Mental Health Justice Act of 2021
Bill: S.515 | Sponsor: Sen. Warren, Elizabeth (D-MA)
Policy area: Health

Summary:
Mental Health Justice Act of 2021
This bill creates a grant program for states and local governments to train and dispatch mental health professionals to respond, instead of law enforcement officers, to emergencies that involve people with behavioral health needs.
The Substance Abuse and Mental Health Services Administration (SAMHSA) must manage the program in consultation with the Department of Justice (DOJ). SAMHSA may cancel grants that increase incarceration or institutionalization. Grantees must use funds for purposes including de-escalation and anti-racism training.
The Department of Health and Human Services and the DOJ must evaluate this program.

To authorize the Secretary of Health and Human Services to award grants 
to States and political subdivisions of States to hire, employ, train, 
  and dispatch mental health professionals to respond in lieu of law 
enforcement officers in emergencies involving one or more persons with 
 a mental illness or an intellectual or developmental disability, and 
                          for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Mental Health Justice Act of 2021''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) Needless institutionalization (including in psychiatric 
        hospitals) of people with disabilities is generally a violation 
        of the Americans with Disabilities Act of 1990 (42 U.S.C. 12101 
        et seq.), and the failure to provide sufficient community-based 
        services (such as supported housing, assertive community 
        treatment, mobile crisis, peer support, and supported 
        employment) has resulted in needless institutionalization as 
        well as incarceration of persons with mental illness or an 
        intellectual or developmental disability.
            (2) In the landmark 1999 Supreme Court case Olmstead v. 
        L.C., the Supreme Court ruled that the ``unjustified 
        institutional isolation of persons with disabilities is a form 
        of discrimination'' prohibited by the Americans with 
        Disabilities Act of 1990 (42 U.S.C. 12101 et seq.).
            (3) Regulations promulgated by the Attorney General in 1991 
        affirm that title II of the Americans with Disabilities Act of 
        1990 (42 U.S.C. 12131 et seq.) requires public entities to 
        ``administer services, programs, and activities in the most 
        integrated setting appropriate to the needs of qualified 
        individuals with disabilities'' (28 C.F.R. 35.130(d)). The 
        regulation defines ``the most integrated setting'' as one that 
        ``enables individuals with disabilities to interact with 
        nondisabled persons to the fullest extent possible'' (28 C.F.R. 
        pt. 35, App. B).
            (4) Yet today, persons with a mental illness or an 
        intellectual or developmental disability are more likely to be 
        incarcerated and to be subject to excessive use of force by law 
        enforcement officers:
                    (A) One out of every 4 of the deaths caused by law 
                enforcement officers is a person with mental illness.
                    (B) Persons with a mental illness or an 
                intellectual or developmental disability are often 
                charged with minor, nonviolent offenses. For many of 
                these persons, arrest and incarceration could have been 
                avoided if they had access to intensive community-based 
                services and stable housing.
            (5) Many of the police encounters that lead to the 
        incarceration (and in too many cases, death) of people with 
        mental illness or an intellectual or developmental disability 
        could be avoided by having in place systems that ensure that 
        calls to 911 or to law enforcement result in dispatch of mental 
        health professionals, peer support workers, or others rather 
        than law enforcement officers.
            (6) Many people who are incarcerated would be better served 
        in community services. If there were sufficient community 
        services, and persons with mental illness or an intellectual or 
        developmental disability were connected to those services 
        rather than being arrested, thousands of people with mental 
        illness or an intellectual or developmental disability would 
        avoid needless admissions to hospitals or jails. Further, jails 
        and hospitals would experience less crowding.

SEC. 3. GRANTS FOR MENTAL HEALTH PROFESSIONALS TO ACT AS FIRST 
              RESPONDERS.

    (a) In General.--The Secretary of Health and Human Services (in 
this section referred to as the ``Secretary''), acting through the 
Assistant Secretary for Mental Health and Substance Use and in 
consultation with the Assistant Attorney General for the Civil Rights 
Division of the Department of Justice (in this section referred to as 
the ``Assistant Attorney General''), shall award grants to States and 
political subdivisions of States--
            (1) to hire, employ, train, and dispatch mental health 
        professionals to respond in lieu of law enforcement officers in 
        emergencies in which--
                    (A) an individual calling 911, 988, or another 
                emergency hotline states that a person--
                            (i) is in a mental health crisis; or
                            (ii) may have a mental illness or an 
                        intellectual or developmental disability;
                    (B) a law enforcement officer or other first 
                responder identifies a person as having (or possibly 
                having) a mental illness or an intellectual or 
                developmental disability; or
                    (C) a law enforcement officer or other first 
                responder identifies a person as being (or possibly 
                being) under the influence of a legal or illegal 
                substance;
            (2) to include in the training for mental health 
        professionals pursuant to paragraph (1) training in--
                    (A) the principles of de-escalation and anti-
                racism; and
                    (B) age-appropriate mechanisms for carrying out the 
                professionals' responsibilities;
            (3) to ensure that such mental health professionals link 
        persons described in subparagraph (A), (B), or (C) of paragraph 
        (1) with voluntary community-based services where appropriate; 
        and
            (4) to train the staff of dispatch centers regarding the 
        proper handling of a report of an emergency described in 
        paragraph (1), including training in the principles of de-
        escalation and anti-racism referred to in paragraph (2)(A).
    (b) Delegation.--The Secretary shall delegate responsibility for 
carrying out the Secretary's responsibilities under this section and 
section 4 to the Director of the Center for Mental Health Services of 
the Substance Abuse and Mental Health Services Administration.
    (c) Additional Awards.--The Secretary shall make an additional 
award of funds under this section each fiscal year to grantees that 
demonstrate that their programs under this section resulted in--
            (1) a notable reduction in the incarceration and death of 
        persons with mental illness or an intellectual or developmental 
        disability; or
            (2) a notable reduction in the use of force by police and a 
        notable increase in referrals of persons with a mental illness 
        or intellectual disability to community-based, voluntary 
        support services (other than institutionalization or carceral 
        support services).
    (d) Priority.--In awarding grants under this section, the Secretary 
shall give priority to States and political subdivisions of States 
that--
            (1) have high rates of arrests and incarceration of persons 
        with a mental illness or an intellectual or developmental 
        disability;
            (2) commit to increasing resources for mental health and 
        community-based support services or solutions for such persons; 
        or
            (3) include peer support specialists in their current first 
        responder model.
    (e) Reporting.--
            (1) By grantees.--A recipient of a grant under this section 
        shall submit to the Secretary--
                    (A) a quarterly report on--
                            (i) the number and percentage of 
                        emergencies where mental health professionals 
                        were dispatched in lieu of law enforcement 
                        officers pursuant to assistance under this 
                        section;
                            (ii) such other matters as the Secretary 
                        may require for determining whether the 
                        recipient should receive an additional award 
                        under subsection (c); and
                            (iii) any increase or decrease, compared to 
                        any previous quarter, in incarceration or 
                        institutionalization as a result of dispatching 
                        mental health professionals pursuant to 
                        assistance under this section, disaggregated to 
                        include data specific to persons with 
                        intellectual and developmental disabilities and 
                        mental illnesses where available, so as--
                                    (I) to provide a critical baseline 
                                analysis; and
                                    (II) to ensure that mental health 
                                practitioners are not simply funneling 
                                individuals into other 
                                institutionalized settings; and
                    (B) a final report on the use of such grant.
            (2) By secretary.--Not later than 1 year after awarding the 
        first grant under this section, and annually thereafter, the 
        Secretary shall submit to Congress a report on the grant 
        program under this section.
            (3) Disaggregation of data.--The reporting pursuant to 
        paragraphs (1) and (2) shall be disaggregated by age, gender, 
        race, and ethnicity, to the extent the Secretary determines 
        appropriate.
    (f) Revocation of Grant.--If the Secretary finds, based on 
reporting under subsection (e) or other information, that activities 
funded through a grant under this section are leading to a significant 
increase in incarceration or institutionalization--
            (1) the Secretary shall revoke the grant; and
            (2) the grantee shall repay to the Federal Government any 
        amounts that the grantee--
                    (A) received through the grant; and
                    (B) has not obligated or expended.

SEC. 4. TECHNICAL ASSISTANCE FOR POLITICAL SUBDIVISIONS OF A STATE.

    The Secretary of Health and Human Services, acting through the 
Assistant Secretary for Mental Health and Substance Use and in 
consultation with the Assistant Attorney General for the Civil Rights 
Division of the Department of Justice, shall provide technical 
assistance to grantees under section 3 (or other Federal law), other 
political subdivisions of States, and States to hire, employ, train, 
and dispatch mental health professionals to respond in lieu of law 
enforcement officers, as described in section 3.

SEC. 5. STUDY.

    (a) In General.--The Secretary of Health and Human Services and the 
Assistant Attorney General for the Civil Rights Division of the 
Department of Justice shall conduct a study of the effectiveness of 
programs and activities under sections 3 and 4.
    (b) Qualitative and Longitudinal Examination.--The study under 
subsection (a) shall include a qualitative and longitudinal study of--
            (1) the number of persons diverted from arrests; and
            (2) short- and long-term outcomes for those persons, 
        including reduced recidivism, reduced incidences of use of 
        force, and reduced utilization of resources.
    (c) Completion; Report.--Not later than 3 years after the date of 
enactment of this Act, the Secretary of Health and Human Services and 
the Assistant Attorney General for the Civil Rights Division of the 
Department of Justice shall--
            (1) complete the study under subsection (a);
            (2) submit a report to Congress on the results of such 
        study; and
            (3) publish such report.

SEC. 6. FUNDING.

    To carry out this legislation, there are authorized to be 
appropriated such sums as may be necessary for fiscal year 2021 and 
each subsequent fiscal year.
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