II 

112TH CONGRESS 

2D SESSION S. 3289 

To expand the Medicaid home and community-based services waiver to include 

young individuals who are in need of services that would otherwise 

be required to be provided through a psychiatric residential treatment 

facility, and to change references in Federal law to mental retardation 

to references to an intellectual disability. 

IN THE SENATE OF THE UNITED STATES 

JUNE 13, 2012 

Mr. KERRY (for himself and Mr. GRASSLEY) introduced the following bill; 

which was read twice and referred to the Committee on Finance 

A BILL 

To expand the Medicaid home and community-based services 

waiver to include young individuals who are in need 

of services that would otherwise be required to be provided through a psychiatric residential treatment facility, 

and to change references in Federal law to mental retardation to references to an intellectual disability. 

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 ‘‘Children’s Mental 

5 Health Accessibility Act of 2012’’. 


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1 SEC. 2. EXPANDING THE MEDICAID HOME AND COMMU2 NITY-BASED SERVICES WAIVER TO INCLUDE 

3 YOUTH IN NEED OF SERVICES PROVIDED IN 

4 A PSYCHIATRIC RESIDENTIAL TREATMENT 

5 FACILITY. 

6 (a) IN GENERAL.—Section 1915(c) of the Social Se7 curity Act (42 U.S.C. 1396n(c)) is amended— 

8 (1) in paragraph (1)— 

9 (A) by striking ‘‘a hospital or a nursing fa10 cility or intermediate care facility for the men11 tally retarded’’ and inserting ‘‘a hospital, a 

12 nursing facility, an intermediate care facility for 

13 the intellectually disabled, or a psychiatric resi14 dential treatment facility,’’; and 

15 (B) by striking ‘‘a hospital, nursing facil16 ity, or intermediate care facility for the men17 tally retarded’’ and inserting ‘‘a hospital, nurs18 ing facility, intermediate care facility for the in19 tellectually disabled, or psychiatric residential 

20 treatment facility’’; 

21 (2) in paragraph (2)(B), by striking ‘‘or serv22 ices in an intermediate care facility for the mentally 

23 retarded’’ each place it appears and inserting ‘‘serv24 ices in an intermediate care facility for the intellec25 tually disabled, or services in a psychiatric residen26 tial treatment facility’’; 


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1 (3) in paragraph (2)(C)— 

2 (A) by striking ‘‘or intermediate care facil3 ity for the mentally retarded’’ and inserting 

4 ‘‘intermediate care facility for the intellectually 

5 disabled, or psychiatric residential treatment fa6 cility’’; and 

7 (B) by striking ‘‘or services in an inter8 mediate care facility for the mentally retarded’’ 

9 and inserting ‘‘services in an intermediate care 

10 facility for the intellectually disabled, or services 

11 in a psychiatric residential treatment facility’’; 

12 (4) in paragraph (7)(A), by striking ‘‘or inter13 mediate care facilities for the mentally retarded,’’ 

14 and inserting ‘‘intermediate care facilities for the in15 tellectually disabled, or psychiatric residential treat16 ment facilities,’’; and 

17 (5) by adding at the end the following new 

18 paragraph: 

19 ‘‘(11) For purposes of this subsection, the term ‘psy20 chiatric residential treatment facility’ means a facility 

21 other than a hospital that is certified as meeting the re22 quirements specified in regulations promulgated for such 

23 facilities under section 1905(h)(1) and that provides psy24 chiatric services in an inpatient setting to individuals 


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1 under age 21 for which medical assistance is available 

2 under a State plan under this title.’’. 

3 (b) WAIVER LIMITATION.—Section 1915(c) of such 

4 Act, as amended by subsection (a), is further amended— 

5 (1) in paragraph (2)— 

6 (A) in subparagraph (D), by striking ‘‘; 

7 and’’ and inserting a semicolon; 

8 (B) in subparagraph (E), by striking the 

9 period at the end and inserting a semicolon; 

10 and 

11 (C) by adding at the end the following new 

12 subparagraphs: 

13 ‘‘(F) under the waiver, the total number of 

14 Medicaid inpatient bed days at psychiatric residen15 tial treatment facilities during each fiscal year with16 in the waiver period will not exceed the total number 

17 of Medicaid inpatient bed days at such facilities for 

18 the previous fiscal year as increased by the esti19 mated percentage increase (if any) in the population 

20 of individuals under age 21 residing in the State 

21 over the preceding 12-month period; and 

22 ‘‘(G) the State will provide to the Secretary an23 nually, subject to such requirements as the Sec24 retary determines appropriate, relevant information 

25 and evidence as to the manner in which the State 


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1 will satisfy the requirements described in subpara2 graph (F).’’; and 

3 (2) by adding at the end the following new 

4 paragraph: 

5 ‘‘(12) For purposes of paragraph (2)(F), an indi6 vidual who is under age 21 and is an inpatient in a bed 

7 in a psychiatric residential treatment facility for a single 

8 day shall be counted as one inpatient bed day.’’. 

9 SEC. 3. APPLICATION OF ROSA’S LAW FOR INDIVIDUALS 

10 WITH INTELLECTUAL DISABILITIES. 

11 (a) REFERENCES IN THE SOCIAL SECURITY ACT.— 

12 (1) IN GENERAL.—With the exception of sec13 tion 1930(b) of the Social Security Act (42 U.S.C. 

14 1396u(b)), such Act, as amended by section 2, is 

15 further amended— 

16 (A) by striking, wherever it appears, 

17 ‘‘State mental retardation or developmental dis18 ability authority’’ and inserting ‘‘State intellec19 tual disability or developmental disability au20 thority’’; 

21 (B) by striking, wherever it appears, 

22 ‘‘mental retardation’’ and inserting ‘‘intellectual 

23 disabilities’’; and 


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1 (C) by striking, wherever it appears, ‘‘men2 tally retarded’’ and inserting ‘‘intellectually dis3 abled’’. 

4 (2) CONFORMING AMENDMENT.— 

5 (A) IN GENERAL.—Section 1902(e)(14)(F) 

6 of such Act, as added by section 2002(a) of 

7 Public Law 111–148, is amended by striking 

8 ‘‘mentally retarded’’ and inserting ‘‘intellectu9 ally disabled’’. 

10 (B) EFFECTIVE DATE.—The amendment 

11 made under subparagraph (A) shall take effect 

12 on January 2, 2014. 

13 (b) REFERENCES.— 

14 (1) IN GENERAL.—For purposes of each provi15 sion amended by this Act, issuing or amending regu16 lations to carry out a provision amended by this Act, 

17 or issuing any publication or other official commu18 nication in regards to any provision of the Social Se19 curity Act— 

20 (A) a reference to an intellectual disability 

21 shall mean a condition previously referred to as 

22 mental retardation, or a variation of such term, 

23 and shall have the same meaning with respect 

24 to programs, or qualifications for such pro25 grams, for individuals with such a condition; 


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1 (B) a reference to an individual who is in2 tellectually disabled shall mean an individual 

3 who was previously referred to as an individual 

4 who is mentally retarded, an individual with 

5 mental retardation, or variations of such terms; 

6 (C) a reference to an intermediate care fa7 cility for the intellectually disabled shall mean 

8 a facility that was previously referred to as an 

9 intermediate care facility for the mentally re10 tarded; and 

11 (D) a reference to a State intellectual dis12 ability or developmental disability authority 

13 shall mean an entity that was previously re14 ferred to as a State mental retardation or de15 velopmental disability authority. 

16 (2) REGULATIONS.—For purposes of amending 

17 regulations to carry out this Act, a Federal agency 

18 shall ensure that the regulations clearly state— 

19 (A) that an intellectual disability was for20 merly termed mental retardation; 

21 (B) that individuals with intellectual dis22 abilities were formerly termed individuals who 

23 are mentally retarded; 

24 (C) that an intermediate care facility for 

25 the intellectually disabled was formerly termed 


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1 an intermediate care facility for the mentally 

2 retarded; and 

3 (D) that a State intellectual disability or 

4 developmental disability authority was formerly 

5 termed a State mental retardation or develop6 mental disability authority. 

7 (c) RULE OF CONSTRUCTION.—This Act shall be con8 strued to make amendments to provisions of Federal law 

9 to substitute the term ‘‘intellectual disability’’ for ‘‘mental 

10 retardation’’ or any variation of such term without any 

11 intent to— 

12 (1) change the coverage, eligibility, rights, re13 sponsibilities, or definitions referred to in the 

14 amended provisions; or 

15 (2) compel States to change terminology in 

16 State laws for individuals covered by a provision 

17 amended by this Act. 

Æ 


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