Page:United States Statutes at Large Volume 79.djvu/397

 79 STAT. ]

PUBLIC LAW 89-97-JULY 30, 1965

357

(8) Section 2(a) of such Act is amended (A) by striking out "and" 42 USC 3^2' ^ at the end of paragraph (10); (B) by striking out the period at the end of p a r a ^ a p h (11) and inserting in lieu thereof a semicolon; and (C) by adding after paragraph (11) the following new paragraphs: "(12) if the State plan includes assistance to or m bSialf of individuals who are patients in institutions for mental diseases— " (A) provide for having in effect such agreements or other arrangements with State authorities concerned with mental diseases, and, where appropriate, with such institutions, as may be necessary for carrying out the State plan, including arrangements for joint planning and for development of alternate methods of care, arrangements providing assurance of immediate readmittance to institutions where needed for individuals under alternate plans of care, and arrangements providing for access to patients and facilities, for furnishing information, and for making reports; " (B) provide for an individual plan for each such patient to assure that the institutional care provided to him is in his best interests, including, to that end, assurances that there will be initial and periodic review of his medical and other needs, that he will oe given appropriate medical treatment within the institution, and that there will be a periodic determination of his need for continued treatment in the institution; " (C) provide for the development of alternate plans of care, making maximum utilization of available resources^ for recipients vmo would otherwise need care in such institutions, including appropriate medical treatment and other assistance; for services referred to in section 3(a)(4)(A)(i) and (ii) ''^ ^*sc 3^3^' which are appropriate for such recipients and for such patients; and for methods of administration necessary to assure that the responsibilities of the State agency under the State plan with respect to such recipients and such patients will be effectively carried out; and " (D) provide methods of determining the reasonable cost of institutional care for such patients; and "(13) if the State plan includes assistance to or in behalf of patients in public institutions for mental diseases, show that the State is making satisfactory progress toward developing and implementing a comprehensive mental health program, including l)rovision for utilization of community mental health centers, nursing homes, and other alternatives to care in public institutions for mental diseases." (4) Section 3 of such Act is amended by adding at the end thereof yg^ltat^Y//^^' the following new subsection: 42 USC 3o'3. " (d) Notwithstanding the preceding provisions of this section, the amount determined under such provisions for any State for any quarter which is attributable to expenditures with respect to patients in institutions for mental diseases shall be paid only to the extent that the State makes a showing satisfactoir to the Secretary that total expenditures in the State from Federal, State, and local sources for mental health services (including payments to or in behalf of individuals with mental health problems) under State and local public health and public welfare programs for such quarter exceed the average of the total expenditures m the State from such sources for such services under such programs for each Quarter of the fiscal year ending June 30, 1965. For purposes of this suosection, expenditures for such services for each quarter in the fiscal year ending June 30, 1965, in the

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