Collapse to view only § 300x. Formula grants to States
- § 300x. Formula grants to States
- § 300x-1. State plan for comprehensive community mental health services for certain individuals
- § 300x-2. Certain agreements
- § 300x-3. State mental health planning council
- § 300x-4. Additional provisions
- § 300x-5. Restrictions on use of payments
- § 300x-6. Application for grant
- § 300x-7. Determination of amount of allotment
- § 300x-8. Definitions
- § 300x-9. Funding
§ 300x. Formula grants to States
(a) In general
(b) Purpose of grants
A funding agreement for a grant under subsection (a) is that, subject to section 300x–5 of this title, the State involved will expend the grant only for the purpose of—
(1) providing community mental health services for adults with a serious mental illness and children with a serious emotional disturbance as defined in accordance with section 300x–1(c) of this title;
(2) carrying out the plan submitted under section 300x–1(a) of this title by the State for the fiscal year involved;
(3) evaluating programs and services carried out under the plan; and
(4) planning, administration, and educational activities related to providing services under the plan.
(July 1, 1944, ch. 373, title XIX, § 1911, as added Pub. L. 102–321, title II, § 201(2), July 10, 1992, 106 Stat. 378; amended Pub. L. 114–255, div. B, title VIII, § 8001(a), Dec. 13, 2016, 130 Stat. 1225.)
§ 300x–1. State plan for comprehensive community mental health services for certain individuals
(a) In generalThe Secretary may make a grant under section 300x of this title only if—
(1) the State involved submits to the Secretary a plan for providing comprehensive community mental health services to adults with a serious mental illness and to children with a serious emotional disturbance;
(2) the plan meets the criteria specified in subsection (b); and
(3) the plan is approved by the Secretary.
(b) Criteria for planIn accordance with subsection (a), a State shall submit to the Secretary a plan every two years that, at a minimum, includes each of the following:
(1) System of careA description of the State’s system of care that contains the following:
(A) Comprehensive community-based health systemsThe plan shall—
(i) identify the single State agency to be responsible for the administration of the program under the grant, including any third party who administers mental health services and is responsible for complying with the requirements of this part with respect to the grant;
(ii) provide for an organized community-based system of care for individuals with mental illness, and describe available services and resources in a comprehensive system of care, including services for individuals with co-occurring disorders;
(iii) include a description of the manner in which the State and local entities will coordinate services to maximize the efficiency, effectiveness, quality, and cost-effectiveness of services and programs to produce the best possible outcomes (including health services, rehabilitation services, employment services, housing services, educational services, substance use disorder services, legal services, law enforcement services, social services, child welfare services, medical and dental care services, and other support services to be provided 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, to the maximum extent of their capabilities, including services to be provided by local school systems under the Individuals with Disabilities Education Act [20 U.S.C. 1400 et seq.];
(iv) include a description of how the State promotes evidence-based practices, including those evidence-based programs that address the needs of individuals with early serious mental illness regardless of the age of the individual at onset, provide comprehensive individualized treatment, or integrate mental and physical health services;
(v) include a description of case management services;
(vi) include a description of activities that seek to engage adults with a serious mental illness or children with a serious emotional disturbance and their caregivers where appropriate in making health care decisions, including activities that enhance communication among individuals, families, caregivers, and treatment providers; and
(vii) as appropriate to, and reflective of, the uses the State proposes for the block grant funds, include—(I) a description of the activities intended to reduce hospitalizations and hospital stays using the block grant funds;(II) a description of the activities intended to reduce incidents of suicide using the block grant funds;(III) a description of how the State integrates mental health and primary care using the block grant funds, which may include providing, in the case of individuals with co-occurring mental and substance use disorders, both mental and substance use disorders services in primary care settings or arrangements to provide primary and specialty care services in community-based mental and substance use disorders settings; and(IV) a description of recovery and recovery support services for adults with a serious mental illness and children with a serious emotional disturbance.
(B) Mental health system data and epidemiology
(C) Children’s services
(D) Targeted services to rural and homeless populations
(E) Management services
(2) Goals and objectives
(c) Definitions regarding mental illness and emotional disturbance; methods for estimate of incidence and prevalence
(1) Establishment by Secretary of definitions; dissemination
(2) Standardized methods
(3) Date certain for compliance by Secretary
(d) Requirement of implementation of plan
(1) Complete implementation
(2) Substantial implementation and good faith effort regarding fiscal year 1993
(A) In making a grant under section 300x of this title to a State for fiscal year 1993, the Secretary shall make a determination of the extent to which the State has implemented the plan required in subsection (a). If the Secretary determines that the State has not substantially implemented the plan, the Secretary shall, subject to subparagraph (B), reduce the amount of the allotment under
(B) In carrying out subparagraph (A), if the Secretary determines that the State is making a good faith effort to implement the plan required in subsection (a), the Secretary may make a reduction under such subparagraph in an amount that is less than the amount specified in such subparagraph, except that the reduction may not be made in an amount that is less than 5 percent of the amount determined under section 300x–7 of this title for the State for fiscal year 1993.
(July 1, 1944, ch. 373, title XIX, § 1912, as added Pub. L. 102–321, title II, § 201(2), July 10, 1992, 106 Stat. 379; amended Pub. L. 106–310, div. B, title XXXII, § 3204(a), Oct. 17, 2000, 114 Stat. 1192; Pub. L. 114–255, div. B, title VIII, § 8001(b), Dec. 13, 2016, 130 Stat. 1225.)
§ 300x–2. Certain agreements
(a) Allocation for systems of integrated services for children
(1) In generalWith respect to children with a serious emotional disturbance, a funding agreement for a grant under section 300x of this title is that—
(A) in the case of a grant for fiscal year 1993, the State involved will expend not less than 10 percent of the grant to increase (relative to fiscal year 1992) funding for the system of integrated services described in section 300x–1(b)(9) 1
1 See References in Text note below.
of this title;(B) in the case of a grant for fiscal year 1994, the State will expend not less than 10 percent of the grant to increase (relative to fiscal year 1993) funding for such system; and
(C) in the case of a grant for any subsequent fiscal year, the State will expend for such system not less than an amount equal to the amount expended by the State for fiscal year 1994.
(2) Waiver
(A) Upon the request of a State, the Secretary may provide to the State a waiver of all or part of the requirement established in paragraph (1) if the Secretary determines that the State is providing an adequate level of comprehensive community mental health services for children with a serious emotional distrubance,2
2 So in original. Probably should be “disturbance,”.
as indicated by a comparison of the number 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 servicesA funding agreement for a grant under section 300x of this title for a State is that, with respect to the plan submitted under section 300x–1(a) of this title for the fiscal year involved—
(1) services under the plan will be provided only through appropriate, qualified community programs (which may include community mental health centers, child mental-health programs, psychosocial rehabilitation programs, mental health peer-support programs, and mental-health primary consumer-directed 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 centersThe 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 residing in a defined geographic area (hereafter in this subsection referred to as a “service area”).
(B) Outpatient services, including specialized outpatient services for children, the elderly, individuals with a serious mental illness, and residents of the service areas of the centers who have been discharged from inpatient treatment at a mental health facility.
(C) 24-hour-a-day emergency care services.
(D) Day treatment or other partial hospitalization services, or psychosocial rehabilitation services.
(E) Screening for patients being considered for admission to State mental health facilities 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.
(July 1, 1944, ch. 373, title XIX, § 1913, as added Pub. L. 102–321, title II, § 201(2), July 10, 1992, 106 Stat. 381.)
§ 300x–3. State mental health planning council
(a) In general
(b) DutiesA 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 300x–4(a) of this title by the State involved and to submit to the State any recommendations of the Council for modifications to the plans;
(2) to serve as an advocate for adults with a serious mental illness, children with a severe emotional 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 generalA condition under subsection (a) for a Council is that the Council be composed of residents of the State, including representatives of—
(A) the principal State agencies with respect to—
(i) mental health, education, vocational rehabilitation, criminal justice, housing, and social services; and
(ii) the development of the plan submitted pursuant to title XIX of the Social Security Act [42 U.S.C. 1396 et seq.];
(B) public and private entities concerned with the need, planning, operation, funding, and use of mental health services and related support services;
(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 requirementsA 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 deliberations of the Council; and
(B) not less than 50 percent of the members of the Council are individuals who are not State employees or providers of mental health services.
(d) “Council” defined
(July 1, 1944, ch. 373, title XIX, § 1914, as added Pub. L. 102–321, title II, § 201(2), July 10, 1992, 106 Stat. 382.)
§ 300x–4. Additional provisions
(a) Review of State plan by mental health planning council
The Secretary may make a grant under section 300x of this title to a State only if—
(1) the plan submitted under section 300x–1(a) of this title with respect to the grant and the report of the State under section 300x–52(a) of this title concerning the preceding fiscal year has been reviewed by the State mental health planning council under section 300x–3 of this title; and
(2) the State submits to the Secretary any recommendations received by the State from such council for modifications to the plan (without regard to whether the State has made the recommended modifications) and any comments concerning the annual report.
(b) Maintenance of effort regarding State expenditures for mental health
(1) In general
(2) Exclusion of certain funds
(3) Waiver
(A) In general
(B) Date certain for action upon request
(C) Applicability of waiver
(4) Noncompliance by State
(A) In general
(i) Determination
(ii) Alternative
(B) Submission of information to the secretary
(July 1, 1944, ch. 373, title XIX, § 1915, as added Pub. L. 102–321, title II, § 201(2), July 10, 1992, 106 Stat. 383; amended Pub. L. 106–310, div. B, title XXXII, § 3204(b), (c), Oct. 17, 2000, 114 Stat. 1193; Pub. L. 114–255, div. B, title VIII, § 8001(d), Dec. 13, 2016, 130 Stat. 1228.)
§ 300x–5. Restrictions on use of payments
(a) In general
A funding agreement for a grant under section 300x of this title is that the State involved will not expend the grant—
(1) to provide inpatient services;
(2) to make cash payments to intended recipients of health services;
(3) to purchase or improve land, purchase, construct, or permanently improve (other than minor remodeling) any building or other facility, or purchase major medical equipment;
(4) to satisfy any requirement for the expenditure of non-Federal funds as a condition for the receipt of Federal funds; or
(5) to provide financial assistance to any entity other than a public or nonprofit private entity.
(b) Limitation on administrative expenses
(July 1, 1944, ch. 373, title XIX, § 1916, as added Pub. L. 102–321, title II, § 201(2), July 10, 1992, 106 Stat. 384.)
§ 300x–6. Application for grant
(a) In general
For purposes of section 300x of this title, an application for a grant under such section for a fiscal year in accordance with this section if, subject to subsection (b)—
(1) the plan is received by the Secretary not later than September 1 of the fiscal year prior to the fiscal year for which a State is seeking funds, and the report from the previous fiscal year as required under section 300x–52(a) of this title is received by December 1 of the fiscal year of the grant;
(2) the application contains each funding agreement that is described in this subpart or subpart III for such a grant (other than any such agreement that is not applicable to the State);
(3) the agreements are made through certification from the chief executive officer of the State;
(4) with respect to such agreements, the application provides assurances of compliance satisfactory to the Secretary;
(5) the application contains the plan required in section 300x–1(a) of this title, the information required in section 300x–4(b) of this title, and the report required in section 300x–52(a) of this title;
(6) the application contains recommendations in compliance with section 300x–4(a) of this title, or if no such recommendations are received by the State, the application otherwise demonstrates compliance with such section; and
(7) the application (including the plan under section 300x–1(a) of this title) is otherwise in such form, is made in such manner, and contains such agreements, assurances, and information as the Secretary determines to be necessary to carry out this subpart.
(b) Waivers regarding certain territories
(July 1, 1944, ch. 373, title XIX, § 1917, as added Pub. L. 102–321, title II, § 201(2), July 10, 1992, 106 Stat. 384; amended Pub. L. 106–310, div. B, title XXXII, § 3204(d), (e), Oct. 17, 2000, 114 Stat. 1193; Pub. L. 114–255, div. B, title VIII, § 8001(e), Dec. 13, 2016, 130 Stat. 1229.)
§ 300x–7. Determination of amount of allotment
(a) States
(1) Determination under formula
(2) Determination of term “A”For purposes of paragraph (1), the term “A” means the difference between—
(A) the amount appropriated under section 300x–9(a) of this title for allotments under section 300x of this title for the fiscal year involved; and
(B) an amount equal to 1.5 percent of the amount referred to in subparagraph (A).
(3) Determination of term “U”
(4) Determination of term “X”For purposes of paragraph (1), the term “X” means the product of—
(A) an amount equal to the product of—
(i) the term “P”, as determined for the State involved under paragraph (5); and
(ii) the factor determined under paragraph (8) for the State; and
(B) the greater of—
(i) 0.4; and
(ii) an amount equal to an amount determined for the State in accordance with the following formula:
1−.35 | A | R% | | ||
|---|---|---|---|---|---|
P% | |||||
(5) Determination of term “P”
(A) For purposes of paragraph (4), the term “P” means the sum of—
(i) an amount equal to the product of 0.107 and the number of individuals in the State who are between 18 and 24 years of age (inclusive);
(ii) an amount equal to the product of 0.166 and the number of individuals in the State who are between 25 and 44 years of age (inclusive);
(iii) an amount equal to the product of 0.099 and the number of individuals in the State who are between 45 and 64 years of age (inclusive); and
(iv) an amount equal to the product of 0.082 and the number of individuals in the State who are 65 years of age or older.
(B) With respect to data on population that is necessary for purposes of making a determination under subparagraph (A), the Secretary shall use the most recent data that is available from the Secretary of Commerce pursuant to the decennial census and pursuant to reasonable estimates by such Secretary of changes occurring in the data in the ensuing period.
(6) Determination of term “R%”
(A) For purposes of paragraph (4), the term “R%”, except as provided in subparagraph (D), means the percentage constituted by the ratio of the amount determined under subparagraph (B) for the State involved to the amount determined under subparagraph (C).
(B) The amount determined under this subparagraph for the State involved is the quotient of—
(i) the most recent 3-year arithmetic mean of the total taxable resources of the State, as determined by the Secretary of the Treasury; divided by
(ii) the factor determined under paragraph (8) for the State.
(C) The amount determined under this subparagraph is the sum of the respective amounts determined for the States under subparagraph (B) (including the District of Columbia).
(D)
(i) In the case of the District of Columbia, for purposes of paragraph (4), the term “R%” means the percentage constituted by the ratio of the amount determined under clause (ii) for such District to the amount determined under clause (iii).
(ii) The amount determined under this clause for the District of Columbia is the quotient of—(I) the most recent 3-year arithmetic mean of total personal income in such District, as determined by the Secretary of Commerce; divided by(II) the factor determined under paragraph (8) for the District.
(iii) The amount determined under this clause is the sum of the respective amounts determined for the States (including the District of Columbia) by making, for each State, the same determination as is described in clause (ii) for the District of Columbia.
(7) Determination of term “P%”
(8) Determination of certain factor
(A) The factor determined under this paragraph for the State involved is a factor whose purpose is to adjust the amount determined under clause (i) of paragraph (4)(A), and the amounts determined under each of subparagraphs (B)(i) and (D)(ii)(I) of paragraph (6), to reflect the differences that exist between the State and other States in the costs of providing comprehensive community mental health services to adults with a serious mental illness and to children with a serious emotional disturbance.
(B) Subject to subparagraph (C), the factor determined under this paragraph and in effect for the fiscal year involved shall be determined according to the methodology described in the report entitled “Adjusting the Alcohol, Drug Abuse and Mental Health Services Block Grant Allocations for Poverty Populations and Cost of Service”, dated March 30, 1990, and prepared by Health Economics Research, a corporation, pursuant to a contract with the National Institute on Drug Abuse.
(C) The factor determined under this paragraph for the State involved may not for any fiscal year be greater than 1.1 or less than 0.9.
(D)
(i) Not later than October 1, 1992, the Secretary, after consultation with the Comptroller General, shall in accordance with this section make a determination for each State of the factor that is to be in effect for the State under this paragraph. The factor so determined shall remain in effect through fiscal year 1994, and shall be recalculated every third fiscal year thereafter.
(ii) After consultation with the Comptroller General, the Secretary shall, through publication in the Federal Register, periodically make such refinements in the methodology referred to in subparagraph (B) as are consistent with the purpose described in subparagraph (A).
(b) Minimum allotments for States
(c) Territories
(1) Determination under formulaSubject to paragraphs (2) and (4), the amount of an allotment under section 300x of this title for a territory of the United States for a fiscal year shall be the product of—
(A) an amount equal to the amounts reserved under paragraph (3) for the fiscal year; and
(B) a percentage equal to the quotient of—
(i) the civilian population of the territory, 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 territoriesThe amount of an allotment under section 300x of this title for a territory of the United States for a fiscal year shall be the greater of—
(A) the amount determined under paragraph (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 20.6 percent of the amount received by the territory from allotments made pursuant to this part for fiscal year 1992.
(3) Reservation of amounts
(4) Availability of data on population
(5) Applicability of certain provisions
(July 1, 1944, ch. 373, title XIX, § 1918, as added Pub. L. 102–321, title II, § 201(2), July 10, 1992, 106 Stat. 385; amended Pub. L. 102–352, § 2(a)(8), (9), Aug. 26, 1992, 106 Stat. 938; Pub. L. 105–277, div. A, § 101(f) [title II, § 218(a)], Oct. 21, 1998, 112 Stat. 2681–337, 2681–362; Pub. L. 106–113, div. B, § 1000(a)(4) [title II, § 212(a)], Nov. 29, 1999, 113 Stat. 1535, 1501A–239; Pub. L. 106–310, div. B, title XXXII, § 3205, Oct. 17, 2000, 114 Stat. 1193.)
§ 300x–8. Definitions
For purposes of this subpart:
(1) The terms “adults with a serious mental illness” and “children with a serious emotional disturbance” have the meanings given such terms under section 300x–1(c)(1) of this title.
(2) The term “funding agreement”, with respect to a grant under section 300x of this title to a State, means that the Secretary may make such a grant only if the State makes the agreement involved.
(July 1, 1944, ch. 373, title XIX, § 1919, as added Pub. L. 102–321, title II, § 201(2), July 10, 1992, 106 Stat. 388.)
§ 300x–9. Funding
(a) Authorization of appropriations
(b) Allocations for technical assistance, data collection, and program evaluation
(1) In general
(2)
(3) Program evaluation
(c) Early serious mental illness
(1) In general
(2) State flexibility
(d) Crisis care
(1) In general
(2) Core elements
At the discretion of the single State agency responsible for the administration of the program of the State under a grant under section 300x of this title, funds expended pursuant to paragraph (1) may be used to fund some or all of the core crisis care service components, as applicable and appropriate, including the following:
(A) Crisis call centers.
(B) 24/7 mobile crisis services.
(C) Crisis stabilization programs offering acute care or subacute care in a hospital or appropriately licensed facility, as determined by such State, with referrals to inpatient or outpatient care.
(3) State flexibility
(4) Rule of construction
(July 1, 1944, ch. 373, title XIX, § 1920, as added Pub. L. 102–321, title II, § 201(2), July 10, 1992, 106 Stat. 388; amended Pub. L. 106–310, div. B, title XXXII, § 3204(f), Oct. 17, 2000, 114 Stat. 1193; Pub. L. 114–255, div. B, title VIII, § 8001(c), (f), Dec. 13, 2016, 130 Stat. 1228, 1229; Pub. L. 117–328, div. FF, title I, § 1141(a), (b), Dec. 29, 2022, 136 Stat. 5657.)