[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[S. 2634 Enrolled Bill (ENR)]
S.2634
One Hundred Eighth Congress
of the
United States of America
AT THE SECOND SESSION
Begun and held at the City of Washington on Tuesday,
the twentieth day of January, two thousand and four
An Act
To amend the Public Health Service Act to support the planning,
implementation, and evaluation of organized activities involving
statewide youth suicide early intervention and prevention strategies, to
authorize grants to institutions of higher education to reduce student
mental and behavioral health problems, 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 ``Garrett Lee Smith Memorial Act''.
SEC. 2. FINDINGS.
Congress makes the following findings:
(1) More children and young adults die from suicide each year
than from cancer, heart disease, AIDS, birth defects, stroke, and
chronic lung disease combined.
(2) Over 4,000 children and young adults tragically take their
lives every year, making suicide the third overall cause of death
between the ages of 10 and 24. According to the Centers for Disease
Control and Prevention, suicide is the third overall cause of death
among college-age students.
(3) According to the National Center for Injury Prevention and
Control of the Centers for Disease Control and Prevention, children
and young adults accounted for 15 percent of all suicides completed
in 2000.
(4) From 1952 to 1995, the rate of suicide in children and
young adults tripled.
(5) From 1980 to 1997, the rate of suicide among young adults
ages 15 to 19 increased 11 percent.
(6) From 1980 to 1997, the rate of suicide among children ages
10 to 14 increased 109 percent.
(7) According to the National Center of Health Statistics,
suicide rates among Native Americans range from 1.5 to 3 times the
national average for other groups, with young people ages 15 to 34
making up 64 percent of all suicides.
(8) Congress has recognized that youth suicide is a public
health tragedy linked to underlying mental health problems and that
youth suicide early intervention and prevention activities are
national priorities.
(9) Youth suicide early intervention and prevention have been
listed as urgent public health priorities by the President's New
Freedom Commission in Mental Health (2002), the Institute of
Medicine's Reducing Suicide: A National Imperative (2002), the
National Strategy for Suicide Prevention: Goals and Objectives for
Action (2001), and the Surgeon General's Call to Action To Prevent
Suicide (1999).
(10) Many States have already developed comprehensive statewide
youth suicide early intervention and prevention strategies that
seek to provide effective early intervention and prevention
services.
(11) In a recent report, a startling 85 percent of college
counseling centers revealed an increase in the number of students
they see with psychological problems. Furthermore, the American
College Health Association found that 61 percent of college
students reported feeling hopeless, 45 percent said they felt so
depressed they could barely function, and 9 percent felt suicidal.
(12) There is clear evidence of an increased incidence of
depression among college students. According to a survey described
in the Chronicle of Higher Education (February 1, 2002), depression
among freshmen has nearly doubled (from 8.2 percent to 16.3
percent). Without treatment, researchers recently noted that
``depressed adolescents are at risk for school failure, social
isolation, promiscuity, self-medication with drugs and alcohol, and
suicide--now the third leading cause of death among 10-24 year
olds.''.
(13) Researchers who conducted the study ``Changes in
Counseling Center Client Problems Across 13 Years'' (1989-2001) at
Kansas State University stated that ``students are experiencing
more stress, more anxiety, more depression than they were a decade
ago.'' (The Chronicle of Higher Education, February 14, 2003).
(14) According to the 2001 National Household Survey on Drug
Abuse, 20 percent of full-time undergraduate college students use
illicit drugs.
(15) The 2001 National Household Survey on Drug Abuse also
reported that 18.4 percent of adults aged 18 to 24 are dependent on
or abusing illicit drugs or alcohol. In addition, the study found
that ``serious mental illness is highly correlated with substance
dependence or abuse. Among adults with serious mental illness in
2001, 20.3 percent were dependent on or abused alcohol or illicit
drugs, while the rate among adults without serious mental illness
was only 6.3 percent.''.
(16) A 2003 Gallagher's Survey of Counseling Center Directors
found that 81 percent were concerned about the increasing number of
students with more serious psychological problems, 67 percent
reported a need for more psychiatric services, and 63 percent
reported problems with growing demand for services without an
appropriate increase in resources.
(17) The International Association of Counseling Services
accreditation standards recommend 1 counselor per 1,000 to 1,500
students. According to the 2003 Gallagher's Survey of Counseling
Center Directors, the ratio of counselors to students is as high as
1 counselor per 2,400 students at institutions of higher education
with more than 15,000 students.
SEC. 3. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT.
(a) Youth Interagency Research, Training, and Technical Assistance
Centers.--Section 520C of the Public Health Service Act (42 U.S.C.
290bb-34) is amended--
(1) in subsection (a)--
(A) by striking ``Health, shall award grants'' and
inserting ``Health--
``(1) shall award grants'';
(B) by striking the period at the end and inserting ``;
and''; and
(C) by adding at the end the following:
``(2) shall award a competitive grant to 1 additional research,
training, and technical assistance center to carry out the
activities described in subsection (d).'';
(2) in subsection (c), in the matter preceding paragraph (1),
by striking ``grant or contract under subsection (a)'' and
inserting ``grant or contract under subsection (a)(1)'';
(3) in subsection (d)--
(A) by striking ``Appropriations.--For the purpose of
carrying out this section'' and inserting ``Appropriations.--
``(1) For the purpose of awarding grants or contracts under
subsection (a)(1)''; and
(B) by adding at the end the following:
``(2) For the purpose of awarding a grant under subsection
(a)(2), there are authorized to be appropriated $3,000,000 for
fiscal year 2005, $4,000,000 for fiscal year 2006, and $5,000,000
for fiscal year 2007.'';
(4) by redesignating subsection (d) as subsection (e); and
(5) by inserting after subsection (c) the following:
``(d) Additional Center.--The additional research, training, and
technical assistance center established under subsection (a)(2) shall
provide appropriate information, training, and technical assistance to
States, political subdivisions of a State, Federally recognized Indian
tribes, tribal organizations, institutions of higher education, public
organizations, or private nonprofit organizations for--
``(1) the development or continuation of statewide or tribal
youth suicide early intervention and prevention strategies;
``(2) ensuring the surveillance of youth suicide early
intervention and prevention strategies;
``(3) studying the costs and effectiveness of statewide youth
suicide early intervention and prevention strategies in order to
provide information concerning relevant issues of importance to
State, tribal, and national policymakers;
``(4) further identifying and understanding causes and
associated risk factors for youth suicide;
``(5) analyzing the efficacy of new and existing youth suicide
early intervention techniques and technology;
``(6) ensuring the surveillance of suicidal behaviors and
nonfatal suicidal attempts;
``(7) studying the effectiveness of State-sponsored statewide
and tribal youth suicide early intervention and prevention
strategies on the overall wellness and health promotion strategies
related to suicide attempts;
``(8) promoting the sharing of data regarding youth suicide
with Federal agencies involved with youth suicide early
intervention and prevention, and State-sponsored statewide or
tribal youth suicide early intervention and prevention strategies
for the purpose of identifying previously unknown mental health
causes and associated risk factors for suicide in youth;
``(9) evaluating and disseminating outcomes and best practices
of mental and behavioral health services at institutions of higher
education; and
``(10) other activities determined appropriate by the
Secretary.''.
(b) Suicide Prevention for Youth.--Title V of the Public Health
Service Act (42 U.S.C. 290aa et seq.) is amended--
(1) in section 520E (42 U.S.C. 290bb-36)--
(A) in the section heading by striking ``CHILDREN AND
ADOLESCENTS'' and inserting ``YOUTH'';
(B) by striking subsection (a) and inserting the following:
``(a) In General.--The Secretary shall award grants or
cooperative agreements to public organizations, private nonprofit
organizations, political subdivisions, consortia of political
subdivisions, consortia of States, or Federally recognized Indian
tribes or tribal organizations to design early intervention and
prevention strategies that will complement the State-sponsored
statewide or tribal youth suicide early intervention and prevention
strategies developed pursuant to section 520E.'';
(C) in subsection (b), by striking all after
``coordinated'' and inserting ``with the relevant Department of
Health and Human Services agencies and suicide working
groups.'';
(D) in subsection (c)--
(i) in the matter preceding paragraph (1), by striking
``A State'' and all that follows through ``desiring'' and
inserting ``A public organization, private nonprofit
organization, political subdivision, consortium of
political subdivisions, consortium of States, or federally
recognized Indian tribe or tribal organization desiring'';
(ii) by redesignating paragraphs (1) through (9) as
paragraphs (2) through (10), respectively;
(iii) by inserting before paragraph (2) (as so
redesignated) the following:
``(1)(A) comply with the State-sponsored statewide early
intervention and prevention strategy as developed under section
520E; and
``(B) in the case of a consortium of States, receive the
support of all States involved;'';
(iv) in paragraph (2) (as so redesignated), by striking
``children and adolescents'' and inserting ``youth'';
(v) in paragraph (3) (as so redesignated), by striking
``best evidence-based,'';
(vi) in paragraph (4) (as so redesignated), by striking
``primary'' and all that follows and inserting ``general,
mental, and behavioral health services, and substance abuse
services;'';
(vii) in paragraph (5) (as so redesignated), by
striking ``children and'' and all that follows and
inserting ``youth including the school systems, educational
institutions, juvenile justice system, substance abuse
programs, mental health programs, foster care systems, and
community child and youth support organizations;'';
(viii) by striking paragraph (8) (as so redesignated)
and inserting the following:
``(8) offer access to services and care to youth with diverse
linguistic and cultural backgrounds;''; and
(ix) by striking paragraph (9) (as so redesignated) and
inserting the following:
``(9) conduct annual self-evaluations of outcomes and
activities, including consulting with interested families and
advocacy organizations;'';
(E) by striking subsection (d) and inserting the following:
``(d) Use of Funds.--Amounts provided under a grant or cooperative
agreement under this section shall be used to supplement, and not
supplant, Federal and non-Federal funds available for carrying out the
activities described in this section. Applicants shall provide
financial information to demonstrate compliance with this section.'';
(F) in subsection (e)--
(i) by striking ``, contract,''; and
(ii) by inserting after ``Secretary that the'' the
following: ``application complies with the State-sponsored
statewide early intervention and prevention strategy as
developed under section 520E and the'';
(G) in subsection (f), by striking ``, contracts,'';
(H) in subsection (g)--
(i) by striking ``A State'' and all that follows
through ``organization receiving'' and inserting ``A public
organization, private nonprofit organization, political
subdivision, consortium of political subdivisions,
consortium of States, or Federally recognized Indian tribe
or tribal organization receiving''; and
(ii) by striking ``, contract,'' each place such term
appears;
(I) in subsection (h), by striking ``, contracts,'';
(J) in subsection (i)--
(i) by striking ``A State'' and all that follows
through ``organization receiving'' and inserting ``A public
organization, private nonprofit organization, political
subdivision, consortium of political subdivisions,
consortium of States, or Federally recognized Indian tribe
or tribal organization receiving''; and
(ii) by striking ``, contract,'';
(K) in subsection (k), by striking ``5 years'' and
inserting ``3 years'';
(L) in subsection (l)--
(i) in paragraph (2), by striking ``21'' and inserting
``24''; and
(ii) in paragraph (3), by striking ``which might have
been'';
(M) in subsection (m)--
(i) by striking ``Appropriation.--'' and all that
follows through ``For'' in paragraph (1) and inserting
``Appropriation.--For''; and
(ii) by striking paragraph (2);
(N) by redesignating subsection (m) as subsection (n); and
(O) by inserting after subsection (l) the following:
``(m) Definitions.--In this section, the terms `early
intervention', `educational institution', `institution of higher
education', `prevention', `school', and `youth' have the meanings given
to those terms in section 520E.''; and
(2) by redesignating section 520E as section 520E-1.
(c) Youth Suicide and Early Intervention and Prevention
Strategies.--Title V of the Public Health Service Act (42 U.S.C. 290aa
et seq.) is amended by inserting before section 520E-1 (as redesignated
by subsection (b)) the following:
``SEC. 520E. YOUTH SUICIDE EARLY INTERVENTION AND PREVENTION
STRATEGIES.
``(a) In General.--The Secretary, acting through the Administrator
of the Substance Abuse and Mental Health Services
Administration, shall award grants or cooperative agreements to
eligible entities to--
``(1) develop and implement State-sponsored statewide or tribal
youth suicide early intervention and prevention strategies in
schools, educational institutions, juvenile justice systems,
substance abuse programs, mental health programs, foster care
systems, and other child and youth support organizations;
``(2) support public organizations and private nonprofit
organizations actively involved in State-sponsored statewide or
tribal youth suicide early intervention and prevention strategies
and in the development and continuation of State-sponsored
statewide youth suicide early intervention and prevention
strategies;
``(3) provide grants to institutions of higher education to
coordinate the implementation of State-sponsored statewide or
tribal youth suicide early intervention and prevention strategies;
``(4) collect and analyze data on State-sponsored statewide or
tribal youth suicide early intervention and prevention services
that can be used to monitor the effectiveness of such services and
for research, technical assistance, and policy development; and
``(5) assist eligible entities, through State-sponsored
statewide or tribal youth suicide early intervention and prevention
strategies, in achieving targets for youth suicide reductions under
title V of the Social Security Act.
``(b) Eligible Entity.--
``(1) Definition.--In this section, the term `eligible entity'
means--
``(A) a State;
``(B) a public organization or private nonprofit
organization designated by a State to develop or direct the
State-sponsored statewide youth suicide early intervention and
prevention strategy; or
``(C) a Federally recognized Indian tribe or tribal
organization (as defined in the Indian Self-Determination and
Education Assistance Act) or an urban Indian organization (as
defined in the Indian Health Care Improvement Act) that is
actively involved in the development and continuation of a
tribal youth suicide early intervention and prevention
strategy.
``(2) Limitation.--In carrying out this section, the Secretary
shall ensure that each State is awarded only 1 grant or cooperative
agreement under this section. For purposes of the preceding
sentence, a State shall be considered to have been awarded a grant
or cooperative agreement if the eligible entity involved is the
State or an entity designated by the State under paragraph (1)(B).
Nothing in this paragraph shall be construed to apply to entities
described in paragraph (1)(C).
``(c) Preference.--In providing assistance under a grant or
cooperative agreement under this section, an eligible entity shall give
preference to public organizations, private nonprofit organizations,
political subdivisions, institutions of higher education, and tribal
organizations actively involved with the State-sponsored statewide or
tribal youth suicide early intervention and prevention strategy that--
``(1) provide early intervention and assessment services,
including screening programs, to youth who are at risk for mental
or emotional disorders that may lead to a suicide attempt, and that
are integrated with school systems, educational institutions,
juvenile justice systems, substance abuse programs, mental health
programs, foster care systems, and other child and youth support
organizations;
``(2) demonstrate collaboration among early intervention and
prevention services or certify that entities will engage in future
collaboration;
``(3) employ or include in their applications a commitment to
evaluate youth suicide early intervention and prevention practices
and strategies adapted to the local community;
``(4) provide timely referrals for appropriate community-based
mental health care and treatment of youth who are at risk for
suicide in child-serving settings and agencies;
``(5) provide immediate support and information resources to
families of youth who are at risk for suicide;
``(6) offer access to services and care to youth with diverse
linguistic and cultural backgrounds;
``(7) offer appropriate postsuicide intervention services,
care, and information to families, friends, schools, educational
institutions, juvenile justice systems, substance abuse programs,
mental health programs, foster care systems, and other child and
youth support organizations of youth who recently completed
suicide;
``(8) offer continuous and up-to-date information and awareness
campaigns that target parents, family members, child care
professionals, community care providers, and the general public and
highlight the risk factors associated with youth suicide and the
life-saving help and care available from early intervention and
prevention services;
``(9) ensure that information and awareness campaigns on youth
suicide risk factors, and early intervention and prevention
services, use effective communication mechanisms that are targeted
to and reach youth, families, schools, educational institutions,
and youth organizations;
``(10) provide a timely response system to ensure that child-
serving professionals and providers are properly trained in youth
suicide early intervention and prevention strategies and that
child-serving professionals and providers involved in early
intervention and prevention services are properly trained in
effectively identifying youth who are at risk for suicide;
``(11) provide continuous training activities for child care
professionals and community care providers on the latest youth
suicide early intervention and prevention services practices and
strategies;
``(12) conduct annual self-evaluations of outcomes and
activities, including consulting with interested families and
advocacy organizations;
``(13) provide services in areas or regions with rates of youth
suicide that exceed the national average as determined by the
Centers for Disease Control and Prevention; and
``(14) obtain informed written consent from a parent or legal
guardian of an at-risk child before involving the child in a youth
suicide early intervention and prevention program.
``(d) Requirement for Direct Services.--Not less than 85 percent of
grant funds received under this section shall be used to provide direct
services, of which not less than 5 percent shall be used for activities
authorized under subsection (a)(3).
``(e) Coordination and Collaboration.--
``(1) In general.--In carrying out this section, the Secretary
shall collaborate with relevant Federal agencies and suicide
working groups responsible for early intervention and prevention
services relating to youth suicide.
``(2) Consultation.--In carrying out this section, the
Secretary shall consult with--
``(A) State and local agencies, including agencies
responsible for early intervention and prevention services
under title XIX of the Social Security Act, the State
Children's Health Insurance Program under title XXI of the
Social Security Act, and programs funded by grants under title
V of the Social Security Act;
``(B) local and national organizations that serve youth at
risk for suicide and their families;
``(C) relevant national medical and other health and
education specialty organizations;
``(D) youth who are at risk for suicide, who have survived
suicide attempts, or who are currently receiving care from
early intervention services;
``(E) families and friends of youth who are at risk for
suicide, who have survived suicide attempts, who are currently
receiving care from early intervention and prevention services,
or who have completed suicide;
``(F) qualified professionals who possess the specialized
knowledge, skills, experience, and relevant attributes needed
to serve youth at risk for suicide and their families; and
``(G) third-party payers, managed care organizations, and
related commercial industries.
``(3) Policy development.--In carrying out this section, the
Secretary shall--
``(A) coordinate and collaborate on policy development at
the Federal level with the relevant Department of Health and
Human Services agencies and suicide working groups; and
``(B) consult on policy development at the Federal level
with the private sector, including consumer, medical, suicide
prevention advocacy groups, and other health and education
professional-based organizations, with respect to State-
sponsored statewide or tribal youth suicide early intervention
and prevention strategies.
``(f) Rule of Construction; Religious and Moral Accommodation.--
Nothing in this section shall be construed to require suicide
assessment, early intervention, or treatment services for youth whose
parents or legal guardians object based on the parents' or legal
guardians' religious beliefs or moral objections.
``(g) Evaluations and Report.--
``(1) Evaluations by eligible entities.--Not later than 18
months after receiving a grant or cooperative agreement under this
section, an eligible entity shall submit to the Secretary the
results of an evaluation to be conducted by the entity concerning
the effectiveness of the activities carried out under the grant or
agreement.
``(2) Report.--Not later than 2 years after the date of
enactment of this section, the Secretary shall submit to the
appropriate committees of Congress a report concerning the results
of--
``(A) the evaluations conducted under paragraph (1); and
``(B) an evaluation conducted by the Secretary to analyze
the effectiveness and efficacy of the activities conducted with
grants, collaborations, and consultations under this section.
``(h) Rule of Construction; Student Medication.--Nothing in this
section or section 520E-1 shall be construed to allow school personnel
to require that a student obtain any medication as a condition of
attending school or receiving services.
``(i) Prohibition.--Funds appropriated to carry out this section,
section 520C, section 520E-1, or section 520E-2 shall not be used to
pay for or refer for abortion.
``(j) Parental consent.--States and entities receiving funding
under this section and section 520E-1 shall obtain prior written,
informed consent from the child's parent or legal guardian for
assessment services, school-sponsored programs, and treatment involving
medication related to youth suicide conducted in elementary and
secondary schools. The requirement of the preceding sentence does not
apply in the following cases:
``(1) In an emergency, where it is necessary to protect the
immediate health and safety of the student or other students.
``(2) Other instances, as defined by the State, where parental
consent cannot reasonably be obtained.
``(k) Relation to Education Provisions.--Nothing in this section or
section 520E-1 shall be construed to supersede section 444 of the
General Education Provisions Act, including the requirement of prior
parental consent for the disclosure of any education records. Nothing
in this section or section 520E-1 shall be construed to modify or
affect parental notification requirements for programs authorized under
the Elementary and Secondary Education Act of 1965 (as amended by the
No Child Left Behind Act of 2001; Public Law 107-110).
``(l) Definitions.--In this section:
``(1) Early intervention.--The term `early intervention' means
a strategy or approach that is intended to prevent an outcome or to
alter the course of an existing condition.
``(2) Educational institution; institution of higher education;
school.--The term--
``(A) `educational institution' means a school or
institution of higher education;
``(B) `institution of higher education' has the meaning
given such term in section 101 of the Higher Education Act of
1965; and
``(C) `school' means an elementary or secondary school (as
such terms are defined in section 9101 of the Elementary and
Secondary Education Act of 1965).
``(3) Prevention.--The term `prevention' means a strategy or
approach that reduces the likelihood or risk of onset, or delays
the onset, of adverse health problems that have been known to lead
to suicide.
``(4) Youth.--The term `youth' means individuals who are
between 10 and 24 years of age.
``(m) Authorization of Appropriations.--
``(1) In general.--For the purpose of carrying out this
section, there are authorized to be appropriated $7,000,000 for
fiscal year 2005, $18,000,000 for fiscal year 2006, and $30,000,000
for fiscal year 2007.
``(2) Preference.--If less than $3,500,000 is appropriated for
any fiscal year to carry out this section, in awarding grants and
cooperative agreements under this section during the fiscal year,
the Secretary shall give preference to States that have rates of
suicide that significantly exceed the national average as
determined by the Centers for Disease Control and Prevention.''.
(d) Mental and Behavioral Health Services on Campus.--Title V of
the Public Health Service Act (42 U.S.C. 290aa et seq.) is amended by
inserting after section 520E-1 (as redesignated by subsection (b)) the
following:
``SEC. 520E-2. MENTAL AND BEHAVIORAL HEALTH SERVICES ON
CAMPUS.
``(a) In General.--The Secretary, acting through the Director of
the Center for Mental Health Services, in consultation with the
Secretary of Education, may award grants on a competitive basis to
institutions of higher education to enhance services for students with
mental and behavioral health problems that can lead to school failure,
such as depression, substance abuse, and suicide attempts, so that
students will successfully complete their studies.
``(b) Use of Funds.--The Secretary may not make a grant to an
institution of higher education under this section unless the
institution agrees to use the grant only for--
``(1) educational seminars;
``(2) the operation of hot lines;
``(3) preparation of informational material;
``(4) preparation of educational materials for families of
students to increase awareness of potential mental and behavioral
health issues of students enrolled at the institution of higher
education;
``(5) training programs for students and campus personnel to
respond effectively to students with mental and behavioral health
problems that can lead to school failure, such as depression,
substance abuse, and suicide attempts; or
``(6) the creation of a networking infrastructure to link
colleges and universities that do not have mental health services
with health care providers who can treat mental and behavioral
health problems.
``(c) Eligible grant recipients.--Any institution of higher
education receiving a grant under this section may carry out activities
under the grant through--
``(1) college counseling centers;
``(2) college and university psychological service centers;
``(3) mental health centers;
``(4) psychology training clinics; or
``(5) institution of higher education supported, evidence-
based, mental health and substance abuse programs.
``(d) Application.--An institution of higher education desiring a
grant under this section shall prepare and submit an application to the
Secretary at such time and in such manner as the Secretary may require.
At a minimum, the application shall include the following:
``(1) A description of identified mental and behavioral health
needs of students at the institution of higher education.
``(2) A description of Federal, State, local, private, and
institutional resources currently available to address the needs
described in paragraph (1) at the institution of higher education.
``(3) A description of the outreach strategies of the
institution of higher education for promoting access to services,
including a proposed plan for reaching those students most in need
of mental health services.
``(4) A plan to evaluate program outcomes, including a
description of the proposed use of funds, the program objectives,
and how the objectives will be met.
``(5) An assurance that the institution will submit a report to
the Secretary each fiscal year on the activities carried out with
the grant and the results achieved through those activities.
``(e) Requirement of Matching Funds.--
``(1) In general.--The Secretary may make a grant under this
section to an institution of higher education only if the
institution agrees to make available (directly or through donations
from public or private entities) non-Federal contributions in an
amount that is not less than $1 for each $1 of Federal funds
provided in the grant, toward the costs of activities carried out
with the grant (as described in subsection (b)) and other
activities by the institution to reduce student mental and
behavioral health problems.
``(2) Determination of amount contributed.--Non-Federal
contributions required under paragraph (1) may be in cash or in
kind. Amounts provided by the Federal Government, or services
assisted or subsidized to any significant extent by the Federal
Government, may not be included in determining the amount of such
non-Federal contributions.
``(3) Waiver.--The Secretary may waive the requirement
established in paragraph (1) with respect to an institution of
higher education if the Secretary determines that extraordinary
need at the institution justifies the waiver.
``(f) Reports.--For each fiscal year that grants are awarded under
this section, the Secretary shall conduct a study on the results of the
grants and submit to the Congress a report on such results that
includes the following:
``(1) An evaluation of the grant program outcomes, including a
summary of activities carried out with the grant and the results
achieved through those activities.
``(2) Recommendations on how to improve access to mental and
behavioral health services at institutions of higher education,
including efforts to reduce the incidence of suicide and substance
abuse.
``(g) Definition.--In this section, the term `institution of higher
education' has the meaning given such term in section 101 of the Higher
Education Act of 1965.
``(h) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated $5,000,000
for fiscal year 2005, $5,000,000 for fiscal year 2006, and $5,000,000
for fiscal year 2007.''.
Speaker of the House of Representatives.
Vice President of the United States and
President of the Senate.