238 
part B of the Individuals with Disabilities Education 
Act; 
‘‘(2) ensure that the plan is consistent with 
such individualized education program and provides 
for coordinating services under the plan with serv-
ices under such program; and 
‘‘(3) ensure that the memorandum of under-
standing entered into under section 572(d)(3)(B) re-
garding such Act includes provisions regarding com-
pliance with this subsection. 
‘‘(d) CONTENTS OF PLAN.—A funding agreement for 
a grant under section 571(a) is that the plan required in 
subsection (a) for a child will— 
‘‘(1) identify and state the needs of the child 
for the services available pursuant to section 572 
through the system; 
‘‘(2) provide for each of such services that is 
appropriate to the circumstances of the child, includ-
ing, except in the case of children who are less than 
14 years of age, the provision of appropriate voca-
tional counseling and rehabilitation, and transition 
services (as defined in section 602 of the Individuals 
with Disabilities Education Act); 
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‘‘(3) establish objectives to be achieved regard-
ing the needs of the child and the methodology for 
achieving the objectives; and 
‘‘(4) designate an individual to be responsible 
for providing the case management required in sec-
tion 572(e)(1) or certify that case management serv-
ices will be provided to the child as part of the indi-
vidualized education program of the child under the 
Individuals with Disabilities Education Act. 
‘‘SEC. 574. ADDITIONAL PROVISIONS. 
‘‘(a) OPTIONAL SERVICES.—In addition to services 
described in subsection (c) of section 572, a system of care 
under subsection (a) of such section may, in expending 
a grant under section 571(a), provide for— 
‘‘(1) preliminary assessments to determine 
whether a child should be provided access to the sys-
tem; 
‘‘(2) training in— 
‘‘(A) the administration of the system; 
‘‘(B) the provision of intensive home-based 
services under paragraph (4) of section 572(c), 
intensive day treatment under paragraph (5) of 
such section, and foster care or group homes 
under paragraph (7) of such section; and 
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‘‘(C) the development of individualized 
plans for purposes of section 573; 
‘‘(3) recreational activities for children provided 
access to the system; and 
‘‘(4) such other services as may be appropriate 
in providing for the comprehensive needs with re-
spect to mental health of children with a serious 
emotional disturbance. 
‘‘(b) COMPREHENSIVE PLAN.—The Secretary may 
make a grant under section 571(a) only if, with respect 
to the jurisdiction of the public entity involved, the entity 
has submitted to the Secretary, and has had approved by 
the Secretary, a plan for the development of a jurisdiction- 
wide system of care for community-based services for chil-
dren with a serious emotional disturbance that specifies 
the progress the public entity has made in developing the 
jurisdiction-wide system, the extent of cooperation across 
agencies serving children in the establishment of the sys-
tem, the Federal and non-Federal resources currently 
committed to the establishment of the system, and the cur-
rent gaps in community services and the manner in which 
the grant under section 571(a) will be expended to address 
such gaps and establish local systems of care. 
‘‘(c) LIMITATION
ON IMPOSITION
OF FEES
FOR 
SERVICES.—A funding agreement for a grant under sec-
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tion 571(a) is that, if a charge is imposed for the provision 
of services under the grant, such charge— 
‘‘(1) will be made according to a schedule of 
charges that is made available to the public; 
‘‘(2) will be adjusted to reflect the income of 
the family of the child involved; and 
‘‘(3) will not be imposed on any child whose 
family has income and resources of equal to or less 
than 100 percent of the official poverty line, as es-
tablished by the Director of the Office of Manage-
ment and Budget and revised by the Secretary in ac-
cordance with section 673(2) of the Omnibus Budget 
Reconciliation Act of 1981. 
‘‘(d) RELATIONSHIP
TO
ITEMS
AND
SERVICES 
UNDER OTHER PROGRAMS.—A funding agreement for a 
grant under section 571(a) is that the grant, and the non- 
Federal contributions made with respect to the grant, will 
not be expended to make payment for any item or service 
to the extent that payment has been made, or can reason-
ably be expected to be made, with respect to such item 
or service— 
‘‘(1) under any State compensation program, 
under an insurance policy, or under any Federal or 
State health benefits program; or 
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‘‘(2) by an entity that provides health services 
on a prepaid basis. 
‘‘(e) LIMITATION ON ADMINISTRATIVE EXPENSES.— 
A funding agreement for a grant under section 571(a) is 
that not more than 2 percent of the grant will be expended 
for administrative expenses incurred with respect to the 
grant by the public entity involved. 
‘‘(f) REPORTS TO SECRETARY.—A funding agree-
ment for a grant under section 571(a) is that the public 
entity involved will annually submit to the Secretary (and 
provide a copy to the State involved) a report on the activi-
ties of the entity under the grant that includes a descrip-
tion of the number of children provided access to systems 
of care operated pursuant to the grant, the demographic 
characteristics of the children, the types and costs of serv-
ices provided pursuant to the grant, the availability and 
use of third-party reimbursements, estimates of the unmet 
need for such services in the jurisdiction of the entity, and 
the manner in which the grant has been expended toward 
the establishment of a jurisdiction-wide system of care for 
children with a serious emotional disturbance, and such 
other information as the Secretary may require with re-
spect to the grant. 
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‘‘(g) 
DESCRIPTION
OF
INTENDED
USES
OF 
GRANT.—The Secretary may make a grant under section 
571(a) only if— 
‘‘(1) the public entity involved submits to the 
Secretary a description of the purposes for which the 
entity intends to expend the grant; 
‘‘(2) the description identifies the populations, 
areas, and localities in the jurisdiction of the entity 
with a need for services under this section; and 
‘‘(3) the description provides information relat-
ing to the services and activities to be provided, in-
cluding a description of the manner in which the 
services and activities will be coordinated with any 
similar services or activities of public or nonprofit 
entities. 
‘‘(h) REQUIREMENT
OF APPLICATION.—The Sec-
retary may make a grant under section 571(a) only if an 
application for the grant is submitted to the Secretary, 
the application contains the description of intended uses 
required in subsection (g), and the application is in such 
form, is made in such manner, and contains such agree-
ments, assurances, and information as the Secretary de-
termines to be necessary to carry out this section. 
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‘‘SEC. 575. GENERAL PROVISIONS. 
‘‘(a) DURATION OF SUPPORT.—The period during 
which payments are made to a public entity from a grant 
under section 571(a) may not exceed 6 fiscal years. 
‘‘(b) TECHNICAL ASSISTANCE.— 
‘‘(1) IN GENERAL.—The Secretary shall, upon 
the request of a public entity— 
‘‘(A) provide technical assistance to the en-
tity regarding the process of submitting to the 
Secretary applications for grants under section 
571(a) and 576; and 
‘‘(B) provide to the entity training and 
technical assistance with respect to the plan-
ning, development, and operation of systems of 
care pursuant to section 572. 
‘‘(2) AUTHORITY
FOR
GRANTS
AND
CON-
TRACTS.—The Secretary may provide technical as-
sistance under subsection (a) directly or through 
grants to, or contracts with, public and nonprofit 
private entities. 
‘‘(c) EVALUATIONS AND REPORTS BY SECRETARY.— 
‘‘(1) IN
GENERAL.—The Secretary shall, di-
rectly or through contracts with public or private en-
tities, provide for annual evaluations of programs 
carried out pursuant to section 571(a). The evalua-
tions shall assess the effectiveness of the systems of 
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care operated pursuant to such section, including 
longitudinal studies of outcomes of services provided 
by such systems, other studies regarding such out-
comes, the effect of activities under this part on the 
utilization of hospital and other institutional set-
tings, the barriers to and achievements resulting 
from interagency collaboration in providing commu-
nity-based services to children with a serious emo-
tional disturbance, and assessments by parents of 
the effectiveness of the systems of care. 
‘‘(2) REPORT
TO
CONGRESS.—The Secretary 
shall, not later than 1 year after the date on which 
amounts are first appropriated under subsection (c), 
and annually thereafter, submit to the Congress a 
report summarizing evaluations carried out pursuant 
to paragraph (1) during the preceding fiscal year 
and making such recommendations for administra-
tive and legislative initiatives with respect to this 
section as the Secretary determines to be appro-
priate. 
‘‘(d) DEFINITIONS.—For purposes of this part: 
‘‘(1) The term ‘child’ means an individual 
through the age of 21 years. 
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‘‘(2) The term ‘family’, with respect to a child 
provided access to a system of care under section 
572(a), means— 
‘‘(A) the legal guardian of the child; and 
‘‘(B) as appropriate regarding mental 
health services for the child, the parents of the 
child (biological or adoptive, as the case may 
be) and any foster parents of the child. 
‘‘(3) The term ‘funding agreement’, with re-
spect to a grant under section 571(a) to a public en-
tity, means that the Secretary may make such a 
grant only if the public entity makes the agreement 
involved. 
‘‘(4) The term ‘serious emotional disturbance’ 
includes, with respect to a child, any child who has 
a serious emotional disorder, a serious behavioral 
disorder, or a serious mental disorder. 
‘‘(e) RULE OF CONSTRUCTION.—Nothing in this part 
shall be construed as limiting the rights of a child with 
a serious emotional disturbance under the Individuals with 
Disabilities Education Act. 
‘‘SEC. 576. STATE INTEGRATED SYSTEMS OF CARE GRANTS 
FOR KEEPING FAMILIES TOGETHER. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Center for Mental Health Services, 
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shall award grants or cooperative agreements to States for 
the purpose of facilitating and promoting the implementa-
tion in local communities of an integrated system of care 
for children with mental illness, especially for those with 
serious emotional disturbance. 
‘‘(b) APPLICATIONS.—To be eligible for a grant 
under subsection (a), a State shall submit to the Secretary 
an applications that shall include, at a minimum, the fol-
lowing: 
‘‘(1) An assurance that the State will establish 
a board to be made up of, at least, the directors of 
the State departments or agencies responsible for 
mental health, substance use disorder, child welfare, 
education, medicaid, juvenile justice, and consumers 
and families of consumers to carry out the purpose 
of the grant. 
‘‘(2) A description of the specific population 
that the State wishes to focus on under the grant. 
‘‘(3) An assurance that the plan required under 
subsection (e) will be submitted within 18 months of 
the receipt of the grant. 
‘‘(4) Otherwise be in such form, made in such 
manner, and contain such agreements, assurances, 
and information as the Secretary determines to be 
necessary. 
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‘‘(c) DURATION
OF GRANTS.—The period during 
which payments are made under a grant under this section 
may not exceed 5 years. 
‘‘(d) PRIORITY.—In awarding grants under this sec-
tion, the Secretary shall give priority to States that elect 
to use grant funds to focus on children who are, or are 
at risk of being placed, in the child welfare or juvenile 
justice systems as a direct result of parents relinquishing 
their rights in order to get the mental health services their 
child needs. 
‘‘(e) PLAN.—To be eligible to receive a grant under 
this section, a State shall agree to submit to the Secretary 
for approval, a plan, within 18 months of the receipt of 
the grant, that at a minimum includes the following: 
‘‘(1) A description of the population that the 
State will focus on, including indications on the 
number of individuals in the population and the se-
verity of their mental illness. 
‘‘(2) A description of how these individuals are 
being served or not served by the State system. 
‘‘(3) A description of the finances that are cur-
rently being used throughout the State to serve this 
population, including funds from the mental health 
agency. 
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‘‘(4) A description of the types of services such 
population is receiving, including if applicable, serv-
ices provided under section 571. 
‘‘(5) A description of the coordination that ex-
ists among the various agencies serving children, in-
cluding child welfare, education, health, and juvenile 
justice agencies. 
‘‘(6) A description of the barriers that exist in 
the provision of services, including State policies and 
procedures. 
‘‘(7) A description of how the State intends to 
overcome these barriers, including changing the bar-
riers within State policies and procedures. 
‘‘(8) A description of how the State will finance 
the implementation of systems of care for children. 
‘‘(9) A description of how the State intends to 
promote a comprehensive system of care that in-
cludes a shift in reliance on residential and institu-
tional services to increased home and community- 
based services. 
‘‘(10) A description of the number of children 
in the child welfare or juvenile justice system as a 
direct result of parents relinquishing their rights in 
order to get the mental health services that their 
child needed. 
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‘‘(11) A description of how the State intends to 
track outcomes through data collection for individ-
uals that receive services in the system of care, in-
cluding improved school attendance and achieve-
ment, reduced substance use, reduced contact with 
law enforcement, detention and arrest rates, reduc-
tions in out-of-home placement, and mental health 
improvements sustained. 
‘‘(f) USE OF FUNDS.—Amounts received under a 
grant under this section may be used for any activity nec-
essary for the development of the plan submitted under 
subsection (e) and any costs associated with the implemen-
tation of the approved plan. 
‘‘(g) TRAINING AND TECHNICAL ASSISTANCE.—The 
Secretary shall, upon the request of the State, provide 
training and technical assistance to the State in the devel-
opment and implementation of the plan submitted under 
subsection (e). 
‘‘(h) REPORTS.—Beginning with the second year in 
which a State receives a grant under this section, and each 
grant year thereafter, the State shall submit a report to 
the Secretary detailing the State’s progress in imple-
menting the plan submitted under subsection (e). 
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‘‘SEC. 577. AUTHORIZATION OF APPROPRIATIONS. 
‘‘(a) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this part, there are authorized to 
be appropriated $150,000,000 for fiscal year 2011, and 
such sums as may be necessary for each of the fiscal years 
2012 through 2015. 
‘‘(b) GRANTS UNDER SECTION 576.—Not to exceed 
$10,000,000 of the amount appropriated under subsection 
(a) for each fiscal year may be used for grants under sec-
tion 576. 
‘‘PART F—WORKFORCE DEVELOPMENT 
‘‘SEC. 581. WORKFORCE DEVELOPMENT GRANTS, CON-
TRACTS, AND COOPERATIVE AGREEMENTS 
FOR MENTAL HEALTH AND SUBSTANCE USE 
DISORDERS. 
‘‘(a) PURPOSE.—It is the purpose of this section to 
promote workforce development by identifying and imple-
menting innovative and effective strategies to recruit and 
retain qualified mental health promotion and treatment 
and substance use disorder prevention and treatment staff 
and by disseminating those strategies to States and public 
and non-profit private providers of mental health and sub-
stance use disorder services. 
‘‘(b) GRANTS AND CONTRACTS.—The Secretary shall 
award grants, contracts, or cooperative agreements to eli-
gible entities to identify and implement effective, innova-
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tive strategies to recruit and retain a workforce qualified 
to provide mental health and substance use disorder pre-
vention and treatment services in the public sector. 
‘‘(c) ELIGIBILITY.—To be eligible to receive a grant, 
contract, or cooperative agreement under this section, an 
entity shall— 
‘‘(1) be a State, American Indian or Alaska Na-
tive tribe, tribal organization, a health facility or 
program operated by or pursuant to a contract or 
grant with the Indian Health Service, or non-profit 
entity; 
‘‘(2) submit to the Secretary an application at 
such time, in such manner, and containing such in-
formation as the Secretary may require; 
‘‘(3) agree to collect and provide to the Sec-
retary such data as required by the Secretary to ob-
jectively demonstrate the effect of the strategy im-
plemented through such grant, contract, or coopera-
tive agreement; and 
‘‘(4) agree to participate in conferences con-
ducted by the Secretary expressly for the purposes 
of developing recommendations on best practices for 
recruiting and retaining a qualified workforce. 
‘‘(d) USE OF FUNDS.— 
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‘‘(1) 
IN
GENERAL.—An 
entity 
shall 
use 
amounts received under this section to identify and 
implement innovative strategies to— 
‘‘(A) identify and recruit individuals into 
the mental health and substance use disorder 
public service workforce, including paraprofes-
sionals and individuals in recovery and their 
families; 
‘‘(B) assist individuals in obtaining basic 
or specialized competencies for providing mental 
health promotion and treatment services and 
substance use disorder prevention, treatment, 
and recovery services; and 
‘‘(C) retain qualified mental health and 
substance use disorder treatment staff, includ-
ing staff who provide services that promote 
mental health, prevent substance use, or treat 
mental illness and substance use disorders. 
‘‘(2) LIMITATION.—Eligible entities that receive 
funds under this section may not use such funds to 
pay for loan repayment or forgiveness programs, or 
for a degree at an institution of higher education or 
at any other institution. 
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‘‘(e) PRIORITIES.—In awarding grants, contracts, or 
cooperative agreements under this section the Secretary 
shall ensure that priority is given to— 
‘‘(1) entities in rural areas and mental health 
and substance use disorder manpower shortage 
areas; and 
‘‘(2) entities that agree to focus on the inclu-
sion of racial and ethnic minorities in the workforce. 
‘‘(f) GEOGRAPHIC DISTRIBUTION.—The Secretary 
shall ensure that to the extent practicable, an equitable 
distribution of grants, contracts, and cooperative agree-
ments among the geographical regions of the United 
States and between urban and rural populations. 
‘‘(g) TECHNICAL ASSISTANCE.—The Secretary shall 
provide technical assistance to eligible entities and conduct 
conferences to promote the sharing of ideas for the devel-
opment of best practices in the recruitment and retention 
of a qualified mental health and substance use disorder 
prevention and treatment workforce. 
‘‘(h) EVALUATION.—Not later than 3 years after the 
receipt of a grant, contract, or cooperative agreement 
under this section, an entity shall— 
‘‘(1) conduct an evaluation of the activities car-
ried out with funds received under the grant, con-
tract, or cooperative agreement; 
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‘‘(2) submit to the Secretary a report con-
cerning the results of the evaluation under para-
graph (1); and 
‘‘(3) participate in any further evaluation of the 
program by the Secretary. 
‘‘(i) DISSEMINATION.—The Secretary shall dissemi-
nate to States and public and non-profit private providers 
of mental health and substance use disorder services the 
proven effective strategies developed under this section. 
‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section, 
$25,000,000 for fiscal year 2011, and such sums as may 
be necessary for each of fiscal years 2012 through 2015. 
‘‘SEC. 582. DATA COLLECTION AND REPORT ON WORK-
FORCE ISSUES. 
‘‘Not later than 5 years after the date of enactment 
of the SAMHSA Modernization Act of 2010, the Adminis-
trator shall submit to the appropriate committees of Con-
gress a report based on the data collected pursuant to sec-
tions 1912(b) and 1931(b). Such report shall contain— 
‘‘(1) an assessment of the mental health and 
substance use disorder workforce capacity, strengths, 
and weaknesses as of the date of the report; 
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‘‘(2) recommendations for legislation to assist 
Congress in reauthorizing this title in fiscal year 
2014; 
‘‘(3) specific recommendations for States, com-
munities, and public and non-profit private providers 
of mental health and substance use disorder services; 
‘‘(4) data and best practices identified under 
section 581; and 
‘‘(5) recommendations for national outcomes 
measures of workforce. 
‘‘PART G—SCHOOL–BASED MENTAL HEALTH 
‘‘SEC. 585. SCHOOL-BASED MENTAL HEALTH AND CHIL-
DREN AND VIOLENCE. 
‘‘(a) IN GENERAL.—The Secretary, in collaboration 
with the Secretary of Education and in consultation with 
the Attorney General, shall, directly or through grants, 
contracts or cooperative agreements awarded to public en-
tities and local education agencies, assist local commu-
nities and schools in applying a public health approach 
to mental health services both in schools and in the com-
munity. Such approach should provide comprehensive age 
appropriate services and supports and incorporate age ap-
propriate strategies of positive behavioral interventions 
and supports. A comprehensive school mental health pro-
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gram funded under this section shall assist children in 
dealing with violence. 
‘‘(b) ACTIVITIES.—Under the program under sub-
section (a), the Secretary may— 
‘‘(1) provide financial support to enable local 
communities to implement a comprehensive school 
mental health program that incorporates positive be-
havioral interventions and supports to foster the 
health and development of children; 
‘‘(2) provide technical assistance to local com-
munities with respect to the development of pro-
grams described in paragraph (1); 
‘‘(3) provide assistance to local communities in 
the development of policies to address child and ado-
lescent mental health issues and violence when and 
if it occurs; 
‘‘(4) facilitate community partnerships among 
families, students, law enforcement agencies, edu-
cation systems, mental health and substance use dis-
order service systems, family-based mental health 
service systems, welfare agencies, healthcare service 
systems, and other community-based systems; and 
‘‘(5) establish mechanisms for children and ado-
lescents to report incidents of violence or plans by 
other children or adolescents to commit violence. 
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‘‘(c) REQUIREMENTS.— 
‘‘(1) IN GENERAL.—To be eligible for a grant, 
contract, or cooperative agreement under subsection 
(a) an entity shall— 
‘‘(A) be a partnership between a local edu-
cation agency and at least one community pro-
gram or agency that is involved in mental 
health; and 
‘‘(B) submit an application, that is en-
dorsed by all members of the partnership, that 
makes the assurances described in paragraph 
(2). 
‘‘(2) REQUIRED ASSURANCES.—An application 
under paragraph (1) shall assure the following: 
‘‘(A) That the applicant will ensure that, 
in carrying out activities under this section, the 
local educational agency involved will enter into 
a memorandum of understanding— 
‘‘(i) with, at a minimum, public or 
private mental health entities, healthcare 
entities, law enforcement or juvenile justice 
entities, child welfare agencies, family- 
based mental health entities, families and 
family organizations, and other commu-
nity-based entities; and 
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‘‘(ii) that clearly states— 
‘‘(I) the responsibilities of each 
partner with respect to the activities 
to be carried out; 
‘‘(II) how each partner will be ac-
countable for carrying out such re-
sponsibilities; and 
‘‘(III) the amount of non-Federal 
funding or in-kind contributions that 
each such partner will contribute in 
order to sustain the program. 
‘‘(B) That the comprehensive school-based 
mental health program carried out under this 
section support the flexible use of funds to ad-
dress— 
‘‘(i) the promotion of the social, emo-
tional, and mental health of all students in 
an environment that is conducive to learn-
ing; 
‘‘(ii) the reduction in the likelihood of 
at risk students developing social or emo-
tional problems or mental health and sub-
stance use disorders; 
‘‘(iii) the early identification of social 
or emotional problems or mental health 
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and substance use disorders and the provi-
sion of early intervention services; 
‘‘(iv) the treatment or referral for 
treatment of students with existing social 
or emotional problems or mental health 
and substance use disorders; and 
‘‘(v) the development and implementa-
tion of programs to assist children in deal-
ing with violence. 
‘‘(C) That the comprehensive mental 
health program carried out under this section 
will provide for in-service training of all school 
personnel, including ancillary staff and volun-
teers, in— 
‘‘(i) the techniques and support need-
ed to identify early children with, or at risk 
of, mental illness; 
‘‘(ii) the use of referral mechanisms 
that effectively link such children to treat-
ment intervention services; 
‘‘(iii) 
strategies 
that 
promote 
a 
schoolwide positive environment, and in-
cludes an on-going training and coaching 
component; 
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‘‘(iv) strategies for promoting the so-
cial, emotional, and mental health of all 
students; and 
‘‘(v) strategies to increase the knowl-
edge and skills of school and community 
leaders on the application of a public 
health approach to comprehensive school- 
based mental health programs. 
‘‘(D) That the comprehensive school-based 
mental health programs carried out under this 
section will demonstrate the measures to be 
taken to sustain the program after funding 
under this section terminates. 
‘‘(E) That the local education agency part-
nership involved is supported by the State edu-
cational and mental health system to ensure 
that the sustainability of the programs is estab-
lished after funding under this section termi-
nates. 
‘‘(F) That the comprehensive school-based 
mental health program carried out under this 
section is based on scientifically valid research, 
when available, or evidence-based practices. 
‘‘(G) That the comprehensive school-based 
mental health program carried out under this 
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section is coordinated with early intervening ac-
tivities carried out under the Individuals with 
Disabilities Education Act. 
‘‘(d) GEOGRAPHICAL DISTRIBUTION.—The Secretary 
shall ensure that grants, contracts or cooperative agree-
ments under subsection (a) will be distributed equitably 
among the regions of the country and among urban and 
rural areas. 
‘‘(e) DURATION
OF AWARDS.—With respect to a 
grant, contract or cooperative agreement under subsection 
(a), the period during which payments under such an 
award will be made to the recipient shall be 5 years. An 
entity may only receive one award under this section, ex-
cept that an entity that is providing services and supports 
on a regional basis may receive additional funding after 
the expiration of the preceding grant period. 
‘‘(f) EVALUATION AND MEASURES OF OUTCOMES.— 
‘‘(1) DEVELOPMENT
OF
PROCESS.—The Ad-
ministrator shall develop a process for evaluating ac-
tivities carried out under this section. Such process 
shall include— 
‘‘(A) the development of guidelines for the 
submission of program data by such recipients; 
‘‘(B) the development of measures of out-
comes (in accordance with paragraph (2)) to be 
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applied by such recipients in evaluating pro-
grams carried out under this section; and 
‘‘(C) the submission of annual reports by 
such recipients concerning the effectiveness of 
programs carried out under this section. 
‘‘(2) MEASURES OF OUTCOMES.— 
‘‘(A) IN
GENERAL.—The Administrator 
shall develop measures of outcomes to be ap-
plied by recipients of assistance under this sec-
tion, and the Administrator, in evaluating the 
effectiveness of programs carried out under this 
section. Such measures shall include student 
and family measures as provided for in sub-
paragraph (B) and local educational measures 
as provided for under subparagraph (C). 
‘‘(B) STUDENT AND FAMILY MEASURES OF 
OUTCOMES.—The measures of outcomes devel-
oped under paragraph (1)(B) relating to stu-
dents and families shall, with respect to activi-
ties carried out under a program under this 
section, at a minimum include provisions to 
evaluate— 
‘‘(i) whether the program resulted in 
an increase in social and emotional com-
petency; 
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‘‘(ii) whether the program resulted in 
an increase in student academic achieve-
ment; 
‘‘(iii) whether the program resulted in 
a reduction in disruptive and aggressive 
behaviors; 
‘‘(iv) whether the program resulted in 
improved family functioning; 
‘‘(v) whether the program resulted in 
a reduction in substance use disorders; 
‘‘(vi) whether the program resulted in 
a reduction in suspensions, truancy, expul-
sions and violence; and 
‘‘(vii) whether the program resulted in 
improved access to care for mental health 
disorders. 
‘‘(C) LOCAL EDUCATIONAL OUTCOMES.— 
The outcome measures developed under para-
graph (1)(B) relating to local educational sys-
tems shall, with respect to activities carried out 
under a program under this section, at a min-
imum include provisions to evaluate— 
‘‘(i) the effectiveness of comprehensive 
school mental health programs established 
under this section; 
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‘‘(ii) the effectiveness of formal part-
nership linkages among child and family 
serving institutions, community support 
systems, and the educational system; 
‘‘(iii) the progress made in sustaining 
the program once funding under the grant 
has expired; and 
‘‘(iv) the effectiveness of training and 
professional development programs for all 
school personnel. 
‘‘(3) SUBMISSION OF ANNUAL DATA.—An entity 
that receives a grant, contract, or cooperative agree-
ment under this section shall annually submit to the 
Administrator a report that include data to evaluate 
the success of the program carried out by the entity 
based on whether such program is achieving the pur-
poses of the program. Such reports shall utilize the 
measures of outcomes under paragraph (2) in a rea-
sonable manner to demonstrate the progress of the 
program in achieving such purposes. 
‘‘(4) EVALUATION BY ADMINISTRATOR.—Based 
on the data submitted under paragraph (3), the Ad-
ministrator shall annually submit to Congress a re-
port concerning the results and effectiveness of the 
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programs carried out with assistance received under 
this section. 
‘‘(g) INFORMATION
AND
EDUCATION.—The Sec-
retary shall establish comprehensive information and edu-
cation programs to disseminate the findings of the knowl-
edge development and application under this section to the 
general public and to health care professionals. 
‘‘(h) AMOUNT OF GRANTS AND AUTHORIZATION OF 
APPROPRIATIONS.— 
‘‘(1) AMOUNT OF GRANTS.—A grant under this 
section shall be in an amount that is not more than 
$1,000,000 for each of grant years 2011 through 
2015. The Secretary shall determine the amount of 
each such grant based on criteria determined by the 
Secretary. 
‘‘(2) AUTHORIZATION
OF
APPROPRIATIONS.— 
There is authorized to be appropriated to carry out 
this section, $200,000,000 for each of fiscal years 
2011 through 2015. 
‘‘SEC. 586. GRANTS TO ADDRESS THE PROBLEMS OF PER-
SONS WHO EXPERIENCE VIOLENCE RELATED 
STRESS. 
‘‘(a) IN
GENERAL.—The Secretary shall award 
grants, contracts or cooperative agreements to public and 
nonprofit private entities, as well as to Indian tribes and 
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tribal organizations, for the purpose of developing and 
maintaining programs that provide for the continued oper-
ation of the National Child Traumatic Stress Initiative, 
that focus on the behavioral and biological aspects of psy-
chological trauma response and for developing knowledge 
with regard to evidence-based practices for treating trau-
ma-related disorders of children and youth resulting from 
witnessing or experiencing a traumatic event. 
‘‘(b) PRIORITIES.—In awarding grants, contracts or 
cooperative agreements under subsection (a) related to the 
development of knowledge and provision of services based 
on evidence-based practices for treating disorders associ-
ated with psychological trauma, the Secretary shall give 
priority to mental health agencies and programs that have 
established clinical and basic research experience in the 
field of trauma-related mental disorders, and that con-
tribute to the establishment of a national trauma infra-
structure. 
‘‘(c) GEOGRAPHICAL DISTRIBUTION.—The Secretary 
shall ensure that grants, contracts or cooperative agree-
ments under subsection (a) with respect to centers of ex-
cellence are distributed equitably among the regions of the 
country and among urban and rural areas. 
‘‘(d) EVALUATION.—The Secretary, as part of the 
application process, shall require that each applicant for 
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a grant, contract or cooperative agreement under sub-
section (a) submit a plan for the rigorous evaluation of 
the activities funded under the grant, contract or agree-
ment, including both process and outcomes evaluation, 
and the submission of an evaluation at the end of the 
project period. 
‘‘(e) DURATION
OF AWARDS.—With respect to a 
grant, contract or cooperative agreement under subsection 
(a), the period during which payments under such an 
award will be made to the recipient for 5 years. Such 
grants, contracts or agreements may be renewed, except 
that expertise and experience in the field of trauma-related 
disorders shall be the priority criterion for new and con-
tinuing grant, contract, or cooperative agreement awards. 
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section, 
$50,000,000 for fiscal year 2011, and such sums as may 
be necessary for each of fiscal years 2012 through 2015. 
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‘‘PART H—REQUIREMENT RELATING TO THE 
RIGHTS OF RESIDENTS OF CERTAIN FACILITIES 
‘‘Subpart I—Medical Facilities 
‘‘SEC. 591. REQUIREMENT RELATING TO THE RIGHTS OF 
RESIDENTS OF CERTAIN MEDICAL FACILI-
TIES. 
‘‘(a) IN GENERAL.—A public or private general hos-
pital, nursing facility, intermediate care facility, or other 
health care facility, that receives support in any form from 
any program supported in whole or in part with funds ap-
propriated to any Federal department or agency shall pro-
tect and promote the rights of each resident of the facility, 
including the right to be free from physical or mental 
abuse, corporal punishment, and any restraints or involun-
tary seclusions imposed for purposes of discipline or con-
venience. 
‘‘(b) REQUIREMENTS.—Restraints and seclusion may 
only be imposed on a resident of a facility described in 
subsection (a) if— 
‘‘(1) the restraints or seclusion are imposed to 
ensure the physical safety of the resident, a staff 
member, or others; and 
‘‘(2) the restraints or seclusion are imposed 
only upon the written order of a physician, or other 
licensed practitioner permitted by the State and the 
facility to order such restraint or seclusion, that 
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specifies the duration and circumstances under 
which the restraints are to be used (except in emer-
gency circumstances specified by the Secretary until 
such an order could reasonably be obtained). 
‘‘(c) CURRENT LAW.—This part shall not be con-
strued to affect or impede any Federal or State law or 
regulations that provide greater protections than this part 
regarding seclusion and restraint. 
‘‘(d) DEFINITIONS.—In this section: 
‘‘(1) 
RESTRAINTS.—The 
term 
‘restraints’ 
means— 
‘‘(A) any physical restraint that is a me-
chanical or personal restriction that immobilizes 
or reduces the ability of an individual to move 
his or her arms, legs, or head freely, not includ-
ing devices, such as orthopedically prescribed 
devices, surgical dressings or bandages, protec-
tive helmets, or any other methods that involves 
the physical holding of a resident for the pur-
pose of conducting routine physical examina-
tions or tests or to protect the resident from 
falling out of bed or to permit the resident to 
participate in activities without the risk of 
physical harm to the resident (such term does 
not include a physical escort); and 
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‘‘(B) a drug or medication that is used as 
a restraint to control behavior or restrict the 
resident’s freedom of movement that is not a 
standard treatment for the resident’s medical or 
psychiatric condition. 
‘‘(2) SECLUSION.—The term ‘seclusion’ means 
a behavior control technique involving locked isola-
tion. Such term does not include a time out. 
‘‘(3) PHYSICAL
ESCORT.—The term ‘physical 
escort’ means the temporary touching or holding of 
the hand, wrist, arm, shoulder or back for the pur-
pose of inducing a resident who is acting out to walk 
to a safe location. 
‘‘(4) TIME OUT.—The term ‘time out’ means a 
behavior management technique that is part of an 
approved treatment program and may involve the 
separation of the resident from the group, in a non- 
locked setting, for the purpose of calming. Time out 
is not seclusion. 
‘‘SEC. 592. REPORTING REQUIREMENT. 
‘‘(a) IN GENERAL.—Each facility to which the Pro-
tection and Advocacy for Mentally Ill Individuals Act of 
1986 applies shall notify the appropriate agency, as deter-
mined by the Secretary, of each death that occurs at each 
such facility while a patient is restrained or in seclusion, 
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of each death occurring within 24 hours after the patient 
has been removed from restraints and seclusion, or where 
it is reasonable to assume that a patient’s death is a result 
of such seclusion or restraint. A notification under this 
section shall include the name of the resident and shall 
be provided not later than 7 days after the date of the 
death of the individual involved. 
‘‘(b) FACILITY.—In this section, the term ‘facility’ 
has the meaning given the term ‘facilities’ in section 
102(3) of the Protection and Advocacy for Mentally Ill 
Individuals Act of 1986 (42 U.S.C. 10802(3)). 
‘‘SEC. 593. REGULATIONS AND ENFORCEMENT. 
‘‘(a) TRAINING.—Not later than 1 year after the date 
of the enactment of this part, the Secretary, after con-
sultation with appropriate State and local protection and 
advocacy organizations, physicians, facilities, and other 
health care professionals and patients, shall promulgate 
regulations that require facilities to which the Protection 
and Advocacy for Mentally Ill Individuals Act of 1986 (42 
U.S.C. 10801 et seq.) applies, to meet the requirements 
of subsection (b). 
‘‘(b) REQUIREMENTS.—The regulations promulgated 
under subsection (a) shall require that— 
‘‘(1) facilities described in subsection (a) ensure 
that there is an adequate number of qualified profes-
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sional and supportive staff to evaluate patients, for-
mulate written individualized, comprehensive treat-
ment plans, and to provide active treatment meas-
ures; 
‘‘(2) appropriate training be provided for the 
staff of such facilities in the use of restraints and 
any alternatives to the use of restraints; and 
‘‘(3) such facilities provide complete and accu-
rate notification of deaths, as required under section 
592(a). 
‘‘(c) ENFORCEMENT.—A facility to which this part 
applies that fails to comply with any requirement of this 
part, including a failure to provide appropriate training, 
shall not be eligible for participation in any program sup-
ported in whole or in part by funds appropriated to any 
Federal department or agency. 
‘‘Subpart II—Non-Medical and Community-Based 
Facilities 
‘‘SEC. 595. REQUIREMENT RELATING TO THE RIGHTS OF IN-
DIVIDUALS OF CERTAIN NON-MEDICAL, COM-
MUNITY-BASED FACILITIES FOR CHILDREN 
AND YOUTH. 
‘‘(a) PROTECTION OF RIGHTS.— 
‘‘(1) IN GENERAL.— 
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‘‘(A) COMMUNITY-BASED
FACILITIES.—A 
public or private non-medical, community-based 
facility for children and youth (as defined in 
regulations to be promulgated by the Secretary) 
that receives support in any form from any pro-
gram supported in whole or in part with funds 
appropriated under this Act shall protect and 
promote the rights of each resident of the facil-
ity, including the right to be free from physical 
or mental abuse, corporal punishment, and any 
restraints or involuntary seclusions imposed for 
purposes of discipline or convenience. 
‘‘(B) SCHOOLS.—A public, private, resi-
dential or non-residential school (as defined in 
regulations to be promulgated by the Secretary 
in consultation with the Secretary of Edu-
cation) that receives support in any form from 
any program supported in whole or in part with 
funds appropriated to any Federal department 
or agency shall protect and promote the rights 
of each individual of the facility, including the 
right to be free from physical or mental abuse, 
corporal punishment (as defined by State law), 
and any restraints or involuntary seclusions im-
posed for purposes of discipline or convenience. 
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‘‘(2) 
NONAPPLICABILITY.—Notwithstanding 
this part, a facility that provides inpatient psy-
chiatric treatment services for individuals under the 
age of 21, as authorized and defined in subsections 
(a)(16) and (h) of section 1905 of the Social Secu-
rity Act, shall comply with the requirements of part 
H. 
‘‘(3) APPLICABILITY
OF
MEDICAID
PROVI-
SIONS.—A non-medical, community-based facility for 
children and youth funded under the Medicaid pro-
gram under title XIX of the Social Security Act 
shall continue to meet all existing requirements for 
participation in such program that are not affected 
by this part. 
‘‘(b) REQUIREMENTS.— 
‘‘(1) IN GENERAL.—Physical restraints and se-
clusion may only be imposed on an individual by a 
facility described in subsection (a)(1) if— 
‘‘(A) the restraints or seclusion are im-
posed only in emergency circumstances and only 
to ensure the immediate physical safety of the 
individual, a staff member, students, or others 
and less restrictive interventions have been de-
termined to be ineffective; and 
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‘‘(B) the restraints or seclusion are im-
posed only by an individual trained and cer-
tified, by a State-recognized body (as defined in 
regulation promulgated by the Secretary, and in 
the case of facilities described in subsection 
(a)(1)(B) promulgated by the Secretary in con-
sultation with the Secretary of Education) and 
pursuant to a process determined appropriate 
by the State and approved by the Secretary, 
and in the case of facilities described in sub-
section (a)(1)(B) approved by the Secretary in 
consultation with the Secretary of Education, in 
the prevention and use of physical restraint and 
seclusion, including the needs and behaviors of 
the population served, relationship building, al-
ternatives to restraint and seclusion, de-esca-
lation methods, avoiding power struggles, 
thresholds for restraints and seclusion, the 
physiological and psychological impact of re-
straint and seclusion, monitoring physical signs 
of distress and obtaining medical assistance, 
legal issues, position asphyxia, escape and eva-
sion techniques, time limits, the process for ob-
taining approval for continued restraints, proce-
dures to address problematic restraints, docu-
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mentation, processing with children, and follow- 
up with staff, and investigation of injuries and 
complaints. 
‘‘(2) INTERIM
PROCEDURES
RELATING
TO 
TRAINING AND CERTIFICATION.— 
‘‘(A) IN GENERAL.—Until such time as the 
State develops a process to assure the proper 
training and certification of facility personnel in 
the skills and competencies referred to in para-
graph (1)(B), the facility involved shall develop 
and implement an interim procedure that meets 
the requirements of subparagraph (B). 
‘‘(B) REQUIREMENTS.—A procedure devel-
oped under subparagraph (A) shall— 
‘‘(i) ensure that a supervisory or sen-
ior staff person with training in restraint 
and seclusion who is competent to conduct 
a face-to-face assessment (as defined in 
regulations promulgated by the Secretary, 
and in the case of facilities described in 
subsection (a)(1)(B) promulgated by the 
Secretary in consultation with the Sec-
retary of Education), will assess the men-
tal and physical well-being of the child or 
youth being restrained or secluded and as-
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sure that the restraint or seclusion is being 
done in a safe manner; 
‘‘(ii) ensure that the assessment re-
quired under clause (i) take place as soon 
as practicable, but in no case later than 1 
hour after the initiation of the restraint or 
seclusion; and 
‘‘(iii) ensure that the supervisory or 
senior staff person continues to monitor 
the situation for the duration of the re-
straint and seclusion. 
‘‘(3) LIMITATIONS.— 
‘‘(A) IN GENERAL.—The use of a drug or 
medication that is used as a restraint to control 
behavior or restrict the individual’s freedom of 
movement that is not a standard treatment for 
the individual’s medical or psychiatric condition 
in a facility described in subsection (a)(1) is 
prohibited. 
‘‘(B) PROHIBITION.—The use of mechan-
ical restraints in a facility described in sub-
section (a)(1) is prohibited. 
‘‘(C) LIMITATION.—A facility for children 
and youth described in subsection (a)(1) may 
only use seclusion when a staff member is con-
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the Secretary determines that the State is not in 
compliance with such subsection, the Secretary 
shall— 
‘‘(A) reduce the amount of the allotment 
under such section for the State for the fiscal 
year involved by an amount equal to 40 percent 
of the amount determined under section 1933 
for the State for the fiscal year; or 
‘‘(B) require the State to certify to the 
Secretary by May 1 of the fiscal year for which 
the State is seeking grant funds, that the State 
will— 
‘‘(i) maintain State expenditures in 
such fiscal year for tobacco prevention pro-
grams and for compliance activities, in-
cluding enforcement, at a level that is not 
less than the level of expenditures main-
tained by the State for such activities for 
the previous fiscal year; and 
‘‘(ii) increase State expenditures to 
ensure compliance with the State law re-
quired under subsection (a) by an amount 
equal to the product of— 
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