Mental Health Services for Students Act of 2020
This bill provides specific statutory authority for the Project AWARE (Advancing Wellness and Resiliency in Education) State Educational Agency Grant Program that is administered by the Substance Abuse and Mental Health Services Administration. The program supports school-based mental health services, including screening, treatment, and outreach programs.
[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1109 Introduced in House (IH)]
<DOC>
116th CONGRESS
1st Session
H. R. 1109
To amend the Public Health Service Act to revise and extend projects
relating to children and to provide access to school-based
comprehensive mental health programs.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 8, 2019
Mrs. Napolitano (for herself, Mr. Katko, Mr. Lowenthal, Ms. DelBene,
Mr. Tonko, Mr. Cicilline, Mr. Payne, Mr. Lujan, Mr. Doggett, Ms.
McCollum, Mr. Moulton, Mr. Schiff, Mr. Welch, Mr. Heck, Mr. Grijalva,
Ms. Hill of California, Ms. Judy Chu of California, Mr. Kilmer, Ms.
Wilson of Florida, Ms. Kelly of Illinois, Miss Rice of New York, Mr.
Ryan, Mr. Khanna, Mr. Reed, Mr. Larsen of Washington, Ms. Jackson Lee,
Ms. Moore, Mr. DeSaulnier, Ms. Pingree, Mrs. Lawrence, Ms. Speier, Mr.
Panetta, Mr. Soto, Ms. Roybal-Allard, Mrs. Watson Coleman, Mr.
Ruppersberger, Mr. Cardenas, Mr. Aguilar, Mr. Gomez, Mr. DeFazio, Mr.
McGovern, Mr. Blumenauer, Ms. Omar, Mrs. Murphy, Mr. Sablan, Mr.
Gallego, Mr. Suozzi, Mr. Cohen, Mr. Cisneros, Ms. Matsui, Ms. Sanchez,
Ms. Kuster of New Hampshire, Mrs. Carolyn B. Maloney of New York, Ms.
Johnson of Texas, Mr. Raskin, Mr. Carbajal, Ms. Castor of Florida, and
Mr. McNerney) introduced the following bill; which was referred to the
Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to revise and extend projects
relating to children and to provide access to school-based
comprehensive mental health programs.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Mental Health Services for Students
Act of 2019''.
SEC. 2. PURPOSES.
The purposes of this Act are to--
(1) revise, increase funding for, and expand the scope of
the Project AWARE State Educational Agency Grant Program
carried out by the Secretary of Health and Human Services, in
order to provide access to more comprehensive school-based
mental health services and supports;
(2) provide for comprehensive staff development for school
and community service personnel working in the school;
(3) provide for comprehensive training to improve health
and academic outcomes for children with, or at risk for, mental
health disorders, for parents or guardians, siblings, and other
family members of such children, and for concerned members of
the community;
(4) provide for comprehensive, universal, evidence-based
screening to identify children and adolescents with potential
mental health disorders or unmet emotional health needs;
(5) recognize best practices for the delivery of mental
health care in school-based settings, including school-based
health centers;
(6) provide for comprehensive training for parents or
guardians, siblings, other family members, and concerned
members of the community on behalf of children and adolescents
experiencing mental health trauma, disorder, or disability; and
(7) establish formal working relationships between health,
human service, and educational entities that support the mental
and emotional health of children and adolescents in the school
setting.
SEC. 3. AMENDMENTS TO THE PUBLIC HEALTH SERVICE ACT.
(a) Technical Amendments.--The second part G (relating to services
provided through religious organizations) of title V of the Public
Health Service Act (42 U.S.C. 290kk et seq.) is amended--
(1) by redesignating such part as part J; and
(2) by redesignating sections 581 through 584 as sections
596 through 596C, respectively.
(b) School-Based Mental Health and Children.--Section 581 of the
Public Health Service Act (42 U.S.C. 290hh) (relating to children and
violence) is amended to read as follows:
``SEC. 581. SCHOOL-BASED MENTAL HEALTH; CHILDREN AND ADOLESCENTS.
``(a) In General.--The Secretary, in collaboration with the
Secretary of Education, shall, directly or through grants, contracts,
or cooperative agreements awarded to eligible entities described in
subsection (c), assist local communities and schools (including schools
funded by the Bureau of Indian Education) in applying a public health
approach to mental health services both in schools and in the
community. Such approach shall provide comprehensive developmentally
appropriate services and supports that are linguistically and
culturally appropriate and trauma-informed, and incorporate
developmentally appropriate strategies of positive behavioral
interventions and supports. A comprehensive school-based mental health
program funded under this section shall assist children in dealing with
traumatic experiences, grief, bereavement, risk of suicide, and
violence.
``(b) Activities.--Under the program under subsection (a), the
Secretary may--
``(1) provide financial support to enable local communities
to implement a comprehensive culturally and linguistically
appropriate, trauma-informed, and developmentally appropriate,
school-based mental health program that--
``(A) builds awareness of individual trauma and the
intergenerational, continuum of impacts of trauma on
populations;
``(B) trains appropriate staff to identify, and
screen for, signs of trauma exposure, mental health
disorders, or risk of suicide; and
``(C) incorporates positive behavioral
interventions, family engagement, student treatment,
and multigenerational supports to foster the health and
development of children, prevent mental health
disorders, and ameliorate the impact of trauma;
``(2) provide technical assistance to local communities
with respect to the development of programs described in
paragraph (1);
``(3) provide assistance to local communities in the
development of policies to address child and adolescent trauma
and mental health issues and violence when and if it occurs;
``(4) facilitate community partnerships among families,
students, law enforcement agencies, education agencies, mental
health and substance use disorder service systems, family-based
mental health service systems, child welfare agencies, health
care providers (including primary care physicians, mental
health professionals, and other professionals who specialize in
children's mental health such as child and adolescent
psychiatrists), institutions of higher education, faith-based
programs, trauma networks, and other community-based systems;
and
``(5) establish mechanisms for children and adolescents to
report incidents of violence or plans by other children,
adolescents, or adults to commit violence.
``(c) Requirements.--
``(1) In general.--To be eligible for a grant, contract, or
cooperative agreement under subsection (a), an entity shall--
``(A) be a partnership that includes--
``(i) a State educational agency, as
defined in section 8101 of the Elementary and
Secondary Education Act of 1965, in
coordination with one or more local educational
agencies, as defined in section 8101 of the
Elementary and Secondary Education Act of 1965,
or a consortium of any entities described in
subparagraph (B), (C), (D), or (E) of section
8101(30) of such Act; and
``(ii) in accordance with paragraph
(2)(A)(i), appropriate public or private
entities that employ interventions that are
evidence-based, as defined in section 8101 of
the Elementary and Secondary Education Act of
1965; and
``(B) submit an application, that is endorsed by
all members of the partnership, that--
``(i) specifies which member will serve as
the lead partner; and
``(ii) contains the assurances described in
paragraph (2).
``(2) Required assurances.--An application under paragraph
(1) shall contain assurances as follows:
``(A) The eligible entity will ensure that, in
carrying out activities under this section, the
eligible entity will enter into a memorandum of
understanding--
``(i) with at least 1 community-based
mental health provider, including a public or
private mental health entity, health care
entity, family-based mental health entity,
trauma network, or other community-based
entity, as determined by the Secretary (and
which may include additional entities such as a
human services agency, law enforcement or
juvenile justice entity, child welfare agency,
agency, an institution of higher education, or
another entity, as determined by the
Secretary); and
``(ii) that clearly states--
``(I) the responsibilities of each
partner with respect to the activities
to be carried out, including how family
engagement will be incorporated in the
activities;
``(II) how school-employed and
school-based or community-based mental
health professionals will be utilized
for carrying out such responsibilities;
``(III) how each such partner will
be accountable for carrying out such
responsibilities; and
``(IV) the amount of non-Federal
funding or in-kind contributions that
each such partner will contribute in
order to sustain the program.
``(B) The comprehensive school-based mental health
program carried out under this section supports the
flexible use of funds to address--
``(i) universal prevention, through the
promotion of the social, emotional, mental, and
behavioral health of all students in an
environment that is conducive to learning;
``(ii) selective prevention, through the
reduction in the likelihood of at risk students
developing social, emotional, mental,
behavioral health problems, suicide, or
substance use disorders;
``(iii) the screening for, and early
identification of, social, emotional, mental,
behavioral problems, suicide risk, or substance
use disorders and the provision of early
intervention services;
``(iv) the treatment or referral for
treatment of students with existing social,
emotional, mental, behavioral health problems,
or substance use disorders;
``(v) the development and implementation of
evidence-based programs to assist children who
are experiencing or have been exposed to trauma
and violence, including program curricula,
school supports, and after-school programs; and
``(vi) the development and implementation
of evidence-based programs to assist children
who are grieving, which may include training
for school personnel on the impact of trauma
and bereavement on children, and services to
provide support to grieving children.
``(C) The comprehensive school-based mental health
program carried out under this section will provide for
in-service training of all school personnel, including
ancillary staff and volunteers, in--
``(i) the techniques and supports needed to
promote early identification of children with
trauma histories, children who are grieving,
and children with a mental health disorder or
at risk of developing a mental health disorder,
or who are at risk of suicide;
``(ii) the use of referral mechanisms that
effectively link such children to appropriate
prevention, treatment, and intervention
services in the school and in the community and
to follow-up when services are not available;
``(iii) strategies that promote a school-
wide positive environment, including strategies
to prevent bullying, which includes cyber-
bullying;
``(iv) strategies for promoting the social,
emotional, mental, and behavioral health of all
students; and
``(v) strategies to increase the knowledge
and skills of school and community leaders
about the impact of trauma and violence and on
the application of a public health approach to
comprehensive school-based mental health
programs.
``(D) The comprehensive school-based mental health
program carried out under this section will include
comprehensive training for parents or guardians,
siblings, and other family members of children with
mental health disorders, and for concerned members of
the community in--
``(i) the techniques and supports needed to
promote early identification of children with
trauma histories, children who are grieving,
children with a mental health disorder or at
risk of developing a mental health disorder,
and children who are at risk of suicide;
``(ii) the use of referral mechanisms that
effectively link such children to appropriate
prevention, treatment, and intervention
services in the school and in the community and
follow-up when such services are not available;
and
``(iii) strategies that promote a school-
wide positive environment, including strategies
to prevent bullying, including cyber-bullying.
``(E) The comprehensive school-based mental health
program carried out under this section will demonstrate
the measures to be taken to sustain the program (which
may include seeking funding for the program under a
State Medicaid plan under title XIX of the Social
Security Act or a waiver of such a plan, or under a
State plan under subpart 1 of part B or part E of title
IV of the Social Security Act).
``(F) The eligible entity is supported by the State
agency with primary responsibility for behavioral
health to ensure that the comprehensive school-based
mental health program carried out under this section
will be sustainable after funding under this section
terminates.
``(G) The comprehensive school-based mental health
program carried out under this section will be
coordinated with early intervening activities carried
out under the Individuals with Disabilities Education
Act or activities funded under part A of title IV of
the Elementary and Secondary Education Act of 1965.
``(H) The comprehensive school-based mental health
program carried out under this section will be trauma-
informed, evidence-based, and developmentally,
culturally, and linguistically appropriate.
``(I) The comprehensive school-based mental health
program carried out under this section will include a
broad needs assessment of youth who drop out of school
due to policies of `zero tolerance' with respect to
drugs, alcohol, or weapons and an inability to obtain
appropriate services.
``(J) The mental health services provided through
the comprehensive school-based mental health program
carried out under this section will be provided by
qualified mental and behavioral health professionals
who are certified, credentialed, or licensed in
compliance with applicable Federal and State law and
regulations by the State involved and who are
practicing within their area of expertise.
``(K) Students will be permitted to self-refer to
the mental health program for mental health care and
self-consent for mental health crisis care to the
extent permitted by State or other applicable law.
``(3) Coordinator.--Any entity that is a member of a
partnership described in paragraph (1)(A) may serve as the
coordinator of funding and activities under the grant if all
members of the partnership agree.
``(4) Compliance with hipaa.--A grantee under this section
shall be deemed to be a covered entity for purposes of
compliance with the regulations promulgated under section
264(c) of the Health Insurance Portability and Accountability
Act of 1996 with respect to any patient records developed
through activities under the grant.
``(5) Compliance with ferpa.--Section 444 of the General
Education Provisions Act (commonly known as the `Family
Educational Rights and Privacy Act of 1974') shall apply to any
entity that is a member of the partnership in the same manner
that such section applies to an educational agency or
institution (as that term is defined in such section).
``(d) Geographical Distribution.--The Secretary shall ensure that
grants, contracts, or cooperative agreements under subsection (a) will
be distributed equitably among the regions of the country and among
urban and rural areas.
``(e) Duration of Awards.--With respect to a grant, contract, or
cooperative agreement under subsection (a), the period during which
payments under such an award will be made to the recipient shall be 5
years, with options for renewal.
``(f) Evaluation and Measures of Outcomes.--
``(1) Development of process.--The Assistant Secretary
shall develop a fiscally appropriate process for evaluating
activities carried out under this section. Such process shall
include--
``(A) the development of guidelines for the
submission of program data by grant, contract, or
cooperative agreement recipients;
``(B) the development of measures of outcomes (in
accordance with paragraph (2)) to be applied by such
recipients in evaluating programs carried out under
this section; and
``(C) the submission of annual reports by such
recipients concerning the effectiveness of programs
carried out under this section.
``(2) Measures of outcomes.--
``(A) In general.--The Assistant Secretary shall
develop measures of outcomes to be applied by
recipients of assistance under this section, and the
Assistant Secretary, in evaluating the effectiveness of
programs carried out under this section. Such measures
shall include student and family measures as provided
for in subparagraph (B) and local educational measures
as provided for under subparagraph (C).
``(B) Student and family measures of outcomes.--The
measures for outcomes developed under paragraph (1)(B)
relating to students and families shall, with respect
to activities carried out under a program under this
section, at a minimum include provisions to evaluate
whether the program is effective in--
``(i) increasing social and emotional
competency;
``(ii) improving academic outcomes,
including as measured by proficiency on the
annual assessments under section 1111(b)(2) of
the Elementary and Secondary Education Act of
1965;
``(iii) reducing disruptive and aggressive
behaviors;
``(iv) improving child functioning;
``(v) reducing substance use disorders;
``(vi) reducing rates of suicide;
``(vii) reducing suspensions, truancy,
expulsions, and violence;
``(viii) increasing high school graduation
rates, calculated using the four-year adjusted
cohort graduation rate or the extended-year
adjusted cohort graduation rate (as such terms
are defined in section 8101 of the Elementary
and Secondary Education Act of 1965);
``(ix) improving attendance rates and rates
of chronic absenteeism;
``(x) improving access to care for mental
health disorders, including access to mental
health services that are trauma-informed, and
developmentally, linguistically, and culturally
appropriate;
``(xi) improving health outcomes; and
``(xii) decreasing disparities among
vulnerable and protected populations in
outcomes described in clauses (i) through
(viii).
``(C) Local educational outcomes.--The outcome
measures developed under paragraph (1)(B) relating to
local educational systems shall, with respect to
activities carried out under a program under this
section, at a minimum include provisions to evaluate--
``(i) the effectiveness of comprehensive
school mental health programs established under
this section;
``(ii) the effectiveness of formal
partnership linkages among child and family
serving institutions, community support
systems, and the educational system;
``(iii) the progress made in sustaining the
program once funding under the grant has
expired;
``(iv) the effectiveness of training and
professional development programs for all
school personnel that incorporate indicators
that measure cultural and linguistic
competencies under the program in a manner that
incorporates appropriate cultural and
linguistic training;
``(v) the improvement in perception of a
safe and supportive learning environment among
school staff, students, and parents;
``(vi) the improvement in case-finding of
students in need of more intensive services and
referral of identified students to prevention,
early intervention, and clinical services;
``(vii) the improvement in the immediate
availability of clinical assessment and
treatment services within the context of the
local community to students posing a danger to
themselves or others;
``(viii) the increased successful
matriculation to postsecondary school;
``(ix) reduced suicide rates;
``(x) reduced referrals to juvenile
justice; and
``(xi) increased educational equity.
``(3) Submission of annual data.--An eligible entity
described in subsection (c) that receives a grant, contract, or
cooperative agreement under this section shall annually submit
to the Assistant Secretary a report that includes data to
evaluate the success of the program carried out by the entity
based on whether such program is achieving the purposes of the
program. Such reports shall utilize the measures of outcomes
under paragraph (2) in a reasonable manner to demonstrate the
progress of the program in achieving such purposes.
``(4) Evaluation by assistant secretary.--Based on the data
submitted under paragraph (3), the Assistant Secretary shall
annually submit to Congress a report concerning the results and
effectiveness of the programs carried out with assistance
received under this section.
``(5) Limitation.--An eligible entity shall use not more
than 20 percent of amounts received under a grant under this
section to carry out evaluation activities under this
subsection.
``(g) Information and Education.--The Secretary shall establish
comprehensive information and education programs to disseminate the
findings of the knowledge development and application under this
section to the general public and to health care professionals.
``(h) Amount of Grants and Authorization of Appropriations.--
``(1) Amount of grants.--A grant under this section shall
be in an amount that is not more than $2,000,000 for each of
the first 5 fiscal years following the date of enactment of the
Mental Health Services for Students Act of 2019. The Secretary
shall determine the amount of each such grant based on the
population of children up to age 21 of the area to be served
under the grant.
``(2) Authorization of appropriations.--There is authorized
to be appropriated to carry out this section, $200,000,000 for
each of the first 5 fiscal years following the date of
enactment of the Mental Health Services for Students Act of
2019.''.
(c) Conforming Amendment.--Part G of title V of the Public Health
Service Act (42 U.S.C. 290hh et seq.), as amended by subsection (b), is
further amended by striking the part designation and heading and
inserting the following:
``PART G--SCHOOL-BASED MENTAL HEALTH''.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Energy and Commerce.
Referred to the Subcommittee on Health.
Subcommittee Hearings Held.
Committee Consideration and Mark-up Session Held.
Ordered to be Reported (Amended) by Voice Vote.
Reported (Amended) by the Committee on Energy and Commerce. H. Rept. 116-553.
Reported (Amended) by the Committee on Energy and Commerce. H. Rept. 116-553.
Placed on the Union Calendar, Calendar No. 453.
Mr. Pallone moved to suspend the rules and pass the bill, as amended.
Considered under suspension of the rules. (consideration: CR H5014-5015)
DEBATE - The House proceeded with forty minutes of debate on H.R. 1109.
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Passed/agreed to in House: On motion to suspend the rules and pass the bill, as amended Agreed to by voice vote.
On motion to suspend the rules and pass the bill, as amended Agreed to by voice vote. (text: CR H5014-5015)
Motion to reconsider laid on the table Agreed to without objection.
Received in the Senate and Read twice and referred to the Committee on Health, Education, Labor, and Pensions.