[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5613 Introduced in House (IH)]






107th CONGRESS
  2d Session
                                H. R. 5613

   To establish a demonstration project to implement evidence-based 
  preventive-screening methods to detect mental illness and suicidal 
         tendencies in school-age youth at selected facilities.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            October 10, 2002

 Ms. DeLauro introduced the following bill; which was referred to the 
 Committee on Energy and Commerce, and in addition to the Committee on 
Education and the Workforce, 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 committee concerned

_______________________________________________________________________

                                 A BILL


 
   To establish a demonstration project to implement evidence-based 
  preventive-screening methods to detect mental illness and suicidal 
         tendencies in school-age youth at selected facilities.

    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 ``Children's Mental Health Screening 
and Prevention Act of 2002''.

SEC. 2. FINDINGS.

     The Congress finds as follows:
            (1) Over the past 20 years, advances in scientific research 
        have changed the way of thinking about children's mental health 
        and proven that the same mental disorders that afflict adults 
        can also occur in children and adolescents.
            (2) In January 2001, the Report of the Surgeon General's 
        Conference on Children's Mental Health noted that 74 percent of 
        individuals age 21 with mental disorders had prior problems, 
        indicating that children's mental disorders often persist into 
        adulthood.
            (3) Scientific research has demonstrated that early 
        identification and treatment of mental disorders in youth 
        greatly improves a child or adolescent's prognosis throughout 
        his or her lifetime.
            (4) In January 2001, the Surgeon General noted that, while 
        1 in 10 children and adolescents in the United States suffers 
        from mental illness severe enough to cause some level of 
        impairment, only 1 in 5 of such children and adolescents 
        receives needed mental health treatment.
            (5) In September 2002, the National Council on Disability 
        noted that between 60 and 70 percent of youth in the juvenile 
        justice system have an emotional disturbance and almost 50 
        percent have co-occurring disabilities.
            (6) The World Health Organization has reported that youth 
        neuropsychiatric disorders will rise by over 50 percent by 
        2020, making such disorders 1 of the top 5 causes of 
        disability, morbidity, and mortality among children and 
        adolescents.
            (7) Psychological autopsy studies have found that 90 
        percent of youths who end their own lives have depression or 
        another diagnosable mental or substance abuse disorder at the 
        time of their deaths, verifying a link between mental illness 
        and suicide.
            (8) In 1999, the Surgeon General recognized that mental 
        illness and substance abuse disorders are, in fact, the 
        greatest risk factors for suicidal behavior, and that properly 
        identifying and treating mental illness and substance abuse 
        disorders are an important part of suicide prevention 
        activities.
            (9) The National Council on Disability has also stated that 
        ``the failure to identify and treat mental disabilities between 
        children and youth has serious consequences, including school 
        failure, involvement with the justice system and other tragic 
        outcomes,'' including ``the growing problem of teen suicides 
        and/or suicide attempts''.
            (10) The Centers for Disease Control and Prevention 
        reported that in 2000 suicide was the 3rd leading cause of 
        death among youth 15 to 24 years of age.
            (11) The Substance Abuse and Mental Health Services 
        Administration reported that in 1999 almost 3,000,000 youth 
        were at risk for suicide, but only 36 percent received mental 
        health treatment.
            (12) According to the Youth Risk Behavior Surveillance 
        System of the Centers for Disease Control and Prevention, among 
        high school students surveyed in 2001, 19 percent had seriously 
        considered attempting suicide, almost 15 percent had made a 
        specific plan to attempt suicide, almost 9 percent had 
        attempted suicide, and almost 3 percent had made an attempt at 
        suicide that required medical attention.
            (13) The Centers for Disease Control and Prevention 
        reported that each year in the United States, almost as many 
        adolescents and young adults commit suicide as die from all 
        natural causes combined, including leukemia, birth defects, 
        pneumonia, influenza, and AIDS.
            (14) In January 2001, the Surgeon General issued a goal to 
        ``improve the assessment of and recognition of mental health 
        needs in children'' in part by encouraging ``early 
        identification of mental health needs in existing preschool, 
        child care, education, health, welfare, juvenile justice, and 
        substance abuse treatment systems''.
            (15) Toward that end, the efforts, initiatives, and 
        activities of the Federal Government should be used to support 
        evidence-based preventive-screening methods to detect mental 
        illness and suicidal tendencies in school-age youth.

SEC. 3. MENTAL HEALTH SCREENING DEMONSTRATION PROJECT.

    (a) In General.--The Secretary of Health and Human Services, the 
Secretary of Education, and the Attorney General, acting jointly and in 
consultation with the Directors (as that term is defined in subsection 
(j)), shall make a grant to 1 demonstration facility in each of the 10 
demonstration areas (designated under subsection (b)) to implement 
evidence-based preventive-screening methods to detect mental illness 
and suicidal tendencies in school-age youth.
    (b) Designation of Demonstration Areas.--
            (1) Designation.--Not later than 6 months after the date of 
        enactment of this Act, the Secretaries, in consultation with 
        the Directors, shall designate 10 demonstration areas for 
        purposes of making grants under this section.
            (2) Inclusion of certain areas.--The Secretaries shall 
        include in the demonstration areas designated under paragraph 
        (1) at least 1 of each of the following:
                    (A) An urban area that is eligible for designation 
                under section 332 of the Public Health Service Act (42 
                U.S.C. 254e) as a health professional shortage area.
                    (B) An area that has a shortage of mental health 
                professionals.
                    (C) An area in a county that is not included in any 
                standard metropolitan statistical area.
                    (D) An area in a county that is included in a 
                standard metropolitan statistical area.
                    (E) An area that is located in an Indian 
                reservation.
    (c) Period of Grants.--Each grant made under subsection (a) shall 
be for a period of 3 years.
    (d) Application Requirements.--
            (1) In general.--To seek a grant under this section, a 
        demonstration facility shall submit an application at such time 
        and in such manner as the Secretaries reasonably require.
            (2) Contents.--An application submitted by a demonstration 
        facility for a grant under subsection (a) shall--
                    (A) demonstrate that the facility has formed a 
                multidisciplinary project implementation committee;
                    (B) specify an evidence-based preventive-screening 
                method to be implemented with the grant;
                    (C) demonstrate that the facility has the means to 
                obtain the necessary resources and tools, other than 
                personnel, to implement the specified evidence-based 
                preventive-screening method;
                    (D) demonstrate that the facility has existing 
                staff, will hire new staff, or will partner with staff 
                from a local, licensed mental health or medical 
                organization to conduct the specified evidence-based 
                screening method, and that such staff will include at 
                least 1 licensed mental health professional with a 
                minimum of a master's degree in a mental health 
                discipline;
                    (E) identify the location (which need not be at the 
                facility) where the specified evidence-based 
                preventive-screening method will be implemented;
                    (F) demonstrate that the facility has obtained full 
                approval to screen at such location;
                    (G) identify the sample of school-age youth to be 
                screened with the specified evidence-based preventive-
                screening method;
                    (H) identify a method for obtaining written consent 
                from the parent or legal guardian of any minor taking 
                part in the specified evidence-based preventive-
                screening method;
                    (I) identify, for the purpose of determining the 
                ability of the facility to case manage treatment for 
                participating youth, the capacity of licensed 
                individuals or entities offering mental health care 
                (including any such mental health professionals, 
                hospitals, residential treatment centers, and 
                outpatient clinics) to accept referral of individuals 
                for further mental health evaluation and treatment--
                            (i) within 10 miles of the location 
                        identified under subparagraph (E); and
                            (ii) within 40 miles of such location; and
                    (J) contain such other information as the 
                Secretaries reasonably require.
    (e) Information Collection.--The Secretaries may not make a grant 
to an applicant under subsection (a) for a demonstration project unless 
the applicant agrees to collect the following:
            (1) Information on the demographics of youth participating 
        in the project, including--
                    (A) the number of youth solicited to participate in 
                the project, including the number of such youth 
                disaggregated by age, gender, and ethnicity; and
                    (B) the number of youth actually participating in 
                the project, including the number of such youth 
                disaggregated by age, gender, and ethnicity.
            (2) Information on the outcomes of evidence-based 
        preventive-screening methods, including--
                    (A) the number of screening refusals, due to lack 
                of consent by a parent or legal guardian or refusal of 
                the youth;
                    (B) the number of youth with positive outcomes for 
                all mental illnesses, including such number 
                disaggregated by disorder;
                    (C) the number of youth with positive outcomes for 
                suicidal ideation; and
                    (D) the number of youth with positive outcomes for 
                suicide attempts.
            (3) Information on referrals based on outcomes, including--
                    (A) the number of youth referred for clinical 
                interviews to determine need for further evaluation or 
                treatment;
                    (B) the number of youth referred for further 
                evaluation or treatment, including such number 
                disaggregated by type and location of treatment;
                    (C) the number of youth and their parents or legal 
                guardians who accept referrals for further evaluation 
                or treatment; and
                    (D) the number of youth and their parents or legal 
                guardians who refuse referrals for further evaluation 
                or treatment.
            (4) Information on treatment based on referrals, 
        including--
                    (A) the number of referred youth who accepted a 
                referral but did not show up for the first evaluation 
                or treatment appointment;
                    (B) the number of referred youth who attended 1 
                appointment;
                    (C) the number of referred youth who attended 2 to 
                5 appointments;
                    (D) the number of referred youth who attended 6 to 
                10 appointments; and
                    (E) the number of referred youth who attended more 
                than 10 appointments.
            (5) To the extent practicable, information on suicide 
        attempts, suicide rates, and access to evidence-based mental 
        health screening and suicide prevention programs among school-
        age youth for the 3 years preceding the commencement of the 
        project.
            (6) Such additional information as the Secretaries 
        reasonably require.
    (f) Information Reporting.--The Secretaries may not make a grant to 
an applicant under subsection (a) for a demonstration project unless 
the applicant agrees to report information collected under subsection 
(e) to the Secretaries as follows:
            (1) Information collected under paragraphs (1), (2), (3), 
        (4), and (6) of subsection (e) shall be reported--
                    (A) not later than the date that is 2 months after 
                completion of the 1st year of the project;
                    (B) not later than the date that is 2 months after 
                completion of the 2nd year of the project; and
                    (C) not later than the date that is 2 months after 
                completion of the 3rd year of the project.
            (2) Any information collected under paragraph (5) of 
        subsection (e) shall be reported not later than the date that 
        is 6 months after commencement of the demonstration project.
    (g) Feasibility of Collecting Information on Preceding Years.--In 
making grants under subsection (a), the Secretaries may not 
discriminate against an applicant because it will not be practicable, 
owing to insufficient funds or otherwise, for the applicant to collect 
information under subsection (e)(5).
    (h) Advisory Panel.--
            (1) Establishment.--Not later than 14 months after making 
        the first grant under subsection (a), the Secretaries shall 
        convene an advisory panel.
            (2) Duties.--The advisory panel shall--
                    (A) assist in the review and evaluation of the 
                information collected and reported pursuant to 
                subsections (e) and (f), respectively; and
                    (B) submit recommendations to each of the 
                Secretaries on the use or improvement of evidence-based 
                preventive-screening methods to detect mental illness 
                and suicidal tendencies in school-age youth.
            (3) Membership.--The advisory panel shall consist of not 
        more than 20 members, and the members shall represent the 
        following:
                    (A) National or local organizations representing 
                for-profit and nonprofit mental health care treatment 
                facilities.
                    (B) National or local organizations representing 
                mental health care professionals.
                    (C) National or local organizations representing 
                mental health care consumers.
                    (D) National or local organizations representing 
                school-based mental health care professionals.
                    (E) National or local organizations dedicated to 
                school-based health care.
                    (F) National or local organizations representing 
                school administrators.
                    (G) National or local organizations representing 
                school boards and school board members.
                    (H) National or local organizations representing 
                juvenile justice professionals.
                    (I) National or local organizations dedicated to 
                juvenile justice.
                    (J) National or local organizations representing 
                foster care professionals.
                    (K) National or local organizations dedicated to 
                foster care.
                    (L) National or local organizations dedicated to 
                child welfare.
                    (M) Accredited child and adolescent psychiatric 
                programs at national medical colleges and universities.
                    (N) Any other entities or individuals that the 
                Secretaries deem appropriate.
    (i) Report.--Not later than 6 months after the end of the 3-year 
grant period for the last grant made under subsection (a), the 
Secretaries, in consultation with the Directors and the advisory panel, 
shall submit to the Congress a report on the grants made under this 
section. Such report shall be based on the information collected and 
reported under subsections (e) and (f), respectively, and shall include 
the evaluation and recommendations of the advisory panel.
    (j) Definitions.--In this section:
            (1) Advisory panel.--The term ``advisory panel'' means the 
        advisory panel convened under subsection (h).
            (2) Demonstration facility.--The term ``demonstration 
        facility'' means a facility that serves at-risk youth or 
        performs outreach to school-age youth, including any elementary 
        school, secondary school, school-based health center, juvenile 
        justice facility, foster care setting, homeless shelter, youth 
        drop-in center, youth outreach organization, or youth 
        residential treatment center.
            (3) Directors.--The term ``Directors'' means the 
        Administrator of the Health Resources and Services 
        Administration, the Administrator of the Substance Abuse and 
        Mental Health Services Administration, the Director of the 
        Centers for Disease Control and Prevention, the Director of the 
        Indian Health Service, and the Director of the National 
        Institute of Mental Health.
            (4) Elementary school; secondary school.--The terms 
        ``elementary school'' and ``secondary school'' have the 
        meanings given those terms in section 9101 of the Elementary 
        and Secondary Education Act (20 U.S.C. 7801).
            (5) Evidence-based preventive-screening method.--The term 
        ``evidence-based preventive-screening method'' means a 
        preventive-screening method that has been shown to be valid and 
        effective through research that is conducted by independent 
        scientific teams, is determined by well-regarded scientists to 
        be of high quality, and meets the quality standards for 
        publication in scientific peer-reviewed journals.
            (6) School-age youth.--The term ``school-age youth'' means 
        an individual who is 6 to 18 years of age, or who is enrolled 
        in any elementary school or secondary school.
            (7) Secretaries.--The term ``Secretaries'' means the 
        Secretary of Health and Human Services, the Secretary of 
        Education, and the Attorney General, acting jointly.
    (k) Authorization of Appropriations.--There are authorized to be 
appropriated to the Secretaries to carry out this section $3,000,000 
for each of fiscal years 2004 through 2006, and such sums as may be 
necessary thereafter, to remain available until expended.
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