---
kind: "section"
citation: "24 U.S.C. § 225b"
title: "24"
title_heading: "Hospitals and Asylums"
number: "225b"
heading: "Development of plan for mental health system for the District"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/24/225b"
units:
  - "Chapter 4 — Saint Elizabeths Hospital"
  - "Subchapter III — Mental Health Service for District of Columbia"
---

# §225b. Development of plan for mental health system for the District

- (a) **Responsibility for mental health services; effective date; final system implementation plan; comprehensive mental health program—**
  - (1) Subject to [subsection (g)](#g) of this section and [section 225g(b)(1) of this title](/usc/24/225g.md?p=b-1), effective October 1, 1987, the [District](/usc/24/225a.md?p=4) shall be responsible for the provision of mental health services to residents of the [District](/usc/24/225a.md?p=4).
  - (2) Not later than October 1, 1993, the [Mayor](/usc/24/225a.md?p=3) shall complete the implementation of the final [system implementation plan](/usc/24/225a.md?p=8) reviewed by the Congress and the [Council](/usc/24/225a.md?p=9) in accordance with the provisions of this subchapter for the establishment of a comprehensive [District](/usc/24/225a.md?p=4) 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](/usc/24/225a.md?p=3) shall prepare a preliminary [system implementation plan](/usc/24/225a.md?p=8) 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](/usc/24/225a.md?p=3) shall submit the preliminary [system implementation plan](/usc/24/225a.md?p=8) to the [Council](/usc/24/225a.md?p=9) no later than 3 months from October 1, 1985. The [Council](/usc/24/225a.md?p=9) shall review such plan and transmit written recommendations to the [Mayor](/usc/24/225a.md?p=3) regarding any revisions to such plan no later than 60 days after such submission. The [Mayor](/usc/24/225a.md?p=3) 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](/usc/24/225a.md?p=8) shall be considered by the [Council](/usc/24/225a.md?p=9) consistent with the provisions of [section 422(12)](/usc/24/422.md) of the District of Columbia Home Rule Act.
  - (4) After the review of the [Council](/usc/24/225a.md?p=9) pursuant to [paragraph (3)](#b-3), the [Mayor](/usc/24/225a.md?p=3) 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.
- (c) **Contents of system implementation plan—** The [system implementation plan](/usc/24/225a.md?p=8) 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](/usc/24/225a.md?p=5) 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](/usc/24/225a.md?p=1) which are proposed for assumption by the [District](/usc/24/225a.md?p=4), those facilities at Saint Elizabeths [Hospital](/usc/24/225a.md?p=1) which are proposed for utilization by the [District](/usc/24/225a.md?p=4) under a comprehensive [District](/usc/24/225a.md?p=4) 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](/usc/24/225a.md?p=1) 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](/usc/24/225f.md?p=a-1) needed to provide mental health and other services provided by the Department of Human Services under the final [system implementation plan](/usc/24/225a.md?p=8).
- (d) **Consultation; labor-management advisory committee; public comments—**
  - (1) The [Mayor](/usc/24/225a.md?p=3) shall develop the [system implementation plan](/usc/24/225a.md?p=8) in close consultation with officials of Saint Elizabeths [Hospital](/usc/24/225a.md?p=1), through working groups to be established by the [Secretary](/usc/24/225a.md?p=2) and the [Mayor](/usc/24/225a.md?p=3) for that purpose.
  - (2) The [Mayor](/usc/24/225a.md?p=3) and the [Secretary](/usc/24/225a.md?p=2) shall establish a labor-management advisory committee, requesting the participation of Federal and [District](/usc/24/225a.md?p=4) employee organizations affected by this subchapter, to make recommendations on the [system implementation plan](/usc/24/225a.md?p=8). The committee shall consider staffing patterns under a comprehensive [District](/usc/24/225a.md?p=4) mental health care system, retention of [Hospital](/usc/24/225a.md?p=1) employees under such system, Federal retraining for such employees, and any other areas of concern related to the establishment of a comprehensive [District](/usc/24/225a.md?p=4) system. In developing the [system implementation plan](/usc/24/225a.md?p=8) the [Mayor](/usc/24/225a.md?p=3) shall carefully consider the recommendations of the committee. Such advisory committee shall not be subject to chapter 10 of title 5.
  - (3) The [Mayor](/usc/24/225a.md?p=3) 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](/usc/24/225a.md?p=3) and the [Secretary](/usc/24/225a.md?p=2) may, during the [service coordination period](/usc/24/225a.md?p=6), by mutual agreement and consistent with the requirements of the [system implementation plan](/usc/24/225a.md?p=8) direct the shift of selected program responsibilities and staff resources from Saint Elizabeths [Hospital](/usc/24/225a.md?p=1) to the [District](/usc/24/225a.md?p=4). The [Secretary](/usc/24/225a.md?p=2) may assign staff occupying positions in affected programs to work under the supervision of the [District](/usc/24/225a.md?p=4). The [Mayor](/usc/24/225a.md?p=3) 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)](#e-2-B), after October 1, 1984, and during the [service coordination period](/usc/24/225a.md?p=6), no request for proposals may be issued by the [Secretary](/usc/24/225a.md?p=2) for any areas of commercial activity at the [Hospital](/usc/24/225a.md?p=1) pursuant to Office of Management and Budget circular A–76.
    - (B) The limitation under [subparagraph (A)](#e-2-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](/usc/24/225a.md?p=3) in the development of the [system implementation plan](/usc/24/225a.md?p=8), the [Secretary](/usc/24/225a.md?p=2) shall contract for a financial audit and a physical plant audit of all existing facilities at the [Hospital](/usc/24/225a.md?p=1) 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](/usc/24/225a.md?p=4) codes and estimate the useful life of existing facility support systems.
  - (2)
    - (A) Pursuant to such physical plant audit, the [Secretary](/usc/24/225a.md?p=2) shall initiate not later than October 1, 1987, and, except as provided under an agreement entered into pursuant to [subparagraph (C)](#f-2-C), complete not later than October 1, 1993, such repairs and renovations to such physical plant and facility support systems of the [Hospital](/usc/24/225a.md?p=1) as are to be utilized by the [District](/usc/24/225a.md?p=4) under the [system implementation plan](/usc/24/225a.md?p=8) as part of a comprehensive [District](/usc/24/225a.md?p=4) mental health system, as are necessary to meet any applicable code requirements or standards.
    - (B) At a minimum until October 1, 1987, the [Secretary](/usc/24/225a.md?p=2) shall maintain all other facilities and infrastructure of the [Hospital](/usc/24/225a.md?p=1) not assumed by the [District](/usc/24/225a.md?p=4) in the condition described in such audit.
    - (C) The [Secretary](/usc/24/225a.md?p=2) may enter into an agreement with the [Mayor](/usc/24/225a.md?p=3) under which the [Secretary](/usc/24/225a.md?p=2) shall provide funds to the [Mayor](/usc/24/225a.md?p=3) to complete the repairs and renovations described in [subparagraph (A)](#f-2-A) and to make other capital improvements that are necessary for the safe and cost effective delivery of mental health services in the [District](/usc/24/225a.md?p=4), except that $7,500,000 of the funds provided to the [Mayor](/usc/24/225a.md?p=3) under such an agreement shall be used to make capital improvements to facilities not located at Saint Elizabeths [Hospital](/usc/24/225a.md?p=1). Of the $7,500,000 provided for improvements to facilities not located at the [Hospital](/usc/24/225a.md?p=1), 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](/usc/24/225a.md?p=6), the District of Columbia and the [Secretary](/usc/24/225a.md?p=2), to the extent provided in the [Federal court consent decree](/usc/24/225a.md?p=5), 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](/usc/24/225a.md?p=8). No provision of this subchapter or any action or agreement during the [service coordination period](/usc/24/225a.md?p=6) may be so construed as to absolve or relieve the [District](/usc/24/225a.md?p=4) or the Federal Government of their joint or respective responsibilities to implement fully the mandates of the [Federal court consent decree](/usc/24/225a.md?p=5).

## Footnotes

[^1]: So in original. Probably should be “responsibilities”.

## 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.)

## Notes

### Editorial Notes

### References in Text

Section 422 of the District of Columbia Home Rule Act, referred to in subsec. (b)(3), is section 422 of Pub. L. 93–198, title IV, Dec. 24, 1973, 87 Stat. 790, which is not classified to the Code.

### Amendments

2022—Subsec. (d)(2). Pub. L. 117–286 substituted “chapter 10 of title 5.” for “the Federal Advisory Committee Act.”

1997—Subsec. (b)(3). Pub. L. 105–33 substituted “District of Columbia Home Rule Act” for “District of Columbia Self-Government and Governmental Reorganization Act”.

1991—Subsec. (a)(2). Pub. L. 102–150, § 3(a), substituted “October 1, 1993” for “October 1, 1991”.

Subsec. (f)(2)(A). Pub. L. 102–150, §§ 2(1), 3(a), substituted “and, except as provided under an agreement entered into pursuant to subparagraph (C), complete” for “and complete” and “October 1, 1993” for “October 1, 1991”.

Subsec. (f)(2)(C). Pub. L. 102–150, § 2(2), added subpar. (C).

### Statutory Notes and Related Subsidiaries

### Change of Name

Committee on Governmental Affairs of Senate changed to Committee on Homeland Security and Governmental Affairs of Senate, effective Jan. 4, 2005, by Senate Resolution No. 445, One Hundred Eighth Congress, Oct. 9, 2004.

Committee on Labor and Human Resources of Senate changed to Committee on Health, Education, Labor, and Pensions of Senate by Senate Resolution No. 20, One Hundred Sixth Congress, Jan. 19, 1999.

### Effective Date of 1997 Amendment

Amendment by Pub. L. 105–33 effective Oct. 1, 1997, except as otherwise provided in title XI of Pub. L. 105–33, see section 11721 of Pub. L. 105–33, set out as a note under section 4246 of Title 18, Crimes and Criminal Procedure.

### Abolition of House Committee on the District of Columbia

Committee on the District of Columbia of House of Representatives abolished by House Resolution No. 6, One Hundred Fourth Congress, Jan. 4, 1995. References to Committee on the District of Columbia treated as referring to Committee on Government Reform and Oversight of House of Representatives, see section 1(b) of Pub. L. 104–14, set out as a note preceding section 21 of Title 2, The Congress. Committee on Government Reform and Oversight of House of Representatives changed to Committee on Government Reform of House of Representatives by House Resolution No. 5, One Hundred Sixth Congress, Jan. 6, 1999. Committee on Government Reform of House of Representatives changed to Committee on Oversight and Government Reform of House of Representatives by House Resolution No. 6, One Hundred Tenth Congress, Jan. 5, 2007. Committee on Oversight and Government Reform of House of Representatives changed to Committee on Oversight and Reform of House of Representatives by House Resolution No. 6, One Hundred Sixteenth Congress, Jan. 9, 2019. Committee on Oversight and Reform of House of Representatives changed to Committee on Oversight and Accountability of House of Representatives by House Resolution No. 5, One Hundred Eighteenth Congress, Jan. 9, 2023.

### Termination of Claims

Pub. L. 109–396, title I, § 102, Dec. 15, 2006, 120 Stat. 2712, provided that: In General.—Notwithstanding any other provision of law, the United States is not required to perform, or to reimburse the District of Columbia for the cost of performing, any of the following services: Repairs or renovations pursuant to section 4(f) of the Saint Elizabeths Hospital and District of Columbia Mental Health Services Act (24 U.S.C. 225b(f); sec. 44–903(f), D.C. Official Code). Preservation, maintenance, or repairs pursuant to a use permit executed on September 30, 1987, under which the United States (acting through the Secretary of Health and Human Services) granted permission to the District of Columbia to use and occupy portions of the Saint Elizabeths Hospital property known as the ‘West Campus’. Mental health diagnostic and treatment services for referrals as described in section 9(b) of the Saint Elizabeths Hospital and District of Columbia Mental Health Services Act (24 U.S.C. 225g(b); sec. 44–908(b), D.C. Official Code), but only with respect to services provided on or before the date of the enactment of this Act [Dec. 15, 2006]. Effect on Pending Claims.—Any claim of the District of Columbia against the United States for the failure to perform, or to reimburse the District of Columbia for the cost of performing, any service described in subsection (a) which is pending as of the date of the enactment of this Act shall be extinguished and terminated.”