‘‘(II) has a documented history

2 of sexual offenses or sexual abuse, as

3 a victim or perpetrator;

4 ‘‘(III) has substance abuse prob5 lems, health problems, learning dis6 abilities, or histories of family abuse

7 or violence; or

8 ‘‘(IV) has developmental disabil9 ities.

10 ‘‘(C) MEDICAL AND MENTAL HEALTH

11 EMERGENCIES.—All correctional facilities shall

12 have written policies and procedures on suicide

13 prevention. All staff working in correctional fa14 cilities shall be trained and certified annually in

15 suicide prevention. Facilities shall have written

16 arrangements with a hospital or other facility

17 for providing emergency medical and mental

18 health care. Physical and mental health services

19 shall be available to an incarcerated juvenile 24

20 hours per day, 7 days per week.

21 ‘‘(D) CLASSIFICATION OF JUVENILES.—

22 ‘‘(i) IN GENERAL.—Juvenile facilities

23 shall classify and house juveniles in living

24 units according to a plan that includes age,

25 gender, offense, special medical or mental
7

•S 464 IS

1 health condition, size, and vulnerability to

2 victimization. Younger, smaller, weaker,

3 and more vulnerable juveniles shall not be

4 placed in housing units with older, more

5 aggressive juveniles.

6 ‘‘(ii) BOOT CAMPS.—juveniles who are

7 under 13 years old or who have serious

8 medical conditions or mental illness shall

9 not be placed in paramilitary boot camps.

10 ‘‘(E) CONFIDENTIALITY OF RECORDS.—

11 Mental health and substance abuse treatment

12 records of juveniles shall be treated as confiden13 tial and shall be excluded from the records that

14 States require to be routinely released to other

15 correctional authorities and school officials.

16 ‘‘(F) MANDATORY REPORTING.—States

17 shall keep records of the incidence and types of

18 mental health and substance abuse disorders in

19 their juvenile justice populations, the range and

20 scope of services provided, and barriers to serv21 ice. The State shall submit an analysis of this

22 information yearly to the Department of Jus23 tice.

24 ‘‘(G) STAFF RATIOS FOR CORRECTIONAL

25 FACILITIES.—Each secure correctional facility
8

•S 464 IS

1 shall have a minimum ratio of no fewer than 1

2 mental health counselor to every 50 juveniles.

3 Mental health counselors shall be professionally

4 trained and certified or licensed. Each secure

5 correctional facility shall have a minimum ratio

6 of 1 clinical psychologist for every 100 juve7 niles. Each secure correctional facility shall

8 have a minimum ratio of 1 licensed psychiatrist

9 for every 100 juveniles receiving psychiatric

10 care.

11 ‘‘(H) USE OF FORCE.—

12 ‘‘(i) WRITTEN GUIDELINES.—All juve13 nile facilities shall have a written behav14 ioral management system based on incen15 tives and rewards to reduce misconduct

16 and to decrease the use of restraints and

17 seclusion by staff.

18 ‘‘(ii) LIMITATIONS ON RESTRAINT.—

19 Control techniques such as restraint, seclu20 sion, chemical sprays, and room confine21 ment shall be used only in response to ex22 treme threats to life or safety. Use of these

23 techniques shall be approved by the facility

24 superintendent or chief medical officer and

25 documented in the juvenile’s file along with
9

•S 464 IS

1 the justification for use and the failure of

2 less restrictive alternatives.

3 ‘‘(iii) LIMITATION ON ISOLATION.—

4 Isolation and seclusion shall be used only

5 for immediate and short-term security or

6 safety reasons. No juvenile shall be placed

7 in isolation without approval of the facility

8 superintendent or chief medical officer or

9 their official staff designee. All cases shall

10 be documented in the juvenile’s file along

11 with the justification. A juvenile shall be in

12 isolation only the amount of time necessary

13 to achieve security and safety of the juve14 nile and staff. Staff shall monitor each ju15 venile in isolation once every 15 minutes

16 and conduct a professional review of the

17 need for isolation at least every 4 hours.

18 Any juvenile held in seclusion for 24 hours

19 shall be examined by a physician or li20 censed psychologist.

21 ‘‘(I) IDEA AND REHABILITATION ACT.—

22 All juvenile facilities shall abide by all manda23 tory requirements and time lines set forth

24 under the Individuals with Disabilities Edu-
10

•S 464 IS

1 cation Act and section 504 of the Rehabilitation

2 Act of 1973.

3 ‘‘(J) ADVOCACY ASSISTANCE.—

4 ‘‘(i) IN GENERAL.—The Secretary of

5 Health and Human Services shall make

6 grants to the systems established under

7 part C of the Developmental Disabilities

8 Assistance and Bill of Rights Act (42

9 U.S.C. 6041 et seq.) to monitor the mental

10 health and special education services pro11 vided by grantees to juveniles under sub12 paragraphs (A), (B), (C), (H), and (I),

13 and to advocate on behalf of juveniles to

14 assure that such services are properly pro15 vided.

16 ‘‘(ii) APPROPRIATION.—The Secretary

17 of Health and Human Services will reserve

18 no less than 3 percent of the funds appro19 priated under this section for the purposes

20 set forth in clause (i).

21 ‘‘(c) PARTNERSHIPS.—

22 ‘‘(1) IN GENERAL.—Any partnership desiring to

23 receive a grant under this section shall submit an

24 application at such time, in such manner, and con-
11

•S 464 IS

1 taining such information as the Attorney General

2 and the Secretary may prescribe.

3 ‘‘(2) CONTENTS.—In accordance with guide4 lines established by the Attorney General and the

5 Secretary, each application submitted under para6 graph (1) shall—

7 ‘‘(A) set forth a program or activity for

8 carrying out one or more of the purposes speci9 fied in this section and specifically identify each

10 such purpose such program or activity is de11 signed to carry out;

12 ‘‘(B) provide that such program or activity

13 shall be administered by or under the super14 vision of the applicant;

15 ‘‘(C) provide for the proper and efficient

16 administration of such program or activity;

17 ‘‘(D) provide for regular evaluation of such

18 program or activity;

19 ‘‘(E) provide an assurance that the pro20 posed program or activity will supplement, not

21 supplant, similar programs and activities al22 ready available in the community; and

23 ‘‘(F) provide for such fiscal control and

24 fund accounting procedures as may be nec25 essary to ensure prudent use, proper disburse-
12

•S 464 IS

1 ment, and accurate accounting of funds receiv2 ing under this section.

3 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—

4 ‘‘(1) IN GENERAL.—There are authorized to be

5 appropriated from the Violent Crime Reduction

6 Trust Fund, $500,000,000 for fiscal years 1999,

7 2000, 2001, 2002, and 2003 to carry out this sec8 tion.

9 ‘‘(2) ALLOCATION.—Of amounts appropriated

10 under paragraph (1)—

11 ‘‘(A) 35 percent shall be used for diversion

12 programs under subsection (b)(1); and

13 ‘‘(B) 65 percent shall be used for treat14 ment programs under subsection (b)(2).

15 ‘‘(3) INCENTIVES.—The Attorney General and

16 the Secretary shall give preference under subsection

17 (b)(2) to partnerships that integrate treatment pro18 grams to serve juveniles with co-occurring mental

19 health and substance abuse disorders.

20 ‘‘(4) WAIVERS.—The Attorney General and the

21 Secretary may grant a waiver of requirements under

22 subsection (b)(2) for good cause.’’.
13

•S 464 IS

1 SEC. 3. INITIATIVE FOR COMPREHENSIVE, INTERSYSTEM

2 PROGRAMS.

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

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

5 adding at the end the following:

6 ‘‘SEC. 520D. INITIATIVE FOR COMPREHENSIVE, INTERSYS7 TEM PROGRAMS.

8 ‘‘(a) IN GENERAL.—The Attorney General and the

9 Secretary, acting through the Director of the Center for

10 Mental Health Services, shall award competitive grants to

11 eligible entities for programs that address the service

12 needs of juveniles and juveniles with serious mental ill13 nesses by requiring the State or local juvenile justice sys14 tem, the mental health system, and the substance abuse

15 treatment system to work collaboratively to ensure—

16 ‘‘(1) the appropriate diversion of such juveniles

17 and juveniles from incarceration;

18 ‘‘(2) the provision of appropriate mental health

19 and substance abuse services as an alternative to in20 carceration and for those juveniles on probation or

21 parole; and

22 ‘‘(3) the provision of followup services for juve23 niles who are discharged from the juvenile justice

24 system.

25 ‘‘(b) ELIGIBILITY.—To be eligible to receive a grant

26 under this section an entity shall—
14

•S 464 IS

1 ‘‘(1) be a State or local juvenile justice agency,

2 mental health agency, or substance abuse agency;

3 ‘‘(2) prepare and submit to the Secretary an

4 application at such time, in such manner, and con5 taining such information as the Secretary may re6 quire, including—

7 ‘‘(A) an assurance that the applicant has

8 the consent of all entities described in para9 graph (1) in carrying out and coordinating ac10 tivities under the grant; and

11 ‘‘(B) with respect to services for juveniles,

12 an assurance that the applicant has collabo13 rated with the State or local educational agency

14 and the State or local welfare agency in carry15 ing out and coordinating activities under the

16 grant;

17 ‘‘(3) be given priority if it is a joint application

18 between juvenile justice and substance abuse or

19 mental health agencies; and

20 ‘‘(4) ensure that funds from non-Federal

21 sources are available to match amounts provided

22 under the grant in an amount that is not less

23 than—
15

•S 464 IS

1 ‘‘(A) with respect to the first 3 years

2 under the grant, 25 percent of the amount pro3 vided under the grant; and

4 ‘‘(B) with respect to the fourth and fifth

5 years under the grant, 50 percent of the

6 amount provided under the grant.

7 ‘‘(c) USE OF FUNDS.—

8 ‘‘(1) INITIAL YEAR.—An entity that receives a

9 grant under this section shall, in the first fiscal year

10 in which amounts are provided under the grant, use

11 such amounts to develop a collaborative plan—

12 ‘‘(A) for how the guarantee will institute a

13 system to provide intensive community

14 services—

15 ‘‘(i) to prevent high-risk juveniles

16 from coming in contact with the justice

17 system; and

18 ‘‘(ii) to meet the mental health and

19 substance abuse treatment needs of juve20 niles on probation or recently discharged

21 from the justice system; and

22 ‘‘(B) providing for the exchange by agen23 cies of information to enhance the provision of

24 mental health or substance abuse services to ju25 veniles.
16

•S 464 IS

1 ‘‘(2) 2–5TH YEARS.—With respect to the sec2 ond through fifth fiscal years in which amounts are

3 provided under the grant, the grantee shall use

4 amounts provided under the grant—

5 ‘‘(A) to furnish services, such as assertive

6 community treatment, wrap-around services for

7 juveniles, multisystemic therapy, outreach, inte8 grated mental health and substance abuse

9 treatment, case management, health care, and

10 transitional and independent living services,

11 mentoring programs, home-based services, and

12 provision of appropriate after school and sum13 mer programing;

14 ‘‘(B) to establish a network of boundary

15 spanners to conduct regular meetings with

16 judges, provide liaison with mental health and

17 substance abuse workers, share and distribute

18 information, and coordinate with mental health

19 and substance abuse treatment providers, and

20 probation or parole officers concerning provision

21 of appropriate mental health and drug and alco22 hol addiction services for individuals on proba23 tion or parole;

24 ‘‘(C) to provide cross-system training

25 among police, corrections, and mental health
17

•S 464 IS

1 and substance abuse providers with the purpose

2 of enhancing collaboration and the effectiveness

3 of all systems;

4 ‘‘(D) to provide coordinated and effective

5 aftercare programs for juveniles with emotional

6 or mental disorders who are discharged from

7 jail, prison, or juvenile facilities;

8 ‘‘(E) to purchase technical assistance to

9 achieve the grant project’s goals; and

10 ‘‘(F) to furnish services, to train personnel

11 in collaborative approaches, and to enhance

12 intersystem collaboration.

13 ‘‘(3) DEFINITION.—In paragraph (2)(B), the

14 term ‘boundary spanners’ means professionals who

15 act as case managers for juveniles with mental dis16 orders and substance abuse addictions, within both

17 justice agency facilities and community mental

18 health programs and who have full authority from

19 both systems to act as problem-solvers and advocates

20 on behalf of individuals targeted for service under

21 this program.

22 ‘‘(d) AREA SERVED BY THE PROJECT.—An entity re23 ceiving a grant under this section shall conduct activities

24 under the grant to serve at least a single political jurisdic25 tion.
18

•S 464 IS

1 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There

2 shall be made available to carry out the section, not less

3 than 10 percent of the amount appropriated under section

4 1935(a) for each of the fiscal years 1999 through 2003.’’.

5 SEC. 4. INTERAGENCY RESEARCH, TRAINING, AND TECH6 NICAL ASSISTANCE CENTERS.

7 (a) GRANTS OR CONTRACTS.—The Secretary of

8 Health and Human Services, acting through the Sub9 stance Abuse and Mental Health Services Administration

10 and in consultation with the Juvenile Justice and Delin11 quency Prevention Office and the Justice Assistance Bu12 reau, shall award grants and contracts for the establish13 ment of 4 research, training, and technical assistance cen14 ters to carry out the activities described in subsection (c).

15 (b) ELIGIBILITY.—To be eligible to receive a grant

16 or contract under subsection (a), an entity shall—

17 (1) be a public or nonprofit private entity; and

18 (2) prepare and submit to the Secretary of

19 Health and Human Services an application, at such

20 time, in such manner, and containing such informa21 tion as the Secretary may require.

22 (c) ACTIVITIES.—A center established under a grant

23 or contract under subsection (a) shall—

24 (1) provide training with respect to state-of-the25 art mental health and justice-related services and
19

•S 464 IS

1 successful mental health and substance abuse-justice

2 collaborations, to public policymakers, law enforce3 ment administrators, public defenders, police, proba4 tion officers, judges, parole officials, jail administra5 tors and mental health and substance abuse provid6 ers and administrators;

7 (2) engage in research and evaluations concern8 ing State and local justice and mental health sys9 tems, including system redesign initiatives, and dis10 seminate information concerning the results of such

11 evaluations;

12 (3) provide direct technical assistance, including

13 assistance provided through toll-free telephone num14 bers, concerning issues such as how to accommodate

15 individuals who are being processed through the

16 courts under the Americans with Disabilities Act of

17 1990 (42 U.S.C. 12101 et seq.), what types of men18 tal health or substance abuse service approaches are

19 effective within the judicial system, and how commu20 nity-based mental health or substance abuse services

21 can be more effective, including relevant regional,

22 ethnic, and gender-related considerations; and

23 (4) provide information, training, and technical

24 assistance to State and local governmental officials

25 to enhance the capacity of such officials to provide
20

•S 464 IS

1 appropriate services relating to mental health or

2 substance abuse.

3 (d) AUTHORIZATION OF APPROPRIATIONS.—There is

4 authorized to be appropriated, $4,000,000 for each fiscal

5 year to carry out this section.

Æ