[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[S. 2634 Referred in House (RFH)]

  2d Session
                                S. 2634


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              July 9, 2004

            Referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 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 provide funds for campus mental and behavioral health service 
                    centers, 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 has 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. AMENDMENT TO THE PUBLIC HEALTH SERVICES ACT.

    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, and Federally recognized Indian tribes or 
tribal organizations to implement the State-sponsored statewide or 
tribal youth suicide early intervention and prevention strategy as 
developed under section 596A.'';
                    (C) in subsection (b), by striking all after 
                ``coordinated'' and inserting ``with the Strategy for 
                Suicide Prevention Federal Steering Group and the 
                suicide prevention resource center provided for under 
                section 596B.'';
                    (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, and Federally recognized 
                        Indian tribes 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) comply with the State-sponsored statewide early 
        intervention and prevention strategy as developed under section 
        596A;'';
                            (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 596A and'';
                    (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, 
                        and Federally recognized Indian tribes or 
                        tribal organization receiving''; and
                            (ii) by striking ``contract,'' each place 
                        that such 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, 
                        and Federally recognized Indian tribes 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)(2), by striking ``21'' and 
                inserting ``24''; and
                    (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);
            (2) by inserting after part I (42 U.S.C. 290jj et seq), the 
        following:

         ``PART J--SUICIDE EARLY INTERVENTION AND PREVENTION'';

            (3) by redesignating section 520E (42 U.S.C. 290bb-36), as 
        amended by paragraph (1), as section 596 and transferring such 
        section to part J (as added by paragraph (2)); and
            (4) by adding at the end of part J (as added by paragraph 
        (2) and amended by paragraph (3)), the following:

``SEC. 596A. YOUTH SUICIDE EARLY INTERVENTION AND PREVENTION 
              STRATEGIES, TRAINING, AND TECHNICAL ASSISTANCE.

    ``(a) Youth Suicide Early Intervention and Prevention Strategies.--
            ``(1) 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--
                    ``(A) 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;
                    ``(B) 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;
                    ``(C) 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
                    ``(D) 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 (42 U.S.C. 701 et seq.).
            ``(2) Eligible entity.--
                    ``(A) Definition.--In this subsection, the term 
                `eligible entity' means--
                            ``(i) a State;
                            ``(ii) 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; and
                            ``(iii) 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.
                    ``(B) Preference.--In awarding grants and 
                cooperative agreements under this section, the 
                Secretary shall give preference to States that have 
                rates of youth suicide that significantly exceed the 
                national average as determined by the Centers for 
                Disease Control and Prevention.
                    ``(C) Limitation.--In carrying out this section, 
                the Secretary shall ensure that each State is awarded 
                only one 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 subparagraph (A)(ii). Nothing in this 
                subparagraph shall be construed to apply to entities 
                described in subparagraph (A)(iii).
            ``(3) Preference.--In providing assistance under a grant or 
        cooperative agreement under this subsection, an eligible entity 
        shall give preference to public organizations, private 
        nonprofit organizations, political subdivisions, and tribal 
        organizations actively involved with the State-sponsored 
        statewide or tribal youth suicide early intervention and 
        prevention strategy that--
                    ``(A) 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;
                    ``(B) demonstrate collaboration among early 
                intervention and prevention services or certify that 
                entities will engage in future collaboration;
                    ``(C) employ or include in their applications a 
                commitment to evaluate youth suicide early intervention 
                and prevention practices and strategies adapted to the 
                local community;
                    ``(D) 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;
                    ``(E) provide immediate support and information 
                resources to families of youth who are at risk for 
                suicide;
                    ``(F) offer access to services and care to youth 
                with diverse linguistic and cultural backgrounds;
                    ``(G) offer appropriate post-suicide 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;
                    ``(H) 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;
                    ``(I) 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;
                    ``(J) 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;
                    ``(K) 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;
                    ``(L) conduct annual self-evaluations of outcomes 
                and activities, including consulting with interested 
                families and advocacy organizations; and
                    ``(M) 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.
            ``(4) Requirement for direct services.--Not less than 85 
        percent of grant funds received under this subsection shall be 
        used to provide direct services.
    ``(b) Suicide Prevention Resource Center; Training and Technical 
Assistance.--
            ``(1) Operation of center.--The Secretary, acting through 
        the Administrator of the Substance Abuse and Mental Health 
        Services Administration and in consultation with the National 
        Strategy for Suicide Prevention Federal Steering Group, shall 
        award a competitive grant or contract to a public or private 
        nonprofit entity for the establishment of a Suicide Prevention 
        Resource Center to carry out the activities described in 
        paragraph (3).
            ``(2) Application.--To be eligible for a grant or contract 
        under paragraph (1), an entity shall prepare and submit to the 
        Secretary an application at such time, in such manner, and 
        containing such information as the Secretary may require.
            ``(3) Authorized activities.--The Suicide Prevention 
        Resource Center shall provide appropriate information, 
        training, and technical assistance to States, political 
        subdivisions of a State, Federally recognized Indian tribes, 
        tribal organizations, public organizations, or private 
        nonprofit organizations for--
                    ``(A) the development or continuation of statewide 
                or tribal youth suicide early intervention and 
                prevention strategies;
                    ``(B) ensuring the surveillance of youth suicide 
                early intervention and prevention strategies;
                    ``(C) 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;
                    ``(D) further identifying and understanding causes 
                and associated risk factors for youth suicide;
                    ``(E) analyzing the efficacy of new and existing 
                youth suicide early intervention techniques and 
                technology;
                    ``(F) ensuring the surveillance of suicidal 
                behaviors and nonfatal suicidal attempts;
                    ``(G) 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;
                    ``(H) 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; and
                    ``(I) other activities determined appropriate by 
                the Secretary.
            ``(5) Authorization of appropriations.--There is authorized 
        to be appropriated to carry out this subsection, $3,000,000 for 
        fiscal year 2005, $4,000,000 for fiscal year 2006, and 
        $5,000,000 for fiscal year 2007.
    ``(c) Coordination and Collaboration.--
            ``(1) In general.--In carrying out this section, the 
        Secretary shall collaborate with the National Strategy for 
        Suicide Prevention Federal Steering Group and other Federal 
        agencies 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 (42 
                U.S.C. 1396 et seq.), the State Children's Health 
                Insurance Program under title XXI of the Social 
                Security Act (42 U.S.C. 1397aa et seq.), programs 
                funded by grants under title V of the Social Security 
                Act (42 U.S.C. 701 et seq.), and programs under part C 
                of the Individuals with Disabilities Education Act (20 
                U.S.C. 1431 et seq.);
                    ``(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.--The Secretary shall--
                    ``(A) coordinate and collaborate on policy 
                development at the Federal level with the National 
                Strategy for Suicide Prevention Federal Steering Group; 
                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.
    ``(d) Rule of Construction; Religious Accommodation.--Nothing in 
this section shall be construed to preempt any State law, including any 
State law that does not require the suicide early intervention for 
youth whose parents or legal guardians object to such early 
intervention based on the parents' or legal guardians' religious 
beliefs.
    ``(e) Evaluations and report.--
            ``(1) Evaluations by eligible entities.--Not later than 18 
        months after receiving a grant or cooperative agreement under 
        subsection (a), 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.
    ``(f) Authorization of Appropriations.--For the purpose of carrying 
out subsection (a), there are authorized to be appropriated $7,000,000 
for fiscal year 2005, $16,000,000 for fiscal year 2006, $25,000,000 for 
fiscal year 2007, and such sums as may be necessary for each of fiscal 
years 2008 and 2009.

``SEC. 596B. MENTAL AND BEHAVIORAL HEALTH SERVICES ON CAMPUS.

    ``(a) Purpose.--It is the purpose of this section to increase 
access to, and enhance the range of, services for students with mental 
and behavioral health problems that can lead to school failure, such as 
depression, substance abuse, and suicide attempts, so as to ensure that 
college students have the support necessary to successfully complete 
their studies.
    ``(b) Program Authorized.--From funds appropriated under subsection 
(j), the Secretary shall award competitive grants to institutions of 
higher education to create or expand mental and behavioral health 
services to students at such institutions, to provide such services, 
and to develop best practices for the delivery of such services. Such 
grants shall, subject to the availability of such appropriations, be 
for a period of 3 years.
    ``(c) Eligible Grant Recipients.--Any institution of higher 
education that seeks to provide, or provides, mental and behavioral 
health services to students is eligible to apply for a grant under this 
section. Services may be provided at--
            ``(1) college counseling centers;
            ``(2) college and university psychological service centers;
            ``(3) mental health centers;
            ``(4) psychology training clinics; and
            ``(5) institution of higher education supported, evidence-
        based, mental health and substance abuse screening programs.
    ``(d) Applications.--Each institution of higher education seeking 
to obtain a grant under this section shall submit an application to the 
Secretary. Each such application shall include--
            ``(1) a description of identified mental and behavioral 
        health needs of students at the institution of higher 
        education;
            ``(2) a description of currently available Federal, State, 
        local, private, and institutional resources to address the 
        needs described in paragraph (1) at the institution of higher 
        education;
            ``(3) an outline of program objectives and anticipated 
        program outcomes, including an explanation of how the treatment 
        provider at the institution of higher education will coordinate 
        activities under this section with existing programs and 
        services;
            ``(4) the anticipated impact of funds provided under this 
        section in improving the mental and behavioral health of 
        students attending the institution of higher education;
            ``(5) outreach strategies, including ways in which the 
        treatment provider at the institution of higher education 
        proposes to reach students, promote access to services, and 
        address the range of needs of students;
            ``(6) a proposed plan for reaching those students most in 
        need of services;
            ``(7) a plan to evaluate program outcomes and assess the 
        services provided with funds under this section;
            ``(8) financial information concerning the applicant to 
        demonstrate compliance with subsection (h); and
            ``(9) such additional information as is required by the 
        Secretary.
    ``(e) Peer Review of Applications.--The Secretary, in consultation 
with the Secretary of Education, shall provide the applications 
submitted under this section to a peer review panel for evaluation. 
With respect to each application, the peer review panel shall recommend 
the application for funding or for disapproval.
    ``(f) Use of Funds.--Funds provided by a grant under this section 
may be used for 1 or more of the following activities:
            ``(1) Prevention, screening, early intervention, 
        assessment, treatment, management, and education of mental and 
        behavioral health problems that can lead to school failure, 
        such as depression, substance abuse, and suicide attempts by 
        students enrolled at the institution of higher education.
            ``(2) Education of families to increase awareness of 
        potential mental and behavioral health issues of students 
        enrolled at the institution of higher education.
            ``(3) Hiring staff trained to identify and treat mental and 
        behavioral health problems, including residents and interns 
        such as those in psychological doctoral and post doctoral 
        programs.
            ``(4) Evaluating and disseminating outcomes and best 
        practices of mental and behavioral health services.
    ``(g) Additional required elements.--Each institution of higher 
education that receives a grant under this section shall--
            ``(1) provide annual reports to the Secretary describing 
        the use of funds, the program's objectives, and how the 
        objectives were met, including a description of program 
        outcomes;
            ``(2) perform such additional evaluations as the Secretary 
        may require, which may include--
                    ``(A) increases in range of services provided;
                    ``(B) increases in the quality of services 
                provided;
                    ``(C) increases in access to services;
                    ``(D) college continuation rates;
                    ``(E) decreases in college dropout rates;
                    ``(F) increases in college graduation rates; and
                    ``(G) accepted and valid measurements and 
                assessments of improved mental health functionality; 
                and
            ``(3) coordinate such institution's program under this 
        section with other related efforts on campus by entities 
        concerned with the general mental and behavioral health needs 
        of students.
    ``(h) Supplement not Supplant.--Grant funds provided 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. Grantees shall provide financial information to 
demonstrate compliance with this subsection.
    ``(i) Requirement for Direct Services and Limitations.--
            ``(1) Direct services.--Not less than 75 percent of grant 
        funds received under this section shall be used to provide 
        direct services.
            ``(2) Administrative costs.--Not more than 5 percent of 
        grant funds received under this section shall be used for 
        administrative costs.
            ``(3) Prohibition on use for construction or renovation.--
        Grant funds received under this section shall not be used for 
        construction or renovation of facilities or buildings.
    ``(j) Authorization of Appropriations.--There are authorized to be 
appropriated for grants under this section, $5,000,000 for fiscal year 
2005, $7,000,000 for fiscal year 2006, $10,000,000 for fiscal year 
2007, and such sums as may be necessary for each fiscal years 2008 and 
2009.

``SEC. 596C. DEFINITIONS.

    ``In this part:
            ``(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 901 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.
            ``(4) Youth.--The term `youth' means individuals who are 
        between 6 and 24 years of age.''.

            Passed the Senate July 8, 2004.

            Attest:

                                             EMILY J. REYNOLDS,

                                                             Secretary.