24 U.S.C. § 225b — Development of plan for mental health system for the District

submitted 42 years ago by Pub. L. 98-621 to r/title-24-HOSPITALS-AND-ASYLUMS · 1,420 words · no verdicts yet

in plain englishAI-generated · not legal advice

Starting October 1, 1987, the District of Columbia became responsible for mental health services to its residents, and the Mayor had to finish a comprehensive system implementation plan by October 1, 1993. The section sets out how the Mayor develops, submits, and reviews the plan with the Council and Congress, what the plan must contain, required consultation with Hospital staff and the public, limits on shifting programs and outsourcing during the transition, and required financial and physical audits with repairs funded partly by the Secretary.

(a) Responsibility for mental health services. (1) Subject to subsection (g) and section 225g(b)(1), starting October 1, 1987, the District became responsible for providing mental health services to its residents. (2) By no later than October 1, 1993, the Mayor had to finish carrying out the final system implementation plan - reviewed by Congress and the Council under this subchapter - to build a full District mental health system that delivers services through community mental health facilities. (b) Mayor's plan development and review process. (1) The Mayor had to write a preliminary system implementation plan within 3 months of October 1, 1985, and a final plan within 12 months of that date. (2) The Mayor had to send the preliminary plan to the Council within 3 months of October 1, 1985. The Council had 60 days after that to review it and send the Mayor written recommendations for changes. The Mayor then had to send the revised preliminary plan to the House Committee on the District of Columbia and the Senate Committees on Labor and Human Resources and on Governmental Affairs for their review and comment. (3) The Council had to consider the final plan under section 422(12) of the District of Columbia Home Rule Act. (4) After the Council's review, the Mayor had to send the final plan to those same House and Senate committees for review and comment. (c) Contents of the plan. The plan had to: describe an integrated, comprehensive, coordinated District mental health system; identify the types of treatment offered, staffing patterns, and proposed service sites; identify ways to attract and keep enough qualified staff; fully comply with the Dixon v. Heckler consent decree and applicable D.C. laws and court decrees; identify which Hospital positions, programs, and functions the District would take over, which Hospital facilities the District would use, and the staffing and programs at community facilities receiving those functions; identify capital improvements needed at the Hospital and elsewhere in the District for safe, cost-effective mental health services; and identify the specific real property, buildings, improvements, and personal property to be transferred under section 225f(a)(1) to provide mental health and other services the Department of Human Services previously provided. (d) Consultation. (1) The Mayor had to develop the plan in close consultation with Hospital officials, through working groups set up by the Secretary and the Mayor. (2) The Mayor and Secretary had to set up a labor-management advisory committee, inviting affected federal and District employee unions, to make recommendations on the plan - covering staffing patterns, keeping Hospital employees, federal retraining for them, and other transition concerns. The Mayor had to carefully consider this committee's recommendations. The committee was not subject to chapter 10 of title 5. (3) The Mayor and the working groups had to seek public comment while developing the plan, including from professional organizations, provider agencies and individuals, and mental health advocacy groups in the District. (e) Shifting programs and staff; limits on outsourcing. (1) During the service coordination period, the Mayor and Secretary could agree, consistent with the plan's requirements, to shift certain program responsibilities and staff from the Hospital to the District. The Secretary could assign affected staff to work under District supervision. The Mayor had to notify the same House and Senate committees in writing at least 30 days before any such shift. (2)(A) Except as described in (B), after October 1, 1984 and during the service coordination period, the Secretary could not request proposals for outsourcing commercial activities at the Hospital under OMB Circular A-76. (B) This limit did not apply to studies already started under that circular before October 1, 1984. (f) Audits and facility maintenance. (1) To help the Mayor develop the plan, the Secretary had to arrange a financial audit and a physical plant audit of all existing Hospital facilities, completed by January 1, 1986. The financial audit had to follow generally accepted accounting principles. The physical plant audit had to consider relevant national and District codes and estimate how much useful life the facility systems had left. (2)(A) Based on that physical plant audit, the Secretary had to start, by October 1, 1987, and - except as allowed under an agreement made under (C) - finish by October 1, 1993, whatever repairs and renovations to Hospital facilities the District would use under the plan were needed to meet applicable code requirements or standards. (B) Until at least October 1, 1987, the Secretary had to keep all other Hospital facilities and infrastructure not yet taken over by the District in the condition described in the audit. (C) The Secretary could agree with the Mayor to give the District funds to complete those repairs and renovations and make other needed capital improvements, except that $7,500,000 of those funds had to go toward capital improvements at facilities not located at the Hospital - and of that amount, at least $5,000,000 had to go toward housing facilities for seriously and chronically mentally ill people. (g) Service coordination period responsibilities. During the service coordination period, the District and the Secretary - to the extent the federal court consent decree required - shared joint responsibility for giving citizens the full range of mental health services described in the decree and the plan. Nothing in this subchapter, or any action or agreement made during this period, releases either the District or the federal government from their duty to fully carry out the consent decree's requirements.

the actual law source: uscode.house.gov ↗public domain

(a) Responsibility for mental health services; effective date; final system implementation plan; comprehensive mental health program

(1)

Subject to subsection (g) of this section and section 225g(b)(1) of this title, 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, 1993, 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 subchapter 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) Mayor; preliminary system implementation plan; final implementation plan; submission to and review by Council and Congressional committees

(1)

The Mayor shall prepare a preliminary system implementation plan for a comprehensive mental health system no later than 3 months from October 1, 1985, and a final implementation plan no later than 12 months from October 1, 1985.

(2)

The Mayor shall submit the preliminary system implementation plan to the Council no later than 3 months from October 1, 1985. 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 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 subchapter.

(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 Home Rule 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 subchapter.

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 functions 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, improvements, and personal property to be transferred pursuant to section 225f(a)(1) of this title needed to provide mental health and other services provided by the Department of Human Services under the final system implementation plan.

(d) Consultation; labor-management advisory committee; public comments

(1)

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-management advisory committee, requesting the participation of Federal and District employee organizations affected by this subchapter, to make recommendations on the system implementation plan. The committee 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 committee. Such advisory committee shall not be subject to chapter 10 of title 5.

(3)

The Mayor and such working groups shall, in developing the plan, solicit comments from the public, which shall include professional organizations, provider agencies and individuals, and mental health advocacy groups in the District of Columbia.

(e) Shift of selected program responsibilities and staff resources; commercial activity proposals; exemption of certain studies

(1)

The Mayor and the Secretary may, during the service coordination period, by mutual agreement and consistent with the requirements 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 1 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 commercial 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) Financial and physical plant audits; repairs and renovations; maintenance of facilities and infrastructure

(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 principles. 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, except as provided under an agreement entered into pursuant to subparagraph (C), complete not later than October 1, 1993, 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.

(C)

The Secretary may enter into an agreement with the Mayor under which the Secretary shall provide funds to the Mayor to complete the repairs and renovations described in subparagraph (A) and to make other capital improvements that are necessary for the safe and cost effective delivery of mental health services in the District, except that $7,500,000 of the funds provided to the Mayor under such an agreement shall be used to make capital improvements to facilities not located at Saint Elizabeths Hospital. Of the $7,500,000 provided for improvements to facilities not located at the Hospital, not less than $5,000,000 shall be used to make capital improvements to housing facilities for seriously and chronically mentally ill individuals.

(g) Service coordination period; responsibility for providing services

During the service coordination period, the District of Columbia 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 subchapter or any action or agreement during the service coordination 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.

Source credit: (Pub. L. 98–621, § 4, Nov. 8, 1984, 98 Stat. 3371; Pub. L. 102–150, §§ 2, 3(a), Oct. 31, 1991, 105 Stat. 980; Pub. L. 105–33, title XI, § 11717(b), Aug. 5, 1997, 111 Stat. 786; Pub. L. 117–286, § 4(a)(179), Dec. 27, 2022, 136 Stat. 4325.)

history & why it existsrecord from the source credit

1984Enacted · Pub. L. 98-621 · 98 Stat. 3371
1991Amended · Pub. L. 102-150 · 105 Stat. 980
1997Amended · Pub. L. 105-33 · 111 Stat. 786
2022Amended · Pub. L. 117-286 · 136 Stat. 4325

A history note hasn’t been published yet. The record shows enactment by Pub. L. 98-621 on 1984-11-08.

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