42 U.S.C. § 290ff–1 — Requirements with respect to carrying out purpose of grants

(a) Systems of comprehensive care: (1) To get a grant under section 290ff(a) of this title, the public entity must carry out that purpose only by setting up one or more local "systems of care" that give every enrolled child access to each of the services listed in subsection (c). The entity may do this itself, or by making grants to, and contracting with, public and nonprofit private entities. (2) Each system of care must: (A) be set up in a community the public entity picks; (B) include enough public agencies and nonprofit private entities to make sure every service in subsection (c) is available to every enrolled child; (C) be built on agreements the entity signs with those agencies and entities; (D) coordinate how the system's services are delivered; and (E) set up one office whose job is to connect children to the system, coordinate its services, and inform the public about it. (3) The entity must also seek cooperation among all local public agencies that provide human services in the community — including mental health, education, child welfare, and juvenile justice agencies — in building and running the system. (b) Age limit: A system of care must give a child access through age 21. (c) Required mental health services: The system's mental health services for a child's serious emotional disturbance must include: (1) diagnostic and evaluation services; (2) outpatient services — including individual, group, and family counseling, professional consultation, and medication review and management — provided at a clinic, office, school, or other fitting location; (3) emergency services, available 24 hours a day, 7 days a week; (4) intensive home-based services for children and families when the child is at imminent risk of being placed outside the home; (5) intensive day-treatment services; (6) respite care; (7) therapeutic foster care, therapeutic foster family homes, individual therapeutic residential homes, and group homes caring for no more than 10 children; and (8) help for the child in moving from child services to adult services. (d) Arrangements for other appropriate services: (1) The system must: (A) sign a memorandum of understanding with each provider listed in paragraph (2), to help make that provider's services available to every enrolled child; and (B) not spend the grant money, or the required non-Federal match, to pay for those non-mental-health services. (2) Those providers are: providers of medical services other than mental health services, providers of educational services, providers of vocational counseling and rehabilitation services, and providers of mental-health-related protection and advocacy services. (3) The system must also sign memoranda of understanding to facilitate: (A) services available under Medicaid (title XIX of the Social Security Act), including early and periodic screening, diagnosis, and treatment; (B) services available under parts B and C of the Individuals with Disabilities Education Act; and (C) services under other appropriate programs the Secretary identifies. (e) General rules on services: (1) Case management — the system must manage each enrolled child's case to make sure: (A) the child's services are coordinated and the child's need for them is checked periodically; (B) the family is told how much progress the child is making toward the goals in the child's plan under section 290ff–2 of this title; and (C) the system helps establish the child's and family's eligibility for other Federal, State, or local health, mental health, education, or social service programs, and helps make sure the child actually gets those services. (2) Other rules — the system must: (A) deliver services in the cultural context that best fits the child and family; (B) make sure staff can communicate directly with the child and family; (C) not discriminate based on race, religion, national origin, sex, disability, or age; (D) try to keep each child in the least restrictive, most normal setting that is still clinically appropriate; and (E) do outreach so people know what services the system offers, including finding children with a serious emotional disturbance early. (3) None of this can be read to: (A) stop a system from separating boys and girls by sex in housing provided for residential treatment under subsection (c), where appropriate for the children's treatment, or from following the age-21 rule in subsection (b); or (B) let the system spend the grant, or its non-Federal match, on legal services or on anything barred by subsection (d)(1)(B). (f) Spending restrictions: The grant, and the required non-Federal match, cannot be spent to: (1) buy or improve real property, including building or renovating facilities; (2) pay for room and board in residential programs serving 10 or fewer children; (3) pay for room and board or other costs tied to caring for children in larger residential treatment centers or inpatient hospitals — except for intensive home-based services and other services delivered on an outpatient basis; or (4) pay for training any individual, except the specific training authorized under section 290ff–3(a)(2) of this title, and short continuing-education courses lasting no more than 2 days. (g) Waivers: The Secretary may waive one or more of the required services in subsection (c) for a public entity that is an Indian Tribe or tribal organization, or American Samoa, Guam, the Marshall Islands, the Federated States of Micronesia, the Commonwealth of the Northern Mariana Islands, the Republic of Palau, or the U.S. Virgin Islands, but only if — after peer review — the Secretary determines the system of care is family-centered and uses the least restrictive setting that is still clinically appropriate.