[Congressional Record Volume 149, Number 84 (Tuesday, June 10, 2003)]
[Senate]
[Pages S7627-S7630]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. BINGAMAN (for himself, Ms. Collins, Mr. Jeffords, and Mr. 
        Dodd):
  S. 1223. A bill to increase the number of well-trained mental health 
service professionals (including those based in schools) providing 
clinical mental health care to children and adolescents, and for other 
purposes; to the Committee on Health, Education, Labor, and Pensions.
  Mr. BINGAMAN. Mr. President, I rise today because there is a crisis 
in our country that begs our attention. This crisis is the overwhelming 
lack of adequate mental health services available to the children and 
adolescents in our Nation and it is time that we address it. As I 
speak, over 13,700,000 young people are suffering from diagnosable 
psychiatric disorders. Sadly, fewer than one-third of these have access 
to mental healthcare. Today I am introducing the ``Child Healthcare 
Crisis Relief Act'' along with Senators Collins, Jeffords, and Dodd in 
an effort to reduce the disparity between the need for mental health 
services and resources available to meet that need.
  The landmark report ``Mental Health: A Report of the Surgeon 
General'' illuminated the crisis in 1999. 13,700,000 young people have 
diagnosable mental disorders including 6-9,000,000 children and 
adolescents who meet the definition for having a serious emotional 
disturbance and 5-9 percent of youth who meet the definition for having 
severe functional impairment. Unfortunately, few of these young people 
have access to adequate mental health services. The resulting lack of 
treatment leads to a lifetime cycle of difficulties from unresolved 
mental health issues. These difficulties are often as severe as school 
failure, substance abuse, job and relationship instability, and even 
criminal behavior or suicide. In many cases, young people who do not 
receive the mental health treatment that they need end up in foster 
care or even in the juvenile justice system. In my state of New Mexico, 
a 2002 report concluded that 1 in 7 incarcerated youth is currently in 
a detention center solely because there is no appropriate treatment 
option available. These youth are actually cleared to leave as soon as 
they have adequate treatment in place. In fact, from January 2001 to 
December of 2001 an estimated 718 New Mexico youth were collectively 
incarcerated for 31.3 years waiting for a treatment opening. Most other 
States are facing similar situations. In fact, studies have found that 
nationally more than 1 in 3 youth in detention centers have a mental 
health disorder. Clearly, this is an issue that demands our immediate 
attention.
  One of the key barriers to treatment is the shortage of available 
specialists trained in the identification, diagnosis, and treatment of 
children and adolescents with emotional and behavioral disorders. The 
1999 Surgeon General's Report stated, ``there is a dearth of child 
psychiatrists, appropriately trained clinical child psychologists, and 
social workers.'' There are particularly acute shortages in the number 
of mental health service professionals serving children and adolescents 
with serious emotional disorders as well as those serving rural areas. 
Nationwide, 4,358 urban, suburban, and rural localities have been 
designated mental health Professional Shortage Areas by the Federal 
Government. The President's New Freedom Commission has recognized the 
shortage and has made a recommendation to develop a strategic plan to 
address it. The Council on Graduate Medical Education and the State 
Mental Health Commissioners have also recognized this shortage of 
mental health professionals.

  The Child Healthcare Crisis Relief Act will help remove one of the 
key barriers to treatment for children and adolescents with mental 
illnesses: the lack of available specialists trained in this field. 
This bill creates incentives to help recruit and retain child mental 
health professionals providing direct clinical care and to improve, 
expand, or help create programs to train child mental health 
professionals through several mechanisms. The bill provides loan 
repayment and scholarships for child mental health and school-based 
service professionals to help pay back educational loans. It provides 
grants to graduate schools to provide for internships and field 
placements in child mental health services. It provides grants to help 
with the preservice and inservice training of paraprofessionals who 
work in the children's mental health clinical settings. It also 
provides grants to graduate schools to help develop and expand child 
and adolescent mental health programs. Finally, the bill allows for an 
increase in the number of child and adolescent psychiatrists permitted 
under the Medicare Graduate Medical Education Program, extends the 
Board Eligibility period for residents and fellows from 4 years to 6 
years, and instructs the secretary to prepare a report on the 
distribution and need for child mental health and school-based 
professionals.
  I ask my colleagues in the Senate to join me along with Senators 
Collins, Jeffords, and Dodd in supporting this essential legislation. 
Over 13 million children in our country are counting on us.
  As Walt Disney once said, ``Our Nation's greatest national resource 
is the minds of our children.'' Let us not fail these 13 million 
people.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 1223

       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 ``Child Health Care Crisis 
     Relief Act''.

     SEC. 2. FINDINGS.

       Congress finds the following:
       (1) The Center for Mental Health Services estimates that 20 
     percent or 13,700,000 of the Nation's children and 
     adolescents have a diagnosable mental health disorder, and 
     about \2/3\ of these children and adolescents do not receive 
     mental health care.
       (2) According to ``Mental Health: A Report of the Surgeon 
     General'' in 1999, there are

[[Page S7628]]

     approximately 6,000,000 to 9,000,000 children and adolescents 
     in the United States (accounting for 9 to 13 percent of all 
     children and adolescents in the United States) who meet the 
     definition for having a serious emotional disturbance.
       (3) According to the Center for Mental Health Services, 
     approximately 5 to 9 percent of children and adolescents in 
     the United States meet the definition for extreme functional 
     impairment.
       (4) According to the Surgeon General's Report, there are 
     particularly acute shortages in the numbers of mental health 
     service professionals serving children and adolescents with 
     serious emotional disorders.
       (5) According to the National Center for Education 
     Statistics in the Department of Education, there are 
     approximately 513 students for each school counselor in 
     United States schools, which ratio is more than double the 
     recommended ratio of 250 students for each school counselor.
       (6) According to a year 2000 estimate of the Bureau of 
     Health Professions, the demand for the services of child and 
     adolescent psychiatry is projected to increase by 100 percent 
     by 2020.
       (7) The development and application of knowledge about the 
     impact of disasters on children, adolescents, and their 
     families has been impeded by critical shortages of qualified 
     researchers and practitioners specializing in this work.
       (8) According to the Bureau of the Census, the population 
     of children and adolescents in the United States under the 
     age of 18 is projected to grow by more than 40 percent, from 
     70,000,000 to more than 100,000,000 by 2050.

     SEC. 3. LOAN REPAYMENTS, SCHOLARSHIPS, AND GRANTS TO IMPROVE 
                   CHILD AND ADOLESCENT MENTAL HEALTH CARE.

       Part B of title VII of the Public Health Service Act (42 
     U.S.C. 293 et seq.) is amended by adding at the end the 
     following:

     ``SEC. 742. LOAN REPAYMENTS, SCHOLARSHIPS, AND GRANTS TO 
                   IMPROVE CHILD AND ADOLESCENT MENTAL HEALTH 
                   CARE.

       ``(a) Loan Repayments for Child and Adolescent Mental 
     Health Service Professionals.--
       ``(1) Establishment.--The Secretary, acting through the 
     Administrator of the Health Resources and Services 
     Administration, may establish a program of entering into 
     contracts on a competitive basis with eligible individuals 
     (as defined in paragraph (2)) under which--
       ``(A) the eligible individual agrees to be employed full-
     time for a specified period of at least 2 years in providing 
     mental health services to children and adolescents; and
       ``(B) the Secretary agrees to make, during the period of 
     employment described in subparagraph (A), partial or total 
     payments on behalf of the individual on the principal and 
     interest due on the undergraduate and graduate educational 
     loans of the eligible individual.
       ``(2) Eligible individual.--For purposes of this section, 
     the term `eligible individual' means an individual who--
       ``(A) is receiving specialized training or clinical 
     experience in child and adolescent mental health in 
     psychiatry, psychology, school psychology, psychiatric 
     nursing, social work, school social work, marriage and family 
     therapy, school counseling, or professional counseling and 
     has less than 1 year remaining before completion of such 
     training or clinical experience; or
       ``(B)(i) has a license in a State to practice allopathic 
     medicine, osteopathic medicine, psychology, school 
     psychology, psychiatric nursing, social work, school social 
     work, marriage and family therapy, school counseling, or 
     professional counseling; and
       ``(ii)(I) is a mental health service professional who 
     completed (but not before the end of the calendar year in 
     which this section is enacted) specialized training or 
     clinical experience in child and adolescent mental health 
     services described in subparagraph (A); or
       ``(II) is a physician who graduated from (but not before 
     the end of the calendar year in which this section is 
     enacted) an accredited child and adolescent psychiatry 
     residency or fellowship program in the United States.
       ``(3) Additional eligibility requirements.--The Secretary 
     may not enter into a contract under this subsection with an 
     eligible individual unless the individual--
       ``(A) is a United States citizen or a permanent legal 
     United States resident; and
       ``(B) if enrolled in a graduate program (including a 
     medical residency or fellowship), has an acceptable level of 
     academic standing as determined by the Secretary.
       ``(4) Priority.--In entering into contracts under this 
     subsection, the Secretary shall give priority to applicants 
     who--
       ``(A) are or will be working with high priority 
     populations;
       ``(B) have familiarity with evidence-based methods in child 
     and adolescent mental health services;
       ``(C) demonstrate financial need; and
       ``(D) are or will be--
       ``(i) working in the publicly funded sector;
       ``(ii) working in organizations that serve underserved 
     populations; or
       ``(iii) willing to provide patient services--

       ``(I) regardless of the ability of a patient to pay for 
     such services; or
       ``(II) on a sliding payment scale if a patient is unable to 
     pay the total cost of such services.

       ``(5) Meaningful loan repayment.--If the Secretary 
     determines that funds appropriated for a fiscal year to carry 
     out this subsection are not sufficient to allow a meaningful 
     loan repayment to all expected applicants, the Secretary 
     shall limit the number of contracts entered into under 
     paragraph (1) to ensure that each such contract provides for 
     a meaningful loan repayment.
       ``(6) Amount.--
       ``(A) Maximum.--For each year of the employment period 
     described in paragraph (1)(A), the Secretary shall not, under 
     a contract described in paragraph (1), pay more than $35,000 
     on behalf of an individual.
       ``(B) Consideration.--In determining the amount of payments 
     to be made on behalf of an eligible individual under a 
     contract described in paragraph (1), the Secretary shall 
     consider the income and debt load of the eligible individual.
       ``(7) Applicability of certain provisions.--The provisions 
     of sections 338E and 338F shall apply to the program 
     established under paragraph (1) to the same extent and in the 
     same manner as such provisions apply to the National Health 
     Service Corps Loan Repayment Program established in subpart 
     III of part D of title III.
       ``(8) Authorization of appropriations.--There is authorized 
     to be appropriated to carry out this subsection $10,000,000 
     for each of fiscal years 2004 through 2008.
       ``(b) Scholarships for Students Studying To Become Child 
     and Adolescent Mental Health Service Professionals.--
       ``(1) Establishment.--The Secretary, acting through the 
     Administrator of the Health Resources and Services 
     Administration, may establish a program to award scholarships 
     on a competitive basis to eligible students who agree to 
     enter into full-time employment (as described in paragraph 
     (4)(C)) as a child and adolescent mental health service 
     professional after graduation or completion of a residency or 
     fellowship.
       ``(2) Eligible student.--For purposes of this subsection, 
     the term `eligible student' means a United States citizen or 
     a permanent legal United States resident who--
       ``(A) is enrolled or accepted to be enrolled in a graduate 
     program that includes specialized training or clinical 
     experience in child and adolescent mental health in 
     psychology, school psychology, psychiatric nursing, social 
     work, school social work, marriage and family therapy, school 
     counseling, or professional counseling; or
       ``(B) is enrolled or accepted to be enrolled in an 
     accredited graduate training program of allopathic or 
     osteopathic medicine in the United States and intends to 
     complete an accredited residency or fellowship in child and 
     adolescent psychiatry.
       ``(3) Priority.--In awarding scholarships under this 
     subsection, the Secretary shall give--
       ``(A) highest priority to applicants who previously 
     received a scholarship under this subsection and satisfy the 
     criteria described in subparagraph (B); and
       ``(B) second highest priority to applicants who--
       ``(i) demonstrate a commitment to working with high 
     priority populations;
       ``(ii) have familiarity with evidence-based methods in 
     child and adolescent mental health services;
       ``(iii) demonstrate financial need; and
       ``(iv) are or will be--

       ``(I) working in the publicly funded sector;
       ``(II) working in organizations that serve underserved 
     populations; or
       ``(III) willing to provide patient services--

       ``(aa) regardless of the ability of a patient to pay for 
     such services; or
       ``(bb) on a sliding payment scale if a patient is unable to 
     pay the total cost of such services.
       ``(4) Requirements.--The Secretary may award a scholarship 
     to an eligible student under this subsection only if the 
     eligible student agrees--
       ``(A) to complete any graduate training program, 
     internship, residency, or fellowship applicable to that 
     eligible student under paragraph (2);
       ``(B) to maintain an acceptable level of academic standing 
     (as determined by the Secretary) during the completion of 
     such graduate training program, internship, residency, or 
     fellowship; and
       ``(C) to be employed full-time after graduation or 
     completion of a residency or fellowship, for at least the 
     number of years for which a scholarship is received by the 
     eligible student under this subsection, in providing mental 
     health services to children and adolescents.
       ``(5) Use of scholarship funds.--A scholarship awarded to 
     an eligible student for a school year under this subsection 
     may be used to pay for only tuition expenses of the school 
     year, other reasonable educational expenses (including fees, 
     books, and laboratory expenses incurred by the eligible 
     student in the school year), and reasonable living expenses, 
     as such tuition expenses, reasonable educational expenses, 
     and reasonable living expenses are determined by the 
     Secretary.
       ``(6) Amount.--The amount of a scholarship under this 
     subsection shall not exceed the total amount of the tuition 
     expenses, reasonable educational expenses, and reasonable 
     living expenses described in paragraph (5).
       ``(7) Applicability of certain provisions.--The provisions 
     of sections 338E and 338F shall apply to the program 
     established under paragraph (1) to the same extent and in the 
     same manner as such provisions apply to the National Health 
     Service Corps Scholarship Program established in subpart III 
     of part D of title III.

[[Page S7629]]

       ``(8) Authorization of appropriations.--There is authorized 
     to be appropriated to carry out this subsection $5,000,000 
     for each of fiscal years 2004 through 2008.
       ``(c) Clinical Training Grants for Professionals.--
       ``(1) Establishment.--The Secretary, acting through the 
     Administrator of the Health Resources and Services 
     Administration, and in cooperation with the Administrator of 
     the Substance Abuse and Mental Health Services 
     Administration, may establish a program to award grants on a 
     competitive basis to accredited institutions of higher 
     education to establish or expand internships or other field 
     placement programs for students receiving specialized 
     training or clinical experience in child and adolescent 
     mental health in the fields of psychiatry, psychology, school 
     psychology, psychiatric nursing, social work, school social 
     work, marriage and family therapy, school counseling, or 
     professional counseling.
       ``(2) Priority.--In awarding grants under this subsection, 
     the Secretary shall give priority to applicants that--
       ``(A) have demonstrated the ability to collect data on the 
     number of students trained in child and adolescent mental 
     health and the populations served by such students after 
     graduation;
       ``(B) have demonstrated familiarity with evidence-based 
     methods in child and adolescent mental health services; and
       ``(C) have programs designed to increase the number of 
     professionals serving high priority populations.
       ``(3) Requirements.--The Secretary may award a grant to an 
     applicant under this subsection only if the applicant agrees 
     that--
       ``(A) any internship or other field placement program 
     assisted under the grant will prioritize cultural competency;
       ``(B) students benefiting from any assistance under this 
     subsection will be United States citizens or permanent legal 
     United States residents;
       ``(C) the institution will provide to the Secretary such 
     data, assurances, and information as the Secretary may 
     require; and
       ``(D) with respect to any violation of the agreement 
     between the Secretary and the institution, the institution 
     will pay such liquidated damages as prescribed by the 
     Secretary by regulation.
       ``(4) Application.--Each institution of higher education 
     desiring a grant under this section shall submit to the 
     Secretary an application at such time, in such manner, and 
     containing such information as the Secretary may require 
     including a description of the experience of such institution 
     in working with child and adolescent mental health issues.
       ``(5) Authorization of appropriations.--There is authorized 
     to be appropriated to carry out this subsection $10,000,000 
     for each of fiscal years 2004 through 2008.
       ``(d) Progressive Education Grants for Paraprofessionals.--
       ``(1) Establishment.--The Secretary, acting through the 
     Administrator of the Health Resources and Services 
     Administration, and in cooperation with the Administrator of 
     the Substance Abuse and Mental Health Services 
     Administration, may establish a program to award grants on a 
     competitive basis to State-licensed mental health nonprofit 
     and for-profit organizations, including accredited 
     institutions of higher education, (in this subsection 
     referred to as `organizations') to enable such organizations 
     to pay for programs for preservice or in-service training of 
     paraprofessional child and adolescent mental health workers.
       ``(2) Definition.--For purposes of this subsection, the 
     term `paraprofessional child and adolescent mental health 
     worker' means an individual who is not a mental health 
     service professional, but who works at the first stage of 
     contact with children and families who are seeking mental 
     health services.
       ``(3) Priority.--In awarding grants under this subsection, 
     the Secretary shall give priority to organizations that--
       ``(A) have demonstrated the ability to collect data on the 
     number of paraprofessional child and adolescent mental health 
     workers trained by the applicant and the populations served 
     by these workers after the completion of the training;
       ``(B) have familiarity with evidence-based methods in child 
     and adolescent mental health services; and
       ``(C) have programs designed to increase the number of 
     paraprofessional child and adolescent mental health workers 
     serving high priority populations.
       ``(4) Requirements.--The Secretary may award a grant to an 
     organization under this subsection only if the organization 
     agrees that--
       ``(A) any training program assisted under the grant will 
     prioritize cultural competency;
       ``(B) the organization will provide to the Secretary such 
     data, assurances, and information as the Secretary may 
     require; and
       ``(C) with respect to any violation of the agreement 
     between the Secretary and the organization, the organization 
     will pay such liquidated damages as prescribed by the 
     Secretary by regulation.
       ``(5) Application.--Each organization desiring a grant 
     under this subsection shall submit to the Secretary an 
     application at such time, in such manner, and containing such 
     information as the Secretary may require including a 
     description of the experience of the organization in working 
     with paraprofessional child and adolescent mental health 
     workers.
       ``(6) Authorization of appropriations.--There is authorized 
     to be appropriated to carry out this subsection $5,000,000 
     for each of fiscal years 2004 through 2008.
       ``(e) Child and Adolescent Mental Health Program 
     Development Grants.--
       ``(1) Establishment.--The Secretary, acting through the 
     Administrator of the Health Resources and Services 
     Administration, may establish a program to increase the 
     number of well-trained child and adolescent mental health 
     service professionals in the United States by awarding grants 
     on a competitive basis to accredited institutions of higher 
     education to enable such institutions to establish or expand 
     accredited graduate child and adolescent mental health 
     programs.
       ``(2) Priority.--In awarding grants under this subsection, 
     the Secretary shall give priority to applicants that--
       ``(A) demonstrate familiarity with the use of evidence-
     based methods in child and adolescent mental health services;
       ``(B) provide experience in and collaboration with 
     community-based child and adolescent mental health services;
       ``(C) have included normal child development education in 
     their curricula; and
       ``(D) demonstrate commitment to working with high priority 
     populations.
       ``(3) Use of funds.--Funds awarded under this subsection 
     may be used to establish or expand any accredited graduate 
     child and adolescent mental health program in any manner 
     deemed appropriate by the Secretary, including improving the 
     coursework, related field placements, or faculty of such 
     program.
       ``(4) Requirements.--The Secretary may award a grant to an 
     accredited institution of higher education under this 
     subsection only if the institution agrees that--
       ``(A) any child and adolescent mental health program 
     assisted under the grant will prioritize cultural competency;
       ``(B) the institution will provide to the Secretary such 
     data, assurances, and information as the Secretary may 
     require; and
       ``(C) with respect to any violation of the agreement 
     between the Secretary and the institution, the institution 
     will pay such liquidated damages as prescribed by the 
     Secretary by regulation.
       ``(5) Authorization of appropriations.--There is authorized 
     to be appropriated to carry out this subsection $15,000,000 
     for each of fiscal years 2004 through 2008.
       ``(f) Definitions.--In this section:
       ``(1) High priority population.--The term `high priority 
     population' means a population that has a high incidence of 
     children and adolescents who have serious emotional 
     disturbances, are racial and ethnic minorities, or live in 
     underserved urban or rural areas.
       ``(2) Mental health service professional.--The term `mental 
     health service professional' means an individual with a 
     graduate or postgraduate degree from an accredited 
     institution of higher education in psychiatry, psychology, 
     school psychology, psychiatric nursing, social work, school 
     social work, marriage and family counseling, school 
     counseling, or professional counseling.
       ``(3) Specialized training or clinical experience in child 
     and adolescent mental health.--The term `specialized training 
     or clinical experience in child and adolescent mental health' 
     means training and clinical experience that--
       ``(A) is part of or occurs after completion of an 
     accredited graduate program in the United States for training 
     mental health service professionals;
       ``(B) consists of at least 500 hours of training or 
     clinical experience in treating children and adolescents; and
       ``(C) is comprehensive, coordinated, developmentally 
     appropriate, and of high quality to address the unique ethnic 
     and cultural diversity of the United States population.''.

     SEC. 4. AMENDMENTS TO SOCIAL SECURITY ACT TO IMPROVE CHILD 
                   AND ADOLESCENT MENTAL HEALTH CARE.

       (a) Increasing Number of Child and Adolescent Psychiatry 
     Residents Permitted To Be Paid Under the Medicare Graduate 
     Medical Education Program.--Section 1886(h)(4)(F) of the 
     Social Security Act (42 U.S.C. 1395ww(h)(4)(F)) is amended by 
     adding at the end the following:
       ``(iii) Increase allowed for training in child and 
     adolescent psychiatry.--In applying clause (i), there shall 
     not be taken into account such additional number of full-time 
     equivalent residents in the field of allopathic or 
     osteopathic medicine who are residents or fellows in child 
     and adolescent psychiatry as the Secretary determines 
     reasonable to meet the need for such physicians as 
     demonstrated by the 1999 report of the Department of Health 
     and Human Services entitled `Mental Health: A Report of the 
     Surgeon General'.''.
       (b) Extension of Medicare Board Eligibility Period for 
     Residents and Fellows in Child and Adolescent Psychiatry.--
       (1) In general.--Section 1886(h)(5)(G) of the Social 
     Security Act (42 U.S.C. 1395ww(h)(5)(G)) is amended--
       (A) in clause (i), by striking ``and (v)'' and inserting 
     ``(v), and (vi)''; and
       (B) by adding at the end the following:
       ``(vi) Child and adolescent psychiatry training programs.--
     In the case of an individual enrolled in a child and 
     adolescent psychiatry residency or fellowship program 
     approved by the Secretary, the period of board eligibility 
     and the initial residency period shall be the period of board 
     eligibility for the specialty of general psychiatry, plus 2 
     years

[[Page S7630]]

     for the subspecialty of child and adolescent psychiatry.''.
       (2) Conforming amendment.--Section 1886(h)(5)(F) of the 
     Social Security Act (42 U.S.C. 1395ww(h)(5)(F)) is amended by 
     striking ``subparagraph (G)(v)'' and inserting ``clauses (v) 
     and (vi) of subparagraph (G)''.
       (3) Effective date.--The amendments made by paragraph (1) 
     shall apply to residency training years beginning on or after 
     July 1, 2003.

     SEC. 5. CHILD MENTAL HEALTH PROFESSIONAL REPORT.

       (a) Study.--The Administrator of the Health Resources and 
     Services Administration (in this section referred to as the 
     ``Administrator'') shall study and make findings and 
     recommendations on the distribution and need for child mental 
     health service professionals, including--
       (1) the need for specialty certifications;
       (2) the breadth of practice types;
       (3) the adequacy of locations;
       (4) the adequacy of education and training; and
       (5) an evaluation of best practice characteristics.
       (b) Disaggregation.--The results of the study required by 
     subsection (a) shall be disaggregated by State.
       (c) Report.--Not later than 1 year after the date of 
     enactment of this Act, the Administrator shall submit to the 
     appropriate committees of Congress and make publicly 
     available a report on the study, findings, and 
     recommendations required by subsection (a).
       (d) Revision.--Each year the Administrator shall revise the 
     report required under subsection (c).
       (e) Authorization of Appropriations.--There are authorized 
     to be appropriated to carry out this section such sums as may 
     be necessary for each of fiscal years 2004 through 2008.

     SEC. 6. REPORTS.

       (a) Transmission.--The Secretary of Health and Human 
     Services shall transmit a report described in subsection (b) 
     to Congress--
       (1) not later than 3 years after the date of the enactment 
     of this Act; and
       (2) not later than 5 years after the date of the enactment 
     of this Act.
       (b) Contents.--The reports transmitted to Congress under 
     subsection (a) shall address each of the following:
       (1) The effectiveness of the amendments made by, and the 
     programs carried out under, this Act in increasing the number 
     of child and adolescent mental health service professionals 
     and paraprofessional child and adolescent mental health 
     workers.
       (2) The demographics of the individuals served by such 
     increased number of child and adolescent mental health 
     service professionals and paraprofessional child and 
     adolescent mental health workers.
                                 ______