279 
tinuously face-to-face monitoring the individual 
and when strong licensing or accreditation and 
internal controls are in place. 
‘‘(c) RULE OF CONSTRUCTION.— 
‘‘(1) IN
GENERAL.—Nothing in this section 
shall be construed as prohibiting the use of re-
straints for medical immobilization, adaptive sup-
port, or medical protection. 
‘‘(2) CURRENT LAW.—This part shall not be 
construed 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) MECHANICAL RESTRAINT.—The term ‘me-
chanical restraint’ means the use of devices as a 
means of restricting an individual’s freedom of 
movement. 
‘‘(2) 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 an individual who is acting out to 
walk to a safe location. 
‘‘(3) PHYSICAL RESTRAINT.—The term ‘phys-
ical restraint’ means a personal restriction that im-
mobilizes or reduces the ability of an individual to 
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move his or her arms, legs, or head freely. Such 
term does not include a physical escort. 
‘‘(4) SECLUSION.—The term ‘seclusion’ means 
a behavior control technique involving locked isola-
tion. Such term does not include a time out. 
‘‘(5) TIME OUT.—The term ‘time out’ means a 
behavior management technique that is part of an 
approved treatment program or individual service 
plan and may involve the separation of the indi-
vidual from the group, in a non-locked setting, for 
the purpose of calming. Time out is not seclusion. 
‘‘SEC. 596. REPORTING REQUIREMENT. 
‘‘Each facility (described in section 595(a)(1)) shall 
notify the appropriate State licensing or regulatory agen-
cy, as determined by the Secretary, and in the case of fa-
cilities described in section 595(a)(1)(B) determined by 
the Secretary in consultation with the Secretary of Edu-
cation— 
‘‘(1) of each death that occurs at each such fa-
cility. A notification under this section shall include 
the name of the resident and shall be provided not 
later than 24 hours after the time of the individuals 
death; and 
‘‘(2) of the use of seclusion or restraints in ac-
cordance with regulations promulgated by the Sec-
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retary, in consultation with the Secretary of Edu-
cation in the case of facilities described in section 
595(a)(1)(B), and the States. 
‘‘SEC. 597. REGULATIONS AND ENFORCEMENT. 
‘‘(a) TRAINING.—Not later than 6 months after the 
date of the enactment of the SAMHSA Modernization Act 
of 2010, the Secretary, after consultation with the Sec-
retary of Education in the case of facilities described in 
section 595(a)(1)(B), appropriate State, local, public and 
private protection and advocacy organizations, health care 
professionals, social workers, facilities described in section 
595(a)(1), and individuals receiving services from such fa-
cilities, shall promulgate regulations that— 
‘‘(1) require States that license non-medical, 
community-based residential facilities for children 
and youth to develop licensing rules and monitoring 
requirements concerning behavior management prac-
tice that will ensure compliance with Federal regula-
tions and to meet the requirements of subsection 
(b); 
‘‘(2) require States that monitor compliance of 
facilities described in section 595(a)(1)(B) with Fed-
eral and State laws and standards to develop rules 
and monitoring requirements concerning behavior 
management practice that will ensure compliance 
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with Federal regulations and meet the requirements 
of subsection (b); 
‘‘(3) require States to develop and implement 
such licensing rules and monitoring requirements 
within 1 year after the promulgation of the regula-
tions referred to in the matter preceding paragraph 
(1); and 
‘‘(4) support the development of national guide-
lines and standards on the quality, quantity, orienta-
tion and training, required under this part, as well 
as the certification or licensure of those staff respon-
sible for the implementation of behavioral interven-
tion concepts and techniques. 
‘‘(b) REQUIREMENTS.—The regulations promulgated 
under subsection (a) shall require— 
‘‘(1) that facilities described in subsection (a) 
ensure that there is an adequate number of qualified 
professional and supportive staff to evaluate individ-
uals, formulate written individualized, comprehensive 
treatment plans, and to provide active treatment 
measures; 
‘‘(2) the provision of appropriate training and 
certification of the staff of such facilities in the pre-
vention and use of physical restraint and seclusion, 
including the needs and behaviors of the population 
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served, relationship building, alternatives to re-
straint, de-escalation methods, avoiding power strug-
gles, thresholds for restraints, the physiological im-
pact of restraint and seclusion, monitoring physical 
signs of distress and obtaining medical assistance, 
legal issues, position asphyxia, escape and evasion 
techniques, time limits for the use of restraint and 
seclusion, the process for obtaining approval for con-
tinued restraints and seclusion, procedures to ad-
dress problematic restraints, documentation, proc-
essing with children, and follow-up with staff, and 
investigation of injuries and complaints; and 
‘‘(3) that such facilities provide complete and 
accurate notification of deaths, as required under 
section 596. 
‘‘(c) ENFORCEMENT.—A State to which this part ap-
plies that fails to comply with any requirement of this 
part, including a failure to provide appropriate training 
and certification, shall not be eligible for participation in 
any program supported in whole or in part by funds ap-
propriated to any Federal department or agency.’’. 
(b) TECHNICAL AMENDMENTS.—Part G of title V of 
the Public Health Service Act (42 U.S.C. 290kk et seq.), 
as added by section 144 of the Community Renewal Tax 
Relief Act of 2000 (as enacted into law by section 1(a)(7) 
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of Public Law 106–554; 114 Stat. 2763A–619), is amend-
ed— 
(1) by redesignating such part as part I; 
(2) by transferring such part so as to appear 
after part H (as so designated by the amendment 
made by subsection (a)); and 
(3) by redesignating sections 581 through 584 
as sections 599 through 599C, respectively. 
SEC. 3. AMENDMENTS TO TITLE XIX OF THE PUBLIC 
HEALTH SERVICE ACT. 
(a) IN GENERAL.—Part B of title XIX of the Public 
Health Service Act (42 U.S.C. 300x–1 et seq.), except for 
section 1955 (42 U.S.C. 300x–65), is amended to read 
as follows: 
‘‘PART B—BLOCK GRANTS REGARDING MENTAL 
HEALTH AND SUBSTANCE USE DISORDERS 
‘‘Subpart I—Block Grants for Community Mental 
Health Services 
‘‘SEC. 1911. FORMULA GRANTS TO STATES. 
‘‘(a) IN GENERAL.—For the purpose described in 
subsection (b), the Secretary, acting through the Director 
of the Center for Mental Health Services, shall make an 
allotment each fiscal year for each State in an amount 
determined in accordance with section 1918. The Sec-
retary shall make a grant to the State of the allotment 
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made for the State for the fiscal year if the State submits 
to the Secretary an application in accordance with section 
1917. 
‘‘(b) PURPOSE OF GRANTS.—A funding agreement 
for a grant under subsection (a) is that, subject to section 
1916, the State involved will expend the grant only for 
the purpose of— 
‘‘(1) providing community mental health serv-
ices for adults with serious mental illness and chil-
dren with serious emotional disturbances as defined 
in accordance with section 1912(c); 
‘‘(2) carrying out the plan submitted under sec-
tion 1912(a) by the State for the fiscal year in-
volved; 
‘‘(3) evaluating programs and services carried 
out under this subpart; and 
‘‘(4) planning, administration, and educational 
activities related to providing services under the 
plan. 
‘‘SEC. 1912. STATE PLAN FOR COMPREHENSIVE COMMU-
NITY MENTAL HEALTH SERVICES FOR CER-
TAIN INDIVIDUALS. 
‘‘(a) IN GENERAL.—The Secretary may make a grant 
under section 1911 only if— 
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‘‘(1) the State involved submits to the Secretary 
a plan for providing comprehensive community men-
tal health services to adults with a serious mental ill-
ness and to children with a serious emotional dis-
turbance; 
‘‘(2) the plan meets the criteria specified in 
subsection (b); and 
‘‘(3) the plan is approved by the Secretary. 
‘‘(b) CRITERIA FOR PLAN.— 
‘‘(1) IN
GENERAL.—In accordance with sub-
section (a), a State shall, at least once every 3 years, 
submit to the Secretary a plan that, at a minimum, 
includes the following: 
‘‘(A) SYSTEM OF CARE.—A description of 
the State’s system of care that contains the fol-
lowing: 
‘‘(i) 
COMPREHENSIVE
COMMUNITY- 
BASED
MENTAL
HEALTH
SYSTEMS.—The 
plan shall— 
‘‘(I) identify the single State 
agency to be responsible for the ad-
ministration of the program under the 
grant, including any third party who 
administers mental health services 
and is responsible for complying with 
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the requirements of this part with re-
spect to the grant; 
‘‘(II) provide for an organized 
community-based system of care for 
individuals with mental illness and de-
scribe available services and resources 
in a comprehensive system of care, in-
cluding services for individuals with 
co-occurring disorders; 
‘‘(III) include a description of the 
manner in which the State and local 
entities will coordinate services (in-
cluding health services, rehabilitation 
services, employment services, housing 
services, educational services, sub-
stance use disorder services, juvenile 
justice services, law enforcement serv-
ices, social services, child welfare serv-
ices, medical and dental care services, 
and other support services to be pro-
vided with Federal, State, and local 
public and private resources) with 
other agencies to enable individuals 
receiving services to function outside 
of inpatient or residential institutions, 
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to the maximum extent of their capa-
bilities, including services to be pro-
vided by local school systems under 
the Individuals with Disabilities Edu-
cation Act; 
‘‘(IV) include a description of 
how the State promotes evidence- 
based practices; 
‘‘(V) include a description of case 
management services; 
‘‘(VI) provide for activities lead-
ing to a reduction of hospitalization; 
‘‘(VII) include a description of 
how the State integrates mental 
health and substance use disorder 
services and primary health care, 
which may include providing mental 
health and substance use disorder 
services in primary care settings or 
providing primary and specialty care 
services in community-based mental 
health and substance use disorder 
service settings; and 
‘‘(VIII) include a description of 
how the State assures a smooth tran-
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sition of children with serious emo-
tional disturbances from the children’s 
service system to the adult service sys-
tem. 
‘‘(ii) MENTAL HEALTH SYSTEM DATA 
AND EPIDEMIOLOGY.—Utilizing the defini-
tions for adults with a serious mental ill-
ness and children with a serious emotional 
disturbance established in accordance with 
subsection (c), the plan shall— 
‘‘(I) provide estimates on the in-
cidence and prevalence of individuals 
who are adults with a serious mental 
illness and children with a serious 
emotional disturbance in the State, by 
age, sex, race, and ethnicity; 
‘‘(II) provide information on the 
number of adults with a serious men-
tal illness and children with a serious 
emotional disturbance in community- 
based treatment within the State by 
age, sex, race, and ethnicity; 
‘‘(III) provide estimates on the 
number of adults with a serious men-
tal illness and children with a serious 
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emotional disturbance who are home-
less or have a co-occurring mental 
health and substance use disorder; 
and 
‘‘(IV) provide the latest national 
outcome measurement data in accord-
ance with section 504(b). 
‘‘(iii) CHILDREN’S SERVICES.—In the 
case of children with a serious emotional 
disturbance (as defined pursuant to sub-
section (c)), the plan shall provide for a 
system of integrated social services, edu-
cational services, child welfare services, ju-
venile justice services, law enforcement 
services, and substance use disorder serv-
ices that, together with health and mental 
health services, will be provided in order 
for such children to receive care that is ap-
propriate for their multiple needs (such 
system to include services provided under 
the Individuals with Disabilities Education 
Act). 
‘‘(iv) TARGETED SERVICES TO RURAL, 
HOMELESS, 
AND
OLDER
ADULT
POPU-
LATIONS.—The plan shall describe the 
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State’s outreach to and services for indi-
viduals who are homeless and older adults 
with mental illness, and the manner in 
which community-based services will be 
provided to individuals residing in rural 
areas. 
‘‘(v) MANAGEMENT
SERVICES.—The 
plan shall describe— 
‘‘(I) the resources available in the 
State to pay for the services including 
funding under Medicaid, other Fed-
eral programs such as grants to the 
State, local jurisdictions of the State, 
or non-profit private entities awarded 
grants under title V and how the 
State is maximizing these resources, 
and the manner in which the State in-
tends to expend the grant under sec-
tion 1911 for the fiscal year involved; 
‘‘(II) the manner in which the 
State intends to comply with each of 
the funding agreements in this sub-
part and subpart III; and 
‘‘(III) the existing mental health 
and substance use disorders work-
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force, including data on the number of 
individuals who serve in the system of 
care designated by profession, the 
need for additional professionals and 
paraprofessionals, the efforts of the 
State to recruit and retain a qualified 
mental health and substance use dis-
orders workforce, and a copy of the 
standards the State uses in certifying 
or licensing community-based mental 
health services facilities and mental 
health providers. 
‘‘(B) SYSTEM ANALYSIS.—An analysis of 
the mental health system of care within the 
State that identifies the strengths and weak-
nesses of that system of care, and an assess-
ment of the adequacy of that system of care to 
respond to the need for services. 
‘‘(C) GOAL
AND
OBJECTIVES.—A set of 
quantifiable goals and objectives for the period 
of the plan, including goals and objectives re-
lated to the national outcomes measures estab-
lished in accordance with section 504, including 
targets and milestones that are intended to be 
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met and the activities that will be undertaken 
to achieve those targets. 
‘‘(D) OTHER
INFORMATION.—Any other 
information determined appropriate by the Sec-
retary. 
‘‘(2) 
AUTHORITY
REGARDING
MODIFICA-
TIONS.—As a condition of awarding a grant to a 
State under section 1911 for a fiscal year, the Sec-
retary may require that the State modify any provi-
sion of the plan submitted by the State under this 
section (including provisions on priorities in carrying 
out authorized activities). If the Secretary approves 
such plan and awards a grant to the State for the 
fiscal year, the Secretary may not during such year 
require the State to modify the plan. 
‘‘(3) STATE REQUEST FOR MODIFICATIONS.—If 
the State determines that modifications to the State 
plan under this section are necessary, the State may 
request the approval of the Secretary for such modi-
fications through the annual report of the State 
under section 1942. 
‘‘(4) 
MENTAL
HEALTH
EMERGENCY
RE-
SPONSE.— 
‘‘(A) REQUIREMENTS.—The State plan 
under this section shall include the State’s plan 
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for addressing the mental health and substance 
use disorder needs of individuals in the State in 
the event of an emergency or major disaster. 
‘‘(B) DEMONSTRATION.—The State shall 
demonstrate how the mental health and sub-
stance use disorder plan under subparagraph 
(A) for providing for the mental health needs of 
individuals in the event of an emergency or 
major disaster is incorporated into the State’s 
All-Hazards Public Health Emergency Pre-
paredness and Response Plan required under 
section 319C–1. If the mental health emergency 
response plan under subparagraph (A) is not so 
incorporated, the State shall describe how such 
plan will be incorporated into the State Emer-
gency Response Plan during the period that the 
State plan under this section is in effect. 
‘‘(C) DEFINITIONS.—In this paragraph, 
the terms ‘emergency’ and ‘major disaster’ have 
the meanings given such terms in section 102 
of the Robert T. Stafford Disaster Relief and 
Emergency Assistance Act. 
‘‘(c) DEFINITIONS REGARDING MENTAL ILLNESS 
AND EMOTIONAL DISTURBANCE; METHODS FOR ESTI-
MATE OF INCIDENCE AND PREVALENCE.— 
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‘‘(1) ESTABLISHMENT BY SECRETARY OF DEFI-
NITIONS; DISSEMINATION.—For purposes of this 
subpart, the Secretary shall establish definitions for 
the terms ‘adults with a serious mental illness’ and 
‘children with a serious emotional disturbance’. The 
Secretary shall disseminate the definitions to the 
States. 
‘‘(2) STANDARDIZED METHODS.—The Secretary 
shall establish standardized methods for making the 
estimates required in subsection (b)(1) with respect 
to a State. A funding agreement for a grant under 
section 1911 for the State is that the State will uti-
lize such methods in making the estimates. 
‘‘SEC. 1913. CERTAIN AGREEMENTS. 
‘‘(a) ALLOCATION FOR SYSTEMS OF INTEGRATED 
SERVICES FOR CHILDREN.— 
‘‘(1) IN
GENERAL.—With respect to children 
with a serious emotional disturbance, a funding 
agreement for a grant under section 1911 is that the 
State involved will expend not less than an amount 
equal to the amount expended by the State for fiscal 
year 2006. 
‘‘(2) WAIVER.— 
‘‘(A) Upon the request of a State, the Sec-
retary may provide to the State a waiver of all 
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or part of the requirement established in para-
graph (1) if the Secretary determines that the 
State is providing an adequate level of com-
prehensive community mental health services 
for children with a serious emotional disturb-
ance, as indicated by a comparison of the num-
ber of such children for which such services are 
sought with the availability in the State of the 
services. 
‘‘(B) The Secretary shall approve or deny 
a request for a waiver under subparagraph (A) 
not later than 120 days after the date on which 
the request is made. 
‘‘(C) Any waiver provided by the Secretary 
under subparagraph (A) shall be applicable only 
to the fiscal year involved. 
‘‘(b) PROVIDERS OF SERVICES.—A funding agree-
ment for a grant under section 1911 for a State is that, 
with respect to the plan submitted under section 1912(a) 
for the fiscal year involved— 
‘‘(1) services under the plan will be provided 
only through appropriate, qualified community pro-
grams (which may include community mental health 
centers, child mental-health programs, psychosocial 
rehabilitation programs, mental health peer-support 
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programs, and mental-health primary consumer-di-
rected programs); and 
‘‘(2) services under the plan will be provided 
through community mental health centers only if the 
centers meet the criteria specified in subsection (c). 
‘‘(c) CRITERIA FOR MENTAL HEALTH CENTERS.— 
The criteria referred to in subsection (b)(2) regarding 
community mental health centers are as follows: 
‘‘(1) With respect to mental health services, the 
centers provide services as follows: 
‘‘(A) Services principally to individuals re-
siding in a defined geographic area (hereafter 
in this subsection referred to as a ‘service 
area’). 
‘‘(B) Outpatient services, including special-
ized outpatient services for children, older 
Americans, individuals with a serious mental ill-
ness, and residents of the service areas of the 
centers who have been discharged from inpa-
tient treatment at a mental health facility. 
‘‘(C) 24-hour-a-day emergency care serv-
ices. 
‘‘(D) Day treatment or other partial hos-
pitalization services, or psychosocial rehabilita-
tion services. 
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‘‘(E) Screening for patients being consid-
ered for admission to State mental health facili-
ties to determine the appropriateness of such 
admission. 
‘‘(2) The mental health services of the centers 
are provided, within the limits of the capacities of 
the centers, to any individual residing or employed 
in the service area of the center regardless of ability 
to pay for such services. 
‘‘(3) The mental health services of the centers 
are available and accessible promptly, as appropriate 
and in a manner which preserves human dignity and 
assures continuity and high quality care. 
‘‘SEC. 1914. STATE MENTAL HEALTH PLANNING COUNCIL. 
‘‘(a) IN GENERAL.—A funding agreement for a grant 
under section 1911 is that the State involved will establish 
and maintain a State mental health planning council in 
accordance with the conditions described in this section. 
‘‘(b) DUTIES.—A condition under subsection (a) for 
a Council is that the duties of the Council are— 
‘‘(1) to review plans provided to the Council 
pursuant to section 1915(a) by the State involved 
and to submit to the State any recommendations of 
the Council for modifications to the plans; 
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‘‘(2) to serve as an advocate for adults with a 
serious mental illness, children with a severe emo-
tional disturbance, and other individuals with mental 
illnesses or emotional problems; and 
‘‘(3) to monitor, review, and evaluate, not less 
than once each year, the allocation and adequacy of 
mental health services within the State. 
‘‘(c) MEMBERSHIP.— 
‘‘(1) IN
GENERAL.—A condition under sub-
section (a) for a Council is that the Council be com-
posed of residents of the State, including representa-
tives of— 
‘‘(A) the principal State agencies with re-
spect to— 
‘‘(i) mental health, education, voca-
tional rehabilitation, criminal justice, hous-
ing, and social services; and 
‘‘(ii) the development of the plan sub-
mitted pursuant to title XIX of the Social 
Security Act; 
‘‘(B) public and private entities concerned 
with the need, planning, operation, funding, and 
use of mental health services and related sup-
port services; 
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‘‘(C) adults with serious mental illnesses 
who are receiving (or have received) mental 
health services; and 
‘‘(D) the families of such adults or families 
of children with emotional disturbance. 
‘‘(2) CERTAIN
REQUIREMENTS.—A condition 
under subsection (a) for a Council is that— 
‘‘(A) with respect to the membership of the 
Council, the ratio of parents of children with a 
serious emotional disturbance to other members 
of the Council is sufficient to provide adequate 
representation of such children in the delibera-
tions of the Council; and 
‘‘(B) not less than 50 percent of the mem-
bers of the Council are individuals who are not 
State employees or providers of mental health 
services. 
‘‘(d) DEFINITION.—For purposes of this section, the 
term ‘Council’ means a State mental health planning 
council. 
‘‘SEC. 1915. ADDITIONAL PROVISIONS. 
‘‘(a) REVIEW OF STATE PLAN BY MENTAL HEALTH 
PLANNING COUNCIL.—The Secretary may make a grant 
under section 1911 to a State only if— 
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srobinson on DSKHWCL6B1PROD with BILLS
357 
‘‘(A) an amount equal to the amounts re-
served under paragraph (3) for the fiscal year; 
and 
‘‘(B) a percentage equal to the quotient 
of— 
‘‘(i) the civilian population of the ter-
ritory, as indicated by the most recently 
available data; divided by 
‘‘(ii) the aggregate civilian population 
of the territories of the United States, as 
indicated by such data. 
‘‘(2) 
MINIMUM
ALLOTMENT
FOR
TERRI-
TORIES.—The amount of an allotment under section 
1921 for a territory of the United States for a fiscal 
year shall be the greater of— 
‘‘(A) the amount determined under para-
graph (1) for the territory for the fiscal year; 
‘‘(B) $50,000; and 
‘‘(C) with respect to fiscal years 1993 and 
1994, an amount equal to 79.4 percent of the 
amount received by the territory from allot-
ments made pursuant to this part for fiscal 
year 1992. 
‘‘(3) RESERVATION
OF
AMOUNTS.—The Sec-
retary shall each fiscal year reserve for the terri-
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srobinson on DSKHWCL6B1PROD with BILLS