[Congressional Record Volume 151, Number 25 (Monday, March 7, 2005)]
[Senate]
[Pages S2159-S2161]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. BINGAMAN:
  S. 537. 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, the landmark report Mental Health: A 
Report of the Surgeon General brought the hidden mental health crisis 
to the attention of the U.S. public. According to that report, 13.7 
million of the Nation's children and adolescents, twenty percent, have 
a diagnosable mental disorder, the most common of which include Anxiety 
Disorder, Attention Deficit/Hyperactivity Disorder (ADHD) and 
Depression. Unfortunately, only one out of five of those in need will 
receive mental health care. One of the primary reasons for this across 
the Nation is that mental health services to help treat children are in 
short supply. Long waiting lists for children seeking care, even those 
in crisis, are not uncommon. In New Mexico, it's estimated that 56,000 
children and adolescents have a mental or emotional disorder. Of these, 
almost 20,000 have serious emotional disorders. As of June 2003, there 
were only 13 licensed child and adolescent psychiatrists to serve the 
entire State of New Mexico. In addition, there are fewer trained 
psychologists and social workers per 100,000 population in New Mexico 
than the country as a whole. Children with untreated mental disorders 
are at a higher risk for school failure and dropping out, violence, 
drug abuse, suicide, and criminal activity. A 2002 report documented 
that approximately one in seven youth in New Mexico detention centers 
incarcerated because mental health care is not available. From January 
to December 2001, 718 New Mexico youth were collectively incarcerated 
for 31.3 years just to wait for a mental health treatment opening. 
Clearly, something needs to be done to address this growing shortage of 
these important health professionals.
  The Surgeon General states that there is a dearth of child 
psychiatrists, appropriately trained clinical child psychologists, or 
social workers. Nationwide, 3,543 urban, suburban, and rural localities 
have been designated Mental Health Professional Shortage Areas by the 
Federal Government due to their severe lack of psychiatrists, 
psychologists, social workers and other professionals to serve children 
and adults. According to the U.S. Bureau of Health Professions, the 
demand for the services of child and adolescent psychiatrists is 
projected to increase by 100 percent by 2020, while the number of these 
professionals is expected to increase by only 30 percent resulting in a 
shortage of over 4,000 child and adolescent psychiatrists by that year. 
The National Center for Education Statistics within the U.S. Department 
of Education reports that the national average student-to-school 
counselor ratio in U.S. schools is 513:1, more than double the 
recommended ratio of 250:1.
  In the United States, there are approximately 7,000 child and 
adolescent psychiatrists and only 300 new child and adolescent 
psychiatrists are trained each year. In 2000, the Bureau of Health 
Professions projected that between 1995 and 2020, the use of child and 
adolescent psychiatrists will increase by 100 percent.
  While the Nation as a whole is experiencing a shortage of mental 
health professionals, the problem is most acute in the rural areas. In 
NM for example, 4/5 of the psychiatrists in NM are located in 
Bernalillo and Santa Fe Counties. This area is also home to 70 percent 
of the psychologists, 53 percent of counselors and 47 percent of the 
social workers--leaving the rest of the State at a severe disadvantage.
  It is in response to the mental health workforce crisis that I rise 
with my colleagues Senator Collins of Maine, Senator Harkin of Iowa, 
Senator Dodd of Connecticut, Senator Kennedy from Massachusetts, 
Senator Reed from Rhode Island and Senator Sarbanes of Maryland, to 
offer The Child Healthcare Crisis Relief Act. 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. It provides loan 
repayment and scholarships for child mental health and school-based 
service professionals as well as internships and field placements in 
child mental health services and training for paraprofessionals who 
work in children's mental health clinical settings. This bill also 
provides grants to graduate schools to help develop and expand child 
and adolescent mental health programs. It allows for an increase in the 
number of Child and Adolescent Psychiatrists permitted under the 
Medicare Graduate Medical Education Program and, extends the Board 
Eligibility period for residents and fellows from four years to six 
years.
  Finally, this bill asks the Secretary to prepare a report on the 
distribution and need for child mental health and school-based 
professionals with respect to specialty certifications, practice 
characteristics, professional licensure, practice types, locations, 
education, and training, broken down by State so that we may better 
comprehend the mental health workforce needs that are facing our 
Nation.
  I ask unanimous consent that the text of this bill be printed in the 
Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 537

       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 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.

       Subpart 2 of part E of title VII of the Public Health 
     Service Act (42 U.S.C. 295 et seq.) is amended by adding at 
     the end the following:

     ``SEC. 771. 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

[[Page S2160]]

     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 2006 through 2010.
       ``(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.
       ``(8) Authorization of appropriations.--There is authorized 
     to be appropriated to carry out this subsection $5,000,000 
     for each of fiscal years 2006 through 2010.
       ``(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 benefitting 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 2006 through 2010.

[[Page S2161]]

       ``(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 2006 through 2010.
       ``(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 2006 through 2010.
       ``(f) Definitions.--In this section:
       ``(1) High priority population.--The term `high priority 
     population' means a population that has a significantly 
     greater incidence than the national average of children who 
     have serious emotional disturbances, children who are racial 
     and ethnic minorities, or children who 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 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, 2006.

     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 2 years 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).

     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.
                                 ______