"(a) Systems of Comprehensive Care. -   "(1) In General - An agreement referred to in section 1924(a) is that, with respect to children with serious emotional disturbance, the State involved will carry out the purpose described in such section only through establishing and operating 1 or more systems of care for making each of the mental health services specified in subsection (c) available to each child admitted to the system. In providing for such a system, the State may make grants to, and enter into contracts with, public and nonprofit private entities.   "(2) Structure of system. - An agreement referred to in section 1924(a) is that a system of care under paragraph (1) will -     "(A) be established in a community selected by the State;   "(B) consist of such public and nonprofit private entities in the community as are necessary to ensure that each of the services specified in subsection (c) is available to each child admitted to the system;   "(C) be established pursuant to agreements entered into between such entities and the State;   "(D) coordinate the provision of the services of the system; and   "(E) establish an office whose functions are to serve as the location through which children are admitted to the system, to coordinate the provision of services of the system, and to provide information to the public regarding the system.   "(3) Collaboration of Local Public Entities. - An agreement referred to in section 1924(a) is that, for purposes of the establishment and operation of a system of care under paragraph (1), the State involved will ensure collaboration among all public entities that provide human services in the community in which the system is established, including but not limited to those providing mental health services, educational services, child welfare services, or juvenile justice services.

	"(b) Limitation on Age of Children Admitted to System. - An agreement referred to
in section 1924(a) is that a system of care under subsection (a) will not admit an individual to the system if the individual is more that 21 years of age.
	"(c) Required Mental Health Services of System. - An agreement referred to
in section 1924(a) is that mental health services provided by a system of care under subsection (a) will include, with respect to serious emotional disturbance in a child -

"(1) diagnostic and evaluation services;   "(2) outpatient services provided in a clinic, office, school or other appropriate location, including individual, group and family counseling services, professional consultation, and review and management of medications;   "(3) emergency services, available 24-hours a day, 7 days a week;   "(4) intensive home-based services for children and their families when the child is at imminent risk of out-of-home placement;   "(5) intensive day-treatment services;   "(6) respite care;   "(7) therapeutic foster care services, and services in therapeutic foster family homes or individual therapeutic residential homes, and groups homes caring for not more that 8 children; and   "(8) assisting the child in making the transition from the services received as a child to the services to be received as an adult.

"(d) Required Arrangements Regarding Other Appropriate Services -   "(1) In General. - An agreement referred to in section 1924(a) is that -   "(A) a system of care under subsection (a) will enter into a memorandum of understanding with each of the providers specified in paragraph (2) in order to facilitate the availability of the services of the provider involved to each child admitted to the system; and   "(B) the grant under such section 1924(a), and the non-Federal contributions made with respect to the grant, will not be expended to pay the costs of providing such linked non-mental health services to any individual.   "(2) Specification of Services. - The providers referred to in paragraph (1) are providers of medical services other than mental health services, providers of educational services, providers of vocational counseling and vocational rehabilitation services, and providers of protection and advocacy services with respect to mental health.   "(3) Facilitation of Services of Certain Programs. - An agreement referred to in section 1924(a) is that a system of care under subsection (a) will, for purposes of paragraph (1), enter into a memorandum of understanding regarding facilitation of -     "(A) services available pursuant to title XIX of the Social Security Act, including services regarding early periodic screening, diagnosis, and treatment;   "(B) services available under parts B and H of the Education of the Handicapped Act; and   "(C) services available under other appropriate programs, as identified by the Secretary.

"(e) General Provisions Regarding Services of System. -   "(1) Case Management Services. - An agreement referred to in section 1924(a) is that a system of care under subsection (a) will provide for the case management of each child admitted to the system in order to ensure that -

"(A) the services provided through the system to the child are coordinated and that the need of each such child for the services is periodically reassessed;   "(B) information is provided to the family of the child on the extent of progress being made toward the objectives established for the child under the plan of services implemented for the child pursuant to section 1926; and   "(C) the system provides assistance with respect to -

"(i) establishing the eligibility of the child, and the family of the child, for financial assistance and services under Federal, State, or local programs providing for health services, mental health services, educational services, social services, or other services; and   "(ii) seeking to ensure that the child receives appropriate services available under such programs.

"(2) Other Provisions. - An agreement referred to in section 1924(a) is that a system of care under subsection (a), in providing the services of the system, will -

"(A) provide the services of the system in the cultural context that is most appropriate of the child and family involved;   "(B) ensure that individuals providing such services to the child can effectively communicate with the child and family in the most direct manner;   "(C) provide the services without discriminating against the child or the family of the child on the basis of race, religion, national origin, sex disability, or age;   "(D) seek to ensure that each child admitted to the system of care remains in the least restrictive, most normative environment that is clinically appropriate; and   "(E) provide outreach services to inform individuals, as appropriate, of the services available from the system, including identifying children with serious emotional disturbance who are in the early stages of such emotional disturbance.

"(3) Rule of Construction. - An agreement made under paragraph (2) may not be construed -

"(A) with respect to subparagraph (B) of such subparagraph -   "(i) to prohibit a system of care under subsection (a) from requiring that, in housing provided by the grantee for purposes of residential treatment services authorized under subsection (c), males and females be segregated to the extent appropriate in the treatment of the children involved; or   "(ii) to prohibit the system of care from complying with the agreement made under subsection (b); or

"(B) with respect to subparagraph (C) of such paragraph, to authorize the system of care to expend the grant under section 1924(a) (or the non-Federal contributions made with respect to the grant) to provide legal services or any service with respect to which expenditures regarding the grant are prohibited under subsection (d)(1)(B).

	"(f) Restrictions on Use of Grant. - An agreement referred to in section 1924(a) is
that the grant under such section, and the non-Federal contributions made with respect to the grant, will not be expanded -

"(1) to purchase or improve real property (including the construction or renovation of facilities);   "(2) to provide for room and board in residential programs serving 8 or fewer children;   "(3) to provide for room and board or any other services or expenditures associated with care of children in residential treatment centers serving more than 8 children or in inpatient hospital settings; or   "(4) to provide for the training of any individual, except training authorized in section 1927(a)(2) and training provided through any appropriate course in continuing education whose duration does not exceed 2 days.

SEC. 1926. INDIVIDUALIZED PLAN FOR SERVICES.

	"(a) In General. - An agreement referred to in section 1924(a) is that a system of
care under section 1925(a) will develop and implement an individualized plan of services for each child admitted to the system, and that the plan will be developed and implemented with the participation of the family of the child involved and, unless clinically inappropriate, with the participation of the child.
	"(b) Contents of Plan. - An agreement referred to in section 1924(a)
is that the individualized plan under subsection (a) for a child will -

"(1) be developed, and reviewed and as appropriate revised not less than once each year, by a multidisciplinary team of appropriately qualified individuals who provide services through the system, including mental health services, other health services, educational services, social services, and, subject to paragraph (3), vocational counseling and vocational rehabilitation;   "(2) identify and state the needs of the child for the services available pursuant to section 1925 through the system;   "(3) provide for each of such services that is appropriate to the circumstances of the child, including, except in the case of children who are less than 14 years of age, the provision of appropriate vocational counseling and vocational rehabilitation;   "(4) establish objectives to be achieved regarding the needs of the child and the methodology for achieving the objectives; and   "(5) designate an individual to be responsible for providing the case management required in section 1925(e)(1).

SEC.1927. ADDITIONAL PROVISIONS.

	"(a) Establishment of System of Care During First Year of Grant. - An
agreement referred to in section 1924(a) is that the State involved will establish not less than 1 system of care under section 1925(a) during the first fiscal year for which the State receives payments under the grant.
	"(b) Optional Services. - In addition to services described in subsection (c) of
section 1925, a system of care under subsection (a) of such section may, in expending a grant under section 1924(a), provide for -

"(1) preliminary assessments to determine whether a child should be admitted to the system;   "(2) training in the administration of the system, in providing foster care or group homes under section 1925(c)(7), and in the development of individualized plans for purposes of section 1926;   "(3) recreational activities for children admitted to the system; and   "(4) such other services as may be appropriate in providing for the comprehensive needs with respect to mental health of children with serious emotional distrubances.

	"(c) Comprehensive Plan. - The secretary may not make a grant under
section 1924(a) unless the State involved has submitted to the Secretary, and has had approved by the Secretary, a plan for the development of a State-wide system of care for community-based services for children with serious emotional disturbance that specifies the progress the State has made in developing the State-wide system, the extent of cooperation across agencies serving children in the establishment of the system, the Federal and non-Federal resources currently committed to the establishment of the system, and the current gaps in community services and the manner in which the grant under section 1924(a) will be expended to address such gaps and establish local systems of care.
	"(d) Representation on State Planning Council. - In the case of a State receiving
payments from an allotment under subpart 1, an agreement referred to in section 1924(a) is that the mental health planning council established pursuant to section 1916(e) will include as members of the council a ratio of parents of children with serious emotional disturbances to other members of the council that is sufficient to provide adequate representation of such children in the deliberations of the council.
	"(e) Limitation on Imposition of Fees for Services. - An agreement referred
to in section 1924(a) is that, if a charge is imposed for the provision of services under a grant under such section, such charge

"(1) will be made according to a schedule of charges that is made available to the public;   "(2) will be adjusted to reflect the income of the family of the child involved; and   "(3) will be not be imposed on any child whose family has income and resources of equal to or less than 100 percent of the official poverty line, as established by the Director of the Office of Management and Budget and revised by the Secretary in accordance with section 673(2) of the Omnibus Budget Reconciliation Act of 1981.

	"(f) Relationship to Items and Services Under Other Programs. - An agreement under
section 1924(a) is that the grant under such section, and the non-Federal contributions made with respect to the grant, will not be expended to make payment for any item or service to the extent that payment has been made, or can reasonably be expected to be made, with respect to such item or service -

"(1) under any State compensation program, under an insurance policy, or under any Federal or State health benefits program; or   "(2) by an entity that provides health services on a prepaid basis.

	"(g) Limitation on Administrative Expenses. - An agreement under section 1924(a) is
that not more than 2 percent of the grant under such section will be expended for State administrative expenses with respect to the grant.
	"(h) Reports to Secretary. - An agreement referred to in section 1924(a) is that the
State involved will annually submit to the Secretary a report on the activities of the State under the grant that includes a description of the number of children admitted to systems of care operated pursuant to the grant, the demographic characteristics of the children, the types and costs of services provided pursuant to the grant, estimates of the unmet need for such services in the State, and the manner in which the grant has been expended toward the establishment of a State-wide system of care for children with serious emotional disturbances, and such other information as the Secretary may require with respect to the grant.

	"(i) Description of Intended Uses of Grant. - The Secretary may not make a grant
under section 1924(a) unless -

"(1) the State involved submits to the Secretary a description of the purposes for which the State intends to expend the grant;   "(2) the description identifies the populations, areas, and localities in the State with a need for services under this section; and   "(3) the description provides information relating to the services and activities to be provided, including a description of the manner in which the services and activities will be coordinated with any similar services or activities of public or nonprofit entities.

	"(j) Requirement of Application. - The Secretary may not make a grant under
section 1924(a) unless an application for the grant is submitted to the Secretary, the application contains the description of intended uses required in subsection (i), and the application is 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 section.

SEC. 1927. GENERAL PROVISIONS.

"(a) Duration of Support Regarding Systems of Care. -

"(1) Limitation Regarding State Involved. - The period during which payments are made to a State from a grant under section 1924(a) may not exceed 5 fiscal years.   "(2) Limitation Regarding System of Care Involved. -

	"(A) With respect to the system (or systems) of care established
by a State pursuant to section 1925 during the first two fiscal years of a grant under section 1924(a), the system of care -

"(i) may receive amounts from the grant for the first and second fiscal years for which the State receives the grant;   "(ii) may receive amounts from the grant for any third fiscal year for which the State receives the grant, if the State submits to the Secretary a request for the system to receive such amounts during such fiscal year and the Secretary determines that the system is making satisfactory progress; and   "(iii) may not receive amounts from the grant for any subsequent fiscal year of payments under the grant.

"(B)(i) Payments made to a State under any fourth or fifth fiscal year of a grant under section 1924 may be expended only to establish and operate systems of care pursuant to section 1925 in addition to the systems established by the State during the first two fiscal years of the grant.

"(ii) The Secretary may not make payments to a State for any fourth or fifth fiscal year of a grant under section 1924(a) unless, with respect to the system (or systems) of care established by the State pursuant to section 1925 during the first two fiscal years of the grant -

"(I) the system of care is operating effectively; and   "(II) the Secretary determines that for such third and fourth fiscal years the system will continue to operate effectively notwithstanding that, under subparagraph (A), the system is no longer eligible to receive amounts from the grant.

"(b) Technical Assistance. -

"(1) InGeneral - The Secretary shall, upon the request of a State receiving a grant under section 1924(a) -

"(A) provide technical assistance to the State regarding the process of submitting to the Secretary applications for grants under section 1924(a);   "(B) provide to the State training and technical assistance with respect to the planning, development, and operation of systems of care pursuant to section 1925

"(2) Authority for Grants and Contracts. - the Secretary may provide technical assistance under subsection (a) directly or through grants to, or contracts with, public and nonprofit private entities.

"(c) Evaluations and Reports by Secretary. -

"(1) In General. - The Secretary shall, directly or through contracts with public or private entities, provide for annual evaluations of programs carried out pursuant to section 1924(a). The evaluations shall assess the effectiveness of the systems of care operated pursuant to such section, including longitudinal studies of outcomes of services provided by such systems, other studies regarding such outcomes, the effect of activities under this subpart on the utilization of hospital and other institutional settings, the barriers to and achievements resulting from interagency collaboration in providing community-based services to children with serious emotional disturbance, and assessments by parents of the effectiveness of the systems of care.   "(2) Report to Congress. - The Secretary shall, not later than 1 year after the date on which amounts are first appropriated under subsection (c), and annually thereafter, submit to the Congress a report summarizing evaluations carried out pursuant to paragraph (1) during the preceding fiscal year and making such recommendations for administrative and legislative initiatives with respect to this section as the Secretary determines to be appropriate.

"(d) Definitions. - For purposes of this subpart:

"(1) The term "child" means an individual not more than 21 years of age.   "(2) the term "family", with respect to a child admitted to a system of care under section 1925(a), means -

"(A) the legal guardian of the child; and

"(B) as appropriate regarding mental health services for the child, the parents of the child (biological or adoptive, as the case may be) and any foster parents of the child.

"(3) The term "serious emotional disturbance" includes, with respect to a child, any child who has a serious emotional disorder, a serious behavioral disorder, or a serious mental disorder. "(e) Funding. -   "(1) Authorization of Appropriations. - For the purpose of carrying out this subpart, there are authorized to be appropriated $100,000,000 for fiscal year 1992, $200,000,000 for fiscal year 1993, and $300,000,000 for fiscal year 1994.   "(2) Set-Aside Regarding Technical Assistance. - Of the amounts appropriated under paragraph (1) for a fiscal year, the Secretary shall make available not less than $3,000,000 for the purpose of carrying out subsection (b).   "(3) Limitation on Initial Number of Grants. - For fiscal year 1992, the Secretary may not make more than 10 grants under section 1924(a).".

SEC.3. EFFECTIVE DATE.

The amendments made by this Act shall take effect October 1, 1991, or upon the date of the enactment of this Act, whichever occurs later.