Protection and Advocacy for Mentally Ill Individuals Amendments Act of 1988
PL 100-509 (S.2393), enacted 10/20/1988

PUBLIC LAW 100-509—OCT. 20, 1988 
102 STAT. 2543 
Public Law 100-509 
100th Congress 
An Act 
To amend the Protection and Advocacy for Mentally 1
1
1 Individuals Act of 1986 to 
reauthorize such Act, 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 "Protection and Advocacy for 
Mentally 111 Individuals Amendments Act of 1988". 
SEC. 
2
. 
REFERENCES. 
Except as otherwise specifically provided, whenever in this Act an 
amendment or repeal is expressed in terms of an amendment to, or 
a repeal of, a section or other provision, the reference shall be 
considered to be made to a section or other provision of the Protec-
tion and Advocacy for Mentally 111 Individuals Act of 1986 (42 U.S.C. 
10801 et seq.). 
SEC. 3. SCOPE OF COVERAGE. 
Section 102 (42 U.S.C. 10802) is amended— 
(1) in paragraph (1), by inserting "or death" after "caused, 
injury"; 
(2) in paragraph (3)— 
(A) by inserting "(i)" after the subparagraph designation 
in subparagraph (B); 
(B) by striking out the period at the end of subparagraph 
(B) and inserting in lieu thereof the following: ", even if the 
whereabouts of such inpatient or resident are unknown;"; 
and 
(C) by adding at the end thereof the following new 
clauses: 
"(ii) who is in the process of being admitted to a facility 
rendering care or treatment, including persons being trans-
ported to such a facility; or"; 
"(iii) who is involuntarily confined in a municipal deten-
tion facility for reasons other than serving a sentence 
resulting from conviction for a criminal offense."; and 
(3) in paragraph (4)— 
(A) by inserting "or death" after "injury" each place such 
word occurs; and 
(B) by inserting before the period at the end thereof the 
following: ", including the failure to maintain adequate 
numbers of appropriately trained staff. 
SEC. 4. ESTABLISHMENT OF A GOVERNING AUTHORITY. 
Section 105 (42 U.S.C. 10805) is amended— 
(1) in subsection (a)(6), by striking out "a board" and inserting 
in lieu thereof "an advisory council"; and 
(2) by adding at the end thereof the following new subsection: 
Oct. 20, 1988 
[S. 2393] 
Protection and 
Advocacy for 
Mentally 1
1
1 
Individuals 
Amendments 
Act of 1988. 
42 use 10801 
note. 
Health care 
facilities. 
102 STAT. 2544 
PUBLIC LAW 100-509—OCT. 20, 1988 
State and local 
governments. 
Health and 
medical care. 
"(c)(1)(A) Each system established in a State, through allotments 
received under section 103, to protect and advocate the rights of 
mentally ill individuals shall have a governing authority. 
"(B) In States in which the governing authority is organized as a 
private non-profit entity with a multi-member governing board, or a 
public system with a multi-member governing board, such governing 
board shall be selected according to the policies and procedures of 
the system. The governing board shall be composed o
f
— 
"(i) members (to be selected no later than October 1, 1990) 
who broadly represent or are knowledgeable about the needs of 
the clients served by the system; and 
"(ii) in the case of a governing authority organized as a 
private non-profit entity, members who broadly represent or are 
knowledgeable about the needs of the clients served by the 
system including the chairperson of the advisory council of such 
system. 
"(2) The governing authority established under paragraph (1) 
shall— 
"(A) be responsible for the planning, design, implementation, 
and functioning of the system; and 
"(B) consistent with subparagraph (A), jointly develop the 
annual priorities of the system with the advisory council.". 
SEC. 5. ADVISORY COUNCIL REPORT. 
Section 105(a)(7) (42 U.S.C. 10805(a)(7)) is amended by striking out 
the period and inserting in lieu thereof the following: ", including a 
section prepared by the advisory council that describes the activities 
of the council and its assessment of the operations of the system;". 
SEC. 6. ACCESS TO RECORDS. 
(a) 
SYSTEM 
REQUIREMENT.—Section 
105(a)(4)(B) (42 U.S.C. 
10805(a)(4)(B)) is amended by striking out "any individual" and 
inserting in lieu thereof "any individual (including an individual 
who has died or whose whereabouts are unknown)". 
(b) DEFINITION OF RECORDS.—Section 106(b) (42 U.S.C. 10806(b)) is 
amended by adding at the end thereof the following new paragraph: 
"(3)(A) As used in this section, the term 'records includes reports 
prepared by any staff of a facility rendering care and treatment or 
reports prepared by an agency charged with investigating reports of 
incidents of abuse, neglect, and injury occurring at such facility that 
describe incidents of abuse, neglect, and injury occurring at such 
facility and the steps taken to investigate such incidents, and dis-
charge planning records. 
"(B) An eligible system shall have access to the type of records 
described in subparagraph (A) in accordance with the provisions of 
subsection (a) and paragraphs (1) and (2) of subsection (b).". 
SEC. 7. MISCELLANEOUS PROVISIONS. 
(a) SUBCONTRACTING.—Section 104(a)(2) (42 U.S.C. 10804(a)(2)) is 
amended by striking out "which, on the date of enactment of this 
Act" and inserting in lieu thereof "including, in particular, groups 
run by individuals who have received or are receiving mental health 
services, or the family members of such individuals, which". 
(b) TECHNICAL ASSISTANCE LIMITATIONS.— 
(1) STATE ASSISTANCE.—Section 104(b)(2) (42 U.S.C. 10804(b)(2)) 
is amended by striking out "5 percent" and inserting in lieu 
thereof "10 percent". 
PUBLIC LAW 100-509—OCT. 20, 1988 
102 STAT. 2545 
(2) ASSISTANCE BY THE SECRETARY.-
10825) is amended to read as follows: 
-Section 10 (42 U.S.C. 
TECHNICAL ASSISTANCE 
"SEC. 115. The Secretary shall use not more than 2 percent of 
the amounts appropriated under section 117 to provide technical 
assistance to eligible systems with respect to activities carried out 
under this title, consistent with requests by such systems for such 
assistance.". 
(c) ADDITIONAL SYSTEM REQUIREMENTS.—Section 105(a) (42 U.S.C. 
10805(a)) (as amended by section 5), is further amended by adding at 
the end thereof the following new paragraphs: 
"(8) on an annual basis, provide the public with an oppor-
tunity to comment on the priorities established by, and the 
activities of, the system; and 
"(9) establish a grievance procedure for clients or prospective 
clients of the system to assure that mentally ill individuals have 
full access to the services of the system.". 
(d) APPLICATIONS.—Section 111 (42 U.S.C. 10821) is amended— 
(1) by inserting "(a)" after the section designation; and 
(2) by adding at the end thereof the following new subsection: 
"(b) Applications submitted under this section shall remain in 
effect for a 3-year period, and the assurances required under this 
section shall be for the same 3-year period.". 
(e) ALLOTMENT FORMULA.—Section 112(a) (42 U.S.C. 10822(a)) is 
amended— 
(1) in paragraph (2) to read as follows: 
"(2) Notwithstanding paragraph (1) and subject to the availability 
of appropriations under section 117— 
"(A) if the total amount appropriated in a fiscal year is at 
least $13,000,000— 
"(i) the amount of the allotment of the eligible system of 
each of the several States, the District of Columbia, and the 
Commonwealth of Puerto Rico shall be the greater o
f
— 
"(I) $140,000; or 
"(II) $125,000 in addition to the amount determined 
under paragraph (3); and 
"(ii) the amount of the allotment of the eligible system of Territories, U.S. 
Guam, American Samoa, the Commonwealth of the North-
ern Mariana Islands, the Trust Territory of the Pacific 
Islands, and the Virgin Islands shall be the greater o
f
— 
"(I) $75,000; or 
"(II) $67,000 in addition to the amount determined 
under paragraph (3); and 
"(B) if the total amount appropriated in a fiscal year is less 
than $13,000,000, the amount of the allotment of the eligible 
system— 
"(i) of each of the several States, the District of Columbia, 
and the Commonwealth of Puerto Rico shall not be less 
than $125,000 in addition to the amount determined under 
paragraph (3); and 
"(ii) of Guam, American Samoa, the Commonwealth of Territories, U.S. 
the Northern Mariana Islands, the Trust Territory of the 
Pacific Islands, and the Virgin Islands shall not be less than 
$67,000 in addition to the amount determined under para-
graph (3)."; and 
District of 
Columbia. 
Puerto Rico. 
District of 
Columbia. 
Puerto Rico. 
102 STAT. 2546 
PUBLIC LAW 100-509—OCT. 20, 1988 
(2) by adding at the end thereof the following new paragraph: 
"(3) In any case in which the total amount appropriated under 
section 117 for a fiscal year exceeds the total amount appropriated 
under such section, as in effect on the day before the date of 
enactment of this paragraph, for the preceding fiscal year by a 
percentage greater than the most recent percentage change in the 
Consumer Price Index published by the Secretary of Labor under 
section 100(c)(1) of the Rehabilitation Act of 1973, the Secretary 
shall increase each of the allotments under clauses (i)(II) and (ii)(II) 
of subparagraph (A) and clauses (i) and (ii) of subparagraph (B) of 
paragraph (2) by an amount which bears the same ratio to the 
amount of such minimum allotment (including any increases in 
such minimum allotment under this paragraph for prior fiscal 
years) as the amount which is equal to the difference between— 
"(A) the total amount appropriated under section 117 for the 
fiscal year for which the increase in minimum allotment is 
made, minus; 
"(B) the total amount appropriated under section 117 for the 
immediately preceding fiscal year, 
bears to the total amount appropriated under section 117 for such 
preceding fiscal year.". 
(f) AUTHORIZATION OF APPROPRIATIONS.—Section 117 (42 U.S.C. 
10827) is amended to read as follows: 
"AUTHORIZATION OF APPROPRIATIONS 
"SEC. 117. For allotments under this title, there are authorized to 
be appropriated $14,300,000 for fiscal year 1989, and such sums as 
may be necessary for fiscal year 1990 and fiscal year 1991.". 
42 u s e 10827 
SEC. 8. EFFECTIVE DATE. 
(a) IN GENERAL.—The amendments made by this Act, other than 
the amendment made by section 7(f), shall become effective on the 
date of the enactment of this Act. 
(b) AUTHORIZATION OF APPROPRIATIONS.—The amendment made by 
section 7(f) shall become effective on October 1, 1988. 
Approved October 20, 1988. 
LEGISLATIVE HISTORY—S. 2393 (H.R. 5155): 
HOUSE REPORTS: No. 100-903 accompanying H.R. 5155 (Comm. on Energy and 
Commerce). 
SENATE REPORTS: No. 100-454 (Comm. on Labor and Human Resources). 
CONGRESSIONAL RECORD, Vol. 134 (1988): 
Aug. 9, considered and passed Senate. 
Sept. 20, H.R. 5155 considered and passed House; proceedings vacated and 
S. 2393, amended, passed in lieu. 
Oct. 4, Senate concurred in certain House amendment with an amendment and 
disagreed to another. 
Oct. 5, House receded and concurred in Senate amendment.