II 

110TH CONGRESS 

1ST SESSION S. 382 

To amend the Public Health Service Act to establish a State family support 

grant program to end the practice of parents giving legal custody of 

their seriously emotionally disturbed children to State agencies for the 

purpose of obtaining mental health services for those children. 

IN THE SENATE OF THE UNITED STATES 

JANUARY 24, 2007 

Ms. COLLINS (for herself, Mr. HARKIN, Mr. KENNEDY, Mr. PRYOR, Mr. 

COLEMAN, Ms. CANTWELL, Mr. DURBIN, Ms. MIKULSKI, Mr. BINGAMAN, 

Mr. LAUTENBERG, and Mr. KERRY) 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 establish a State 

family support grant program to end the practice of 

parents giving legal custody of their seriously emotionally 

disturbed children to State agencies for the purpose of 

obtaining mental health services for those children. 

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 ‘‘Keeping Families To5 gether Act’’. 


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1 SEC. 2. PURPOSE. 

2 It is the purpose of this Act to assist States in elimi3 nating the practice of parents giving custody of their seri4 ously emotionally disturbed children to State agencies for 

5 the purpose of securing mental health care for those chil6 dren. 

7 SEC. 3. FAMILY SUPPORT GRANTS. 

8 Title V of the Public Health Service Act (42 U.S.C. 

9 290aa et seq.) is amended— 

10 (1) by redesignating the second part G (relating 

11 to services provided through religious organizations) 

12 as part J; 

13 (2) by redesignating sections 581 through 584 

14 of part J (as so redesignated) as sections 596 

15 through 596C, respectively; and 

16 (3) by adding at the end the following: 

17 ‘‘PART K—FAMILY SUPPORT 

18 ‘‘SEC. 597. FAMILY SUPPORT GRANTS. 

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

20 the Administrator and in consultation with the task force 

21 established under section 597A, is authorized to award 

22 competitive grants to States to enable such States to es23 tablish systems of care to treat and provide services to 

24 all eligible children and youth. The Secretary shall ensure 

25 that the amount awarded to each grantee is sufficient to 


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1 enable the grantee to accomplish the purposes of the 

2 grant. 

3 ‘‘(b) ELIGIBILITY.—To be eligible for a grant under 

4 subsection (a) a State shall— 

5 ‘‘(1) have laws or policies in effect to ensure 

6 that children receive appropriate mental health serv7 ices so that parents do not have to relinquish legal 

8 custody of such children; 

9 ‘‘(2) submit to the Secretary an application 

10 from the Governor in accordance with subsection (c); 

11 ‘‘(3) provide assurances that the State will pro12 vide matching funds in accordance with subsection 

13 (e); and 

14 ‘‘(4) meet such other requirements as the Sec15 retary determines appropriate. 

16 ‘‘(c) APPLICATION.— 

17 ‘‘(1) IN GENERAL.—An application submitted 

18 for a grant under this section shall include— 

19 ‘‘(A) a brief description of the system of 

20 care that the State intends to establish with 

21 amounts received under the grant to ensure 

22 that eligible children and youth and their fami23 lies receive the appropriate individualized men24 tal health treatment and family support services 

25 necessary to keep such families together; 


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1 ‘‘(B) a description of the process by which 

2 the State will formulate a State plan that meets 

3 the requirements of paragraph (2), including 

4 participants, timelines, and any previous or on5 going efforts related to the establishment of a 

6 statewide system; 

7 ‘‘(C) an estimate of the number of eligible 

8 children and youth in the State, and the num9 ber of eligible children and youth who will be 

10 served under the grant; 

11 ‘‘(D) a description of existing systems of 

12 care in the State (including systems funded 

13 under section 561) and existing interagency col14 laboration that demonstrates a foundation on 

15 which the State can build a system of care 

16 under a grant under this section; 

17 ‘‘(E) a brief description of the manner in 

18 which services for all eligible children and youth 

19 are expected to be funded under the system es20 tablished by the State under the grant; 

21 ‘‘(F) a description of children’s mental 

22 health services capacity in the State and the 

23 steps that will be taken, if necessary, to ensure 

24 that adequate capacity exists to implement the 

25 proposed system of care; 


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1 ‘‘(G) a description of the source of the 

2 State matching funds; and 

3 ‘‘(H) other information as required by the 

4 Secretary. 

5 ‘‘(2) STATE PLAN.—Prior to receiving funds 

6 under the grant for the second grant year, a State 

7 shall submit to the Secretary and the Secretary shall 

8 approve, a State plan that— 

9 ‘‘(A) is developed through a collaborative 

10 process that includes the required State part11 ners as represented by senior officials with pol12 icymaking authority, the required private part13 ners, and other entities that the governor of the 

14 State determines appropriate; 

15 ‘‘(B) contains a description and assess16 ment of the effectiveness of the laws or policies 

17 that the State has in effect to ensure that chil18 dren receive appropriate mental health services 

19 and that parents do not have to relinquish legal 

20 custody of such children in order to obtain such 

21 services; 

22 ‘‘(C) contains a description of the services 

23 to be provided to eligible children and youth 

24 and the sources of such services, including the 


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1 extent to which the State will build upon exist2 ing systems of care within the State; 

3 ‘‘(D) contains a description of the proce4 dures to be implemented for the early identi5 fication, assessment, and referral, by health 

6 care providers, mental health agencies, other 

7 child-serving entities, child welfare, corrections, 

8 and juvenile justice systems, of all eligible chil9 dren and youth for appropriate care and for co10 ordinating services among child welfare, juve11 nile justice, and child mental health agencies, 

12 including co-location of services as appropriate; 

13 ‘‘(E) describes any legislative changes that 

14 are required to implement the State plan; 

15 ‘‘(F) describes how the State screens chil16 dren and youth entering the juvenile justice and 

17 child welfare systems for mental health prob18 lems, including the State’s mental health 

19 screening procedures as part of the early and 

20 periodic screening, diagnostic, and treatment 

21 services described in section 1905(r) of the So22 cial Security Act that are provided under the 

23 medicaid programs; 


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1 ‘‘(G) contains a description of the plan of 

2 the State for ensuring that there will be ade3 quate capacity to serve all eligible children; 

4 ‘‘(H) contains a description of the plan of 

5 the State for financing the system of care devel6 oped under the grant, including— 

7 ‘‘(i) the manner in which the State 

8 will use— 

9 ‘‘(I) contributions from State 

10 agencies; 

11 ‘‘(II) State eligibility options or 

12 waivers authorized with respect to the 

13 State medicaid program such as those 

14 authorized under sections 1902(e)(3) 

15 and 1915(c) of the Social Security 

16 Act; 

17 ‘‘(III) the State Children’s 

18 Health Insurance Program under title 

19 XXI of the Social Security Act (in20 cluding an assurance that grant funds 

21 will not be used as a State match 

22 under the medicaid or SCHIP pro23 grams); and 

24 ‘‘(IV) other public health insur25 ance mechanisms; and 


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1 ‘‘(ii) how Federal grant dollars will be 

2 used to enable the State to achieve a sus3 tainable system of care to serve all eligible 

4 children and youth; 

5 ‘‘(I) contains a description of how the 

6 State will, with respect to providing mental 

7 health treatment and services to eligible chil8 dren and youth, provide outreach services to 

9 families of such children and youth, provide for 

10 public educational activities, and involve fami11 lies of such children and youth in such treat12 ment and services; and 

13 ‘‘(J) establishes a method for tracking and 

14 reporting the number of children and youth en15 tering child welfare and juvenile justice systems 

16 with significant mental health problems. 

17 ‘‘(3) PRIORITY.—In awarding grants under this 

18 section, the Secretary shall give priority to States— 

19 ‘‘(A) that have a history of developing and 

20 supporting local or statewide systems care and 

21 of successful interagency collaboration; 

22 ‘‘(B) that have taken steps to broaden ac23 cess to community-based services for children 

24 with serious emotional disturbances; 


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1 ‘‘(C) that have provided reasonable esti2 mates of the numbers of eligible children and 

3 youth; 

4 ‘‘(D) that have sufficient mental health 

5 service capacity or specific plans for sufficiently 

6 increasing mental health services capacity to 

7 successfully implement the proposed system of 

8 care; 

9 ‘‘(E) in which the governor’s office will 

10 play a leading role in the formulation of the 

11 State plan required under paragraph (2); and 

12 ‘‘(F) that will involve State juvenile and 

13 family court judges in the planning and over14 sight of the system of care. 

15 ‘‘(d) USE OF FUNDS.—A State shall use amounts re16 ceived under a grant under this section to— 

17 ‘‘(1) establish State- and local-level infrastruc18 ture to allow for interagency cooperation and cross 

19 system financing to— 

20 ‘‘(A) support the purchase and delivery of 

21 a comprehensive array of community-based 

22 mental health and family support services to all 

23 eligible children and youth and their families; 


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1 ‘‘(B) decrease categorical funding struc2 tures and eliminate inter-agency fragmentation 

3 of services; and 

4 ‘‘(C) increase the capacity of the State and 

5 local agencies to share, among and between 

6 such respective agencies, public resources and 

7 improve parental access to services for children 

8 with mental health needs to eliminate the need 

9 to relinquish custody of their children in order 

10 for such children to receive treatment for such 

11 needs; 

12 ‘‘(2) expand public health insurance programs 

13 to cover a comprehensive array of community-based 

14 mental health and family support services for eligible 

15 children and youth and their families that will be 

16 sustainable after the grant has expired; 

17 ‘‘(3) deliver mental health care and family sup18 port services to eligible children and youth and their 

19 families as part of a transition to a sustainable sys20 tem of care for such children and youth; 

21 ‘‘(4) provide outreach and public education con22 cerning programs and activities funded under this 

23 section; 

24 ‘‘(5) provide training and professional develop25 ment for personnel who work with eligible children 


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1 and youth as required to successfully implement the 

2 State plan; and 

3 ‘‘(6) carry out other administrative activities re4 lated to the programs and activities carried out 

5 under the grant, including the development and 

6 maintenance of data systems. 

7 ‘‘(e) MATCHING FUNDS.— 

8 ‘‘(1) IN GENERAL.—A State that receives a 

9 grant under this section shall, with respect to the 

10 costs to be incurred by the State in carrying out the 

11 purpose for which the grant is awarded, make avail12 able non-Federal contributions toward such costs in 

13 an amount that— 

14 ‘‘(A) for the third fiscal year for which the 

15 entity receives payments from a grant under 

16 such subsection, is not less than $1 for each $2 

17 of Federal funds provided in the grant; 

18 ‘‘(B) for the fourth such fiscal year, is not 

19 less than $1 for each $1 of Federal funds pro20 vided in the grant; and 

21 ‘‘(C) for the fifth and sixth such fiscal 

22 years, is not less than $2 for each $1 of Fed23 eral funds provided in the grant. 

24 ‘‘(2) DETERMINATION OF AMOUNT CONTRIB25 UTED.—Non-Federal contributions required in paraVerDate Aug 31 2005 22:03 Jan 29, 2007 Jkt 059196 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S382.IS S382

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1 graph (1) may be in cash or in kind, fairly evalu2 ated, including plant, equipment, or services. 

3 Amounts provided by the Federal Government, or 

4 services assisted or subsidized to any significant ex5 tent by the Federal Government, may not be in6 cluded in determining the amount of such non-Fed7 eral contributions. 

8 ‘‘(3) ACCOUNTING REQUIRED.—With respect to 

9 a State that complies with the requirement of para10 graph (2) through the provision of in-kind contribu11 tions, such State shall provide the Secretary with an 

12 accounting that describes the value of such in-kind 

13 contributions. 

14 ‘‘(f) LIMITATION ON USE FOR ADMINISTRATIVE

15 COSTS.—Not more than 5 percent of the amount that a 

16 State receives under a grant under this section shall be 

17 used for administrative costs. 

18 ‘‘(g) PAYMENTS.—Grants under this section shall be 

19 payable over a 6-year period. 

20 ‘‘(h) REPORTING REQUIREMENTS.— 

21 ‘‘(1) IN GENERAL.—Secretary, acting through 

22 the Administrator and in consultation with the task 

23 force established under section 597A, shall require 

24 States to report information that is appropriate to 

25 permit an assessment to be made of the success of 


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1 States in the implementation of programs under this 

2 section. Such information shall, at a minimum, in3 clude— 

4 ‘‘(A) the number of eligible children and 

5 youth in foster care; 

6 ‘‘(B) the number of eligible children and 

7 youth in residential treatment centers; 

8 ‘‘(C) appropriate information concerning 

9 the participation and academic progress of eligi10 ble children and youth in school; 

11 ‘‘(D) measures of the contacts of eligible 

12 children and youth with juvenile justice sys13 tems; 

14 ‘‘(E) measures of the clinical improvement 

15 of eligible children and youth; and 

16 ‘‘(F) information concerning the level of 

17 satisfaction of eligible children and youth and 

18 their families with services received. 

19 ‘‘(2) ANNUAL REPORT BY STATES.—Beginning 

20 with the second fiscal year in which a State receives 

21 funding under a grant under this section, the State 

22 shall annually report to the Secretary on the success 

23 of the programs and activities carried out by the 

24 State under the grant. Such reports shall include the 


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1 information specified in paragraph (1) and other in2 formation required by the Secretary. 

3 ‘‘(3) REPORTS BY THE SECRETARY.— 

4 ‘‘(A) IN GENERAL.—Not later than 3 years 

5 after the date of enactment of this part, the 

6 Secretary shall submit to Congress a report on 

7 the success of States in using grants under this 

8 section to eliminate children and youth custody 

9 relinquishment solely to obtain mental health 

10 care. Such report shall include recommenda11 tions to strengthen the program under this sec12 tion. 

13 ‘‘(B) FINAL REPORT.—Not later than 6 

14 years after the date of enactment of this part, 

15 the Secretary shall submit to Congress a final 

16 report on the success of States in using grants 

17 under this section to eliminate children and 

18 youth custody relinquishment solely to obtain 

19 mental health care. 

20 ‘‘(i) TECHNICAL ASSISTANCE.—The Secretary, in 

21 consultation with the task force established under section 

22 597A, may provide technical assistance to States in car23 rying out programs and activities under this section. The 

24 Secretary shall use not more than 20 percent of the 

25 amount appropriate for each fiscal year, not to exceed 


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1 $5,000,000 in any such fiscal year, to carry out this sub2 section and shall coordinate technical assistance under 

3 this section with other technical assistance programs as 

4 appropriate. 

5 ‘‘(j) DEFINITIONS.—In this section: 

6 ‘‘(1) ELIGIBLE CHILDREN AND YOUTH.—The 

7 term ‘eligible children and youth’ means children 

8 and youth under the age of 21 years who are in the 

9 custody of the State for the purpose of receiving 

10 mental health services or at-risk of entering into the 

11 custody of the State for the purpose of receiving 

12 mental health services. 

13 ‘‘(2) FAMILY SUPPORT SERVICES.—The term 

14 ‘family support services’ means individualized serv15 ices that are designed with input from the family 

16 and provided to eligible children and youth and their 

17 families to promote the mental health of an eligible 

18 child or youth, to strengthen the ability of family 

19 members to care for an eligible child or youth, or to 

20 enable an eligible child or youth to take advantage 

21 of other treatment and family support services. 

22 ‘‘(3) REQUIRED PRIVATE PARTNERS.—The 

23 term ‘required private partners’ includes— 

24 ‘‘(A) representatives of families of seriously 

25 emotionally disturbed children; 


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1 ‘‘(B) representatives of mental health care 

2 providers; 

3 ‘‘(C) representatives of private health in4 surers; and 

5 ‘‘(D) representatives of hospitals and resi6 dential care facilities. 

7 ‘‘(4) REQUIRED STATE PARTNERS.—The term 

8 ‘required State partners’ with respect to a State in9 cludes— 

10 ‘‘(A) the State agency responsible for chil11 dren’s mental health; 

12 ‘‘(B) the State child welfare agency; 

13 ‘‘(C) the State juvenile justice agency; 

14 ‘‘(D) the State Medicaid agency; 

15 ‘‘(E) the State education agency; 

16 ‘‘(F) the State substance abuse agency; 

17 ‘‘(G) the State bureau of insurance; and 

18 ‘‘(H) the office of the Governor of the 

19 State. 

20 ‘‘(5) STATE.—The term ‘State’ includes, in ad21 dition to the several States, the District of Colum22 bia, the Commonwealth of Puerto Rico, the Com23 monwealth of the Northern Mariana Islands, the 

24 Virgin Islands, Guam, American Samoa, the Trust 

25 Territory of the Pacific Islands, and Indian tribes. 


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

2 are authorized to be appropriated to carry out this section, 

3 $8,500,000 for fiscal year 2008, $11,500,000 for fiscal 

4 year 2009, and $20,000,000 for each of fiscal years 2010 

5 through 2013. 

6 ‘‘SEC. 597A. TASK FORCE. 

7 ‘‘(a) ESTABLISHMENT.—The Administrator, in con8 junction with the Director of the Office of Juvenile Justice 

9 and Delinquency Prevention, the Administrator of the Ad10 ministration for Children and Families, the Administrator 

11 of the Centers for Medicare & Medicaid Services, and the 

12 Assistant Secretary of Education for Special Education, 

13 shall establish and staff a task force to examine problems 

14 of mental health in the child welfare and juvenile justice 

15 systems and issues with respect to access by children and 

16 youth to mental health services, and the role of their agen17 cies in promoting access by children and youth to mental 

18 health services. 

19 ‘‘(b) DUTIES.—The task force established under sub20 section (a) shall— 

21 ‘‘(1) work with mental health and child advo22 cates, representatives of families of eligible children 

23 and youth, and representatives of State systems of 

24 care to make recommendations to Congress con25 cerning strategies to improve the delivery of mental 


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1 health services, including prevention services, to chil2 dren and youth with serious emotional disturbances, 

3 including those who are at risk of dropping out of 

4 school or at risk of coming in contact with child wel5 fare and juvenile justice systems; 

6 ‘‘(2) work with mental health and child advo7 cates, representatives of families of eligible children 

8 and youth, and representatives of State systems of 

9 care to develop improved reporting requirements for 

10 States concerning the number of children and youth 

11 entering child welfare and juvenile justice systems 

12 solely to access mental health services; 

13 ‘‘(3) in consultation with States and appro14 priate stakeholders, create standard definitions for 

15 the categories of data to be collected on such chil16 dren and youth; 

17 ‘‘(4) foster interagency cooperation to eliminate 

18 the practice of custody relinquishment; 

19 ‘‘(5) provide advice to the Administrator in im20 plementation of the family support grant programs 

21 under section 597; 

22 ‘‘(6) coordinate and deliver technical assistance 

23 to States and State agencies to help implement pro24 grams under such grant program; 


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1 ‘‘(7) make recommendations to break down bar2 riers to coordination in existing Federal programs 

3 and to allow for more effective integration across 

4 agencies and programs; and 

5 ‘‘(8) provide a biannual report to Congress on 

6 its recommendations and its progress in carrying out 

7 its duties, ending the practice of parents relin8 quishing legal custody of their children with serious 

9 emotional disturbances in order to obtain mental 

10 health services, and improving the delivery of mental 

11 health services to children with serious emotional 

12 disturbances. 

13 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There 

14 are authorized to be appropriated to carry out this section, 

15 $1,000,000 for each of fiscal years 2008 through 2013. 

16 Of the amount appropriate for each fiscal year under this 

17 subsection, 60 percent of such amount shall be made avail18 able to the Secretary, 20 percent of such amount shall 

19 be made available to the Attorney General, and 20 percent 

20 of such amount shall be made available to the Secretary 

21 of Education.’’. 

Æ 


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