Saint Elizabeths Hospital and District of Columbia Mental Health Services Act
PL 98-621 (H.R.6224), enacted 11/08/1984

PUBLIC LAW 98-621—NOV. 8, 1984 
98 STAT. 3369 
Pubjic Law 98-621 
98th Congress 
An Act 
Toj)rovide for the assumption of selected functions, programs, and resources of Saint 
l^izabeths Hospital by the District of Ck)lumbia, to provide for the establishment of 
a comprehensive mental health care system in the District of Columbia, and for 
other purposes. 
Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled, 
SHORT TITLE 
SECTION 1. This Act may be cited as the "Saint Elizabeths Hospital 
and District of Columbia Mental Health Services Act". 
FINDINGS AND PURPOSES 
SEC. 2. (a) The Congress makes the following findings: 
(1) Governmentally administered mental health services in 
the District of Columbia are currently provided through two 
separate public entities, the federally administered Saint Eliza-
beths Hospital and the Mental Health Services Administration 
of the District of Columbia Department of Human Resources. 
(2) The District of Columbia has a continuing responsibility to 
provide mental health services to its residents. 
(3) The Federal Government, through its operation of a na-
tional mental health program at Saint Elizabeths Hospital, has 
for over 100 years assisted the District of Columbia in carrying 
out that responsibility. 
(4) Since its establishment by Congress in 1855, Saint Eliza-
beths Hospital has developed into a respected national mental 
health hospital and study, training, and treatment center, pro-
viding a range of quality mental health and related services, 
including— 
(i) acute and chronic inpatient psychiatric care; 
(ii) outpatient psychiatric and substance abuse clinical 
and related services; 
(iii) Federal court system forensic psychiatry referral, 
evaluation, and patient treatment services for prisoners, 
and for individuals awaiting trial or requiring post-trial or 
post-sentence psychiatric evaluation; 
(iv) patient care and related services for designated 
classes of individuals entitled to mental health benefits 
under Federal law, such as certain members and employees 
of the United States Armed Forces and the Foreign Service, 
and residents of American overseas dependencies; 
(v) District of Columbia court system forensic psychiatry 
referral, evaluation, and patient treatment services for pris-
oners, and for individuals awaiting trial or requiring post-
trial or post-sentence psychiatric evaluation; 
(vi) programs for special populations such as the mentally 
ill deaf; 
Nov. 8, 1984 
[H.R. 6224] 
Saint Elizabeths 
Hospital and 
District of 
Columbia 
Mental Health 
Services Act. 
24 use 225 note. 
24 use 225. 
98 STAT. 3370 
PUBLIC LAW 98-621—NOV. 8, 1984 
Home rule. 
Employment 
and 
unemployment. 
(vii) support for basic and applied clinical psychiatric 
research and related patient services conducted by the 
National Institute of Mental Health and other institutions; 
and 
(viii) professional and paraprofessional training in the 
major mental health disciplines. 
(5) The continuation of the range of services currently pro-
vided by federally administered Saint Elizabeths Hospital must 
be assured, as these services are integrally related to— 
(i) the availability of adequate mental health services to 
District of Columbia residents, nonresidents who require 
mental health services while in the District of Columbia, 
individuals entitled to mental health services under Fed-
eral law, and individuals referred by both Federal and local 
court systems; and 
(ii) the Nation's capacity to increase our knowledge and 
understanding about mental illness and to facilitate and 
continue the development and broad availability of sound 
and modern methods and approaches for the treatment of 
mental illness. 
(6) The assumption of all or selected functions, programs, and 
resources of Saint Elizabeths Hospital from the Federal Govern-
ment by the District of Columbia, and the integration of those 
functions, resources, and programs into a comprehensive 
mental health care system administered solely by the District of 
Columbia, will improve the efficiency and effectiveness of the 
services currently provided through those two separate entities 
by shifting the primary focus of care to an integrated commu-
nity-based system. 
(7) Such assumption of all or selected functions, programs, 
and resources of Saint Elizabeths Hospital by the District of 
Columbia would further the principle of home rule for the 
District of Columbia. 
(b) It is the intent of Congress that— 
(1) the District of Columbia have in operation no later than 
October 1, 1991, an integrated coordinated mental health 
system in the District which provides— 
(A) high quality, cost-effective, and community-based pro-
grams and facilities; 
(B) a continuum of inpatient and outpatient mental 
health care, residential treatment, and support services 
through an appropriate balance of public and private re-
sources; and 
(C) assurances that patient rights and medical needs are 
protected; 
(2) the comprehensive District mental health care system be 
in full compliance with the Federal court consent decree in 
Dixon V. Heckler; 
(3) the District and Federal Governments bear equitable 
shares of the costs of a transition from the present system to a 
comprehensive District mental health system; 
(4) the transition to a comprehensive District mental health 
system provided for by this Act be carried out with maximum 
consideration for the interests of employees of the Hospital and 
provide a right-of-first-refusal to such employees for employ-
ment at comparable levels in positions created under the system 
implementation plan; 
PUBLIC LAW 98-621—NOV. 8, 1984 
98 STAT. 3371 
(5) the Federal Government have the responsibility for the 
retraining of Hospital employees to prepare such employees for 
the requirements of employment in a comprehensive District 
mental health system; 
(6) the Federal Government continue high quality mental 
health research, training, and demonstration programs at Saint 
Elizabeths Hospital; 
(7) the District government establish and maintain accredita-
tion and licensing standards for all services provided in District 
mental health facilities which assure quality care consistent 
with appropriate Federal regulations and comparable with 
standards of the Joint Commission on Accreditation of Hospi-
tals; and 
(8) the comprehensive mental health system plan include a 
component for direct services for the homeless mentally ill. 
Employment 
and 
unemployment. 
Research and 
development. 
DEFINITIONS 
SEC. 3. For the purpose of this Act: 
(1) The term "Hospital" means the institution in the District 
of Columbia known as Saint Elizabeths Hospital operated on 
the date of the enactment of this Act by the Secretary of Health 
and Human Services. 
(2) The term "Secretary" means the Secretary of Health and 
Human Services. 
(3) The term "Mayor" means the Mayor of the District of 
Columbia. 
(4) The term "District" means the District of Columbia. 
(5) The term "Federal court consent decree" means the con-
sent decree in Dixon v. Heckler, Civil Action No. 74-285. 
(6) The term "service coordination period" means a period 
beginning on the effective date of this Act and terminating on 
October 1,1987. 
(7) The term "financial transition period" means a period 
beginning on the effective date of this Act and terminating on 
October 1,1991. 
(8) The term "system implementation plan" means the plan 
for a comprehensive mental health system for the District of 
Columbia to be developed pursuant to this Act. 
(9) The term "Council" means the Council of the District of 
Columbia. 
24 u s e 225a. 
DEVELOPMENT OF PLAN FOR MENTAL HEALTH SYSTEM FOR THE DISTRICT 
SEC. 4. (a)(1) Subject to subsection (g) of this section and section 
9(b)(1), effective October 1, 1987, the District shall be responsible for 
the provision of mental health services to residents of the District. 
(2) Not later than October 1, 1991, the Mayor shall complete the 
implementation of the final system implementation plan reviewed 
by the Congress and the Council in accordance with the provisions of 
this Act for the establishment of a comprehensive District mental 
health system to provide mental health services and programs 
through community mental health facilities to individuals in the 
District of Columbia. 
(b)(1) The Mayor shall prepare a preliminary system implementa-
tion plan for a comprehensive mental health system no later than 3 
24 u s e 225b. 
98 STAT. 3372 
PUBLIC LAW 98-621—NOV. 8, 1984 
87 Stat. 790. 
Labor-
management 
advisory 
committee, 
establishment. 
months from the effective date of this Act, and a final implementa-
tion plan no later than 12 months from the effective date of this Act, 
(2) The Mayor shall submit the preliminary system implementa-
tion plan to the Council no later than 3 months from the effective 
date of this Act. The Council shall review such plan and transmit 
written recommendations to the Mayor regarding any revisions to 
such plan no later than 60 days after such submission. The Mayor 
shall submit the revised preliminary plan to the Committee on the 
District of Columbia of the House of Representatives and the Com-
mittee on Labor and Human Resources and the Committee on 
Governmental Affairs of the Senate for review and comment in 
accordance with the provisions of this Act. 
(3) The final system implementation plan shall be considered by 
the Council consistent with the provisions of section 422(12) of the 
District of Columbia Self-Government and Governmental Reorgani-
zation Act. 
(4) After the review of the Council pursuant to paragraph (3), the 
Mayor shall submit the final implementation plan to the Committee 
on the District of Columbia of the House of Representatives and the 
Committee on Labor and Human Resources and the Committee on 
Governmental Affairs of the Senate for review and comment in 
accordance with the provisions of this Act. 
(c) The system implementation plan shall— 
(1) propose and describe an integrated, comprehensive, and 
coordinated mental health system for the District of Columbia; 
(2) identify the types of treatment to be offered, staffing 
patterns, and the proposed sites for service delivery within the 
District of Columbia comprehensive mental health system; 
(3) identify mechanisms to attract and retain personnel of 
appropriate number and quality to meet the objectives of the 
comprehensive mental health system; 
(4) be in full compliance with the Federal court consent decree 
in Dixon v. Heckler and all applicable District of Columbia 
statutes and court decrees; 
(5) identify those positions, programs, and functions at Saint 
Elizabeths Hospital which are proposed for assumption by the 
District, those facilities at Saint Elizabeths Hospital which are 
proposed for utilization by the District under a comprehensive 
District mental health system, and the staffing patterns and 
programs at community facilities to which the assumed func-
tions are to be integrated; 
(6) identify any capital improvements to facilities at Saint 
Elizabeths Hospital and elsewhere in the District of Columbia 
proposed for delivery of mental health services, which are 
necessary for the safe and cost effective delivery of mental 
health services; and 
(7) identify the specific real property, buildings, improve-
ments, and personal property to be transferred pursuant to 
section 8(aKl) of this Act needed to provide mental health and 
other services provided by the Department of Human Services 
under the final system implementation plan. 
(dXD The Mayor shall develop the system implementation plan in 
close consultation with officials of Saint Elizabeths Hospital, 
through working groups to be established by the Secretary and the 
Mayor for that purpose. 
(2) The Mayor and the Secretary shall establish a labor-manage-
ment advisory committee, requesting the participation of Federal 
PUBLIC LAW 98-621—NOV. 8, 1984 
98 STAT. 3373 
and District employee organizations affected by this Act, to make 
recommendations on the system implementation plan. The commit-
tee shall consider staffing patterns under a comprehensive District 
mental health care system, retention of Hospital employees under 
such system. Federal retraining for such employees, and any other 
areas of concern related to the establishment of a comprehensive 
District system. In developing the system implementation plan the 
Mayor shall carefully consider the recommendations of the commit-
tee. Such advisory committee shall not be subject to the Federal 
Advisory Committee Act. 
(3) The Mayor and such working groups shall, in developing the 
plan, solicit comments from the public, which shall include profes-
sional organizations, provider agencies and individuals, and mental 
health advocacy groups in the District of Columbia. 
(e)(1) The Mayor and the Secretary may, during the service coordi-
nation period, by mutual agreement and consistent with the require-
ments of the system implementation plan direct the shift of selected 
program responsibilities and staff resources from Saint Elizabeths 
Hospital to the District. The Secretary may assign staff occupying 
positions in affected programs to work under the supervision of the 
District. The Mayor shall notify the Committee on the District of 
Columbia of the House of Representatives and the Committee on 
Labor and Human Resources and the Committee on Governmental 
Affairs of the Senate in writing of any planned shift in program 
responsibilites or staff resources not less than 30 days prior to the 
implementation of such shift. 
(2)(A) Except as provided in subparagraph (B), after October 1, 
1984, and during the service coordination period, no request for 
proposals may be issued by the Secretary for any areas of commer-
cial activity at the Hospital pursuant to Office of Management and 
Budget circular A-76. 
(B) The limitation under subparagraph (A) shall not apply to 
studies initiated pursuant to such circular prior to October 1, 1984. 
(f)(1) To assist the Mayor in the development of the system 
implementation plan, the Secretary shall contract for a financial 
audit and a physical plant audit of all existing facilities at the 
Hospital to be completed by January 1, 1986. The financial audit 
shall be conducted according to generally accepted accounting prin-
ciples. The physical plant audit shall recognize any relevant 
national and District codes and estimate the useful life of existing 
facility support systems. 
(2)(A) Pursuant to such physical plant audit, the Secretary shall 
initiate not later than October 1, 1987, and complete not later than 
October 1, 1991, such repairs and renovations to such physical plant 
and facility support systems of the Hospital as are to be utilized by 
the District under the system implementation plan as part of a 
comprehensive District mental health system, as are necessary to 
meet any applicable code requirements or standards. 
(B) At a minimum until October 1, 1987, the Secretary shall 
maintain all other facilities and infrastructure of the Hospital not 
assumed by the District in the condition described in such audit. 
(g) During the service coordination period, the District of Colum-
bia and the Secretary, to the extent provided in the Federal court 
consent decree, shall be jointly responsible for providing citizens 
with the full range and scope of mental health services set forth in 
such decree and the system implementation plan. No provision of 
this Act or any action or agreement during the service coordination 
5 u s e app. 
Prohibition. 
Audit. 
98 STAT. 3374 
PUBLIC LAW 98-621—NOV. 8, 1984 
period may be so construed as to absolve or relieve the District or 
the Federal Government of their joint or respective responsibilities 
to implement fully the mandates of the Federal court consent 
decree. 
CONGRESSIONAL REVIEW OF SYSTEM IMPLEMENTATION PLAN 
24 use 225c. 
SEC. 5. (a) The Committee on the District of Columbia of the House 
of Representatives and the Committee on Labor and Human Re-
sources and the Committee on Governmental Affairs of the Senate 
shall review the preliminary system implementation plan transmit-
ted by the Mayor pursuant to section 4 of this Act to determine the 
extent of its compliance with the provisions of section 2(b) and 
section 4 of this Act, and transmit written recommendations regard-
ing any revisions to the preliminary plan to the Mayor not later 
than 60 days after receipt of such plan. 
(b) The Committee on the District of Columbia of the House of 
Representatives and the Committee on Labor and Human Resources 
and the Committee on Governmental Affairs of the Senate shall, 
within 90 days of submission of the final system implementation 
plan by the Mayor pursuant to section 4 of this Act, review such 
plan to determine the extent to which it is in compliance with the 
provisions of section 2(b) and section 4 of this Act. 
TRANSITION PROVISIONS FOR EMPLOYEES OF THE HOSPITAL 
Retirement. 
SEC. 6. (a) Employees of the Hospital directly affected by the 
24 use 225d. 
assumption of programs and functions by the District government 
who meet the requirements for immediate retirement under the 
provisions of section 8336(d) of title 5, United States Code, shall be 
accorded the opportunity to retire during the 30-day period prior to 
the assumption of such programs and functions. 
(b)(1) The system implementation plan shall prescribe the specific 
number and types of positions needed by the District government at 
the end of the service coordination period. 
(2) Notwithstanding section 3503 of title 5, United States Code, 
employees of the Hospital shall only be transferred to District 
employment under the provisions of this section. 
(c)(1) While on the retention list or the District or Federal agency 
reemployment priority list, the system implementation plan shall 
provide to Hospital employees a right-of-first-refusal to District 
employment in positions for which such employees may qualify, (A) 
created under the system implementation plan in the comprehen-
sive District mental health system, (B) available under the Depart-
ment of Human Services of the District, and (C) available at the 
District of Columbia General Hospital. 
(2) In accordance with Federal regulations, the Secretary shall 
establish retention registers of Hospital employees and provide such 
retention registers to the District government. Employment in posi-
tions identified in the system implementation plan under subsection 
(b) shall be offered to Hospital employees by the District government 
according to each such employee's relative standing on the retention 
registers. 
(3) Employee appeals concerning the retention registers estab-
lished by the Secretary shall be in accordance with Federal 
regulations. 
PUBLIC LAW 98-621—NOV. 8, 1984 
98 STAT. 3375 
(4) Employee appeals concerning employment offers by the Dis-
trict shall be in accordance with the District of Columbia Govern-
ment Comprehensive Merit Personnel Act of 1978. 
(d)(1) Notwithstanding any other provision of law, employees of 
the Hospital, while on the Federal agency reemployment priority 
list, shall have a right-of-first-refusal to employment in comparable 
available positions for which they qualify within the Department of 
Health and Human Services in the Washington metropolitan area. 
(2) If necessary to separate employees of the Hospital from Fed-
eral employment, such employees may be separated only under 
Federal reduction-in-force procedures. 
(3) A Federal agency reemployment priority list and a displaced 
employees program shall be maintained for employees of the Hospi-
tal by the Secretary and the Office of Personnel Management in 
accordance with Federal 
regulations 
for 
Federal 
employees 
separated by reduction-in-force procedures. 
(4) The Mayor shall create and maintain, in consultation with the 
Secretary, a District agency reemployment priority list of those 
employees of the Hospital on the retention registers who are not 
offered employment under subsection (c). Individuals who refuse an 
offer of employment under subsection (c) shall be ineligible for 
inclusion on the District agency reemployment priority list. Such 
reemployment priority list shall be administered in accordance with 
procedures established pursuant to the District of Columbia Govern-
ment Comprehensive Merit Personnel Act of 1978 (D.C. Law 2-139). 
(5) Acceptance of nontemporary employment as a result of refer-
ral from any retention list or agency reemployment priority list 
shall automatically terminate an individual's severance pay as of 
the effective date of such employment. 
(e) Any contract entered into by the District of Columbia for the Contracts. 
provision of mental health services formerly provided by or at the 
Hospital shall require the contractor or provider, in filling new 
positions created to perform under the contract, to give preference 
to qualified candidates on the District agency reemployment pri-
ority list created pursuant to subsection (d) of this section. An 
individual who is offered nontemporary employment with a contrac-
tor shall have his or her name remain on the District agency 
reemployment priority list under subsection (d) for not more than 24 
months from the date of acceptance of such employment. 
CONDITIONS OF EMPLOYMENT FOR FORMER EMPLOYEES OF THE 
HOSPITAL 
SEC. 7. (a) Each individual accepting employment without a break 
24 USC 225e. 
in service with the District government pursuant to section 6 shall— 
(1) except as specifically provided in this Act, be required to 
meet all District qualifications other than licensure require-
ments for appointment required of other candidates, and shall 
become District employees in the comparable District service 
subject to the provisions of the District of Columbia Govern-
ment Comprehensive Merit Personnel Act of 1978, and all other 
statutes and regulations governing District personnel; 
(2) meet all licensure requirements within 18 months of ap-
pointment by the District government; 
(3) notwithstanding chapter 63 of title 5, United States Code, 5 USC 6301 et 
transfer accrued annual and sick leave balances pursuant to seq. 
98 STAT. 3376 
PUBLIC LAW 98-621—NOV. 8, 1984 
title XII of the District of Columbia Comprehensive Merit Per-
sonnel Act of 1978; 
(4) have the grade and rate of pay determined in accordance 
with regulations established pursuant to title XI of the District 
of Columbia Comprehensive Merit Personnel Act of 1978, except 
that no employee shall suffer a loss in the basic rate of pay or in 
seniority; 
(5) if applicable, retain a rate of pay including the physician's 
comparability allowance under the provisions of section 5948 of 
title 5, United States Code, and continue to receive such allow-
ance under the terms of the then prevailing agreement until its 
expiration or for a period of 2 years from the date of appoint-
ment by the District government, whichever occurs later; 
(6) be entitled to the same health and life insurance benefits 
as are available to District employees in the applicable service; 
(7) if employed by the Federal Government before January 1, 
1984, continue to be covered by the United States Civil Service 
Retirement System, under chapter 83 of title 5, United States 
5 use 8301 et 
Code, to the same extent that such retirement system covers 
««9- 
District Government employees; and 
(8) if employed by the Federal Government on or after Janu-
ary 1, 1984, be subject to the retirement system applicable to 
District government employees pursuant to title XXVI, Retire-
ment, of the District of Columbia Government Comprehensive 
Merit Personnel Act of 1978. 
(b) An individual appointed to a position in the District govern-
ment without a break in service, from the retention list, or from the 
District or Federal agency reemployment priority lists shall be 
exempt from the residency requirements of title VIII of the District 
of Columbia Government Comprehensive Merit Personnel Act of 
1978. 
(c) An individual receiving compensation for work injuries pursu-
5 use 8101 et 
ant to chapter 81 of title 5, United States Code, shall— 
seq. 
(1) continue to have the claims adjudicated and the related 
costs paid by the Federal Government until such individual 
recovers and returns to duty; 
(2) if medically recovered and returned to duty, have any 
subsequent claim for the recurrence of the disability determined 
and paid under the provisions of title XXIII of the District of 
Columbia Comprehensive Merit Personnel Act of 1978. 
(d) The District government may initiate or continue an action 
against an individual who accepts employment under section 6(c) for 
cause related to events that occur prior to the end of the service 
coordination period. Any such action shall be conducted in accord-
ance with such Federal laws and regulations under which action 
would have been conducted had the assumption of function by the 
District not occurred. 
(e) Commissioned public health service officers detailed to the 
District of Columbia mental health system shall not be considered 
employees for purposes of any full-time employee equivalency total 
of the Department of Health and Human Services. 
(f) For purposes of this section, Hospital employees shall include 
former patient employees occupying career positions at the 
Hospital. 
PUBLIC LAW 98-621—NOV. 8, 1984 
98 STAT. 3377 
PROPERTY TRANSFER 
SEC. 8. (a)(1) Except as provided in paragraph (2), on October 1, 
1987, the Secretary shall transfer to the District, without compensa-
tion, all right, title, and interest of the United States in all real 
property at Saint Elizabeths Hospital in the District of Columbia 
together with any buildings, improvements, and personal property 
used in connection with such property needed to provide mental 
health and other services provided by the Department of Human 
Services indentified pursuant to section 4(c)(7) of this Act. 
(2) Such real property as is identified by the Secretary by Septem-
ber 30, 1987, as necessary to Federal mental health programs at 
Saint Elizabeths Hospital under section 2(b)(5) shall not be trans-
ferred under this subsection. 
(b) On or before October 1, 1991, the Mayor shall prepare, and 
submit to the Committee on the District of Columbia of the House of 
Representatives and the Committees on Governmental Affairs and 
Labor and Human Resources of the Senate, a master plan, not 
inconsistent with the comprehensive plan for the National Capital, 
for the use of all real property, buildings, improvements, and per-
sonal property comprising Saint Elizabeths Hospital in the District 
of Columbia not transferred or excluded pursuant to subsection (a) 
of this section. In developing such plan, the Mayor shall consult 
with, and provide an opportunity for review by, appropriate Federal, 
regional, and local agencies. Such master plan submitted by the 
Mayor shall be approved by a law enacted by the Congress within 
the twelve-month period following the date such plan is submitted to 
the Committee on the District of Columbia of the House of Repre-
sentatives and the Committees on Governmental Affairs and Labor 
and Human Resources of the Senate. Immediately upon the ap-
proval of any such law, the Secretary shall transfer to the District, 
without compensation, all right, title, and interest of the United 
States in and to such property in accordance with such approved 
plan. The real property, together with the buildings and other 
improvements thereon, including personal property used in connec-
tion therewith, known as the Oxon Cove Park and operated by the 
National Park Service, Department of the Interior, shall not be 
transferred under this Act. 
(c) On October 1,1985, the Secretary shall transfer to the District, 
without compensation, all right, title, and interest of the United 
States to lot 87, square 622, in the subdivision made by the District 
of Columbia Redevelopment Land Agency, as per plat recorded in 
the Office of the Surveyor for the District of Columbia, in liber 154 
at folio 149 (901 First Street N.W., the J.B. Johnson Building and 
grounds). 
FINANCING PROVISIONS 
SEC. 9. (a) There are authorized to be appropriated for grants by 
the Secretary of Health and Human Services to the District of 
Columbia comprehensive mental health system, $30,000,000 for 
fiscal year 1988, $24,000,000 for fiscal year 1989, $18,000,000 for 
fiscal year 1990, and $12,000,000 for fiscal year 1991. 
(bXD Beginning on October 1, 1987, and in each subsequent fiscal 
year, the appropriate Federal agency is directed to pay the District 
of Columbia the full costs for the provision of mental health diagnos-
tic and treatment services for the following types of patients: 
Effective dates. 
24 u s e 225f. 
Development 
plan. 
Appropriation 
authorization. 
Grants. 
24 u s e 225g. 
98 STAT. 3378 
PUBLIC LAW 98-621—NOV. 8, 1984 
Compacts 
between States. 
87 Stat. 813. 
Appropriation 
authorization. 
68 Stat. 434, 
Audit. 
(A) Any individual referred to the system pursuant to a 
Federal statute or by a responsible Federal agency. 
(B) Any individual referred to the system for emergency 
detention or involuntary commitment after being taken into 
custody (i) as a direct result of the individual's action or threat 
of action against a Federal official, (ii) as a direct result of the 
individual's action or threat of action on the grounds of the 
White House or of the Capitol, or (iii) under chapter 9 of title 21 
of the District of Columbia Code. 
(C) Any individual referred to the system as a result of a 
criminal proceeding in a Federal court (including an individual 
admitted for treatment, observation, and diagnosis and an indi-
vidual found incompetent to stand trial or found not guilty by 
reason of insanity). The preceding provisions of this paragraph 
apply to any individual referred to the system (or to Saint 
Elizabeths Hospital) before or after the date of enactment of 
this Act. 
(2) The, responsibility of the United States for the cost of services 
for individuals described in paragraph (1) shall not affect the treat-
ment responsibilities to the District of Columbia under the Inter-
state Compact on Mental Health. 
(c)(1) During the service coordination and the financial transition 
periods, the District of Columbia shall gradually assume a greater 
share of the financial responsibility for the provision of mental 
health services provided by the system to individuals not described 
in subsection (b). 
(2) Section 502 of the District of Columbia Self-Government and 
Governmental Reorganization Act is amended— 
(A) by inserting "(a)" after "SEC. 502.", and 
(B) by adding at the end the following: 
"(b)(1) Except as otherwise provided by paragraph (2), there are 
authorized to be appropriated, in addition to the amounts authorized 
to be appropriated under subsection (a), $25,000,000 for fiscal year 
1986, $35,000,000 for fiscal year 1987, $30,000,000 for fiscal year 1988, 
$20,000,000 for fiscal year 1989, $15,000,000 for fiscal year 1990, and 
$10,000,000 for fiscal year 1991 to the District of Columbia for 
establishing and maintaining a comprehensive mental health 
system. 
"(2) For each of the fiscal years 1986 through 1990 there is 
authorized to be appropriated, in addition to the amount authorized 
under paragraph (1), an amount equal to one-third of the amount 
authorized under paragraph (1) for the succeeding fiscal year. The 
amount authorized to be appropriated under paragraph (1) for any 
such succeeding fiscal year shall be reduced by the amount appropri-
ated for the preceding fiscal year under the first sentence of this 
paragraph.". 
(d) Subject to section 4(f)(2), capital improvements to facilities at 
Saint Elizabeths Hospital authorized during the service coordination 
period shall be the shared responsibility of the District and the 
Federal Government in accordance with Public Law 83-472. 
(e) Pursuant to the financial audit under section 4(f), any unas-
signed liabilities of the Hospital shall be assumed by and shall be 
the sole responsibility of the Federal Government. 
(0(1) After the service coordination period, the Secretary shall 
conduct an audit, under generally accepted accounting procedures, 
to identify the liability of the Federal Government for accrued 
PUBLIC LAW 98-621—NOV. 8, 1984 
98 STAT. 3379 
Appropriation 
authorization. 
Claims. 
annual leave balances for those employees assumed by the District 
under the system implementation plan. 
(2) There is authorized to be appropriated for payment by the 
Federal Government to the District an amount equal to the liability 
identified by such audit. 
(g) Nothing in this Act shall affect the authority of the District of 
Columbia under any other statute to collect costs billed by the 
District of Columbia for mental health services, except that pay-
ment for the same costs may not be collected from more than one 
party. 
(h) The Government of the United States shall be solely responsi-
ble for— 
(1) all claims and causes of action against Saint Elizabeths 
Hospital that accrue before October 1, 1987, regardless of the 
date on which legal proceedings asserting such claims were or 
may be filed, except that the United States shall, in the case of 
any tort claim, only be responsible for any such claim against 
the United States that accrues before October 1, 1987, and the 
United States shall not compromise or settle any claim result-
ing in District liability without the consent of the District, 
which consent shall not be unreasonably withheld; and 
(2) all claims that result in a judgment or award against Saint 
Elizabeths Hospital before October 1,1987. 
REPEALS AND CONFORMING AMENDMENTS 
SEC. 10. (a) Chapter 4 of title LIX of the Revised Statutes of the 
United States (24 U.S.C. 161, 165, 170, 191, 211, 211a, 211b, and 221, 
and D.C. Code 32-405 and 32-406) is repealed. 
(b) The matter under the subheading "SAINT EUZABETHS HOSPI-
TAL." under the heading "DEPARTMENT OF THE INTERIOR." in 
the first section of an Act of June 5, 1920, chapter 235 of the laws of 
4i Stat. 919. 
the second session of the 66th Congress, is amended by striking out 
the second sentence (24 U.S.C. 166). 
(c) The matter under the subheading "SAINT ELIZABETHS HOSPI-
TAL." under the heading "DEPARTMENT OF THE INTERIOR." in 
the first section of the Second Deficiency Appropriation Act, fiscal 
year 1920, is amended by striking out the second and third sentences 
41 Stat. 513. 
(24 U.S.C. 168 and 176). 
(dXD An Act of August 4,1947, chapter 478 of the laws of the first 
session of the 80th Congress (24 U.S.C. 168a, 169, 169a, 185, and 
195a), is repealed. 
(2) The matter under the heading "Saint Elizabeths Hospital" in 
title II of the Departments of Labor, and Health, Education, and 
Welfare Appropriation Act, 1955, is amended by striking out all that 
68 Stat. 437. 
follows "$110,000" before the period. 
(e) The matter under the subheading "GOVERNMENT HOSPITAL FOR 
THE INSANE." under the heading "UNDER THE DEPARTMENT OF 
THE INTERIOR." in the first section of an Act of August 24, 1912, 
chapter 355 of the laws of the second session of the 62d Congress, is 
37 use 461. 
amended by striking out the second sentence (24 U.S.C. 171). 
(f) The first sentence under the subheading "GOVERNMENT HOSPI-
TAL FOR THE INSANE." under the heading "MISCELLANEOUS OB-
JECTS." in the first section of an Act of August 7, 1882, chapter 433 
of the laws of the first session of the 47th Congress, is amended by 
22 Stat. 329. 
striking out— 
98 STAT. 3380 
PUBLIC LAW 98-621—NOV. 8, 1984 
(1) "; and that hereafter the surplus products and waste 
material of the hospital may be sold or exchanged for the 
benefit of the hospital, and proceeds to be used and accounted 
for the same as its other funds:" (24 U.S.C. 172), and 
(2) the two provisos (24 U.S.C. 165 and 195), and by inserting 
in lieu thereof a period. 
(g) The matter under the subheading "SAINT EUZABETHS HOSPI-
TAL." and that subheading under the heading "DEPARTMENT OF 
40 Stat. 19. 
THE INTERIOR." of the Act of April 17, 1917 (24 U.S.C. 175), are 
repealed. 
(h) The matter under the subheading "GOVERNMENT HOSPITAL FOR 
THE INSANE." under the heading "UNDER THE DEPARTMENT OF 
THE INTERIOR." in the first section of an Act of June 30, 1906, 
chapter 3914 of the laws of the first session of the 59th Congress, is 
34 Stat. 730. 
amended by striking out the last three sentences (24 U.S.C. 177). 
(i) An Act of May 9, 1941, chapter 101 of the laws of the first 
session of the 77th Congress (24 U.S.C. 180), is repealed. 
55 Stat. 760. 
(j) The Act of November 15,1941 (24 U.S.C. 181,182,183, and 184) 
is repealed. 
(kXD The matter under the heading "PAY, MISCELLANEOUS." of an 
Act of August 29,1916, chapter 417 of the laws of the first session of 
the 64th Congress, is amended by striking out "Hereafter interned 
persons and prisoners of war, under the jurisdiction of the Navy 
Department, who are or may become insane, shall be entitled to 
admission for treatment to the Government Hospital for the 
39 Stat. 557. 
Insane." (24 U.S.C. 192). 
(2) The matter under the subheading "SAINT ELIZABETHS HOSPI-
TAL." under the heading "DEPARTMENT OF THE INTERIOR." in 
the first section of an Act of October 6,1917, chapter 79 of the laws 
of the first session of the 65th Congress, is amended by striking out 
40 Stat. 373. 
the third through sixth sentences (24 U.S.C. 192, 199, and 200). 
(1) The matter under the subheading "GOVERNMENT HOSPITAL FOR 
THE INSANE." under the heading "MISCELLANEOUS OBJECTS." of 
an Act of July 7,1884, chapter 332 of the laws of the first session of 
the 48th Congress, is amended by striking out the second sentence 
23 Stat. 213. 
(24 U.S.C. 194). 
(m) The matter under the heading "PANAMA CANAL." in the 
first section of an Act of June 12,1917, chapter 27 of the laws of the 
first session of the 65th Congress, is amended by striking out the 
76A Stat. 699. 
following (24 U.S.C. 196): 
"Upon the application of the Governor of the Canal Zone, the 
Secretary of Health, Education, and Welfare may transfer to Saint 
Elizabeths Hospital, in the District of Columbia, for treatment, any 
American citizen subject to a hospitalization order issued under 
section 1637 of title 5 of the Cansd Zone Code, whose legal residence 
in one of the States, territories, the Commonwealth of Puerto Rico 
or the District of Columbia for the purpose of eligibility for public 
medical care it has been impossible to establish. Upon the ascertain-
ment of the legal residence of persons so transferred to Saint 
Elizabeths Hospital, the superintendent of that hospital shall there-
upon transfer them to their respective places of residence, and the 
expenses attendant thereon shall be paid from the appropriation for 
the support of Saint Elizabeths Hospital.". 
(n) An Act of July 18, 1940, chapter 638 of the laws of the third 
session of the 76th Congress (24 U.S.C. 196b), is repealed. 
(o) The matter under the subheading "GOVERNMENT HOSPITAL FOR 
THE INSANE:" under the heading "MISCELLANEOUS OBJECTS." in the 
PUBLIC LAW 98-621—NOV. 8, 1984 
98 STAT. 3381 
first section of an Act of March 3, 1901, chapter 853 of the second 
session of the 56th C!ongress, is amended by striking out the second 
sentence (24 U.S.C. 197). 
3i Stat. ii62. 
(p) The first sentence in the matter under the subheading "MEDI-
CAL AND HOSPITAL DEPARTMENT:" under the heading "MEDICAL DE-
PARTMENT." of an Act of May 11,1908, chapter 163 of the laws of the 
first session of the 60th Congress, is amended by striking out the 
second proviso and the colon preceding and inserting in lieu thereof 
a period (24 U.S.C. 198). 
35 Stat. 122. 
(q) An Act of June 23, 1874, chapter 465 of the laws of the first 
session of the 43rd Congress (24 U.S.C. 212, 213, and 214), is repealed. 
(r) The first sentence of section 4(a) of Public Law 86-571 (24 
U.S.C. 324) is amended by striking out "Saint Elizabeths Hospital, at 
any other" and inserting in lieu thereof "any". 
(s) Section 2104 of the Public Health Service Act (42 U.S.C. 
300aa-3) is repealed. 
(tXD The last sentence of section 206 of an Act of June 9, 1948, 
chapter 428 of the laws of the second session of the 80th C!ongress 
(D.C. Code 22-3508), is amended by striking out "Saint Elizabeths 
Hospital" and inserting in lieu thereof "an appropriate institution". 
(2) Section 207 of that Act (D.C. Code 22-3509) is amended by 
striking out "the Superintendent of Saint Elizabeths Hospital" and 
inserting in lieu thereof "an appropriate supervisory official", and 
by striking out "the Superintendent of the hospital" and inserting 
in lieu thereof "that official". 
(3) Section 208 of that Act (D.C. Code 22-3510) is amended by 
striking out "Saint Elizabeths Hospital" and inserting in lieu 
thereof "an institution". 
(u) The first sentence under the subheading "GOVERNMENT HOSPI- 
24 use 202. 
TAL FOR THE INSANE." under the heading "INTERIOR DEPART-
MENT." of an Act of March 3, 1877, chapter 105 of the laws of the 
second session of the 44th Congress, is amended by striking out the 
semicolon and all that follows before the period (D.C. Code 32-401). 
(v) The first sentence under the subheading "GOVERNMENT HOSPI- 24 use 203. 
TAL FOR THE INSANE." under the heading "MISCELLANEOUS OB-
JECTS." of an Act of March 3, 1879, chapter 182 of the laws of the 
third session of the 45th Congress, is amended by striking out the 
proviso and the colon preceding and inserting in lieu thereof a 
period (D.C. Code 32-402). 
(w) The matter under the subheading "HOSPITAL FOR THE INSANE:" 
under the heading "DISTRICT OF COLUMBIA." of an Act of March 
4, 1913, chapter 149 of the laws of the third session of the 62nd 
Congress, is amended by striking out the second sentence (D.C. Code 
32-404). 
(x) Sections 4 and 5 of an Act of June 22, 1948, chapter 597 of the 
laws of the second session of the 80th Congress (D.C. (llode 32-415 
and 32-416) are repealed. 
(y) The matter under the subheading "GOVERNMENT HOSPITAL FOR 
THE INSANE." under the heading "UNDER THE DEPARTMENT OF 
THE INTERIOR." in the first section of an Act of March 4, 1911, 
chapter 285 of the laws of the third session of the 61st Congress, is 36 Stat. 1421. 
amended by striking out the second sentence. 
24 use 165. 
98 STAT. 3382 
PUBLIC LAW 98-621—NOV. 8, 1984 
EFFECTIVE DATES 
2
4 use 225 note. 
SEC. 11. (a) Except as provided in subsection (b), this Act shall take 
effect on October 1,1985. 
(b) Section 10 shall take effect on October 1,1987. 
Approved November 8, 1984. 
LEGISLATIVE HISTORY—H.R. 6224: 
HOUSE REPORTS: No. 98-1024 and Pt. 2 (Comm. on the District of Columbia). 
CONGRESSIONAL RECORD, Vol. 130 (1984): 
Oct. 2, considered and passed House. 
Oct. 5, considered and passed Senate, amended. 
Oct. 9, House concurred in Senate amendments. 
WEEKLY COMPILATION OF PRESIDENTIAL DOCUMENTS, Vol. 20, No. 45 (1984): 
Nov. 9, Presidential statement.