[Congressional Bills 104th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1284 Introduced in House (IH)]







104th CONGRESS
  1st Session
                                H. R. 1284

  To establish a program to provide grants to improve the quality and 
availability of comprehensive education, health and social services for 
       at-risk youth and their families, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 21, 1995

  Ms. Waters introduced the following bill; which was referred to the 
Committee on Economic and Educational Opportunities, and in addition to 
 the Committee on Commerce, for a period to be subsequently determined 
 by the Speaker, in each case for consideration of such provisions as 
        fall within the jurisdiction of the commtitee concerned

_______________________________________________________________________

                                 A BILL


 
  To establish a program to provide grants to improve the quality and 
availability of comprehensive education, health and social services for 
       at-risk youth and their families, and for other purposes.

    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 ``School-Based Clinic Health Service 
Act of 1995''.

   TITLE I--SCHOOL-BASED OR SCHOOL-LINKED HEALTH AND SOCIAL SERVICES 
                             CENTER GRANTS

SEC. 101. GRANT PROGRAM.

    (a) In General.--The Secretary of Health and Human Services, acting 
through the Administrator of the Health Resources and Services 
Administration, may award grants to eligible local community 
partnerships to coordinate and deliver comprehensive education, health, 
and social services to children or youth in school-based, school-linked 
or community-based locations.
    (b) Eligible Entities.--
            (1) In general.--To be eligible to receive a grant under 
        subsection (a), an entity shall--
                    (A) be a new or existing local community 
                partnership which, at a minimum, shall include--
                            (i) a local health care provider with 
                        experience in delivering services to 
                        adolescents;
                            (ii) one or more local public schools; and
                            (iii) at least one community-based 
                        organization located in the community to be 
                        served that has a history of providing services 
                        to at-risk youth in that community;
                    (B) prepare and submit to the Secretary an 
                application in accordance with subsection (e), that has 
                been developed and agreed to by all members of the 
                partnership;
                    (C) ensure the provision of core services in 
                accordance with subsection (c); and
                    (D) meet any other requirements determined 
                appropriate by the Secretary.
            (2) Participation.--A partnership described in paragraph 
        (1)(A) shall, to the maximum extent feasible, involve broad 
        based community participation from parents and youth to be 
        served, health and social service providers, teachers and other 
        public school and school board personnel, community-based 
        organizations (particularly those serving minority youth), 
        youth development and service organizations and interested 
        business leaders. Such participation may be through an expanded 
        partnership, or an advisory board to such a partnership.
            (3) Targeting.--A partnership described in paragraph (1)(A) 
        shall be located in and created to serve a community in which 
        youth are exposed to a high-risk environment as documented by 
        factors including high rates of children in poverty or who lack 
        access to health care, school dropouts and those retained in 
        grade, alcohol or other drug use, sexually transmitted diseases 
        including HIV, teen pregnancy, early parenthood, suicide, 
        community or gang violence, youth unemployment, and juvenile 
        justice involvement.
    (c) Use of Amounts.--
            (1) Core services.--
                    (A) In general.--A local partnership awarded a 
                grant under subsection (a) shall use amounts received 
                under such grant to coordinate and deliver core 
                services described in subparagraphs (B) and (C) at a 
                school-based, school-linked, or community-based 
                location or locations accessible to, and utilized by, 
                at-risk children, youth, and their families.
                    (B) Comprehensive health, mental health, and social 
                services.--With respect to the delivery of 
                comprehensive health, mental health, and social 
                services, a partnership shall ensure that--
                            (i) at a minimum, health screening and 
                        health care services, counseling and crisis 
intervention and referrals are provided in a single site; and
                            (ii) health, mental health and social 
                        services which cannot be provided directly on-
                        site will be secured through contracted 
                        arrangements with community-based providers and 
                        a case management system that ensures that 
                        populations to be served receive needed 
                        services and appropriate follow-up services, 
                        including supportive services such as the 
                        provision of transportation.
                    (C) Youth development and life planning.--With 
                respect to youth development and life planning 
                services, a partnership shall--
                            (i) provide age appropriate programs and 
                        services that promote the development of life 
                        skills and social competencies which assist 
                        youth in completing school or employment 
                        training, establishing life and career goals, 
                        and avoiding high risk behaviors; and
                            (ii) provide programs and services that are 
                        designed to prevent HIV and other sexually 
                        transmitted diseases, unintended pregnancies, 
                        early parenthood, alcohol and other drug use, 
                        suicide, community or gang violence, and other 
                        risk-taking behaviors that reflect the needs of 
                        the populations identified by the community in 
                        the comprehensive plan of the partnership.
            (2) Coordination of core services.--A partnership awarded a 
        grant under subsection (a) shall, in meeting the requirements 
        of paragraph (1), use amounts received under such grant to 
        coordinate the delivery of existing services of the types 
        described in such paragraph to more effectively utilize 
        available resources prior to adding new resources or developing 
        new services.
            (3) Coordination of core services with additional 
        services.--A partnership awarded a grant under subsection (a) 
        may use amounts received under such grant to coordinate or co-
        locate core services with additional services identified in the 
        comprehensive plan to enhance the support available through the 
        partnership service delivery network.
    (d) Priority and Term of Grants.--
            (1) Priority.--In awarding grants under this subsection the 
        Secretary shall give priority to those applicants that, through 
        their comprehensive services plan, demonstrate that--
                    (A) continuity of access to required core services 
                for youth will be made available on a year round basis 
                or beyond traditional school or service hours, either 
                on site or through a backup referral system of 
                community-based providers; and
                    (B) services to be offered by the partnership will 
                extend beyond the in-school population and will include 
                the provision of core services to out-of-school youth, 
                to the extent practicable.
            (2) Term of grants.--Grants awarded under subsection (a) 
        shall be for a term of not less than 3, or more than 5, years 
        based on the ability of the grantee partnership to achieve the 
        goals and objectives identified in the entity's application. 
        The Secretary may provide 2 year extension awards to those 
        grantee partnerships that, following the initial 3 year grant 
        period, demonstrate substantial progress in the integration of 
        comprehensive services, including broad based institutional 
        support for collaboration from all members of the partnership, 
        and improvement in the health and education outcomes of the 
        populations served relative to baseline community indices.
    (e) Application.--
            (1) In general.--An entity that desires to receive a grant 
        under subsection (a) shall prepare and submit an application to 
        the Secretary at such time, in such manner, and accompanied by 
        such information as the Secretary may reasonably require. Such 
        application shall include a comprehensive services plan that 
        meets the requirements of paragraph (3) and the assurances 
        required under paragraph (4). A copy of such application shall 
        be provided to the State agencies primarily responsible for 
        health and education for the particular State involved.
            (2) Formulation.--In formulating a comprehensive services 
        plan under this subsection, an entity shall document the 
        efforts undertaken by the entity to obtain broad based 
        community input from teachers and school personnel, health 
        providers including organized medicine, social service 
        providers including community-based organizations, and parents 
        and at-risk youth to be served in order to--
                    (A) maximize participation in the needs assessment 
                conducted by the entity;
                    (B) formulate a service plan that is comprehensive 
                and reflective of the needs delineated by youth and 
                families to be served;
                    (C) build institutional support for the services to 
                be provided under the plan from the staff and 
                administration of all members of the partnership and 
                the larger community;
                    (D) encourage increased collaboration among a 
                broader range of public and private providers to 
                improve the quality, availability and variety of 
                services offered within the partnership; and
                    (E) heighten awareness of the linkage between 
                access to comprehensive health and social services and 
                school performance.
            (3) Contents of the plan.--Each plan submitted under 
        paragraph (1) shall include--
                    (A) a description of the children or youth 
                populations to which services will be provided under 
                the grant and an assessment of their health, social 
                services, and education needs;
                    (B) an inventory of existing core services 
                described in subsection (c) that are being provided to 
                such populations within the community, including 
                subpopulations of youth with special needs;
                    (C) an identification of the unmet needs of such 
                populations, gaps in the system of core services 
                available, barriers to the utilization of services, and 
                barriers to the integration of services including 
                conflicting regulatory requirements and eligibility 
                standards;
                    (D) a description of the program goals and 
                objectives and intended outcomes, which may include 
                increased integration and utilization of services by 
                the intended populations, and improved health and 
                education indicators for service recipients relative to 
                the baseline community assessments described in 
                subparagraph (A);
                    (E) a plan for the manner in which data systems 
                used by members of the partnership will be coordinated 
                in order to guide local planning and evaluate the 
                progress made toward achieving program goals and 
                objectives described in subparagraph (D);
                    (F) a description of the means by which the entity 
                will coordinate or co-locate services currently 
                provided by members of the partnership in order to 
                maximize the effectiveness of existing resources;
                    (G) a description of the services that will be 
                directly provided to children or youth populations with 
                funds provided under this Act as needed to address 
                identified unmet core service needs;
                    (H) a description of how the services will be 
                coordinated with the on-going educational activities of 
                the school or schools participating in the partnership 
                and the role the school nurse and other student support 
                personnel will play in the expanded health care 
                services;
                    (I) a description of the process by which program 
                decisions will be made within the partnership;
                    (J) an identification of the partnership's fiscal 
                agent and the manner in which program funds received 
                under this section will be disbursed and monitored; and
                    (K) a description of the strategy for securing the 
                long term financing necessary to ensure a continuity of 
                services made available through the partnership after 
                the termination of the grant period.
            (4) Assurances.--An application submitted under this 
        section shall contain assurances that--
                    (A) core services will be provided in a coordinated 
                manner at a single site providing ready access to the 
                populations to be served, and if such single site is to 
                be school-based, that an affirmative school board vote 
                for the project will be provided;
                    (B) core services will be targeted to populations 
                and subpopulations identified in the comprehensive plan 
                and will be delivered in a culturally sensitive and 
                linguistically appropriate manner;
                    (C) amounts provided to the applicant under this 
                section will be used to coordinate existing services 
                provided by the individual members of the partnership 
                before such amounts are used to provide new services; 
                and
                    (D) amounts provided to the applicant under this 
                section and used to deliver services will be utilized 
                in conformity with the unmet core service needs as 
                identified in the comprehensive plan of the entity.
    (f) Geographic Distribution.--In awarding grants to qualified 
applicants under this title, the Secretary shall ensure--
            (1) an equitable geographic distribution; and
            (2) a distribution to both urban and rural communities in 
        which youth are exposed to a high risk environment in 
        accordance with section 101(b)(3).
    (g) Amount of Grant.--The annual amount of a grant awarded under 
this title shall not be less than $100,000 nor more than $300,000, 
except as provided in section 102.
    (h) Federal Share.--
            (1) In general.--Subject to paragraph (3), a grant for 
        services awarded under this section may not exceed--
                    (A) 90 percent of the total cost of the activities 
                to be funded under the program for the first 2 fiscal 
                years for which the program receives assistance under 
                this section; and
                    (B) 75 percent of the total cost of such activities 
                for subsequent years for which the program receives 
                assistance under this section.
        The remainder of such costs shall be made available as provided 
        in paragraph (2).
            (2) Form of non-federal share.--The non-Federal share 
        required by paragraph (1) may be in cash or in-kind, fairly 
        evaluated, including facilities, equipment, personnel, or 
        services, but may not include amounts provided by the Federal 
        Government. In-kind contributions may include space within a 
        school facility, school personnel, program use of school 
        transportation systems, outposted health and social services 
        personnel, and extension of health provider medical liability 
        insurance.
            (3) Waiver.--The Secretary may waive the requirements of 
        paragraph (1) for any year in accordance with criteria 
        established by regulation. Such criteria shall include a 
        documented need for the services provided under this section 
        and an inability of the grantee to meet the requirements of 
        paragraph (1) despite a good faith effort.
    (i) Training and Technical Assistance.--Entities that receive 
assistance under this section shall use 10 percent of the amount of 
such assistance to provide staff training and to secure necessary 
technical assistance. To the maximum extent feasible, technical 
assistance should be sought through local community-based entities. 
Staff training should include the training of teachers and other school 
personnel necessary to ensure appropriate referral and utilization of 
services and school reinforced linkages between classroom activities 
and services offered.

SEC. 102. PLANNING GRANTS.

    (a) In General.--The Secretary, acting through the Administrator of 
the Health Resources and Services Administration, may award 1-year 
nonrenewable planning grants to entities described in section 
101(b)(1)(A) that agree to establish a local community partnership for 
the purpose of delivering comprehensive services as described in 
section 101.
    (b) Application.--To be eligible to receive a grant under 
subsection (a), a local community partnership shall prepare and submit 
to the Secretary an application, at such time, in such manner, and 
containing such information as the Secretary may reasonably require. A 
copy of such application shall be provided to the State agencies 
primarily responsible for health and education in the particular State 
involved.
    (c) Use of Amounts.--Amounts provided under a grant awarded under 
subsection (a) shall be used to--
            (1) assess the education, health, mental health, and social 
        service needs of children or youth in the community proposed to 
        be served by the local community partnership, and the current 
        service delivery system, to identify unmet needs and barriers 
to services;
            (2) develop a plan for the delivery and coordinating of 
        comprehensive education, health and social services for youth 
        populations to be served in a school-based, school-linked, or 
        community-based location; and
            (3) develop program goals and objectives and intended 
        outcomes and the means by which progress will be measured.
    (d) Limitations.--
            (1) Amount available for grants.--Not more than 10 percent 
        of the amounts appropriated under section 308(l) shall be used 
        to award planning grants under subsection (a).
            (2) Amount available for individual grants.--The Secretary 
        shall not award a grant of more than $50,000 under subsection 
        (a).

      TITLE II--STATE AND LOCAL COORDINATED YOUTH SERVICES GRANTS

SEC. 201. PURPOSE.

    It is the purpose of this title to award grants to citywide or 
countywide consortia, or to a State entity, with a demonstrated 
commitment to the coordination and delivery of comprehensive education, 
health and social services to in-school and out-of-school youth on a 
citywide, countywide or statewide basis through a system of school-
based, school-linked, and community-based comprehensive youth services 
centers.

                   Subtitle A--Local Consortia Grants

SEC. 211. COORDINATION AND SERVICE DELIVERY GRANTS.

    (a) In General.--The Secretary, acting through the Administrator of 
the Health Resources and Services Administration, may award grants to 
eligible consortia to enable such consortia to provide comprehensive 
core services as described in section 231(a).
    (b) Eligible Consortia.--
            (1) In general.--To be eligible to receive a grant under 
        subsection (a), a consortia--
                    (A) shall be a new or existing collaborating group 
                of entities whose membership includes representatives 
                from the local health department, the local educational 
                agency, health and social services providers and 
                community-based organizations located in the service 
                delivery area that have a history of providing service 
                to at-risk youth (including minority youth, school 
                dropouts, adolescent parents, and runaway or homeless 
                youth), youth development organizations, juvenile 
                justice personnel, and parents and the at-risk youth to 
                be served;
                    (B) shall consist of members who have demonstrated 
                a financial or organizational commitment to providing 
                comprehensive education, health, and social services to 
                at-risk youth through an integrated service delivery 
                network directed by the consortia; and
                    (C) shall prepare and submit to the Secretary an 
                application in accordance with section 231(b).
            (2) Definition.--For purposes of paragraph (1):
                    (A) The term ``financial commitment'' means an 
                identification of locally controlled financial 
                resources, including those obtained through individual 
                or joint application with other public and private 
                funding sources, to be dedicated to the planning, 
                coordination and delivery of comprehensive services to 
                at-risk youth by the consortia.
                    (B) The term ``organizational commitment'' means--
                            (i) an identification of existing 
                        institutional and in-kind resources that 
each member of the consortia will dedicate to the goals and objectives 
of the consortia;
                            (ii) an assurance that the training and 
                        technical assistance necessary for teachers and 
                        other frontline service providers to increase 
                        their knowledge, expertise, and willingness to 
                        work collaboratively will be provided;
                            (iii) a commitment to participate in 
                        providing the data necessary to guide the joint 
                        planning, implementation, and ongoing 
                        monitoring consortia activities; and
                            (iv) with respect to the local educational 
                        agency, an affirmative vote by the local school 
                        board on participation in the consortia.

           Subtitle B--Statewide Youth Services Center Grants

SEC. 221. STATEWIDE COORDINATION AND SERVICE DELIVERY GRANTS.

    (a) In General.--The Secretary, acting through the Administrator of 
the Health Resources and Services Administration, may award grants to 
eligible States to enable such State to provide the core services 
described in subsection 231(a) through the awarding of grants to local 
community partnerships or consortia.
    (b) Eligible States.--
            (1) In general.--To be eligible to receive a grant under 
        subsection (a), a State shall--
                    (A) provide assurances that a memorandum of 
                understanding or written cooperative agreement has been 
                entered into by the State agencies responsible for 
                education, health and social services concerning the 
                planned delivery of comprehensive youth services;
                    (B) have a demonstrated financial and 
                organizational commitment to providing comprehensive 
                and co-located health, education, and social services 
                to at-risk youth through the awarding of grants to 
                local communities;
                    (C) currently support the coordinated delivery of 
                such services through a system of school-based, school-
                linked, or community-based comprehensive youth services 
                centers;
                    (D) provide documentation that services are 
                prioritized among communities that have health and 
                social indices that indicate a high risk environment 
                for youth, including high rates of children in poverty 
                or who lack access to health care, teen pregnancy and 
                early parenthood, sexually transmitted diseases 
                including HIV, school dropouts, community or gang 
                violence, alcohol or other drug use, youth unemployment 
                and juvenile justice involvement; and
                    (E) prepare and submit to the Secretary an 
                application in accordance with section 231(b).
            (2) Definitions.--For the purposes of paragraph (1):
                    (A) The term ``demonstrated financial commitment'' 
                means the investment of State-controlled financial and 
                other resources available to States for the purposes of 
                planning, coordinating, and delivering comprehensive 
                services to youth in the most recent fiscal year.
                    (B) The term ``demonstrated organizational 
                commitment'' means--
                            (i) an administrative mechanism in place 
                        under which a statewide system of local 
                        partnerships is implemented among education and 
                        public and private health and social service 
                        providers for collaboration in the joint 
                        planning, coordination, and delivery of 
                        comprehensive services to youth populations; 
                        and
                            (ii) a defined strategic plan for the 
                        manner in which the State provides technical 
                        assistance and training to localities for the 
                        development of the collaborative partnerships 
                        as described in clause (i).

   Subtitle C--Provisions Relating to Both Local and Statewide Grant 
                                Programs

SEC. 231. USE OF AMOUNTS AND APPLICATION.

    (a) Use of Amounts.--
            (1) Core services.--
                    (A) In general.--A consortia or State entity 
                awarded a grant under section 211 or 221 shall use 
                amounts received under such grant to coordinate and 
                deliver core services described in subparagraphs (B) 
                and (C) through a system of school-based, school-
                linked, or community-based youth centers, to serve in-
                school and out-of-school youth and their families;
                    (B) Comprehensive health, mental health, and social 
                services.--With respect to the delivery of 
                comprehensive health, mental health, and social 
services, a consortia or entity shall ensure that--
                            (i) at a minimum, health screening and 
                        health care services, counseling and crisis 
                        intervention and referrals are provided on-
                        site; and
                            (ii) health, mental health and social 
                        services which cannot be provided directly on-
                        site will be secured through referrals to 
                        community-based providers under contractual 
                        arrangements and a case management system that 
                        ensures that youth receive needed services and 
                        appropriate followup services, including 
                        supportive services such as the provision of 
                        transportation.
                    (C) Youth development and life planning.--With 
                respect to youth development and life planning 
                services, a consortia or entity shall--
                            (i) provide programs and services that 
                        promote the development of life skills and 
                        social competencies which assist youth in 
                        completing school or employment training by 
                        helping them to establish life and career goals 
                        and avoid high risk behaviors; and
                            (ii) provide programs and services that are 
                        designed to prevent HIV and other sexually 
                        transmitted diseases, unintended pregnancy, 
                        early parenthood, alcohol and other drug use, 
                        suicide, community or gang violence, and other 
                        adolescent risk taking behaviors that reflect 
                        the needs of the youth populations identified 
                        by the community in the comprehensive plan of 
                        the partnership.
            (2) Coordination and delivery of core services.--An entity 
        awarded a grant under this title shall, in meeting the 
        requirements of paragraph (1), use amounts received under such 
        grant to coordinate and co-locate the delivery of existing core 
        services of the types described in such paragraph into a 
        broader system of health and social services centers accessible 
        to in-school or out-of-school youth to more effectively utilize 
        available resources prior to adding new resources or developing 
        new services.
            (3) Coordination of core services with education and 
        training services for out-of-school youth.--An entity awarded a 
        grant under this title shall use amounts received under such 
        grant to provide outreach services to out-of-school youth 
        (including adolescent parents and runaway and homeless youth) 
        and to coordinate core services with alternative education and 
        job training and placement opportunities for such youth.
            (4) Coordination of core services with additional 
        services.--An entity awarded a grant under this title may use 
        amounts received under such grant to coordinate and co-locate 
        core services with additional services in order to enhance the 
        support available to at-risk youth and their families through 
        the service delivery network.
            (5) Expansion of core services to feeder schools.--An 
        entity awarded a grant under this title may use amounts 
        received under such grant to expand the coordination and 
        delivery of core services to those elementary schools whose 
        students will attend secondary schools currently providing core 
        services.
    (b) Application.--
            (1) In general.--A consortia or State entity that desires 
        to receive a grant under this title shall prepare and submit an 
        application to the Secretary at such time, in such manner, and 
        accompanied by such information as the Secretary may reasonably 
        require. Such application shall include a comprehensive 
        services plan that meets the requirements of paragraph (3) and 
        the assurances required under paragraph (4).
            (2) Formulation.--In formulating a comprehensive services 
        plan under this subsection, a consortia or State entity shall 
        document the efforts undertaken to obtain broadbased community 
        input from teachers and other school personnel, health 
        providers including organized medicine, social services 
        providers including community-based organizations, and parents 
        and at-risk youth in order to--
                    (A) maximize participation in the needs assessment 
                conducted by the entity;
                    (B) formulate a service plan that is comprehensive 
                and reflective of the needs delineated by the youth, 
                families, and neighborhoods to be served under the 
                plan;
                    (C) build institutional support for the services to 
                be provided under the plan from the staff and 
                administration of all members of the consortia and the 
                support of parents and the larger community; and
                    (D) encourage increased collaboration among members 
                of the consortia as well as a broader range of 
                providers to enhance the quality, availability and a 
                variety of services available within the consortia.
            (3) Contents of the plan.--Each plan submitted under 
        paragraph (1) shall include, with respect to local consortia or 
        those localities to be served under a statewide network--
                    (A) a description of the in-school and out-of-
                school youth populations to which services will be 
                provided under the grant and an assessment of their 
                health and social services needs;
                    (B) an inventory of existing core services 
                described in subsection (a) that are being provided to 
                such youth populations, including subpopulations of 
                youth with special needs;
                    (C) an identification of the unmet needs of such 
                youth populations, gaps in the system of core services 
                available, barriers to the utilization of services by 
                such youth, and barriers to the integration of services 
                including conflicting regulatory requirements and 
                eligibility standards;
                    (D) a description of the program goals and 
                objectives and intended outcomes, which may include 
                increased integration and utilization of services by 
                the intended youth populations, and improved health and 
education, indicators for service recipients relative to baseline 
community assessment;
                    (E) a description of the manner in which such data 
                systems will be utilized to guide planning and to 
                evaluate progress toward achieving the program goals 
                and objectives described in subparagraph (D);
                    (F) a description of the means by which an entity 
                awarded a grant under this title will--
                            (i) utilize existing Federal, State, local 
                        and other funding sources and reimbursement 
                        mechanisms (including Medicaid and other third 
                        party payors), received by the entity or its 
                        members for the coordinated delivery of core 
                        services; and
                            (ii) co-locate currently operating services 
                        provided by the entity or its members into a 
                        system of comprehensive health and social 
                        services centers in order to maximize the 
                        effectiveness of existing resources in serving 
                        in-school and out-of-school youth;
                    (G) a description of the services that will be 
                directly provided to such youth populations with funds 
                provided under this Act as needed to address unmet core 
                service needs identified in the comprehensive plan;
                    (H) a plan for the phased-in development of 
                comprehensive school-based and community-based health 
                and social services centers with amounts received under 
                this Act to achieve a citywide, countywide, or 
                Statewide service delivery network of both in-school 
                and out-of-school youth;
                    (I) a plan for the phased-in expansion of services 
                available through the entity by identifying additional 
                opportunities for collaboration with providers offering 
                services in addition to the core services required 
                under subsection (a) which have been identified as 
                needs of such youth populations;
                    (J) a description of the process by which program 
                development, implementation, and evaluation (including 
                the criteria and decisionmaking process that will be 
                used in allocating funds within the youth services 
                center system) will be carried out within the entity;
                    (K) an identification of the fiscal agent or State 
                agency administering the program and the manner in 
                which program funds received under this section will be 
                disbursed and monitored; and
                    (L) a description of the strategy for securing the 
                long-term financing necessary to continue to provide 
                the services made available through the entity after 
                the termination of the grant period.
            (4) Assurances.--An application submitted under this 
        subsection shall contain assurances that--
                    (A) core services will be provided in a coordinated 
                manner to in-school and out-of-school youth through a 
                system of comprehensive services centers providing 
                ready access to the youth and their families to be 
                served;
                    (B) core services will be targeted to youth 
                populations and subpopulations identified in the 
                comprehensive plan and will be delivered in a 
                culturally sensitive and linguistically appropriate 
                manner;
                    (C) amounts provided to the applicant under this 
                section will be used to coordinate existing services 
                before such amounts are used to provide directly the 
                services;
                    (D) amounts provided to the applicant under this 
                section and used to deliver services will be utilized 
                in conformity with the unmet needs as identified in the 
                comprehensive plan of the entity; and
                    (E) entities awarded grants under this title will 
                provide comprehensive services that extend beyond 
                traditional school or service hours, including access 
                to year-round programs and programs that provide 
                services in the evenings or on weekends.
    (c) Term of Grants and Administrative Costs.--
            (1) Term of grants.--Grants awarded under this title shall 
        be for a term of not less than 3, or more than 5, years based 
        on the ability of the grantee to achieve the goals and 
        objectives identified in the entities application. The 
        Secretary may provide 2-year extension awards to those grantees 
        that, following the initial 3-year grant period, demonstrate 
        substantial progress in the integration of comprehensive 
        services for at-risk youth, including broadbased institutional 
        support for collaboration from all members of the consortia, 
        and an improvement in the health and education outcomes of the 
        youth served relative to the baseline community indices.
            (2) Cap on administrative costs.--A grantee may not use in 
        excess of 5 percent of any amounts received under a grant 
        awarded under this title for planning, data collection, 
        administration, accounting, reporting, and program oversight 
        activities.
            (3) Integration incentive.--The Secretary, in making a 
        grant under this title, may make available to an approved 
        consortia or State, an amount equal to--
                    (A) $1 under such a grant for every $5 of Federal 
                funds otherwise available to the individual members of 
                the consortia or State through other Federal 
                discretionary grant programs that will be integrated 
                into the comprehensive service delivery network 
                established by the consortia or State; and
                    (B) $1 under such a grant for every $1 of local, 
                State or other non-Federal funds made available to 
                carry out the purposes of this Act (such non-Federal 
                contributions may be cash, from public or private 
                entities, or in-kind, fairly evaluated, including 
                facilities, equipment, and personnel).
        Amounts provided by the Federal Government and applied under 
        subparagraph (A), may not be included in determining the local 
        share for purposes of this paragraph.

SEC. 232. CONSORTIA OR STATE PLANNING GRANTS.

    (a) In General.--The Secretary, acting through the Administrator of 
the Health Resources and Services Administration, may award 1-year 
nonrenewable planning grants to consortia described in section 
211(b)(1)(A) or to States for the purpose of planning for the delivery 
of comprehensive services as described in section 231.
    (b) Application.--To be eligible to receive a grant under 
subsection (a), consortia or State shall prepare and submit to the 
Secretary an application, at such time, in such manner, and containing 
such information as the Secretary may reasonably require.
    (c) Use of Amounts.--Amounts provided under a grant awarded under 
subsection (a) shall be used to--
            (1) establish an administrative mechanism for the 
        development and implementation of a citywide, countywide, or 
        statewide system of school-based, school-linked, or community-
        based comprehensive youth services centers;
            (2) assess the education, health, mental health, and social 
        service needs of youth proposed to be served, and the current 
        service delivery system, to identify unmet needs and barriers 
        to services for youth;
            (3) develop program goals and objectives and intended 
        outcomes and the means by which progress will be measured; and
            (4) develop a strategic plan for the coordinating and 
        delivery of comprehensive education, health and social services 
        for youth populations to be served in a school-based, school-
        linked, or community-based location.
    (d) Limitations.--
            (1) Amount available for grants.--Not more than 10 percent 
        of the amounts appropriated under section 308(2) shall be used 
        to award planning grants under subsection (a).
            (2) Amount available for individual grants.--The Secretary 
        shall not award a matching grant of more than $150,000 under 
        subsection (a).

                  TITLE III--IMPLEMENTATION PROVISIONS

SEC. 301. INTERRELATIONSHIP BETWEEN TITLES.

    (a) Limitation.--
            (1) In general.--A community that is currently receiving 
        State funds for the delivery of co-located education, health 
        and social services, or a community that will receive funding 
        from the State if such State is funded under subtitle B of 
        title II, shall not be eligible to receive funds under title I.
            (2) Construction.--Nothing in paragraph (1) shall be 
        construed to prevent a community partnership that currently 
        receives State funding for the delivery of co-located 
        education, health, and social services from forming a consortia 
        in order to seek funding for an expanded citywide or countywide 
        youth services network under subtitle A of title II.
    (b) Participation.--A local consortia operating in a locality that 
is receiving State funding for the delivery of co-located education, 
health, and social services, shall include participation from the 
entities receiving such State funding.
    (c) Continued Funding.--At the completion of the 5-year grant 
period under title I, a partnership receiving funds under such title 
shall be eligible for continued funding if such partnership has 
expanded into a citywide or countywide consortia as described under 
subtitle A of title II, or has become part of statewide network as 
described under subtitle B of title II.

SEC. 302. CONSULTATION WITH OTHER DEPARTMENTS.

    The Secretary shall consult with the Secretary of Education in the 
development of program regulations to implement this Act.

SEC. 303. TECHNICAL ASSISTANCE.

    (a) In General.--The Secretary shall--
            (1) widely disseminate information regarding the programs 
        authorized under this Act to appropriate State and local 
        health, education, and human service agencies and community-
        based organizations;
            (2) provide technical assistance to support entities in 
        complying with the requirements of this Act; and
            (3) widely disseminate information with respect to 
        successful and model programs supported with funds provided 
        under this Act to current grantees and to entities described in 
        paragraph (1).
    (b) Administration.--The assistance and information under 
subsection (a) shall be provided directly through the Health Resources 
and Services Administration as the administering agency, other agencies 
within the Department of Health and Human Services with appropriate 
expertise, or through grants, or contracts with, nonprofit 
organizations with appropriate expertise. In carrying out this section, 
the Secretary shall collaborate with the Department of Education, 
Department of Labor, and the Commission on National and Community 
Service.

SEC. 304. REPORT TO SECRETARY.

    (a) In General.--Entities receiving funds under this Act shall 
prepare and submit to the Secretary an annual report that shall contain 
information concerning--
            (1) service utilization, including the number of client 
        visits funded through this Act, the types of services provided, 
        demographic data on the age, sex and race of participants, and 
        the third party reimbursement source for such services 
        provided;
            (2) the most recent data for youth residing in the service 
        delivery area including--
                    (A) school dropout rates, absenteeism, and school 
                reentry rates;
                    (B) teen pregnancy, early parenthood, and sexually 
                transmitted disease rates, including HIV disease rates; 
                and
                    (C) available data on substance abuse rates, 
                juvenile crime indices, and youth unemployment; and
            (3) the number and types of entities participating in the 
        delivery of services through the comprehensive services plan, 
        and the actions taken to coordinate and collaborate with other 
        entities in service delivery.
    (b) Third Year Submissions.--At the end of the third fiscal year 
for which a grant is awarded to an entity under this Act, the entity 
shall submit, as part of the report required under subsection (a), an 
analysis of the progress that has been made in--
            (1) achieving the program goals, objectives and intended 
        outcomes as outlined in the comprehensive services plan; and
            (2) improving the health and education outcomes of the 
        youth served relative to baseline community indices.

SEC. 305. MAINTENANCE OF EFFORT.

    The Secretary may not make a grant to an applicant under this Act 
unless such applicant agrees to maintain the expenditures of the 
applicant for the purposes for which the grant is awarded at a level 
equal to not less than the level of such expenditures maintained by the 
applicant for the year preceding the fiscal year for which the 
applicant is applying to receive the grant.

SEC. 306. DEFINITIONS.

    As used in this Act:
            (1) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
            (2) Child.--The term ``child'' means an individual between 
        the ages of 5 and 10.
            (3) Youth.--The term ``youth'' means individuals between 
        the ages 10 and 21.
            (4) At-risk youth.--The term ``at-risk youth'' shall have 
        the meaning given such term in guidelines utilized by the 
        Centers for Disease Control.

SEC. 307. AUTHORIZATION OF APPROPRIATIONS.

    There are authorized to be appropriated to carry out this Act, 
$2,000,000,000 for fiscal year 1996 and such sums as may be necessary 
for each of the fiscal years 1997 through 2000. Of the amounts 
appropriated for each fiscal year--
            (1) 45 percent of such amount shall be made available to 
        carry out title I;
            (2) 45 percent of such amount shall be made available to 
        carry out title II; and
            (3) 10 percent of such amount shall be made available to 
        carry out section 401.

        TITLE IV--FEDERAL COORDINATED YOUTH SERVICES INITIATIVES

SEC. 401. SPECIAL PROJECTS OF A NATIONAL SIGNIFICANCE.

    (a) In General.--The Secretary, acting through the Administrator of 
the Health Resources and Services Administration, shall establish and 
administer a special projects of national significance program to award 
direct grants to public and nonprofit private entities to enable such 
entities to fund model programs designed to integrate health and social 
services, including HIV prevention, provided to special populations at 
risk as defined in subsection (c).
    (b) Grants.--The Secretary shall award grants under subsection (a) 
based on the--
            (1) need to provide health and social services, including 
        HIV prevention services, to meet the special needs of 
        subpopulations of youth living in high risk environments who 
        may otherwise not be provided with assistance under this Act;
            (2) need to assess the effectiveness of a particular 
        prevention or service model or collaboration strategy; and
            (3) potential replicability of the proposed activity in 
        other localities.
    (c) Special Projects.--Special projects of a national significance 
to be funded under subsection (a) may include those projects that are 
designed to target--
            (1) runaway, homeless, or street youth;
            (2) immigrant or migrant youth;
            (3) youth involved in the juvenile justice system;
            (4) youth involved in the foster care system;
            (5) youth involved in gangs;
            (6) youth with a history of substance abuse;
            (7) youth with HIV disease;
            (8) adolescent parents; and
            (9) Native American youth.

SEC. 402. FEDERAL COUNCIL ON CHILDREN, YOUTH, AND FAMILIES.

    Section 918(k) of the Claude Pepper Young Americans Act of 1990 (42 
U.S.C. 12314(k)) is amended--
            (1) in paragraph (6), by striking ``and'' at the end 
        thereof;
            (2) in paragraph (7), by striking the period and inserting 
        ``; and'' and
            (3) by adding at the end the following new paragraph:
            ``(8) make recommendations to the Congress concerning 
        legislative action needed to facilitate the coordination of 
        education, health, and social services for in school and out of 
        school youth.''.

SEC. 403. EVALUATION AND REPORT TO CONGRESS.

    (a) Report to Congress.--The Secretary shall prepare and submit to 
the appropriate committees of Congress a biannual report concerning the 
implementation of this Act. Such report shall include a summary of the 
data provided in the annual reports submitted to the Secretary under 
section 304, and an assessment of the progress achieved by grantees 
under this Act in stabilizing and improving participant outcomes and 
reducing adverse consequences of adolescent risk taking behaviors and 
the absence of necessary services in the communities served under this 
Act.
    (b) Evaluation.--
            (1) In general.--Not later than 54 months after the date of 
        enactment of this Act, the Secretary shall, through the 
        awarding of grants and contracts to independent entities with 
        expertise in adolescent health and youth development, provide 
        an evaluation of the programs funded under this Act to the 
        appropriate committees of Congress. A representative subset of 
        grantees under each title shall be selected with an equitable 
        geographic distribution, and urban and rural representation. 
        The evaluation process shall commence not later than 12 months 
        after the date of enactment of this Act, with data to be 
        collected under subparagraphs (B), (C), (D), and (E), at yearly 
        intervals. The evaluation report shall be conducted by 
        individuals who are not directly involved in the administration 
        of the programs funded under this Act. The final evaluation 
        report shall include--
                    (A) the program goals and objectives identified in 
                the comprehensive services plans of grantees, and the 
                degree to which they reflect the unmet needs and 
                service gaps of the applicant area as delineated in the 
                grant application;
                    (B) what services were provided by grantees under 
                this Act, who the recipients of the services were, and 
                an assessment of whether high risk youth actually 
                received services provided by grantees, including youth 
                who are out of school, runaway or homeless, and 
                adolescent parents;
                    (C) the impact of a comprehensive and coordinated 
                service delivery system on the baseline health and 
                education indices identified in the comprehensive 
                services plan of the grantee, and an identification of 
                other relevant factors affecting the health and 
                education outcomes among target youth in the service 
                delivery area during the grant period;
                    (D) the expansion of services achieved in the 
                service delivery area, both through enhanced planning 
                and coordination of services and the provision of new 
                service capacity;
                    (E) the degree to which increased utilization of 
                services has paralleled service expansion;
                    (F) the process by which broad based input was 
                achieved in the formulation of comprehensive services 
                plans on an ongoing basis;
                    (G) the methods by which coordination of services 
                was undertaken administratively among agencies and 
                providers, the degree to which service coordination was 
                achieved, and the barriers that impeded the 
                coordination of services; and
                    (H) the sustainability of local partnerships, 
                consortia, and State comprehensive service delivery 
                networks at the completion of the Federal grant period.
            (2) Appropriations.--The Secretary shall use amounts made 
        available under section 2711 of the Public Health Service Act 
        to conduct the evaluation under this section.
                                 <all>
HR 1284 IH----2
HR 1284 IH----3
HR 1284 IH----4
HR 1284 IH----5