[Congressional Record Volume 154, Number 106 (Wednesday, June 25, 2008)]
[Senate]
[Pages S6167-S6169]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      BY Mr. SMITH (for himself and Mr. Dodd):
  S. 3195. A bill to provide assistance to adolescents and young adults 
with serious mental health disorders as they transition to adulthood; 
to the Committee on Health, Education, Labor, and Pensions. I
  Mr. SMITH. Mr. President, I rise today with my colleague Senator Dodd 
to introduce a bill that will have a tremendous impact on millions of 
young adults in America who will suffer from mental illness in their 
lifetime. The Healthy Transition Act of 2008 is an important bill and I 
look forward to its passage.
  Senator Dodd has been an ardent champion for children, and as the 
Sponsor of the Garrett Lee Smith Memorial Act in 2004 and the bill to 
reauthorize the successful grant program again last year, it has been 
an honor to work with him to ensure our Nation's youth and their mental 
health needs are not forgotten.
  I want to begin by thanking my colleague Representative Pete Stark 
for working with me on this important issue and for joining me in 
requesting a report by the Government Accountability Office,GAO last 
year on the barriers facing youth with serious mental health disorders 
as they age into adulthood. It has been a pleasure to work with him on 
drafting legislation that we will introduce today as I know he shares a 
passion for improving the lives of our children and young adults.
  This time in a young person's life is so difficult with the pressures 
of being independent, finding a first job, going to college and really 
discovering who you are. For so many of our Nation's youth this time is 
made so much more difficult by their struggle with mental illness. My 
son Garrett struggled with his transition to adulthood and in his 
ability to access the help he needed during this critical time. These 
young adults deserve our attention, our support and our compassion.
  Finally, I want to thank the many stakeholders and advocates that 
have put so much time and dedication into working with us to introduce 
this bill, the Healthy Transition Act of 2008. They include the 
National Alliance on Mental Illness, the Children's Defense Fund, the 
National Federation of Families for Children's Mental Health, the 
Bazelon Center for Mental Health Law, and the American Psychological 
Association, just to name a few.
  The findings of the GAO report that Congressman Stark and I 
requested, tells us that at least 2.4 million young adults aged 18-26 
had a mental illness in 2006. We know that this number could be greatly 
understated as it does not count young adults who are 
institutionalized, incarcerated or homeless--all of which are groups 
that are known to have higher rates of mental illness.
  These young people have such tremendous challenges that cause them to 
demonstrate lower rates of high school graduation and college 
attendance than their peers who do not suffer from mental illness. They 
also have lower propensity to find employment and remain stable in 
their communities. In my home State of Oregon, this transition-age 
population was found to be 80 percent less likely than any other 
population in the State with mental health needs to receive services.

  However, from this report, and the work innovative States are doing 
to support our young people, we know that we can do a better job of 
helping these youth. We can do better at ensuring they can remain 
stable in their communities, that they can live healthy lives, and that 
they can prosper as adults.
  The bill that Senator Dodd, Representative Stark and I are 
introducing today will support States that want to do better for our 
Nation's young adults with mental illness. As the GAO found, too often 
services are not directed at this population or young adults are shoved 
into a system that was designed for a different age group with 
different needs.
  Our bill, the Healthy Transition Act of 2008, will provide grants to 
States to first develop statewide coordination plans to assist 
adolescents and young adults with a serious mental health disorder to 
acquire the skills and resources they need to make a healthy transition 
to adulthood. After this plan has been submitted and evaluated by 
SAMHSA, States may then compete for a second round of grants to help 
them implement the plan that they have made.
  Lastly, this bill will develop a Committee of Federal Partners that 
will coordinate service programs that assist adolescents and young 
adults with mental illness at the federal level and provide technical 
assistance to States as they implement their plans. They also will 
report to Congress on their activities so that we can ensure they are 
doing their best to make sure these vulnerable young adults get the 
help and support they need.

[[Page S6168]]

  This is such a critical time in a person's life and I look forward to 
continuing to work with my colleagues to make sure it is as healthy and 
positive an experience as it can be. I look forward to working with my 
colleagues to ensure its passage. I urge my colleagues on both sides of 
the aisle to support the bill.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 3195

       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 ``Healthy Transition Act of 
     2008''.

     SEC. 2. HEALTHY TRANSITIONING FOR YOUTH.

       Subpart 3 of part B of title V of the Public Health Service 
     Act (42 U.S.C. 290bb-31 et seq.) is amended by adding at the 
     end the following:

     ``SEC. 520K. HEALTHY TRANSITIONING FOR YOUTH.

       ``(a) Planning Grants.--
       ``(1) In general.--The Secretary, in consultation with the 
     agencies described in subsection (c)(3), shall award grants 
     or cooperative agreements to States to develop plans for the 
     statewide coordination of services to assist adolescents and 
     young adults with a serious mental health disorder in 
     acquiring the skills, knowledge, and resources necessary to 
     ensure their healthy transition to successful adult roles and 
     responsibilities.
       ``(2) Application.--To be eligible for a grant or 
     cooperative agreement under this subsection, a State shall 
     submit to the Secretary an application, at such time, in such 
     manner, and containing such information as the Secretary may 
     require.
       ``(3) Plan.--Not later than 18 months after the receipt of 
     a grant or cooperative agreement under this subsection, a 
     State shall submit to the Secretary a State plan that shall 
     include--
       ``(A) reliable estimates on the number of adolescents and 
     young adults with serious mental health disorders in the 
     State;
       ``(B) information on the youth targeted under this Act, 
     including--
       ``(i) the number of adolescents and young adults with 
     serious mental health disorders in the State and the number 
     of such individuals who are currently being served in the 
     State;
       ``(ii) the number of such individuals who are receiving 
     mental health services provided by State agencies other than 
     the agency responsible for mental health services in the 
     State;
       ``(iii) the number of youth with serious mental health 
     disorders who are involved in the juvenile justice system in 
     the State;
       ``(iv) the number of youth with serious mental health 
     disorders who are involved in the child protection system in 
     the State;
       ``(v) the number of youth with serious mental health 
     disorders who have plans in effect under the Individuals with 
     Disabilities Education Act in the State;
       ``(vi) the number of youth with serious mental health 
     disorders who are involved in vocational rehabilitation in 
     the State;
       ``(vii) the range of ages served by the programs described 
     in clauses (i) through (vi);
       ``(viii) a description of the overall transition 
     coordination that is currently provided by the State or local 
     authorities and programs in the State;
       ``(C) an identification of the skills, knowledge, and 
     resources that adolescents and young adults with serious 
     mental health disorders in the State will need to ensure 
     their successful and healthy transition into adult roles and 
     responsibilities;
       ``(D) an identification of the obstacles that adolescents 
     and young adults with serious mental health disorders in the 
     State encounter while transitioning into adult roles and 
     responsibilities, including breaks in service or programs 
     caused by eligibility and program criteria differences 
     between the child and adult mental health systems and the 
     lack of local access to mental health and transition 
     services;
       ``(E) an identification of the current level, type, 
     quality, effectiveness, and availability of services, 
     including evidence-based practices, available in the State 
     that are uniquely designed for adolescents and young adults 
     with a serious mental health disorder to ensure a healthy 
     transition to successful adult roles and responsibilities;
       ``(F) an identification of adolescents and young adults 
     with a serious emotional disorder who have a low likelihood 
     of a healthy and successful transition due to the severity of 
     their illness, and an identification of how the State will 
     provide treatment and other support services to this 
     population;
       ``(G) an analyses of the strengths, weaknesses, and gaps of 
     the current system in the State, including the availability 
     of lack of mental health professionals trained to treat 
     adolescents and young adults with a serious mental health 
     disorder, as well as barriers, to address the needs of 
     adolescents and young adults with a serious mental health 
     disorder with an appropriate array of effective services and 
     supports;
       ``(H) a description of how the State will improve the 
     system of care to ensure successful and healthy transitions;
       ``(I) a description of how the State will coordinate the 
     services of State and non-State agencies that serve 
     adolescents and young adults with a serious mental health 
     disorder;
       ``(J) a description of how the State will provide a system 
     of coordinated service delivery under the grant or 
     cooperative agreement that will address the effective 
     services, supports, and unique needs of adolescents and young 
     adults with a serious mental disorder, including those who 
     have been placed in out of home settings such as the juvenile 
     justice system or those who are or were involved in the child 
     protection systems;
       ``(K) a description of how the State will coordinate 
     efforts under the grant or cooperative agreement with 
     existing services and systems in the State that focus on life 
     skills necessary for a healthy transition including health, 
     employment and pre-employment training, transportation, 
     housing, recreation, mental health services, substance abuse, 
     vocational rehabilitation services for persons with 
     disabilities, and training for adolescents, young adults and 
     adults, consumers and their families;
       ``(L) a description of how the State will work to build 
     workforce capacity to serve the population described in 
     subparagraph (J);
       ``(M) a description of how the State will reach out to the 
     target population pre-transition, during transition, and 
     post-transition;
       ``(N) a description of how the State is currently utilizing 
     and leveraging (and how the State will use and leverage) 
     Federal funding streams to care for the target population, 
     including funding through Medicaid, the Department of Housing 
     and Urban Development, the Department of Labor though 
     supported employment, the Early and Periodic Screening, 
     Diagnosis, and Treatment Program, and other programs, and 
     including an outline of the barriers the State faces in 
     making Federal funding flow to the targeted population in a 
     coordinated manner;
       ``(O) a description of how the State will involve 
     adolescents and young adults with serious mental health 
     disorders and their families and guardians in the service 
     design, planning, and implementation of the plan under the 
     grant or cooperative agreement;
       ``(P) an implementation subplan that shall be designed to 
     recognize the challenges of implementing a program between 
     communities at a statewide level and how the State will 
     overcome those challenges;
       ``(Q) a description of how the State plans to evaluate 
     outcomes under the program funded under the grant or 
     cooperative agreement;
       ``(R) a designation of the State office that will be the 
     lead agency responsible for administering the program under 
     the grant or cooperative agreement;
       ``(S) a description of how the State will ensure that the 
     activities planned under the grant or cooperative agreement 
     will remain sustainable at the end of the cycle of Federal 
     funding under this section; and
       ``(T) any other information determined appropriate by the 
     Secretary.
       ``(4) Duration of support.--The duration of a grant or 
     cooperative agreement under this subsection shall not exceed 
     2 fiscal years.
       ``(5) Technical assistance.--The Secretary shall provide 
     technical assistance and training in the development of the 
     plan under paragraph (3), including convening a meeting of 
     potential applicants for grants or cooperative agreement 
     under this subsection.
       ``(6) Authorization of appropriations.--
       ``(A) In general.--There is authorized to be appropriated 
     to carry out this subsection, $6,000,000 for fiscal year 
     2009, and such sums as may be necessary for each of fiscal 
     years 2010 through 2013.
       ``(B) Technical assistance.--The Secretary shall make 
     available 15 percent of the amount appropriated under 
     subparagraph (A) in each fiscal year for technical assistance 
     under paragraph (5)
       ``(b) Implementation Grants.--
       ``(1) In general.--The Secretary shall award grants or 
     cooperative agreement to eligible States for the coordination 
     of services to assist adolescents and young adults with 
     serious mental health disorders in acquiring the services, 
     skills, and knowledge necessary to ensure their healthy 
     transition to successful adult roles and responsibilities.
       ``(2) Eligibility.--To be eligible for a grant or 
     cooperative agreement under paragraph (1), a State shall--
       ``(A) be a State that has received a grant or cooperative 
     agreement under subsection (a) and submitted a plan that 
     meets the requirements of paragraph (3) of such subsection; 
     or
       ``(B) be a State that has not received such a grant or 
     cooperative agreement but that has a plan that is equivalent 
     to the plan required under subsection (a)(3).
       ``(3) Application.--To be eligible for a grant or 
     cooperative agreement under this subsection, a State shall 
     submit to the Secretary an application, at such time, in such 
     manner, and containing such information as the Secretary 
     requires, including--
       ``(A) a copy of the plan submitted under subsection (a)(3), 
     or in the case of a State described in paragraph (2)(B), a 
     plan that is equivalent to the plan required under subsection 
     (a)(3);
       ``(B) a list of the State agencies that will participate in 
     the program to be funded under the grant or cooperative 
     agreement along with written verification as to the 
     commitment of such agencies to the program;

[[Page S6169]]

       ``(C) an assurance that the State will develop a 
     coordinating committee composed of representatives of the 
     participating State agencies, as well as consumers and 
     families of consumers;
       ``(D) a description of the role of such coordinating 
     committee; and
       ``(E) the names of at least two local communities that will 
     implement the program at the local level and how those 
     communities will implement the State plan.
       ``(4) Use of funds.--Funds provided under a grant or 
     cooperative agreement under this subsection shall be used to 
     implement the State plan, including--
       ``(A) facilitating a youth ombudsman or other advocacy 
     program;
       ``(B) facilitating peer support programs and networks 
     within the State;
       ``(C) facilitating access to independent living and life 
     skills supports;
       ``(D) developing infrastructure to support access to 
     necessary health, mental health, employment, education, and 
     housing supports; and
       ``(E) facilitating the training of support providers and 
     workforce capacity to serve the target population.
       ``(5) Duration of support.--The duration of a grant or 
     cooperative agreement under this subsection shall not exceed 
     5 fiscal years.
       ``(6) Matching requirement.--
       ``(A) In general.--To be eligible for a grant or 
     cooperative agreement under this subsection, the State shall 
     agree that, with respect to the costs to be incurred by the 
     State in carrying out activities under the grant or 
     cooperative agreement, the State will make available 
     (directly or through donations from public or private 
     entities) non-Federal contributions toward such costs in an 
     amount that--
       ``(i) for the first fiscal year for which the State 
     receives payments under the grant or cooperative agreement, 
     is not less than $1 for each $3 of Federal funds provided 
     under the grant or cooperative agreement;
       ``(ii) for any second or third such fiscal year, is not 
     less than $1 for each $2 of Federal funds provided under the 
     grant or cooperative agreement;
       ``(iii) for any fourth such fiscal year, is not less than 
     $1 for each $1 of Federal funds provided under the grant or 
     cooperative agreement; and
       ``(iv) for any fifth such fiscal year, is not less than $2 
     for each $1 of Federal funds provided under the grant or 
     cooperative agreement.
       ``(B) Determination of amount contributed.--
       ``(i) In general.--Non-Federal contributions required under 
     subparagraph (A) may be in cash or in kind, fairly evaluated, 
     including plant, equipment, or services. Amounts provided by 
     the Federal Government, or services assisted or subsidized to 
     any significant extent by the Federal Government, may not be 
     included in determining the amount of such non-Federal 
     contributions.
       ``(ii) Non-federal contributions.--In making a 
     determination of the amount of non-Federal contributions for 
     purposes of clause (i), the Secretary may include only non-
     Federal contributions in excess of the average amount of non-
     Federal contributions made by the State involved toward the 
     purpose of the grant or cooperative agreement under this 
     subsection for the 2-year period preceding the first fiscal 
     year for which the State receives a grant or cooperative 
     agreement under such subsection.
       ``(7) Technical assistance.--The Secretary shall provide 
     technical assistance and training to recipients of grants or 
     cooperative agreements under this subsection, including 
     convening meetings each year to identify ways of improving 
     State programs. Such meetings shall include the members of 
     the Federal Partners Committee under subsection (c).
       ``(8) Evaluation.--The Secretary shall carry out a cross-
     site evaluation that--
       ``(A) reports on current State efforts to transition the 
     population involved prior to the implementation of the State 
     plans under this section; and
       ``(B) evaluates the program carried out by the State under 
     this section to determine the effectiveness of such program 
     in meeting its goals and objectives as compared with current 
     approaches.
       ``(9) Authorization of appropriations.--
       ``(A) In general.--There is authorized to be appropriated 
     to carry out this subsection, $6,000,000 for each of fiscal 
     years 2009 and 2010, $15,000,000 for fiscal year 2011, 
     $20,000,000 for fiscal year 2012, and $25,000,000 for fiscal 
     year 2013.
       ``(B) Technical assistance and evaluation.--The Secretary 
     shall make available 15 percent of the amount appropriated 
     under subparagraph (A), or $2,000,000 whichever is greater, 
     in each fiscal year for technical assistance under paragraph 
     (7) and the evaluation under paragraph (8).
       ``(c) Federal Partners.--
       ``(1) In general.--The Secretary shall designate an 
     existing Federal entity, or establish a Committee of Federal 
     Partners, to coordinate service programs to assist 
     adolescents and young adults with serious mental health 
     disorders in acquiring the knowledge and skills necessary for 
     them to transition into adult roles and responsibilities.
       ``(2) Existing federal entity.--If the Secretary elects to 
     utilize an existing Federal entity under paragraph (1), the 
     Secretary shall ensure that--
       ``(A) such entity is comprised of representatives of at 
     least the agencies described in paragraph (3); and
       ``(B) such entity shall give special attention to the 
     knowledge and skills needed by adolescents and young adults 
     with mental health disorders in coordinating the programs 
     funded under this section.
       ``(3) Membership.--A Federal entity utilized under this 
     subsection, or a committee established under paragraph (1), 
     shall include representatives of--
       ``(A) the Department of Education (or any subagency of the 
     Department);
       ``(B) the Department of Health and Human Services (or any 
     subagency of the Department);
       ``(C) the Department of Labor (or any subagency of the 
     Department);
       ``(D) the Department of Transportation (or any subagency of 
     the Department);
       ``(E) the Department of Housing and Urban Development (or 
     any subagency of the Department);
       ``(F) the Department of Interior (or any subagency of the 
     Department);
       ``(G) the Department of Justice (or any subagency of the 
     Department);
       ``(H) the Social Security Administration;
       ``(I) an organization representing consumers and families 
     of consumers as designated by the Secretary; and
       ``(J) an organization representing mental health and 
     behavioral health professionals as designated by the 
     Secretary.
       ``(4) Role of entity or committee.--The Federal entity or 
     committee designated or established under paragraph (1) shall 
     review how Federal programs and efforts that address issues 
     related to the transition of adolescents and young adults 
     with serious mental health disorders may be coordinated to 
     ensure the maximum benefit for the individuals being served 
     and to provide technical assistance to the States who are 
     planning or implementing programs under this section.
       ``(5) Report.--Not later than 18 months after the date of 
     enactment of this Act, the Federal entity or committee 
     designated or established under paragraph (1) shall submit to 
     the appropriate committees of Congress, and make available to 
     the general public, a report concerning the participation of 
     Federal agencies and stakeholders in the planning and 
     operations of the entity or committee. Such report shall also 
     contain a description of the status of the efforts of such 
     entity or committee in coordinating Federal efforts on behalf 
     of the target population.
       ``(6) Authorization of appropriations.--There are 
     authorized to be appropriated to carry out this subsection, 
     $1,000,000 for fiscal year 2009, and such sums as may be 
     necessary for each of fiscal years 2010 through 2013.
       ``(d) Definition.--In this section, the term `serious 
     mental health disorder' has the meaning given the term 
     `serious mental illness' by the Administrator for purposes of 
     this title.''.

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