42 U.S.C. § 300x–1 — State plan for comprehensive community mental health services for certain individuals

(a) In general — The Secretary can only make a grant under section 300x if: the State has sent in a plan for giving comprehensive community mental health services to adults with a serious mental illness and children with a serious emotional disturbance; that plan meets the standards in subsection (b); and the Secretary has approved the plan. (b) Criteria for plan — Every two years the State must send the Secretary a plan that at minimum covers: (1) System of care. This must include: (A) a description of the State's community-based health system that names the single State agency running the program (including any third party handling it), describes an organized community-based system of care — including services for people with co-occurring disorders — explains how the State and local groups will coordinate a wide range of services (health, rehabilitation, employment, housing, education, substance use disorder care, legal aid, law enforcement, social services, child welfare, medical and dental care, and other support, including services schools provide under the Individuals with Disabilities Education Act) so people can live outside institutions as much as possible, describes how the State promotes evidence-based practices (including for people with early serious mental illness no matter their age, individualized treatment, and integrating mental and physical health care), describes case management services, and describes how the State involves adults and children and their caregivers in health decisions. Where it fits the State's planned use of the grant money, the plan must also describe activities meant to cut hospital stays, activities meant to reduce suicides, how the State blends mental health and primary care, and what recovery support services it offers. (B) An estimate of how common serious mental illness is among adults and serious emotional disturbance is among children in the State, plus measurable targets and outcome measures for the programs. (C) For children with a serious emotional disturbance, a description of an integrated system of social services, education, child welfare, juvenile justice, law enforcement, and substance use disorder services working together with health and mental health care — including services under the Individuals with Disabilities Education Act — to meet these children's many needs. (D) A description of the State's outreach to homeless people and how it delivers community-based services to people living in rural areas. (E) A description of the State's financial resources, its existing mental health workforce (including staff trained to treat co-occurring disorders), and its training for emergency health workers on mental health, plus how the State plans to spend the grant and meet every funding agreement in this subpart and subpart III. (2) Goals and objectives. The plan must set goals and objectives for the plan period, including specific targets and milestones and the activities that will be used to reach them. (c) Definitions regarding mental illness and emotional disturbance; methods for estimate of incidence and prevalence — (1) The Secretary must create official definitions of "adults with a serious mental illness" and "children with a serious emotional disturbance," and send those definitions to the States. (2) The Secretary must set standard methods for States to use when making the estimates the plan requires; the State's funding agreement requires it to use those methods. (3) The Secretary had to finish both of these — the definitions and the standard methods — and start sending the definitions to States, within 90 days of July 10, 1992. (d) Requirement of implementation of plan — (1) Complete implementation. Except as paragraph (2) provides, when making a grant for a fiscal year, the Secretary checks how fully the State carried out its plan. If the State didn't fully carry it out, the Secretary cuts that State's allotment for the year by 10 percent. (2) Substantial implementation and good faith effort regarding fiscal year 1993. (A) For the 1993 grant only, if the Secretary finds the State didn't substantially carry out its plan, the Secretary — subject to (B) — cuts the allotment by 10 percent. (B) But if the Secretary finds the State made a good faith effort to carry out the plan, the Secretary can make a smaller cut — though never smaller than 5 percent.