I 

118TH CONGRESS 

1ST SESSION H. R. 6451 

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 HOUSE OF REPRESENTATIVES 

NOVEMBER 17, 2023 

Ms. PORTER (for herself, Ms. PRESSLEY, Mr. CA ́RDENAS, Ms. SCANLON, Mr. 

FITZPATRICK, Mr. DOGGETT, Mr. POCAN, Mr. CASTEN, Mr. BOYLE of 

Pennsylvania, Mr. ROBERT GARCIA of California, Ms. PINGREE, Mrs. 

NAPOLITANO, Mr. TAKANO, Mr. PASCRELL, Ms. ROSS, Mrs. WATSON

COLEMAN, Ms. TITUS, Mr. EVANS, Ms. MENG, Mr. GARCI ́A of Illinois, 

Mrs. RAMIREZ, Mr. COHEN, Mr. TRONE, Ms. MOORE of Wisconsin, Ms. 

JACKSON LEE, Ms. NORTON, Ms. JACOBS, Mr. JACKSON of Illinois, Mr. 

CARTER of Louisiana, Ms. CARAVEO, Ms. JAYAPAL, Mr. CONNOLLY, Ms. 

SCHAKOWSKY, Ms. SALINAS, Mr. FOSTER, Ms. OMAR, Ms. BONAMICI, 

Ms. WASSERMAN SCHULTZ, Mr. TORRES of New York, Mr. GRIJALVA, 

Mr. MFUME, Ms. KELLY of Illinois, Ms. CHU, Ms. MCCOLLUM, Mr. 

JOHNSON of Georgia, Ms. WILD, Mr. PHILLIPS, Ms. STANSBURY, Ms. 

LEE of California, Ms. WILLIAMS of Georgia, Mr. CARSON, and Mr. 

LEVIN) introduced the following bill; which was referred to the Committee 

on Energy and Commerce, and in addition to the Committee on the Judiciary, for a period to be subsequently determined by the Speaker, in each 

case for consideration of such provisions as fall within the jurisdiction of 

the committee concerned 

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 disVerDate Sep 11 2014 22:09 Nov 27, 2023 Jkt 049200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6652 E:\BILLS\H6451.IH H6451
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patch 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, 

3 SECTION 1. SHORT TITLE. 

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

5 Act of 2023’’. 

6 SEC. 2. GRANTS FOR MENTAL HEALTH PROFESSIONALS TO 

7 ACT AS FIRST RESPONDERS. 

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: 

11 ‘‘SEC. 520O. GRANTS FOR MENTAL HEALTH PROFES12 SIONALS TO ACT AS FIRST RESPONDERS. 

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

14 the Assistant Secretary, and in consultation with the As15 sistant Attorney General for the Civil Rights Division of 

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

17 Indian Tribes, Tribal organizations, and political subdivi18 sions thereof to establish or expand programs— 

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

20 health professionals to respond in lieu of law en21 forcement officers in emergencies in which— 

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1 ‘‘(A) an individual calling 911, 988, or an2 other emergency hotline states that a person— 

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

4 ‘‘(ii) may have a mental illness, a sub5 stance use disorder, a co-occurring mental 

6 illness and substance use disorder, or an 

7 intellectual or developmental disability; or 

8 ‘‘(iii) otherwise appears to need the 

9 immediate support of mental health profes10 sionals; 

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

12 first responder identifies a person as having (or 

13 possibly having) a mental illness or an intellec14 tual or developmental disability (or otherwise 

15 appears to need the support of mental health 

16 professionals); or 

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

18 first responder identifies a person as being (or 

19 possibly being) under the influence of a legal or 

20 illegal substance; 

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

22 professionals pursuant to paragraph (1) training 

23 in— 

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

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1 ‘‘(B) developmentally appropriate tech2 niques; 

3 ‘‘(3) to ensure that such mental health profes4 sionals link persons described in subparagraph (A), 

5 (B), or (C) of paragraph (1) with voluntary commu6 nity-based services where appropriate; 

7 ‘‘(4) to train the staff of dispatch centers re8 garding the proper handling of a report of an emer9 gency described in paragraph (1), including training 

10 in the principles and techniques referred to in sub11 paragraphs (A) and (B) of paragraph (2); and 

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

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

14 make an additional award of funds under this section each 

15 fiscal year to grantees that— 

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

17 their awards under this section, including the condi18 tions specified in subsections (a) and (d); and 

19 ‘‘(2) demonstrate that their programs under 

20 this section resulted in— 

21 ‘‘(A) a notable reduction in the incarcer22 ation and death of persons with mental illness 

23 or an intellectual or developmental disability; or 

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

25 force by police and a notable increase in referVerDate Sep 11 2014 22:09 Nov 27, 2023 Jkt 049200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H6451.IH H6451
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1 rals of persons with a mental illness or intellec2 tual disability to community-based, voluntary 

3 support services (other than institutionalization 

4 or carceral support services). 

5 ‘‘(c) PRIORITY.—In awarding grants under this sec6 tion, the Secretary shall give priority to States, Indian 

7 Tribes, Tribal organizations, and political subdivisions 

8 thereof that— 

9 ‘‘(1) have high rates of arrests and incarcer10 ation of persons with a mental illness, a substance 

11 use disorder, a co-occurring mental health and sub12 stance use disorder, or an intellectual or develop13 mental disability; 

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

15 health and community-based support services or so16 lutions for such persons; or 

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

18 current first responder model. 

19 ‘‘(d) REPORTING.— 

20 ‘‘(1) BY GRANTEES.—A recipient of a grant 

21 under this section shall submit to the Secretary— 

22 ‘‘(A) a quarterly report on— 

23 ‘‘(i) the number and percentage of 

24 emergencies where mental health profes25 sionals were dispatched in lieu of law enVerDate Sep 11 2014 22:09 Nov 27, 2023 Jkt 049200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H6451.IH H6451
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1 forcement officers pursuant to assistance 

2 under this section; 

3 ‘‘(ii) such other matters as the Sec4 retary may require for determining wheth5 er the recipient should receive an addi6 tional award under subsection (b); and 

7 ‘‘(iii) any increase or decrease, com8 pared to any previous quarter, in incarcer9 ation or institutionalization as a result of 

10 dispatching mental health professionals 

11 pursuant to assistance under this section, 

12 disaggregated to include data specific to 

13 persons with intellectual and developmental 

14 disabilities and mental illnesses where 

15 available and permitted to be disclosed 

16 under applicable privacy law, so as— 

17 ‘‘(I) to provide a critical baseline 

18 analysis; and 

19 ‘‘(II) to ensure that mental 

20 health practitioners are not simply 

21 funneling individuals into other insti22 tutionalized settings; and 

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

24 grant. 

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

2 after awarding the first grant under this section, 

3 and annually thereafter, the Secretary shall submit 

4 to the Congress a report on the grant program 

5 under this section. 

6 ‘‘(3) DISAGGREGATION OF DATA.—The report7 ing pursuant to paragraphs (1) and (2) shall, to the 

8 extent determined by the Secretary to be applicable, 

9 be disaggregated by age, sex, gender, race, and eth10 nicity. 

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

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

13 information, that activities funded through a grant under 

14 this section are leading to a significant increase in incar15 ceration or institutionalization— 

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

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

18 Government any amounts that the grantee— 

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

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

21 ‘‘(f) TECHNICAL ASSISTANCE.—The Secretary, act22 ing through the Assistant Secretary, and in consultation 

23 with the Assistant Attorney General for the Civil Rights 

24 Division of the Department of Justice, shall provide tech25 nical assistance to grantees under this section (or other 

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

2 organizations, and political subdivisions thereof, to hire, 

3 employ, train, and dispatch mental health professionals to 

4 respond in lieu of law enforcement officers, as described 

5 in subsection (a). 

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

7 ‘‘(1) The term ‘first responder’ means an indi8 vidual who, in the course of such individual’s profes9 sional duties, is dispatched to respond to fire, med10 ical, public safety, or mental health emergencies. 

11 ‘‘(2) The terms ‘Indian Tribe’ and ‘Tribal orga12 nization’ have the meanings given to the terms ‘In13 dian tribe’ and ‘tribal organization’, respectively, in 

14 section 4 of the Indian Health Care Improvement 

15 Act. 

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

17 an individual who— 

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

19 health condition, a substance use disorder, or a 

20 co-occurring mental health and substance use 

21 disorder; and 

22 ‘‘(B) specializes in supporting individuals 

23 with mental health conditions, substance use 

24 disorders, or co-occurring mental health and 

25 substance use disorders. 

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

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

3 of the five fiscal years following the date of enactment of 

4 this section.’’. 

5 SEC. 3. 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 on the effectiveness of programs and 

10 activities under section 520O of the Public Health Service 

11 Act, as added by section 2. 

12 (b) QUALITATIVE AND LONGITUDINAL EXAMINA13 TION.—The study under subsection (a) shall include a 

14 qualitative and longitudinal study of— 

15 (1) the number of persons diverted from ar16 rests; and 

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

18 persons, including reduced incarceration or institu19 tionalization, reduced incidences of use of force, and 

20 reduced utilization of resources. 

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

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

23 Health and Human Services and the Assistant Attorney 

24 General for the Civil Rights Division of the Department 

25 of Justice shall— 

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

2 (2) submit a report to the Congress on the re3 sults of such study; and 

4 (3) publish such report. 

5 SEC. 4. BEST PRACTICES. 

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

7 Human Services, acting in consultation with the Assistant 

8 Attorney General for Civil Rights, shall develop and pub9 lish best practices relating to the deployment of mental 

10 health professionals acting as first responders. 

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

12 (a) shall— 

13 (1) be informed by lessons learned from the 

14 grant program under section 520O of the Public 

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

16 (2) include best practices for the proper han17 dling and dispatch of a report of an emergency de18 scribed in each of subparagraphs (A), (B), and (C) 

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

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

21 for training in— 

22 (A) the principles and techniques in proc23 essing calls for persons who— 

24 (i) are experiencing a mental health 

25 crisis; 

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1 (ii) may have a mental illness, a sub2 stance use disorder, a co-occurring mental 

3 health and substance use disorder, or an 

4 intellectual or developmental disability; or 

5 (iii) otherwise appear to need the im6 mediate support of mental health profes7 sionals; 

8 (B) the principles of deescalation; and 

9 (C) developmentally appropriate tech10 niques. 

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

12 and Human Services shall— 

13 (1) not later than 1 year after the date of en14 actment of this Act, develop and publish initial best 

15 practices under this section; and 

16 (2) not less than every 5 years thereafter, de17 velop and publish updated best practices under this 

18 section. 

19 (d) DEFINITION.—In this section, the term ‘‘first re20 sponder’’ has the meaning given to such term in section 

21 520O of the Public Health Service Act, as added by sec22 tion 2. 

23 SEC. 5. RULES OF CONSTRUCTION. 

24 (a) HIRING OF LAW ENFORCEMENT OFFICERS.— 

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

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

2 authority of States, public agencies, or municipalities from 

3 hiring or recruiting career law enforcement officers (as de4 fined in section 1709 of the Omnibus Crime Control and 

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

6 in or supervise the prevention, detection, or investigation 

7 of violations of criminal laws when appropriate. 

8 (b) CIRCUMSTANCES OF IMMINENT OR IMMEDIATE

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

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

11 or limit the use of career law enforcement officers during 

12 emergencies— 

13 (1) which such career law enforcement officers 

14 may be best suited to handle; and 

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

16 the health and safety of others that cannot be elimi17 nated by a modification of policies, practices or pro18 cedures, or by the provision of auxiliary aids or serv19 ices. 

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

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

22 limit or alter the protections and requirements of applica23 ble Federal and State civil rights laws and regulations. 

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

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

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1 35.139 and 35.104 of title 28, Code of Federal Regula2 tions (as in effect on the date of enactment of this Act). 

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