[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2531 Introduced in House (IH)]
111th CONGRESS
1st Session
H. R. 2531
To amend the Public Health Service Act to revise and extend projects
relating to children and violence to provide access to school-based
comprehensive mental health programs.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 20, 2009
Mrs. Napolitano (for herself, Ms. DeGette, Mr. Tim Murphy of
Pennsylvania, Mr. Frank of Massachusetts, Ms. Bordallo, Ms. Roybal-
Allard, Mr. Costello, Mrs. Bono Mack, Mr. Bishop of Georgia, Mr.
Kennedy, Mr. Serrano, Ms. Eddie Bernice Johnson of Texas, Ms. Baldwin,
Mr. Olver, Mr. Baca, Mr. McGovern, Mrs. Christensen, Mr. Rodriguez, Mr.
Gene Green of Texas, Mr. Sestak, and Mrs. Capps) introduced the
following bill; which was referred to the Committee on Energy and
Commerce
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to revise and extend projects
relating to children and violence to provide access to school-based
comprehensive mental health programs.
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 ``Mental Health in Schools Act of
2009''.
SEC. 2. FINDINGS.
Congress makes the following findings:
(1) Approximately 1 in 5 children have a diagnosable mental
disorder.
(2) Approximately 1 in 10 children have a serious emotional
or behavioral disorder that is severe enough to cause
substantial impairment in functioning at home, at school, or in
the community. It is estimated that about 75 percent of
children with emotional and behavioral disorders do not receive
specialty mental health services.
(3) Only half of schools across the United States report
having formal partnerships with community mental health
providers to deliver mental health services.
(4) If a school is going to respond to the mental health
needs of its students, it must have access to resources that
provide family-centered, culturally and linguistically
appropriate supports and services.
(5) Effective school mental health programs reflect the
collaboration and commitment of families, students, educators,
and other community partners.
(6) Many schools have school-employed mental health
providers supporting student's social, emotional, and
behavioral health needs in schools. The most common types of
staff providing mental health services in schools were school
counselors, followed by school nurses, school psychologists and
school social workers. Three-quarters of schools had at least
one school counselor on staff, over two-thirds had a school
psychologist or school nurse, and 44 percent had a school
social worker.
(7) Although it is well recognized that mental health
directly affects children's learning and development, in a
recent study one-third of school districts reported decreased
funding for school mental health services, and at the same time
two-thirds of school districts reported increased need for such
services.
SEC. 3. PURPOSES.
It is the purpose of this Act to--
(1) revise, increase funding for, and expand the scope of
the Safe Schools-Healthy Students program in order to provide
access to more comprehensive school-based mental health
services and supports;
(2) provide for comprehensive staff development for school
and community service personnel working in the school; and
(3) provide for comprehensive training for children with
mental health disorders, for parents, siblings, and other
family members of such children, and for concerned members of
the community.
SEC. 4. AMENDMENTS TO THE PUBLIC HEALTH SERVICE ACT.
(a) Technical Amendments.--The second part G (relating to services
provided through religious organizations) of title V of the Public
Health Service Act (42 U.S.C. 290kk et seq.) is amended--
(1) by redesignating such part as part J; and
(2) by redesignating sections 581 through 584 as sections
596 through 596C, respectively.
(b) School-Based Mental Health and Children and Violence.--Section
581 of the Public Health Service Act (42 U.S.C. 290hh) is amended to
read as follows:
``SEC. 581. SCHOOL-BASED MENTAL HEALTH AND CHILDREN AND VIOLENCE.
``(a) In General.--The Secretary, in collaboration with the
Secretary of Education and in consultation with the Attorney General,
shall, directly or through grants, contracts, or cooperative agreements
awarded to public entities and local education agencies, assist local
communities and schools in applying a public health approach to mental
health services both in schools and in the community. Such approach
should provide comprehensive age appropriate services and supports, be
linguistically and culturally appropriate, and incorporate age
appropriate strategies of positive behavioral interventions and
supports. A comprehensive school mental health program funded under
this section shall assist children in dealing with violence.
``(b) Activities.--Under the program under subsection (a), the
Secretary may--
``(1) provide financial support to enable local communities
to implement a comprehensive culturally and linguistically
appropriate, and age-appropriate, school mental health program
that incorporates positive behavioral interventions and
supports to foster the health and development of children;
``(2) provide technical assistance to local communities
with respect to the development of programs described in
paragraph (1);
``(3) provide assistance to local communities in the
development of policies to address child and adolescent mental
health issues and violence when and if it occurs;
``(4) facilitate community partnerships among families,
students, law enforcement agencies, education systems, mental
health and substance use disorder service systems, family-based
mental health service systems, welfare agencies, health care
service systems, and other community-based systems; and
``(5) establish mechanisms for children and adolescents to
report incidents of violence or plans by other children or
adolescents to commit violence.
``(c) Requirements.--
``(1) In general.--To be eligible for a grant, contract, or
cooperative agreement under subsection (a), an entity shall--
``(A) be a partnership between a local education
agency and at least one community program or agency
that is involved in mental health; and
``(B) submit an application, that is endorsed by
all members of the partnership, that contains the
assurances described in paragraph (2).
``(2) Required assurances.--An application under paragraph
(1) shall contain assurances as follows:
``(A) That the applicant will ensure that, in
carrying out activities under this section, the local
educational agency involved will enter into a
memorandum of understanding--
``(i) with, at a minimum, public or private
mental health entities, health care entities,
law enforcement or juvenile justice entities,
child welfare agencies, family-based mental
health entities, families and family
organizations, and other community-based
entities; and
``(ii) that clearly states--
``(I) the responsibilities of each
partner with respect to the activities
to be carried out;
``(II) how each such partner will
be accountable for carrying out such
responsibilities; and
``(III) the amount of non-Federal
funding or in-kind contributions that
each such partner will contribute in
order to sustain the program.
``(B) That the comprehensive school-based mental
health program carried out under this section supports
the flexible use of funds to address--
``(i) the promotion of the social,
emotional, and behavioral health of all
students in an environment that is conducive to
learning;
``(ii) the reduction in the likelihood of
at risk students developing social, emotional,
behavioral health problems, or substance use
disorders;
``(iii) the early identification of social,
emotional, behavioral problems, or substance
use disorders and the provision of early
intervention services;
``(iv) the treatment or referral for
treatment of students with existing social,
emotional, behavioral health problems, or
substance use disorders; and
``(v) the development and implementation of
programs to assist children in dealing with
violence.
``(C) That the comprehensive school-based mental
health program carried out under this section will
provide for in-service training of all school
personnel, including ancillary staff and volunteers,
in--
``(i) the techniques and supports needed to
identify early children with, or at risk of,
mental illness;
``(ii) the use of referral mechanisms that
effectively link such children to treatment and
intervention services in the school and in the
community;
``(iii) strategies that promote a school-
wide positive environment;
``(iv) strategies for promoting the social,
emotional, mental, and behavioral health of all
students; and
``(v) strategies to increase the knowledge
and skills of school and community leaders on
the application of a public health approach to
comprehensive school-based mental health
programs.
``(D) That the comprehensive school-based mental
health program carried out under this section will
include comprehensive training for parents, siblings,
and other family members of children with mental health
disorders, and for concerned members of the community
in--
``(i) the techniques and supports needed to
identify early children with, or at risk of,
mental illness;
``(ii) the use of referral mechanisms that
effectively link such children to treatment and
intervention services in the school and in the
community; and
``(iii) strategies that promote a school-
wide positive environment.
``(E) That the comprehensive school-based mental
health program carried out under this section will
demonstrate the measures to be taken to sustain the
program after funding under this section terminates.
``(F) That the local education agency partnership
involved is supported by the State educational and
mental health system to ensure that the sustainability
of the programs is established after funding under this
section terminates.
``(G) That the comprehensive school-based mental
health program carried out under this section will be
based on evidence-based practices.
``(H) That the comprehensive school-based mental
health program carried out under this section will be
coordinated with early intervening activities carried
out under the Individuals with Disabilities Education
Act.
``(I) That the comprehensive school-based mental
health program carried out under this section will be
culturally and linguistically appropriate.
``(J) That the comprehensive school-based mental
health program carried out under this section will
include a broad needs assessment of youth who drop out
of school due to policies of `zero tolerance' with
respect to drugs, alcohol, or weapons.
``(K) That the mental health services provided
through the comprehensive school-based mental health
program carried out under this section will be provided
by qualified mental and behavioral health professionals
who are certified or licensed by the State involved and
practicing within their area of expertise.
``(d) Geographical Distribution.--The Secretary shall ensure that
grants, contracts, or cooperative agreements under subsection (a) will
be distributed equitably among the regions of the country and among
urban and rural areas.
``(e) Duration of Awards.--With respect to a grant, contract, or
cooperative agreement under subsection (a), the period during which
payments under such an award will be made to the recipient shall be 5
years. An entity may receive only one award under this section, except
that an entity that is providing services and supports on a regional
basis may receive additional funding after the expiration of the
preceding grant period.
``(f) Evaluation and Measures of Outcomes.--
``(1) Development of process.--The Administrator shall
develop a process for evaluating activities carried out under
this section. Such process shall include--
``(A) the development of guidelines for the
submission of program data by grant, contract, or
cooperative agreement recipients;
``(B) the development of measures of outcomes (in
accordance with paragraph (2)) to be applied by such
recipients in evaluating programs carried out under
this section; and
``(C) the submission of annual reports by such
recipients concerning the effectiveness of programs
carried out under this section.
``(2) Measures of outcomes.--
``(A) In general.--The Administrator shall develop
measures of outcomes to be applied by recipients of
assistance under this section, and the Administrator,
in evaluating the effectiveness of programs carried out
under this section. Such measures shall include student
and family measures as provided for in subparagraph (B)
and local educational measures as provided for under
subparagraph (C).
``(B) Student and family measures of outcomes.--The
measures of outcomes developed under paragraph (1)(B)
relating to students and families shall, with respect
to activities carried out under a program under this
section, at a minimum include provisions to evaluate--
``(i) whether the program resulted in an
increase in social and emotional competency;
``(ii) whether the program resulted in an
increase in academic competency;
``(iii) whether the program resulted in a
reduction in disruptive and aggressive
behaviors;
``(iv) whether the program resulted in
improved family functioning;
``(v) whether the program resulted in a
reduction in substance use disorders;
``(vi) whether the program resulted in a
reduction in suspensions, truancy, expulsions
and violence;
``(vii) whether the program resulted in
increased graduation rates; and
``(viii) whether the program resulted in
improved access to care for mental health
disorders.
``(C) Local educational outcomes.--The outcome
measures developed under paragraph (1)(B) relating to
local educational systems shall, with respect to
activities carried out under a program under this
section, at a minimum include provisions to evaluate--
``(i) the effectiveness of comprehensive
school mental health programs established under
this section;
``(ii) the effectiveness of formal
partnership linkages among child and family
serving institutions, community support
systems, and the educational system;
``(iii) the progress made in sustaining the
program once funding under the grant has
expired;
``(iv) the effectiveness of training and
professional development programs for all
school personnel that incorporate indicators
that measure cultural and linguistic
competencies under the program in a manner that
incorporates appropriate cultural and
linguistic training;
``(v) the improvement in perception of a
safe and supportive learning environment among
school staff, students, and parents;
``(vi) the improvement in case-finding of
students in need of more intensive services and
referral of identified students to early
intervention and clinical services;
``(vii) the improvement in the immediate
availability of clinical assessment and
treatment services to students posing a danger
to themselves or others;
``(viii) the increased successful
matriculation to postsecondary school; and
``(ix) reduced referrals to juvenile
justice
``(3) Submission of annual data.--An entity that receives a
grant, contract, or cooperative agreement under this section
shall annually submit to the Administrator a report that
includes data to evaluate the success of the program carried
out by the entity based on whether such program is achieving
the purposes of the program. Such reports shall utilize the
measures of outcomes under paragraph (2) in a reasonable manner
to demonstrate the progress of the program in achieving such
purposes.
``(4) Evaluation by administrator.--Based on the data
submitted under paragraph (3), the Administrator shall annually
submit to Congress a report concerning the results and
effectiveness of the programs carried out with assistance
received under this section.
``(g) Information and Education.--The Secretary shall establish
comprehensive information and education programs to disseminate the
findings of the knowledge development and application under this
section to the general public and to health care professionals.
``(h) Amount of Grants and Authorization of Appropriations.--
``(1) Amount of grants.--A grant under this section shall
be in an amount that is not more than $1,000,000 for each of
grant years 2010 through 2014. The Secretary shall determine
the amount of each such grant based on the population of
children up to age 21 of the area to be served under the grant.
``(2) Authorization of appropriations.--There is authorized
to be appropriated to carry out this section, $200,000,000 for
each of fiscal years 2010 through 2014.''.
(c) Conforming Amendment.--Part G of title V of the Public Health
Service Act (42 U.S.C. 290hh et seq.), as amended by this section, is
further amended by striking the part heading and inserting the
following:
``PART VII--SCHOOL-BASED MENTAL HEALTH''.
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