[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3063 Introduced in House (IH)]






108th CONGRESS
  1st Session
                                H. R. 3063

To authorize the Secretary of Health and Human Services, the Secretary 
      of Education, and the Attorney General to make 10 grants to 
    demonstration facilities to implement evidence-based preventive-
  screening tools to detect mental illness and suicidal tendencies in 
                school-age youth at selected facilities.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 10, 2003

   Ms. DeLauro (for herself, Mr. Waxman, Mr. Serrano, Mr. Towns, Mr. 
   Grijalva, Mrs. Christensen, and Mr. Acevedo-Vila) 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 authorize the Secretary of Health and Human Services, the Secretary 
      of Education, and the Attorney General to make 10 grants to 
    demonstration facilities to implement evidence-based preventive-
  screening tools 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 2003''.

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) According to an interim report by the President's New 
        Freedom Commission on Mental Health, about 7 to 9 percent of 
        all children who are 9 to 17 years of age (about 1 or 2 in 
        every classroom) have a serious emotional disturbance.
            (6) 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.
            (7) 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.
            (8) 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.
            (9) According to an interim report by the President's New 
        Freedom Commission on Mental Health, more than 30,000 lives are 
        lost every year to suicide, which is a largely preventable 
        public health problem.
            (10) 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.
            (11) 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''.
            (12) 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.
            (13) 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.
            (14) 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.
            (15) 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.
            (16) 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''.
            (17) In May 2003, the National Council on Disability noted 
        that ``despite calls for significant prevention and early 
        intervention efforts in schools and the juvenile justice 
        system, there is little evidence that such efforts are 
        widespread''. The Council also found that ``the absence is 
        notable because research suggests that such programming may be 
        the only effective method for reducing the involvement of youth 
        with disabilities in the juvenile justice system''.
            (18) The April 2003 Outline of the Final Report for the 
        President's New Freedom Commission on Mental Health states that 
        ``evidence-based practice interventions should be tested in 
        demonstration projects with oversight by a public-private 
        consortium of stakeholders''.
            (19) An interim report by the President's New Freedom 
        Commission on Mental Health concludes that there is a range of 
        effective treatments, services, and supports to facilitate 
        recovery from mental illness, but the current system can not 
        efficiently deliver them.
            (20) The efforts, initiatives, and activities of the 
        Federal Government should be used to support evidence-based 
        preventive-screening tools 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 
(k)), shall make 10 grants to demonstration facilities to implement 
evidence-based preventive-screening tools to detect mental illness and 
suicidal tendencies in school-age youth and to refer those youth in 
need of assessment or treatment.
    (b) Equitable Geographic Distribution.--To the extent practicable, 
the Secretaries shall ensure an equitable distribution of grants under 
this section among the geographic regions of the United States.
    (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 
                tool 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 tool;
                    (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, and has the ability to train staff--
                            (i) to implement the specified evidence-
                        based screening tool;
                            (ii) to case manage youth with symptoms or 
                        indicators for mental illness, suicidal 
                        ideation, or suicide attempts; and
                            (iii) to work with the parents or guardians 
                        of youth with symptoms or indicators for mental 
                        illness, suicidal ideation, or suicide attempts 
                        to help them understand the youth's outcome and 
                        treatment options;
                    (E) identify the location (which need not be at the 
                facility) where the specified evidence-based 
                preventive-screening tool 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;
                    (H) identify a method for obtaining written consent 
                from the parent or legal guardian of any minor 
                participating in the demonstration project;
                    (I) identify licensed mental health providers 
                (including mental health professionals, hospitals, 
                residential treatment centers, or outpatient clinics) 
                in the community where the facility is located that 
                will partner with the facility to provide further 
                mental health assessments and treatment for 
                participating youth with symptoms or indicators of 
                mental illness, and demonstrate the ability of those 
                providers to accept referrals; and
                    (J) contain such other information as the 
                Secretaries reasonably require.
    (e) Multidisciplinary Project Implementation Committee.--The 
Secretaries may not make a grant to a demonstration facility under 
subsection (a) for a demonstration project unless the facility agrees 
to the following:
            (1) The multidisciplinary project implementation committee 
        formed under subsection (d)(2)(A) will consist of the 
        following:
                    (A) Representatives of the facility.
                    (B) Representatives of the location where the 
                specified evidence-based preventive screening tool will 
                be implemented (if that location is other than the 
                demonstration facility).
                    (C) A facility case manager (as that position is 
                described in subsection (d)(2)(D)(ii)).
                    (D) Mental health providers in the community.
                    (E) Mental health consumers or family members of 
                mental health consumers.
                    (F) Parents or guardians of any school-aged youth 
                to be screened.
            (2) When possible, the multidisciplinary project 
        implementation committee will follow the guidance of any 
        suicide prevention plan endorsed by State or local government 
        officials or local public health officials.
            (3) The multidisciplinary project implementation committee 
        will be responsible for ensuring compliance with the 
        representations made by the facility in its grant application.
            (4) The multidisciplinary project implementation committee 
        will coordinate and collaborate with mental health providers in 
        the community, including those identified in subsection 
        (d)(2)(I), to guarantee that all youth with symptoms or 
        indicators for mental illness, suicidal ideation, or suicide 
        attempts receive appropriate and affordable treatment 
        regardless of the financial or insurance status of the youth's 
        parent or guardian.
    (f) 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 invited to participate in 
                the project, including the number of such youth 
                disaggregated by age, gender, and ethnicity; and
                    (B) the number of youth with symptoms or indicators 
                for mental illness requiring clinical consultation or 
                assessment, including such number disaggregated by 
                disorder.
            (2) Information on the outcomes of evidence-based 
        preventive-screening tools, 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 symptoms or indicators 
                for all mental illnesses, including such number 
                disaggregated by disorder; and
                    (C) post assessment, the number of youth with 
                positive outcomes for suicidal ideation or suicide 
                attempts.
            (3) Information on referrals based on outcomes, including--
                    (A) the number of youth referred for clinical 
                interviews to determine the 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) To the extent practicable, information on treatment 
        based on referrals, including the number of appointments kept 
        by referred youth.
            (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 in the designated jurisdiction in which the grantee 
        is located for the 3 years preceding the commencement of the 
        project.
            (6) To the extent practicable, data on barriers to care 
        encountered by referred youth, including but not limited to 
        linguistic barriers, transportation difficulties, lack of 
        providers in the community, or lack of insurance.
            (7) Such additional information as the Secretaries 
        reasonably require.
    (g) 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 
(f) to the Secretaries as follows:
            (1) Information collected under paragraphs (1), (2), (3), 
        (4), (6), (7), and (8) of subsection (f) 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 (f) shall be reported not later than the date that 
        is 6 months after commencement of the demonstration project.
    (h) 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 (f)(5).
    (i) 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 (f) and (g), respectively; and
                    (B) submit recommendations to each of the 
                Secretaries on the use or improvement of evidence-based 
                preventive-screening tools 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.
    (j) 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 (f) and (g), respectively, and shall include 
the evaluation and recommendations of the advisory panel.
    (k) Definitions.--In this section:
            (1) Advisory panel.--The term ``advisory panel'' means the 
        advisory panel convened under subsection (i).
            (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, youth residential 
        treatment center, or State or local mental health organization.
            (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 tool.--The term 
        ``evidence-based preventive-screening tool'' means a 
        preventive-screening tool 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.
    (l) Authorization of Appropriations.--There are authorized to be 
appropriated to the Secretaries to carry out this section $7,500,000 
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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