[Congressional Record Volume 168, Number 158 (Thursday, September 29, 2022)]
[House]
[Pages H8235-H8252]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
{time} 1115
MENTAL HEALTH MATTERS ACT
General Leave
Mr. DeSAULNIER. Madam Speaker, I ask unanimous consent that all
Members may have 5 legislative days in which to revise and extend their
remarks and insert extraneous material on H.R. 7780, the Mental Health
Matters Act.
The SPEAKER pro tempore (Ms. Jackson Lee). Is there objection to the
request of the gentleman from California?
There was no objection.
The SPEAKER pro tempore. Pursuant to House Resolution 1396 and rule
XVIII, the Chair declares the House in the Committee of the Whole House
on the state of the Union for the consideration of the bill, H.R. 7780.
The Chair appoints the gentleman from Illinois (Mr. Rush) to preside
over the Committee of the Whole.
{time} 1118
In the Committee of the Whole
Accordingly, the House resolved itself into the Committee of the
Whole House on the state of the Union for the consideration of the bill
(H.R. 7780) to support the behavioral needs of students and youth,
invest in the school-based behavioral health workforce, and ensure
access to mental health and substance use disorder benefits, with Mr.
Rush in the chair.
The Clerk read the title of the bill.
The CHAIR. Pursuant to the rule, the bill is considered read the
first time.
General debate shall be confined to the bill and shall not exceed 1
hour equally divided and controlled by the chair and ranking minority
member of the Committee on Education and Labor or their respective
designees.
The gentleman from California (Mr. DeSaulnier) and the gentlewoman
from North Carolina (Ms. Foxx) each will control 30 minutes.
The Chair recognizes the gentleman from California.
Mr. DeSAULNIER. Mr. Chair, I yield myself such time as I may consume.
Mr. Chairman, the COVID-19 pandemic has exacerbated the mental health
crisis among American students, educators, and families.
In 2021, 44 percent of students experienced persistent feelings of
hopelessness; almost 20 percent seriously considered suicide; and 9
percent of American kids attempted suicide.
Regrettably, 80 percent of youth in need of mental health services do
not have the access to heal in their communities. As a result,
educators have been forced to play an outsized role in supporting and
responding to students' mental health needs, leading to increased
depression and trauma among educators, their students, their families,
and the community. However, our schools do not have the specialized
staff necessary to respond to the increased prevalence and complexity
of students' mental health needs.
According to a 2019 ACLU study, no State met the student-to-social
worker ratio of one social worker for every 250 students, as
recommended by the National Association of Social Workers. Not one
State.
On top of that, the national ratio of school psychologists per
students during the 2020-2022 school years was one psychologist per
every 1,162 students--more than double the ratio recommended by the
National Association of School Psychologists. Clearly, this is
unacceptable.
The rise in mental health challenges is not isolated to students and
educators. Nearly half of the United States workforce now suffers from
mental health issues since the COVID-19 pandemic started. Yet, many
workers are denied the mental health and substance use disorder
benefits they are legally entitled to receive under their employer-
sponsored health plan.
In a recent report to Congress, the Departments of Labor, Health and
Human Services, and the Treasury found widespread violations of the
Mental Health Parity and Addiction Equity Act by group health plans.
Unfortunately, some of these plans are failing to maintain parity
between behavioral health benefits and physical health benefits as
required by statute.
The report recommended that Congress enhance the Secretary of Labor's
capacity to enforce the parity law, including providing authority to
impose civil monetary penalties for violations.
Notably, the same recommendations were made by former President
Trump's Commission on Combating the Opioid Crisis, which was led by
then-New Jersey Governor, Chris Christie.
In response to these violations and the national mental health
crisis, I introduced the Mental Health Matters Act, which includes
proposals championed by several committee members.
This legislation helps Head Start agencies implement evidence-based
interventions to improve the behavioral health of children and staff in
Head Start programs.
It improves trauma-informed services in schools by developing
innovative initiatives to link schools and local educational agencies
with local trauma-informed support and mental health systems.
It requires colleges and universities to accept existing
documentation of disability and provide reasonable accommodations so
disabled students can achieve success in higher education.
It also provides the Department of Labor with enhanced authority to
ensure that private, employer-sponsored group health plans and insurers
comply with the mental health parity and related laws.
The bill ensures workers who are wrongfully denied health or
retirement benefits under their job-based plans have meaningful access
to the courts.
And finally, this legislation directs the Department of Education to
award grants to build a pipeline of school-based mental health service
providers and increase the number of mental health professionals
serving in elementary and secondary schools in high-need areas.
Mr. Chairman, simply put, the Mental Health Matters Act delivers the
resources students, educators, and families need to improve their well-
being.
Mr. Chair, I urge my colleagues to support this legislation, and I
reserve the balance of my time.
Ms. FOXX. Mr. Chairman, I yield myself such time as I may consume,
and I thank my good friend from California for yielding time.
Mr. Chairman, H.R. 7780, the Mental Health Matters Act, is a package
of bills our country would be better off without. For example, Title VI
of the bill, the Strengthening Behavioral Health Benefits Act, contains
dangerous policy which would threaten access to critical workplace
benefits.
How would this legislation drive employers to drop benefits? H.R.
7780 allows the Department of Labor, DOL, to levy civil monetary
penalties against plans and employers for ambiguous mental health
parity violations.
Employers who offer mental health benefits under the Employee
Retirement Income Security Act, ERISA, do so voluntarily. They should
not be penalized for violating standards that are unclear and vague.
Republicans and
[[Page H8236]]
Democrats alike support mental health parity, which is why Congress has
passed multiple laws to ensure employers are able to meet mental health
parity requirements.
Yet, despite receiving explicit direction from Congress outlining
what DOL must provide to plans, the Department has yet to issue
guidance. Employers and plans have been asking the Department for years
to comply with the law and provide examples which illustrate compliance
and noncompliance, recommendations to advance compliance, and
clarifying information on how plans may demonstrate compliance.
However, instead of helping plans comply, DOL has blamed them for not
being able to read the minds of Washington bureaucrats. Providing DOL
with the authority to levy civil monetary penalties against plans and
increase their risk of litigation will only force plans to drop mental
health coverage.
This legislation would also increase DOL's budget for mental health
parity enforcement by an additional $275 million over 10 years, a sure
sign DOL wants to double down on its aggression toward employers. This
money would be better spent on compliance assistance instead of
targeting employers based on ambiguous standards.
Additionally, Title VII, the Employee and Retiree Access to Justice
Act, gets rid of arbitration clauses, class action waivers, and
discretionary clauses in employee benefit plans. This opens the door to
increased litigation against plan sponsors which could drastically
increase the cost of administering these plans.
Democrats are treating ERISA arbitration like a treacherous backroom
deal, but, in reality, arbitration settles disputes more quickly and
more often in favor of claimants than litigation. The only people who
benefit from months and years in litigation are trial lawyers.
{time} 1130
This bill also contains provisions regarding the youth mental health
crisis. There is bipartisan agreement that addressing the mental health
of youth matters. However, we can't ignore the fact that Democrats
exacerbated the youth mental health situation by prolonging school
shutdowns.
At the behest of teachers unions, Democrat politicians from the
Centers for Disease Control and Prevention to school district
administrators kept classrooms shuttered, despite knowing that schools
were not major vectors of spread and that children were suffering from
this forced isolation. The results have been catastrophic.
In 2021, more than one-third of high school students reported they
experienced poor mental health during the COVID-19 pandemic. According
to one study, from February to March 2021, the number of ER visits by
young girls for suspected suicide attempts was up by more than 50
percent compared to 2019.
School closures fail students, which is why we should be spending our
time addressing the massive learning loss students suffered because of
these shutdowns. This is a problem that cannot be neglected, especially
if we want to see these young people have as bright a future as
possible.
Lastly, H.R. 7780 includes the Respond, Innovate, Succeed, and
Empower Act, or RISE Act, the intent of which Republicans support.
While I agree that students with disabilities shouldn't have to jump
through hoops to obtain accommodations at school, this legislation will
have unintended consequences as currently drafted.
For example, this legislation forces colleges and universities to
accept outdated documentation from students who are claiming disability
status but who do not, in fact, have a disability. This legislation
should have been debated with stakeholders before being rushed to the
House floor, but, as usual, Democrats took a shortcut.
I encourage my colleagues to work across the aisle and utilize the
deliberative process to form more commonsense and targeted legislation
if they actually want to address our country's mental health situation.
H.R. 7780 is a bill that tries to do too much and none of it well.
Mr. Chairman, I urge my colleagues to vote ``no'' on this
legislation, and I reserve the balance of my time.
Mr. DeSAULNIER. Mr. Chair, I yield myself such time as I may consume.
Mr. Chair, I do want to say that it is always delightful, truthfully,
to see my friend and our differences of opinion. I see Mr. Allen will
speak as well, my wonderful colleague and ranking member of the
subcommittee.
Just as a former small business owner, the term ``voluntary'' is, in
my view, accurate in the sense that it is an employer's choice to
provide health insurance, but the parity is required by statute once
having done that. So, it is a question of terminology, perhaps.
As I have said, even just shortly ago, I am ready to work with my
friend to work on enforcement mechanisms that are efficient because I
think we all agree there is a problem here in this country about mental
health and kids and how we enforce the best possible enforcement for
employers. The vast majority of employers do the right thing, but how
to make sure that people who don't do the right thing, and thereby get
an advantage if we don't enforce the laws against law-abiding
employers, I really think that we can work something out.
This is the best mechanism I see right at the moment, however
imperfect. I look forward to continuing the conversation.
Mr. Chairman, I yield 2 minutes to the gentlewoman from Oregon (Ms.
Bonamici), who is the chair of the Civil Rights and Human Services
Subcommittee of the Education and Labor Committee.
Ms. BONAMICI. Mr. Chairman, I rise today in support of the Mental
Health Matters Act. I thank Representative DeSaulnier for his
leadership and for yielding. I thank Chairman Scott, as well, for
making this important issue a priority in the committee.
In the fall of 2020, pediatric experts declared a national state of
emergency in children's mental health. Our Nation's students continue
to face significant and serious challenges with social, emotional, and
mental health. We must meet them where they are by providing evidence-
based treatment and support so they can learn and thrive.
This timely legislation provides needed resources and will greatly
improve the behavioral health of children and school staff by building
a pipeline of school-based mental health service providers. I want to
mention the Ballmer Institute, which is going to be opening soon in
Oregon for that very purpose.
Because stress can affect the developing brain, this bill invests in
Head Start to address the mental and behavioral health of young
children and to support staff wellness. Importantly, the bill will also
support students with disabilities beyond their high school education
by including my bipartisan bill, the Respond, Innovate, Succeed, and
Empower Act, or RISE Act.
Students with disabilities face many barriers to earning a degree or
credential after high school. Without the proper accommodations,
students with disabilities complete college at a lower rate than their
peers without disabilities. Less than 5 percent of students with
disabilities disclose their specific learning disability to their
college because of stigma. Currently, students are required to obtain
expensive and expansive new evaluations before they can access special
education services in college. This onerous process poses additional
unnecessary barriers to success for students with disabilities.
The RISE Act is bipartisan legislation that aims to provide students
with disabilities with affirmation, comfort, and peace of mind during
their transition from high school to college by allowing college
students to use existing documentation of a disability--whether it is
an IEP, 504 plan, or another type of commonly recognized
documentation--when seeking accommodations on campus.
My bipartisan, bicameral RISE Act will make it easier for students
with disabilities to access the support services they need by easing
the burdensome, expensive, and redundant requirements students
frequently face when entering college. This action alone could save
families hundreds, even thousands, of dollars.
I thank my co-leads, Representatives Bucshon, Schrier, and McMorris
Rodgers, for supporting the RISE Act, Chairman Scott for including the
RISE Act in this important mental health package we are discussing
today, and Speaker Pelosi and Leader
[[Page H8237]]
Hoyer for bringing the Mental Health Matters Act to the floor.
By considering this legislation, we are showing a commitment to
serving our Nation's most vulnerable students and making our schools
and colleges safer and more welcoming places to learn.
Mr. Chairman, I urge all of my colleagues on both sides of the aisle
to support the important Mental Health Matters Act.
Ms. FOXX. Mr. Chairman, I yield 3 minutes to the gentleman from
Georgia (Mr. Allen).
Mr. ALLEN. Mr. Chair, I thank the ranking member for the opportunity
to talk about this important legislation.
Millions of Americans experience mental health issues and struggle to
find adequate care. We all agree on that in this Chamber. This is
especially true among our Nation's youth due in large part to the
prolonged school closures championed by the Democrats.
Republicans have continually stressed the mental health toll students
have shouldered because of these school closures. But closures were led
by Democrats in Democrat-run States that were allies with the teachers
unions.
That is why I have also introduced H.R. 787, the Expanding Student
Access to Mental Health Services Act, which would authorize State and
local educational agencies to use student support and academic
enrichment grants to improve mental health services available to
students by allowing funds to be used for identifying and disseminating
best practices for mental health first aid, emergency planning,
coordination of services, and telehealth services.
I would have loved to have introduced this bill as an amendment to
H.R. 7780, but, unfortunately, the Democrats did not allow any
amendments to this legislation on the floor today. Rather than working
in a bipartisan manner to reform our current mental health care
systems, Democrats are pushing a bill that will punish employers for
offering mental health benefits to their employees and incite brash
litigation against benefit plan sponsors.
Let me repeat: Democrats are pushing a bill that will punish
employers for offering mental health benefits to their employees and
incite brash litigation against benefit plan sponsors.
To add insult to injury, H.R. 7780 recklessly spends 275 million
taxpayer dollars under the guise of mental health parity enforcement,
but the Department of Labor hasn't even clarified what mental health
parity means.
So, we are going to pass it and then figure out what it means. We
have heard that before.
How can it be enforced if no one understands what it is? How can we
authorize this funding without vetting how it will be spent?
Additionally, H.R. 7780 prohibits arbitration clauses, class action
waivers, and discretionary clauses from employee benefit plans under
the Employee Retirement Income Security Act, known as ERISA. In short,
this bill will only benefit trial lawyers and will lead to a reduction
in mental health benefits as employers will have to divert money to pay
attorney's fees.
This is precisely why I tried to submit an amendment to the bill on
the floor today, almost the same amendment I offered during its markup
in the Education and Labor Committee, which the Democrats failed to
pass.
My proposed amendment would have made the Department of Labor's
ability to bring civil action against ERISA plans offering mental
health benefits conditional on the Department issuing additional
guidance on these vague mental health parity requirements. It would
also strike the $275 million in funding that has been allocated to the
Department of Labor. But, again, Democrats blocked our ability to offer
amendments.
Of course, I would be remiss if I didn't mention that Democrats
exempt unions from some of the most damaging provisions of the bill.
It is imperative that we address the mental health crisis that is
plaguing our society, but we should do that by ensuring access to
reliable, high-quality, and affordable mental health services.
The CHAIR. The time of the gentleman has expired.
Ms. FOXX. Mr. Chair, I yield an additional 30 seconds to the
gentleman from Georgia.
Mr. ALLEN. Mr. Chair, I emphasize it is imperative that we address
the mental health crisis that is plaguing our society. We all agree
here in the House on that. But we should do that by ensuring access to
reliable, high-quality, and affordable mental health services, not by
punishing employers with undue litigation for offering these benefits
to our workers.
I remain committed to finding solutions to combat the mental health
problem in this country, especially for our youth. It is my hope that,
in the future, as my chairman said, House Democrats will work in a
bipartisan manner to address this crisis, rather than bringing damaging
legislation such as H.R. 7780 to the floor.
Mr. DeSAULNIER. Mr. Chair, I yield 2 minutes to the very
distinguished gentleman from Connecticut (Mr. Courtney), who is a
member of the Education and Labor Committee.
Mr. COURTNEY. Mr. Chair, for years, leaders in mental health and
addiction have been sounding the alarm that despite the best
intentions, our Nation's mental health parity laws are not meeting the
needs and expectations of patients.
Existing mental health parity laws were supposed to ensure that
patients access mental health benefits with the same ease as medical
benefits under their insurance.
Unfortunately, we know that patients and their families are
continuing to struggle with barriers to needed treatment that should be
prohibited under existing law.
The 2022 mental health parity report to Congress from the U.S.
Department of Labor, HHS, and Treasury found that health plans and
insurers are failing to comply with our Federal parity laws at an
alarming rate, meaning that plans are illegally denying claims for
treatment associated with mental or behavioral health conditions at a
time when substance use disorder, depression, anxiety, and other mental
health conditions are rising rapidly, especially for children.
The legislation we are considering today would implement
recommendations to fix this. The Mental Health Matters Act includes my
legislation, the Strengthening Behavioral Health Benefits Act, which
would bolster the ability of the Department of Labor to effectively
enforce the mental health parity laws and provide resources to the
Department of Labor to help bring plans into compliance. The goal here
is compliance, not retribution.
In their 2022 report, DOL made a series of recommendations for ways
Congress can amend ERISA to empower the Department and patients to hold
insurance companies accountable to the law. In this legislation today,
we are codifying those recommendations.
This will help patients recover funds spent on treatment that their
insurance company should have paid for and will empower DOL to require
insurance companies to revisit claims that they wrongly denied. It will
also allow penalties to be levied against plans that are found in
violation of law, which does not exist today. As the old ancient legal
maxim says, without a remedy, there is no right.
That is what this bill is doing. It is enhancing people's rights for
mental health parity.
{time} 1145
The CHAIR. The time of the gentleman has expired.
Mr. DeSAULNIER. Mr. Chair, I yield an additional 30 seconds to the
gentleman from Connecticut.
Mr. COURTNEY. Mr. Chair, this is not the first time the executive
branch has asked for additional authority from Congress. President
Trump's Commission on Opioids issued a report in 2017 which asked for
exactly the same reforms. DOL must be given the real authority to
regulate the health insurance industry.
``The health insurers are not following Federal law requiring parity
in the reimbursement of mental health and addiction. They must be held
responsible.'' That is a quote from Chris Christie, the chairman of
President Trump's opioid task force.
We are executing on bipartisan recommendations that came from the
prior administration and from the Biden administration to create a real
mental health parity system in our Nation.
[[Page H8238]]
Mr. Chair, I urge passage of the bill.
Ms. FOXX. Mr. Chair, our colleagues keep saying the goal is
compliance. Well, if the goal is compliance, then it is up to the
Department to define the standard. Employers do not know what the
standard is. Therefore, they do not know what is expected of them to
comply.
Mr. Chair, I yield 3 minutes to the gentleman from Virginia (Mr.
Good).
Mr. GOOD of Virginia. Mr. Chair, I rise today in strong opposition to
H.R. 7780.
The China virus lockdowns of our schools resulted in an undisputed
increase in mental health issues for our students, for our children.
This bill is yet another leftist response to the lockdown problems that
Democrats created.
Thanks to Democrat lockdowns in collusion with their beloved teachers
unions, students across this country are suffering academically and
mentally. You know, students--remember, the ones who we were supposed
to put first in decisions regarding our schools. That is what we used
to do.
But 9-year-old students have suffered a 7-point drop in math scores
and a 5-point drop in reading scores since 2020, losing 20 years of
academic progress, meaning children today are posting the same test
scores in reading and math as they did 20 years ago.
The CDC reports that students who experienced long-term isolation
from schools because Democrats would not reopen or let the kids come
back to school, they have experienced acutely higher feelings of
hopelessness and higher rates of attempted suicide as a result.
According to one report, emergency room visits for young girls for
attempted suicides were 51 percent higher in the spring of 2021 than in
the same period in 2019.
History will judge us harshly for how we treated children during the
China virus pandemic, regarding how this government crushed the
economy, this government crushed small businesses, this government
crushed individual liberties and sacrificed our children on the altar
of the leftist political agenda and the special interest groups.
Yet, Democrats still don't want to acknowledge that the pandemic is
over. The President said it. Then, of course, his staff is walking that
back.
Maybe it is because they want to hold on to the power that they have
accumulated in the name of the emergency, or maybe they want to hold on
to proxy voting in this Chamber, or maybe they want to hold on to the
expansion of government and the expansion of the welfare state. But
with poll numbers plunging and suburban moms and minorities and others
fleeing the Democratic Party, not to mention literally fleeing blue
States that are even more destroyed by their policies, they are
suddenly realizing and Democrats are saying: Houston, we have a
problem.
Their solutions are all wrong and promise more of what created the
suffering across America. They don't want to understand or don't care
to understand that it was government that exacerbated the problems from
the China virus lockdowns that caused the mental health issues for our
students, and expanding this government will only increase the problem.
H.R. 7780 prohibits arbitration and conflict resolution clauses in
employee benefit plans, creating an opening for trial lawyers--perhaps
the only group that the Democrats love more than teachers unions, trial
lawyers--allowing them to sue and trip up businessowners in troublesome
and expensive litigation.
Instead of empowering businessowners after the harmful lockdown
mandates from the Democrats, they instead want to create more ways to
hurt the American economy.
Mr. Chair, I urge my colleagues to oppose this bill.
Mr. DeSAULNIER. Mr. Chair, I yield 2 minutes to the gentlewoman from
Texas (Ms. Jackson Lee).
Ms. JACKSON LEE. Mr. Chair, I thank the gentleman from California for
his enormous leadership, and I thank the sponsors of this legislation
for their hard work.
It is always baffling to me, as I have spoken on the floor of the
House and served in this Congress, how colleagues can look a crisis in
the face and run head-on as a locomotive, smashing the solution,
speaking ill about those who need and are suffering, and that is what
we are hearing today.
I am very glad to rise in support of the Mental Health Matters Act,
H.R. 7780, and I hope some of my friends on the other side of the aisle
will recognize that we are the problem-solvers. We are not the bomb-
throwers. We are not supposed to be looking at every solution, and
because it comes from somebody of a different party, we want to fight
them for it.
I know what happened during the pandemic. I was out in the community
doing testing and vaccinations. I talked to parents about online
learning, those who didn't have access to broadband, and I knew what it
did to the children.
Why? Because children view schools and their daily activities as
their work. Adults go to work; children go to school. It builds their
confidence, their sense of esteem, their friendships, lifelong
friendships. That was all undone because of the pandemic.
Do you know what else we did? We saved lives. If we had continued in-
school learning, we would have lost thousands of children and their
families.
We must repair what was broken, not because we broke it but because
there was a pandemic. So, this legislation provides grants to build a
pipeline of school-based mental health service providers, more nurses
in the school. It directs the Department of Education to award grants
to State agencies to develop more school-based mental health providers.
It requires institutions of higher learning to let incoming students
with existing documentation have access to disability resources and
creates a grant program I am most excited about, increasing student
access to treatment of evidence-based trauma. They experienced trauma.
Add to that trauma the families in Uvalde that I visited on Monday
who are still crying with the pain of the loss of their children.
It is clearly a bill that we should accept, and it is a bill that I
support enthusiastically, Mr. Chair, the Mental Health Matters Act,
H.R. 7780.
Ms. FOXX. Mr. Chair, I yield 5 minutes to the gentlewoman from
Michigan (Mrs. McClain).
Mrs. McCLAIN. Mr. Chair, my amendment to H.R. 7780 would establish
that parents have the right to be informed of any mental health-related
issues with their children. In other words, schools may not hide
critical information from parents.
Before my colleagues say this isn't necessary or this isn't needed,
just open social media. You will find examples of teachers and school
personnel bragging about how they covertly discuss transgender issues
with their students, regardless of their accordance with schools or
State laws.
I think it is disappointing that it has come to this, that on the
House floor, we have to make an affirmative case for parents' rights.
Yet, here we are.
School officials and personnel are not the parents. School officials
and personnel have no right to ignore a parent's decision on what they
think is best for their child.
This amendment protects both parents and students. It would ensure
that parents are never excluded from their children's health
conversations and that teachers and administrators can't make these
decisions unilaterally.
If you want to protect children, believe in families and support
hardworking parents, then you must agree with us and support our motion
to recommit.
Every mother and father in this Chamber should want to know what is
happening with their children. Every one of us has the right to know
what a person is telling our child.
If we adopt the motion to recommit, we will instruct the Committee on
Education and Labor to consider my amendment, H.R. 7780, to protect
parents' rights.
I include in the Record the text of the amendment.
Add at the end the following:
TITLE VIII--PARENTAL RIGHTS
SEC. 801. PARENTAL CONSENT AND NOTICE OF PARENTAL RIGHTS.
(a) Informed Parental Consent.--A covered grantee shall
ensure that each parent of a child served by such grantee--
(1) receives the notice of parental rights described in
subsection (b); and
(2) provides informed written consent before the grantee
offers or provides any mental health or other social and
emotional services to the parent's child.
[[Page H8239]]
(b) Notice of Parental Rights.--A covered grantee shall
provide to each parent of a child served by the grantee
written notice of any mental health or other social and
emotional services that may be offered to the child by such
grantee, including--
(1) mental health assessments;
(2) counseling for individual students or group sessions;
(3) any group or individual session related to the child's
or other children's sexual orientation or gender identity;
(4) clubs or other after school activities related to
mental health or other social and emotional learning;
(5) curriculum used to discuss social and emotional
learning or other mental health needs;
(6) books made available to students for discussion of
social and emotional or mental health needs;
(7) interventions utilized by staff to address students'
mental health or other social and emotional needs; and
(8) any evaluations or data collection used to assess
students' individual or school wide mental health or other
social and emotional needs.
(c) Covered Grantee Defined.--In this section, the term
``covered grantee'' means any entity receiving funds under
title I, II, III, or IV, including a State educational
agency, local educational agency, or Head Start grantee.
Mrs. McCLAIN. Mr. Chair, I urge my colleagues to pass this amendment
so we can provide the assurance to parents that they have the right to
protect their children.
Mr. DeSAULNIER. Mr. Chair, I yield 2 minutes to the gentlewoman from
Connecticut (Mrs. Hayes), a distinguished member of the Education and
Labor Committee.
Mrs. HAYES. Mr. Chair, as a teacher, I rise in strong support of the
Mental Health Matters Act.
This crucial legislation will help rebuild schools and address the
mental health crisis plaguing our country by providing schools with
resources to help students and educators heal and recover after this
pandemic.
I am excited that this package includes my legislation, the
Supporting Trauma-Informed Education Practices Act. My legislation
specifically will help develop and improve prevention, screening,
referral, treatment, and support services to students. It will
implement schoolwide positive behavioral interventions and provide
professional development to school personnel. This legislation will
also engage with families and communities to increase awareness of
child and youth trauma.
The broader impact of the pandemic on students and their families is
often overlooked. We talk about the number of children who were lost as
a result of being low, but I remind everyone that those children lost
parents, grandparents, neighbors, and community members to the COVID-19
pandemic. That loss has taken a tremendous toll on their ability to
learn and thrive in school.
The impact of trauma is greater than just one incident. No person,
especially a child, should ever have to carry that weight alone.
As students continue to heal from the most traumatizing interruption
to their academic journeys, they need strong, reliable, and accessible
support services.
Mr. Chair, I urge my colleagues to support this bill to ensure
students recover completely.
Ms. FOXX. Mr. Chair, I would like to correct the record regarding a
comment Chairman Scott made at the Rules Committee Tuesday that
employers must offer mental health benefits.
Most health plans governed by ERISA are not required to offer mental
health benefits. Let me repeat myself: Most mental health benefits
offered by employers with ERISA plans are offered voluntarily.
Offering comprehensive health coverage is a valuable tool used to
recruit and retain employees. When employers choose to offer mental
health benefits, those benefits must be at parity with other benefits.
What parity means is a matter of debate, which is the root of the
problem here.
The Mental Health Parity Act of 1996 required mental health parity
for plans that choose to provide mental health benefits. When these
employer-sponsored plans cover mental health benefits, they must abide
by mental health parity laws.
The Consolidated Appropriations Act of 2021 directed the Department
of Labor to provide additional assistance to plans to comply with
parity requirements. DOL has ignored Congress' mandate to provide
additional assistance to plans and is instead expecting plans to read
the minds of Washington bureaucrats or face litigation and fines.
The problem with this top-down approach is that employers do not have
to subject themselves to DOL's whims. Employers are choosing to cover
mental health benefits. They can just as easily choose not to offer
mental health benefits if Washington is intent on making it too
challenging or costly.
DOL should follow the law and issue additional guidance, specifically
standards, to employers and plans.
Helping employers would undermine the Democrats' long-term goal of
weakening employer-sponsored insurance and implementing government-run
healthcare.
Mr. Chair, I reserve the balance of my time.
{time} 1200
Mr. DeSAULNIER. Mr. Chair, I yield 2 minutes to the gentlewoman from
Massachusetts (Ms. Clark).
Ms. CLARK of Massachusetts. Mr. Chair, recently, hospital staff and
healthcare providers in my district shared with me that their emergency
rooms are filled with children and teens struggling with their mental
health.
We know rates of youth anxiety, depression, and suicidal ideation
have skyrocketed across the country. While this was a problem before
COVID, the pandemic has made it so much worse. This is a national
emergency, specifically in our schools.
Last year, 75 percent of public schools reported increased concerns
around students showing trauma symptoms. Yet, only half of those
schools felt they had the resources to be able to address students'
mental health needs. Our children need help, and our parents need a
place to turn.
The Mental Health Matters Act includes legislation to address the
critical and unmet needs for school-based mental health providers.
My legislation establishes a 5-year grant program to recruit and
retain counselors in public schools, ensuring that whether you are in
Head Start or high school, kids have the mental health care support
they need to be healthy and thrive.
Mr. Chair, a ``yes'' vote today for this act is a vote for a healthy
future for all.
Ms. FOXX. Mr. Chair, I reserve the balance of my time.
Mr. DeSAULNIER. Mr. Chair, could I ask how much time we have
remaining?
The Acting CHAIR (Mr. Crow). The gentleman from California has 14
minutes remaining.
Mr. DeSAULNIER. Mr. Chair, we have no more speakers, I am prepared to
close, and I reserve the balance of my time.
Ms. FOXX. Mr. Chair, passing H.R. 7780 would do a disservice to
students, workers, and job creators. This legislation has been weighed,
it has been measured, and it has been found wanting.
Mr. Chair, I yield back the balance of my time.
Mr. DeSAULNIER. Mr. Chair, I yield myself the balance of my time.
Mr. Chair, I love my good friend's closing. That was artful and
poetic, but I respectfully disagree. I look forward to continuing the
conversation, particularly around enforcement and the definition of
parity.
To me, as a former employer, I thought parity was clear, but if we
need more clarity for some employers, I am happy to have that
discussion.
Mr. Chair, as lawmakers, we have a duty to support Americans' health
and well-being. The Mental Health Matters Act will help us deliver on
that goal by ensuring students, educators, and families receive the
support they need to lead healthier and happier lives, and provide
America with future generations of healthy and happy providers.
I thank the gentleman from Virginia, Chairman Scott; the gentlewoman
from California (Ms. Chu); the gentlewoman from Massachusetts,
Assistant Speaker Clark; the gentlewoman from Connecticut (Mrs. Hayes);
the gentlewoman from Oregon (Ms. Bonamici); the gentleman from
Connecticut (Mr. Courtney); and the gentleman from New Jersey (Mr.
Norcross) for their leadership on this legislation.
Mr. Chair, I yield back the balance of my time.
[[Page H8240]]
Mr. SCOTT of Virginia. Mr. Chair, I rise today in strong support of
the Mental Health Matters Act, led by the gentleman from California,
Mr. DeSaulnier.
The COVID-19 pandemic has exacerbated the mental health crisis among
students, workers, and families.
In 2021, over 44 percent of students experienced persistent feelings
of sadness or hopelessness; almost 20 percent seriously considered
suicide; and 9 percent actually attempted suicide. Regrettably, 80
percent of youth in need of mental health services do not have access
in their communities.
As a result, educators have been forced to play an outsized role in
supporting and responding to students' mental health needs, leading to
increased depression and trauma among educators. However, our schools
do not have the specialized staff necessary to respond to the increased
prevalence and complexity of students' mental health needs.
According to a 2019 ACLU study, no state met the student-to-social
worker ratio of one social worker to every 250 students, as recommended
by the National Association of Social Workers. Furthermore, the
national ratio of school psychologists per students during the 2020-
2022 school years was one psychologist per every 1,100 students--more
than double the ratio recommended by the National Association of School
Psychologists.
The rise in mental health challenges is not isolated to students and
educators. Nearly half of the U.S. workforce now suffers from mental
health issues since the COVID-19 pandemic began.
Yet, many workers are denied the mental health and substance abuse
disorder benefits they are legally entitled to receive under their
employer-sponsored health plan.
In a recent report to Congress, the Departments of Labor, Health and
Human Services, and the Treasury found widespread violations of the
Mental Health Parity and Addiction Equity Act by group health plans and
insurers who are failing to maintain parity between mental health and
substance abuse disorder benefits and physical health benefits.
Further, the report recommended that Congress enhance the Secretary of
Labor's capacity to enforce the parity law, including providing the
authority to impose civil monetary penalties for violations. Notably,
this same recommendation was made by former President Trump's
Commission on Combatting the Opioid Crisis, which was led by then-
Governor Chris Christie.
In response to these violations and the national mental health
crisis, the Chair of the Subcommittee on Health, Employment, Labor, and
Pensions, Mr. DeSaulnier, introduced the Mental Health Matters Act,
which includes proposals championed by several Committee Members.
This legislation:
Helps Head Start agencies implement evidence-based interventions to
improve the behavioral health of children and staff wellness;
Improves trauma-informed services in schools by developing innovative
initiatives to link schools and local educational agencies with local
trauma-informed support and mental health systems;
Requires colleges and universities to accept existing documentation
of disability and provide reasonable accommodations so that disabled
students can achieve success in higher education;
Provides the Department of Labor with enhanced authority to ensure
that private, employer-sponsored group health plans and insurers
fulfill their responsibility to provide mental health and substance
abuse disorder benefits;
Strengthens protections to ensure workers receive behavioral health
care and other benefits they have earned under their job-based plans;
and, finally,
Directs the Department of Education to award grants to build a
pipeline of school-based mental health services providers and increase
the number of mental health professionals serving in elementary and
secondary schools in high-need areas.
Simply put, the Mental Health Matters Act delivers the resources that
students, workers, and families need to improve their well-being.
I want to thank the gentleman from California, Mr. DeSaulnier, for
championing the bill. I also want to thank those that had sponsored
bills that were included in this legislation: the gentle lady from
California, Ms. Chu, the gentlelady from Massachusetts, Assistant
Speaker Clark, the gentle lady from Connecticut, Ms. Hayes, the gentle
lady from Oregon, Ms. Bonamici, the gentleman from Connecticut, Mr.
Courtney, and the gentleman from New Jersey, Mr. Norcross, for their
leadership in helping to put together this legislation.
Mr. Chair, I include in the Record the following letters in support.
National Education Association,
Washington, DC, May 17, 2022.
Education and Labor Committee,
House of Representatives, Washington, D.C.
Dear Representative: On behalf of our 3 million members and
the 50 million students they serve, we urge you to address
the pressing need to modernize America's public school
facilities and address the mental health crisis among
students. Specifically, during the May 18 markup session, we
urge you to support the:
Reopen and Rebuild America's Schools Act (H.R. 604)--This
bill would create a $100 billion grant program and $30
billion tax-credit bond program targeting high-poverty
schools whose facilities pose health and safety risks to
students and educators. It would also provide the means for
such schools to operate safely in accordance with Centers for
Disease Control and Prevention (CDC) guidelines, including
heating, ventilation, and air conditioning (HVAC) systems.
America spends more on public school facilities than any part
of our infrastructure except roads and highways, yet many of
our 100,000 public school buildings are poorly equipped or in
poor physical condition-so poor it undermines student
learning. The federal government, however, remains noticeably
absent from any meaningful investment in this area.
Enhancing Mental Health and Suicide Prevention Through
Campus Planning Act (H.R. 5407)--This bill would promote
positive mental health among college students and encourage
comprehensive planning on college campuses to prevent suicide
and other mental health crises.
Campus Prevention and Recovery Services for Students Act
(H.R. 6493)--This bill would promote evidence-based
prevention and intervention strategies on college campuses.
It would also encourage integration and collaboration among
campus-based health services to address substance use and
mental health.
Mental Health Matters Act (H.R. 7780)--This bill would
promote the use of evidence-based mental health, social-
emotional, and behavioral health interventions for young
children enrolled in early education programs like Head
Start. It would also create a grant program to increase the
number of school-based mental health services providers.
Please support this vitally important legislation.
Sincerely,
Marc Egan,
Director of Government Relations,
National Education Association.
____
National Association of School Psychologists,
Bethesda, MD, September 28, 2022.
Support for Mental Health Matters Act,
Dear Representative, On behalf of the National Association
of School Psychologists (NASP), we encourage you to support
swift passage of the Mental Health Matters Act and the
package of bills it includes. NASP represents 24,000 school
psychologists who work with students, families, educators,
administrators, and community members to ensure that every
student has access to comprehensive mental and behavioral
health support. We are a nonpartisan association committed to
advocating for research-based policies and practices that
ensure all children have the supports they need to thrive at
school, at home, and throughout life.
Schools play a critical role in our mental and behavioral
health care system, and the widespread shortage of school
psychologists and other school-based mental health
professionals exacerbates existing challenges to addressing
the growing number of students' mental and behavioral health
concerns. In order to provide necessary comprehensive
services, NASP recommends a ratio of one school psychologist
per 500 students. Current data estimate a national ratio of
about 1:1200; however, great variability exists among states,
with some states approaching a ratio of 1:5000. Shortages in
school psychology significantly undermine the availability of
high-quality services to students, families, and schools,
particularly in rural, underserved, and other hard to staff
school districts. The Mental Health Matters Act would provide
much needed support for schools and school-based mental
health professionals to address shortages and expand access
to mental and behavioral health supports by passing the
Elementary Secondary School Counseling Act and the Building
Pipeline of School-Based Mental Health Service Providers Act.
School psychologists are also integral to supporting
students with disabilities, and we provide critical supports
to students, educators, and families regarding special
education. We recommend the passage of the Respond, Innovate,
Succeed, and Empower Act, which expands access to needed
accommodations and supports for college students with
disabilities. Additionally, we encourage the passage of the
Supporting Trauma-Informed Education Practices Act through
the Mental Health Matters Act. Its passage would not only
increase student access to evidence-based trauma support
services and mental health care, but it would also support
the mental health of our educators and other school staff,
which is a necessary component of providing comprehensive
mental and behavioral health supports to students.
Thank you for your leadership and commitment to providing
comprehensive mental and behavioral health supports in
schools. We look forward to working with you on this critical
issue. If you have any questions or would like to follow up,
please contact Dr. Kelly Vaillancourt Strobach, NASP Director
of Policy and Advocacy,.
Sincerely,
Kathleen Minke, PhD, NCSP,
Executive Director.
[[Page H8241]]
____
AFSCME,
Washington, DC, September 29, 2022.
House of Representatives,
Washington, DC.
Dear Representative: On behalf of the 1.4 million members
of the American Federation of State, County and Municipal
Employees (AFSCME), we write in support of Congressman
Mrvan's amendment to direct the National Institute for
Occupational Safety and Health (NIOSH) to study and make
recommendations for workers whose mental health is negatively
impacted by their job. AFSCME members and workers across the
nation work in high stress positions including but not
limited to public safety, health care, emergency medical
services and firefighters. Workers such as these already face
workplace stressors that have been exacerbated by the COVID-
19 pandemic forcing essential workers to the brink of a
mental health crisis.
Throughout the pandemic public safety officers, health care
workers and other essential workers answered the call. But
even before the pandemic many of these occupations were at an
increased risk of mental health issues because the nature of
their jobs routinely involves stressful, hazardous,
potentially violent and traumatic situations. A study from
the University of California Berkley found the rate of
correctional or parole officers who have considered suicide
is three times that of the general population. Other research
found suicides rates among correctional officers to be as
high as 12 times that of the general public. Nurses and
doctors have burnout rates and staffing shortages that
directly impact the health care system. A 2020 study
conducted by Mental Health America showed that 76% of health
care workers reported exhaustion and burnout while 75%
reported they were overwhelmed. There is incontrovertible
evidence that this is a national issue that demands a
comprehensive federal scale response.
This amendment recognizes the need to address mental health
at an organizational level. It takes a modern approach to
fund and set up much needed research on workplace and
organization changes that can improve the mental health
outcomes of workers in high stress occupations. Moreover,
this amendment recognizes that it is time we stop adding to
the burden of probation officers, correction officers, public
safety workers, health care workers and others by demanding
that they ``deal with it'' outside of work or figure out how
to provide self-care when the nature of the work leaves them
burnt out, stressed, or in despair that they do not want to
share.
This amendment requires NIOSH to conduct research and fund
training to identify what workplace interventions make a
difference and achieve better mental health outcomes for
workers. It calls for NIOSH to consult with other appropriate
federal departments and agencies to establish a research
program to identify best practices and interventions for
occupations with an elevated risk of workplace stress, post-
traumatic stress or suicide attempts. The focus on best
practices and recommendations would be on occupation-related
or work organization interventions to improve mental health
outcomes to lay the groundwork for a federal response to the
mental health crisis faced by everyday workers.
We ask these workers to put themselves in danger for public
safety. It is time for Congress to support essential and
front-line workers' mental and physical well-being. We ask
you to support Congressman Mrvan's amendment to study
workplace stress and support everyday workers' mental health.
Sincerely,
Edwin S. Jayne,
Director of Federal Government Affairs.
____
September 27, 2022.
Hon. Nancy Pelosi,
Speaker, House of Representatives, Washington, DC.
Hon. Kevin McCarthy,
Minority Leader, House of Representatives,Washington, DC.
Dear Speaker Pelosi and Minority Leader McCarthy, Our
organizations write in strong support of two critical
provisions (Titles VI and VII) contained in the Mental Health
Matters Act (H.R. 7780) that take important steps toward
ensuring parity in coverage of mental health and substance
use disorder (MH/SUD) care and strengthening Americans'
coverage rights under ERISA. We urge the full House to pass
H.R. 7780.
The Strengthening Behavioral Health Benefits Act (Title VI)
would provide civil monetary penalty authority to the U.S.
Department of Labor (USDOL) to enforce the Paul Wellstone and
Pete Domenici Mental Health Parity and Addiction Equity Act
of 2008 (MHPAEA). Providing USDOL this authority will make
recent MH/SUD investments (e.g., those contained in the
Bipartisan Safer Communities Act) go much further by ensuring
that insurance companies are meeting their parity
responsibilities and are not the unintended beneficiaries of
taxpayer funds that effectively displace insurance
reimbursement.
Civil monetary penalty authority will position USDOL--which
has one investigator for every 12,500 plans--to step in more
aggressively when necessary to change plans' coverage
practices, make parity a reality, and increase access to
life-saving treatment. This provision carefully balances the
interests of Americans seeking MH/SUD care with insurers,
plan sponsors, and administrators attempting to comply with
the law. By adding MHPAEA to USDOL's existing civil monetary
penalty authority for violations of the Genetic Information
Non-Discrimination Act (GINA), this provision captures the
existing safe harbor provision that protects insurers, plan
sponsors, and administrators that exercise ``reasonable
diligence'' to comply with the law.
Civil monetary penalty authority to ensure compliance with
MHPAEA has enjoyed bipartisan support in the past. The 2016
Mental Health and Substance Use Disorders Parity Task Force
strongly recommended providing this authority, as did
President Trump's Commission on Combating Drug Addiction and
the Opioid Crisis. In fact, former New Jersey Governor Chris
Christie, chair of the Commission, stated that the authority
is ``absolutely necessary'' and that the Commission
``unequivocally'' supported Congressional action to give
USDOL the authority to issue penalties. We also strongly
support Title Vi's increased appropriation authorization for
the Employee Benefits Security Administration and the
Solicitor of Labor to ensure compliance with ERISA, including
the Federal Parity Act.
Our organizations also strongly support the Employee and
Retiree Access to Justice Act (Title VII), which includes
critical patient-protection provisions for the 136 million
Americans enrolled in ERISA health plans. This legislation
would prohibit ERISA plans from inserting provisions into
plan policies (except when agreed to as part of bona fide
collective bargaining agreements) that force beneficiaries
into mandatory binding arbitrations, taking away their access
to federal courts in order to protect their rights under
ERISA. The expansion of these clauses threatens to undermine
Americans' ability to challenge wrongful coverage denials in
the courts. Congress must act to ensure that ERISA
beneficiaries' rights are protected. In particular,
arbitration clauses would require beneficiaries to bring
individual arbitrations to challenge even widespread policies
that adversely impact thousands of individuals. Not only
would such an individual arbitration process provide no
ability to compel insurers to alter their behavior, allowing
even clear cut misconduct to continue across the board, but
most beneficiaries would be unable to identify attorneys to
bring the claim at all, given that attorneys would have no
financial incentive to do so. Thus, binding arbitration would
only serve the interests of the insurance companies at the
clear expense of ERISA beneficiaries.
The Employee and Retiree Access to Justice Act also
addresses the unfairness of ERISA plans requiring
beneficiaries to litigate their claims subject to an
impossibly high burden of proof. By inserting ``discretionary
clauses'' into their plan policies, ERISA plans grant
themselves broad discretion to interpret the meaning of the
terms of the policies they administer and the facts they
consider when adjudicating benefits under these policies.
Many ERISA plans use discretionary clauses as a strategy to
evade liability for improperly denying benefits, particularly
for mental health and substance use disorders, because
discretionary clauses obligate courts to broadly defer to
insurers' coverage determinations. (See Firestone Tire &
Rubber Co. v. Bruch, 489 U.S. 101, 115 (1989).) Under the
deferential standard of review, courts only reverse benefit
denials that are found to be ``arbitrary and capricious''--
even if they are incorrect determinations. In contrast, under
state law, where insurers are generally not deemed to be
fiduciaries, such deference is not granted. Instead, courts
apply the ordinary, civil standard of de novo review and
reverse insurers' benefit determinations that are wrong on
the merits.
Ironically, the discretion courts grant to ERISA
fiduciaries based on the application of these discretionary
clauses actually conflicts with the underlying purpose of
ERISA. In adopting ERISA, Congress made clear that it was
designed ``to protect interstate commerce and the interests
of participants in employee benefit plans and their
beneficiaries, . . . by establishing standards of conduct,
responsibility, and obligation for fiduciaries of employee
benefit plans, and by providing for appropriate remedies,
sanctions, and ready access to the Federal courts.'' (29
U.S.C. 1001(b)). Thus, while ERISA was intended to place a
heightened duties on fiduciaries, discretionary clauses have
instead shielded fiduciaries from accountability for their
misconduct--a perverse result given the legislative history.
A recent example of the perverse impact of the judicially-
created, deferential standard of review is Wit v. United
Behavioral Health, No. 14-CV-02346-JCS, 2019 WL 1033730 (N.D.
Cal. Mar. 5, 2019), rev'd, 2022 WL 850647 (9th Cir. Mar. 22,
2022), an ERISA case that has been recognized nationwide as a
landmark for mental health patients. Despite a devastating
100-9page plus trial decision, which found that United
Behavioral Health had breached its fiduciary duties by
placing its own financial interests over the needs of its
beneficiaries by denying nearly 70,000 claims based on
substandard medical necessity guidelines that conflicted with
generally accepted standards of care (``GASC''), in express
violation of plan terms and the laws of four states, a 9th
Circuit panel recently reversed that decision in a sparse,
seven-page decision.
In reversing this landmark decision, the panel completely
ignored detailed and extensive findings of fact, including
that UBH had lied to regulators about its medical necessity
guidelines and that its financial officers had vetoed UBH
clinicians' unanimous preference to use non-profit guidelines
that would have complied with GASC solely because the change
would cost more money for
[[Page H8242]]
UBH. Instead, the panel reversed this important holding
solely based on the standard of review, finding that it was
``not unreasonable'' for UBH to interpret its ERISA plans to
allow it to apply medical necessity guidelines that were
substantially more restrictive than generally accepted
standards of care.
In other words, the panel did not determine if using
medical necessity guidelines that were more restrictive than
GASC was actually consistent with the plan terms, nor did it
consider whether UBH's actions to place its own interest
above that of its insureds violated its fiduciary duties, but
instead it simply deferred to UBH's conclusions. As a result,
if allowed to stand, tens of thousands of insureds will lose
their ability to challenge UBH's denials, and it--and other
insurers--will be able to continue using overly restrictive
medical necessity guidelines going forward. This proposed
statute is required to prevent such a travesty from happening
in the future.
Nationally, there is a clear movement by states regulating
fully insured ERISA plans to ban discretionary clauses. In
fact, the National Association of Insurance Commissioners
(NAIC) has adopted a model law entitled the ``Prohibition on
the Use of Discretionary Clauses Model Act.'' The NAIC
describes the purpose of the model act to prohibit
discretionary clauses ``to assure that health insurance
benefits and disability income protection coverage are
contractually guaranteed, and to avoid the conflict of
interest that occurs when the carrier responsible for
providing benefits has discretionary authority to decide when
benefits are due.'' Recognizing the pernicious effects of
discretionary clauses in insurance policies, nearly half of
states have banned these clauses.
Because discretionary clauses are a powerful tool that
insurers have to self-justify coverage decisions, such
clauses have become ubiquitous. Where they are allowed to
stand, patients are at a terrible disadvantage in challenging
wrongful denials of healthcare coverage. This is because, in
turning to the courts to challenge wrongful denials of
benefits, patients must overcome a very high evidentiary bar
by proving that their insurers' determinations were
``arbitrary and capricious.'' This is true even if courts
believe that, on an equal weighing of the evidence, the
insurers' determinations were inconsistent with the terms of
the insurance policies and/or relevant facts known to the
insurers. As the NAIC recognizes, this paradoxically means
that coverage promised in insurance policies is not
necessarily contractually guaranteed.
Federal Circuit Courts have articulated the unfairness that
can result from applying a discretionary review in benefits
cases, while various federal trial courts have noted that the
standard of review in benefits matters is determinative and
that the abuse of discretion standards of review permits
incorrect outcomes.
If discretionary clauses were prohibited for ERISA plans
such outrageous scenarios would no longer be permitted,
because patients would have their claims adjudicated using an
equitable de novo standard of review (meaning from the
beginning, or without deference to the insurer's decision).
This standard means that courts give patients and insurers
equal consideration when deciding whether the insurers'
coverage determinations were wrongful. The evidentiary
standards applied by courts in benefit cases are not
academic. Time and time again, the effect of discretionary
clauses is that patients have little or no recourse for
wrongful benefit determinations.
We urge you to support these critical provisions to help
ensure mental health and addiction parity and protect more
than 130 million Americans' coverage rights under ERISA.
Sincerely,
American Foundation for Suicide Prevention, American
Psychiatric Association, American Psychological Association,
Depression and Bipolar Support Alliance, Eating Disorders
Coalition, Families USA, The Kennedy Forum, Health Law
Advocates, Mental Health America, Mom Congress, National
Federation of Families, National Association for Behavioral
Healthcare, National Health Law Program, Psychotherapy Action
Network, REDC Consortium, SMART Recovery, Treatment Advocacy
Center, 2020 Mom.
____
Mr. SABLAN. Mr. Chair, H.R. 7780, the Mental Health Matters Act, will
provide federal funding to help students and school staff in my
district, the Northern Mariana Islands, access mental health care and
hire more school based mental health service providers.
The COVID-19 pandemic seriously impacted students' social and
emotional development. In 2021, the Centers for Disease Control and
Prevention reported over 44 percent of students felt sadness or
hopelessness, almost 20 percent had suicidal thoughts, and 9 percent
attempted suicide. However, the student mental health crisis preceded
the pandemic. In 2016, CDC found roughly 1in 6 children in America aged
2-8 years were diagnosed with mental, behavioral, or developmental
disorders. The House Early Childhood, Elementary, and Secondary
Education Subcommittee I chair has heard from schools nationwide on the
worsening state of our children's mental health. The House now has an
opportunity to pass the Mental Health Matters Act that I cosponsored to
provide the resources necessary to help schools provide lifesaving care
to our students in need.
H.R. 7780 will set aside $25 million to school districts in the
Marianas and other insular areas for the recruitment and retention of
school-based mental health service providers. The Marianas Public
School System serves a high percentage of students that come from
families with incomes below the poverty line. Students, regardless of
income, should have access to the health care they need. H.R. 7780
expands students' access to mental health care and ensures our schools
have the resources to provide the care they need.
I urge my colleagues to support H.R. 7780.
Ms. JACKSON LEE. Mr. Chair, I rise in support of the Mental Health
Matters Act requiring certain federal actions to increase access to
mental and behavioral health care.
H.R. 7780 creates various grants to support the behavioral needs of
students and youth, invest in the school-based behavioral health
workforce, and ensure access to mental health and substance use
disorder benefits.
This includes increasing the number of mental health professionals
serving in high need public schools and increasing students' access to
evidence-based trauma support.
For institutions of higher education, they will be required to
increase transparency around the accommodations process and allow
students with existing documentation of a disability to access
disability accommodations.
The capacity of the Department of Labor will be strengthened to
ensure that private, employer-sponsored group health plans provide
mental health and substance use disorder benefits.
H.R. 7780 will also plan to hold employee-sponsors accountable when
they are improperly denied mental health and substance use disorder
benefits.
The Coronavirus pandemic and opioid epidemic have only exacerbated
our nation's mental health needs.
The COVID-19 pandemic has been associated with mental health
challenges related to the morbidity and mortality caused by the disease
and the impact of stay-at-home orders.
Adults reporting symptoms of anxiety disorder and depressive disorder
increased considerably in the United States during April through June
of 2020, compared with the same period in 2019.
Children are also not being spared from the mental health impacts
from COVID-19.
In a study of about 1,500 teenagers, 7 out of 10 kids reported that
they were struggling with their mental health in some way.
The Substance Abuse and Mental Health Services Administration hotline
for people in emotional distress registered more than a 1,000 percent
increase in April 2020 compared with the same time last year.
These life changing events have left our children, students, workers,
and families grappling with traumas caused by factors outside of their
control.
Too many Americans make the perilous choice of self-medicating when
they feel that they've run out of other options. We cannot protect our
Nation's health or help communities recover if we do not strengthen our
mental health care system.
Mental illness has long received too little attention from policy
makers and public health advocates who too often reflect upon and
stress the importance of physical health insurance, taking little note
of the importance of mental health coverage.
Therefore, Congress must take the lead in reforming mental health
care options as our current system abandoned too many Americans in
their time of personal crisis.
As a frequent cosponsor of mental health legislation and Legislator
of the Year for the National Mental Health Association, I am proud to
support the Mental Health Matters Act.
The Acting CHAIR. All time for debate has expired.
Pursuant to the rule, the bill shall be considered for amendment
under the 5-minute rule.
In lieu of the amendment in the nature of a substitute recommended by
the Committee on Education and Labor printed in the bill, an amendment
in the nature of a substitute consisting of the text of Rules Committee
Print 117-67, shall be considered as adopted. The bill, as amended,
shall be considered as the original bill for the purpose of further
amendment under the 5-minute rule and shall be considered as read.
The text of the bill, as amended, is as follows:
H.R. 7780
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 Matters Act''.
SEC. 2. TABLE OF CONTENTS.
The table of contents of this Act is as follows:
[[Page H8243]]
Sec. 1. Short title.
Sec. 2. Table of contents.
TITLE I--EARLY CHILDHOOD MENTAL HEALTH ACT
Sec. 101. Short title.
Sec. 102. Identification of effective interventions in Head Start
programs.
Sec. 103. Implementing the interventions in Head Start programs.
Sec. 104. Evaluating implementation of interventions in Head Start
programs.
Sec. 105. Implementing the evaluation framework for Head Start
programs.
Sec. 106. Best Practice Centers.
Sec. 107. Funding.
TITLE II--BUILDING PIPELINE OF SCHOOL-BASED MENTAL HEALTH SERVICE
PROVIDERS ACT
Sec. 201. Short title.
Sec. 202. Definitions.
Sec. 203. Grant program to increase the number of school-based mental
health services providers serving in high-need local
educational agencies.
TITLE III--ELEMENTARY AND SECONDARY SCHOOL COUNSELING ACT
Sec. 301. Short title.
Sec. 302. Definitions.
Sec. 303. Allotments to States and subgrants to local educational
agencies.
Sec. 304. Authorization of appropriations.
TITLE IV--SUPPORTING TRAUMA-INFORMED EDUCATION PRACTICES ACT
Sec. 401. Short title.
Sec. 402. Amendment to the SUPPORT for Patients and Communities Act.
TITLE V--RESPOND, INNOVATE, SUCCEED, AND EMPOWER ACT
Sec. 501. Short title.
Sec. 502. Perfecting amendment to the definition of disability.
Sec. 503. Supporting students with disabilities to succeed once
enrolled in college.
Sec. 504. Authorization of funds for the National Center for
Information and Technical Support for Postsecondary
Students With Disabilities.
Sec. 505. Inclusion of information on students with disabilities.
Sec. 506. Rule of construction.
TITLE VI--STRENGTHENING BEHAVIORAL HEALTH BENEFITS ACT
Sec. 601. Short title.
Sec. 602. Enforcement of Mental Health and Substance Use Disorder
Requirements.
TITLE VII--EMPLOYEE AND RETIREE ACCESS TO JUSTICE ACT
Sec. 701. Short title.
Sec. 702. Unenforceable arbitration clauses, class action waivers,
representation waivers, and discretionary clauses.
Sec. 703. Prohibition on mandatory arbitration clauses, class action
waivers, representation waivers, and discretionary
clauses.
Sec. 704. Effective date.
TITLE I--EARLY CHILDHOOD MENTAL HEALTH ACT
SEC. 101. SHORT TITLE.
This title may be cited as the ``Early Childhood Mental
Health Support Act''.
SEC. 102. IDENTIFICATION OF EFFECTIVE INTERVENTIONS IN HEAD
START PROGRAMS.
(a) Interventions That Improve Social-Emotional and
Behavioral Health of Children.--
(1) In general.--The Secretary of Health and Human Services
acting through the Assistant Secretary for the Administration
for Children and Families (in this section referred to as the
``Secretary'') shall identify and review interventions, best
practices, curricula, and staff trainings--
(A) that improve the behavioral health of children; and
(B) that are evidence based.
(2) Focus.--In carrying out paragraph (1), the Secretary
shall focus on interventions, best practices, curricula, and
staff trainings that--
(A) can be delivered by a provider or other staff member in
or associated with a Head Start program or Early Head Start
center;
(B) are demonstrated to improve or support healthy social,
emotional, or cognitive development for children in Head
Start or Early Head Start programs, with an empirical or
theoretical relationship to later mental health or substance
abuse outcomes;
(C) involve changes to center-wide policies or practices,
or other services and supports offered in conjunction with
Head Start programs or Early Head Start centers, including
services provided to adults or families (with or without a
child present) for the benefit of the children;
(D) demonstrate effectiveness across racial, ethnic, and
geographic populations or demonstrate the capacity to be
adapted to be effective across populations;
(E) offer a tiered approach to addressing need, including--
(i) universal interventions for all children;
(ii) selected prevention for children demonstrating
increased need; and
(iii) indicated prevention for children demonstrating
substantial need;
(F) incorporate trauma-informed care approaches; or
(G) have a proven record of improving early childhood and
social emotional development.
(b) Interventions That Support Staff Wellness.--In carrying
out subsection (a), the Secretary shall identify and review
interventions, best practices, curricula, and staff trainings
that support staff wellness and self-care.
(c) Credentials.--In carrying out subsections (a) and (b),
the Secretary, in consultation with relevant experts, shall
determine the appropriate credentials for individuals who
deliver the interventions, best practices, curricula, and
staff trainings identified by the Secretary.
(d) Consultation; Public Input.--In carrying out this
section, the Secretary shall--
(1) consult with relevant agencies, experts, academics,
think tanks, and nonprofit organizations with expertise in
early childhood, mental health, and trauma-informed care,
including the National Institute of Mental Health, the
Administration for Children and Families, the Substance Abuse
and Mental Health Services Administration, the Institute of
Education Sciences, and the Centers for Disease Control and
Prevention; and
(2) solicit public input on--
(A) the design of the reviews under subsections (a) and
(b); and
(B) the findings and conclusions resulting from such
reviews.
(e) Timing.--The Secretary shall--
(1) complete the initial reviews required by subsections
(a) and (b) not later than 2 years after the date of
enactment of this Act; and
(2) update such reviews and the findings and conclusions
therefrom at least every 5 years.
(f) Reporting.--Not later than 1 year after the date of
enactment of this Act, and every 5 years thereafter, the
Secretary shall submit a report to the Congress on the
results of implementing this section.
SEC. 103. IMPLEMENTING THE INTERVENTIONS IN HEAD START
PROGRAMS.
(a) In General.--The Assistant Secretary for the
Administration for Children and Families shall award grants
to participating Head Start agencies to implement the
interventions, best practices, curricula, and staff trainings
that are identified pursuant to section 102.
(b) Requirements.--The Assistant Secretary shall ensure
that grants awarded under this section are awarded to
grantees representing a diversity of geographic areas across
the United States, including urban, suburban, and rural
areas.
SEC. 104. EVALUATING IMPLEMENTATION OF INTERVENTIONS IN HEAD
START PROGRAMS.
(a) In General.--The Secretary of Health and Human
Services, acting through the Assistant Secretary for Planning
and Evaluation and in coordination with the Assistant
Secretary for the Administration for Children and Families,
shall--
(1) determine whether the interventions, best practices,
curricula, and staff trainings implemented pursuant to
section 103--
(A) are effectively implemented pursuant to section 103 and
other relevant provisions of law such that the anticipated
effect sizes of the interventions, best practices, curricula,
and staff trainings are achieved; and
(B) yield long-term savings;
(2) develop a method for making the determination required
by paragraph (1);
(3) ensure that such method includes competency and testing
approaches, performance or outcome measures, or any other
methods deemed appropriate by the Assistant Secretary, taking
into consideration existing monitoring components of the Head
Start and Early Head Start programs; and
(4) solicit public input on the design, findings, and
conclusions of this process and shall consider whether
updates are necessary at least every 5 years.
(b) Process.--In carrying out subsection (a), the Secretary
of Health and Human Services shall--
(1) conduct any research and evaluation studies needed; and
(2) solicit public input on--
(A) the design of the method developed pursuant to
subsection (a)(2); and
(B) the resulting findings and conclusions.
(c) Timing.--The Secretary of Health and Human Services
shall--
(1) develop the method required by subsection (a)(2) and
make the initial determination required by subsection (a)(1)
not later than 2 years after the date of enactment of this
Act; and
(2) update such method and determination at least every 5
years.
SEC. 105. IMPLEMENTING THE EVALUATION FRAMEWORK FOR HEAD
START PROGRAMS.
(a) Evaluation Method.--The Assistant Secretary for the
Administration for Children and Families shall implement the
evaluation method developed pursuant to section 104(a) in the
Head Start program as a voluntary mechanism for interested
Head Start programs or Early Head Start centers to evaluate
the extent to which such programs or centers have effectively
implemented the interventions, best practices, curricula, and
staff trainings identified pursuant to section 102, with
minimal burden or disruption to programs and centers
interested in participating.
(b) Technical Assistance.--The Assistant Secretary for the
Administration for Children and Families shall provide
guidance, tools, resources, and technical assistance to
grantees for implementing and evaluating interventions, best
practices, curricula, and staff trainings identified pursuant
to section 102 and optimizing the performance of such
grantees on the annual evaluations.
SEC. 106. BEST PRACTICE CENTERS.
The Assistant Secretary for the Administration for Children
and Families may fund up to 5 Best Practice Centers in Early
Childhood Training in universities and colleges to prepare
future Head Start agencies and staff able to deliver the
interventions, best practices, curricula,
[[Page H8244]]
and staff trainings identified pursuant to section 102.
SEC. 107. FUNDING.
(a) Authorization of Appropriations.--There is authorized
to be appropriated $100,000,000 for the period of fiscal
years 2023 through 2032 for carrying out sections 103(b),
104, and 106.
(b) Availability of Appropriations.--Amounts authorized to
be appropriated by subsection (a) are authorized to remain
available until expended.
TITLE II--BUILDING PIPELINE OF SCHOOL-BASED MENTAL HEALTH SERVICE
PROVIDERS ACT
SEC. 201. SHORT TITLE.
This title may be cited as the ``Building Pipeline of
School-Based Mental Health Service Providers Act''.
SEC. 202. DEFINITIONS.
In this title:
(1) Best practices.--The term ``best practices'' means a
technique or methodology that, through experience and
research related to professional practice in a school-based
mental health field, has proven to reliably lead to a desired
result.
(2) Eligible institution.--The term ``eligible
institution'' means an institution of higher education that
offers a program of study that leads to a master's or other
graduate degree--
(A) in school psychology that prepares students in such
program for the State licensing or certification examination
in school psychology;
(B) in school counseling that prepares students in such
program for the State licensing or certification examination
in school counseling;
(C) in school social work that prepares students in such
program for the State licensing or certification examination
in school social work;
(D) in another school-based mental health field that
prepares students in such program for the State licensing or
certification examination in such field, if applicable; or
(E) in any combination of study described in subparagraphs
(A) through (D).
(3) Eligible partnership.--The term ``eligible
partnership'' means--
(A) a partnership between 1 or more high-need local
educational agencies and 1 or more eligible institutions; or
(B) in any region in which local educational agencies may
not have a sufficient elementary school and secondary school
student population to support the placement of all
participating graduate students, a partnership between a
State educational agency, on behalf of 1 or more high-need
local educational agencies, and 1 or more eligible
institutions.
(4) High-need local educational agency.--The term ``high-
need local educational agency'' means a local educational
agency that--
(A) is described in section 200(10) of the Higher Education
Act of 1965 (20 U.S.C. 1021(10)); and
(B) as of the date of application for a grant under this
title, has ratios of school counselors, school social
workers, and school psychologists to students served by the
agency that are not more than 1 school counselor per 250
students, not more than 1 school psychologist per 500
students, and not more than 1 school social worker per 250
students.
(5) Historically black college or university.--The term
``historically Black college or university'' has the meaning
given the term ``part B institution'' in section 322 of the
Higher Education Act of 1965 (20 U.S.C. 1061).
(6) Homeless children and youths.--The term ``homeless
children and youths'' has the meaning given such term in
section 725 of the McKinney-Vento Homeless Assistance Act (42
U.S.C. 11434a).
(7) Indian tribe; tribal organization.--In this section the
terms ``Indian tribe'' and ``tribal organization'' have the
meanings given those terms in section 4 of the Indian Self-
Determination and Education Assistance Act (25 U.S.C. 5304)).
(8) Institution of higher education.--The term
``institution of higher education'' has the meaning given
such term in section 101(a) of the Higher Education Act of
1965 (20 U.S.C. 1001(a)).
(9) Local educational agency.--The term ``local educational
agency'' has the meaning given such term in section 8101 of
the Elementary and Secondary Education Act of 1965 (20 U.S.C.
7801).
(10) Minority-serving institution.--The term ``minority-
serving institution'' means, as defined in section 371(a) of
the Higher Education Act of 1965 (20 U.S.C. 1067q(a)), a
Hispanic-serving institution, an Alaska Native-serving
institution or a Native Hawaiian-serving institution, a
Predominantly Black Institution, an Asian American and Native
American Pacific Islander-serving institution, or a Native
American-serving nontribal institution.
(11) Outlying area.--The term ``outlying area'' has the
meaning given the term in section 8101(36)(A) of the
Elementary and Secondary Education Act of 1965 (20 U.S.C.
7801(36)(A)).
(12) Participating eligible institution.--The term
``participating eligible institution'' means an eligible
institution that is part of an eligible partnership awarded a
grant under section 203.
(13) Participating graduate.--The term ``participating
graduate'' means an individual who--
(A) has received a master's or other graduate degree in a
school-based mental health field from a participating
eligible institution and has obtained a State license or
credential in the school-based mental health field; and
(B) as a graduate student pursuing a career in a school-
based mental health field, was placed in a school served by a
participating high-need local educational agency to complete
required field work, credit hours, internships, or related
training as applicable.
(14) Participating high-need local educational agency.--The
term ``participating high-need local educational agency''
means a high-need local educational agency that is part of an
eligible partnership awarded a grant under section 203.
(15) School-based mental health field.--The term ``school-
based mental health field'' means each of the following
fields:
(A) School counseling.
(B) School social work.
(C) School psychology.
(D) Any other field of study that leads to employment as a
school-based mental health services provider.
(16) School-based mental health services provider.--The
term ``school-based mental health services provider'' has the
meaning given the term in section 4102 of the Elementary and
Secondary Education Act of 1965 (20 U.S.C. 7112).
(17) Secretary.--The term ``Secretary'' means the Secretary
of Education.
(18) State educational agency.--The term ``State
educational agency'' has the meaning given the term in
section 8101 of the Elementary and Secondary Education Act of
1965 (20 U.S.C. 7801).
(19) Student support personnel target ratios.--The term
``student support personnel target ratios'' means the ratios
of school-based mental health services providers to students
recommended to enable such personnel to effectively address
the needs of students, including--
(A) at least 1 school counselor for every 250 students (as
recommended by the American School Counselor Association and
American Counseling Association);
(B) at least 1 school psychologist for every 500 students
(as recommended by the National Association of School
Psychologists); and
(C) at least 1 school social worker for every 250 students
(as recommended by the School Social Work Association of
America).
(20) Tribally controlled college or university.--The term
``tribally controlled college or university'' has the meaning
given such term in section 2 of the Tribally Controlled
Colleges and Universities Assistance Act of 1978 (25 U.S.C.
1801).
(21) Unaccompanied youth.--The term ``unaccompanied youth''
has the meaning given such term in section 725 of the
McKinney-Vento Homeless Assistance Act (42 U.S.C. 11434a).
SEC. 203. GRANT PROGRAM TO INCREASE THE NUMBER OF SCHOOL-
BASED MENTAL HEALTH SERVICES PROVIDERS SERVING
IN HIGH-NEED LOCAL EDUCATIONAL AGENCIES.
(a) Authorization of Grants.--
(1) Grant program authorized.--From amounts made available
to carry out this section, the Secretary shall award grants,
on a competitive basis, to eligible partnerships, to enable
the eligible partnerships to carry out pipeline programs to
increase the number of school-based mental health services
providers employed by high-need local educational agencies by
carrying out any of the activities described in subsection
(e).
(2) Reservations.--From the total amount appropriated under
subsection (j) for a fiscal year, the Secretary shall
reserve--
(A) one-half of 1 percent for the Secretary of the Interior
to carry out programs under this title in schools operated or
funded by the Bureau of Indian Education, Indian tribes and
tribal organizations, or a consortium of Indian tribes and
tribal organizations;
(B) one-half of 1 percent for allotments to outlying areas
based on the relative need of each such area with respect to
mental health services in schools, as determined by the
Secretary in accordance with the purpose of this title;
(C) not more than 3 percent to conduct the evaluations
under subsection (h); and
(D) not more than 2 percent for the administration of the
program under this title and to provide technical assistance
relating to such program.
(b) Grant Period.--A grant awarded under this section shall
be for a 5-year period and may be renewed for additional 5-
year periods upon a showing of adequate progress, as
determined by the Secretary.
(c) Application.--To be eligible to receive a grant under
this section, an eligible partnership shall submit to the
Secretary a grant application at such time, in such manner,
and containing such information as the Secretary may require.
At a minimum, such application shall include--
(1) an assessment of the existing (as of the date of
application) ratios of school-based mental health services
providers (in the aggregate and disaggregated by profession)
to students enrolled in schools in each high-need local
educational agency that is part of the eligible partnership;
and
(2) a detailed description of--
(A) a plan to carry out a pipeline program to train, place,
and retain school-based mental health services providers in
high-need local educational agencies; and
(B) the proposed allocation and use of grant funds to carry
out activities described in subsection (e).
(d) Award Basis.--In awarding grants under this section,
the Secretary shall--
(1) ensure that to the extent practicable, grants are
distributed among eligible entities that will serve
geographically diverse areas; and
(2) give priority to eligible partnerships that--
(A) propose to use the grant funds to carry out the
activities described under paragraphs (1) through (3) of
subsection (e) in schools that have higher numbers or
percentages of low-income students (determined using any of
the measures of poverty described in section 1113(a)(5) of
the Elementary and Secondary Education Act of 1965 (20 U.S.C.
6313(a)(5))), in comparison to other schools that are served
by the high-need local educational agency that is part of the
eligible partnership;
[[Page H8245]]
(B) include 1 or more high-need local educational agencies
that have fewer school-based mental health services
providers, in the aggregate or for a particular school-based
mental health field, per student than other eligible
partnerships that have submitted a grant application under
subsection (c);
(C) include 1 or more eligible institutions of higher
education which are a historically Black college or
university, a minority-serving institution, or a tribally
controlled college or university;
(D) propose to collaborate with other institutions of
higher education with similar programs, including sharing
facilities, faculty members, and administrative costs; and
(E) propose to use grant funds to increase the diversity of
school-based mental health services providers.
(e) Use of Grant Funds.--Grant funds awarded under this
section may be used--
(1) to pay the administrative costs (including supplies,
office and classroom space, supervision, mentoring, and
transportation stipends as necessary and appropriate) related
to--
(A) having graduate students of programs in school-based
mental health fields placed in schools served by
participating high-need local educational agencies to
complete required field work, credit hours, internships, or
related training as applicable for the degree, license, or
credential program of each such student; and
(B) offering required graduate coursework for students of a
graduate program in a school-based mental health services
field on the site of a participating high-need local
educational agency;
(2) for not more than the first 3 years after a
participating graduate receives a master's or other graduate
degree from a program in a school-based mental health field,
or obtains a State license or credential in a school-based
mental health field, to hire and pay all or part of the
salary of the participating graduates working as a school-
based mental health services provider in a school served by a
participating high-need local educational agency;
(3) to increase the number of school-based mental health
services providers per student in schools served by
participating high-need local educational agencies, in order
to meet the student support personnel target ratios;
(4) to recruit, hire, and retain culturally or
linguistically under-represented graduate students of
programs in school-based mental health fields for placement
in schools served by participating high-need local
educational agencies;
(5) to develop coursework that will--
(A) encourage a commitment by graduate students in school-
based mental health fields to work for high-need local
educational agencies;
(B) give participating graduates the knowledge and skill
sets necessary to meet the needs of--
(i) students and families served by high-need local
educational agencies;
(ii) students at risk of not meeting State academic
standards;
(iii) students who--
(I) are English learners (as defined in section 8101 of the
Elementary and Secondary Education Act of 1965 (20 U.S.C.
7801));
(II) are migratory children (as defined in section 1309 of
such Act (20 U.S.C. 6399));
(III) have a parent or caregiver who is a member of the
armed forces, including the National Guard, who has been
deployed or returned from deployment;
(IV) are LGBTQ+, including students who are lesbian, gay,
bisexual, transgender, queer or questioning, nonbinary, or
Two-Spirit;
(V) are homeless children and youth, including
unaccompanied youth;
(VI) have come into contact with the juvenile justice
system or adult criminal justice system, including students
currently or previously held in juvenile detention facilities
or adult jails and students currently or previously held in
juvenile correctional facilities or adult prisons;
(VII) are a child with a disability (as defined in section
8101 of the Elementary and Secondary Education Act of 1965
(20 U.S.C. 7801));
(VIII) have been a victim to, or witnessed, domestic
violence or violence in their community;
(IX) have been exposed to substance misuse at home or in
the community;
(X) are in foster care, are aging out of foster care, or
were formerly in foster care; or
(XI) have been a victim to or witnessed trafficking in
persons; and
(iv) teachers, administrators, and other staff who work for
high-need local educational agencies; and
(C) utilize best practices determined by the American
School Counselor Association, National Association of Social
Workers, School Social Work Association of America, and
National Association of School Psychologists and other
relevant organizations;
(6) to provide tuition credits to graduate students
participating in the pipeline program supported under the
grant;
(7) to fund high-quality ``Grow Your Own'' teacher
preparation programs that provide pathways to State licensure
or certification as a school psychologist, school counselor,
school social worker, or other school-based mental services
provider to recruit and prepare local community members,
career changers, paraprofessionals, after-school program
staff, and others currently working in schools to become
school-based mental health services providers;
(8) to cover the costs of licensure and preparation for
required licensure exams; and
(9) for similar activities to fulfill the purpose of this
title, as the Secretary determines appropriate.
(f) Supplement Not Supplant.--Funds made available under
this section shall be used to supplement, not supplant, other
Federal, State, or local funds available for the activities
described in subsection (e).
(g) Reporting Requirements.--
(1) In general.--Each eligible partnership that receives a
grant under this section shall prepare and submit to the
Secretary an annual report on the progress of the eligible
partnership in carrying out the grant. Such report shall
contain such information as the Secretary may require,
including, at a minimum, a description of--
(A) actual service delivery provided through the grant
funds, including--
(i) descriptive information on the participating eligible
institution, the educational model used, and the actual
academic program performance;
(ii) characteristics of graduate students participating in
the pipeline program supported under the grant, including--
(I) performance on any examinations required by the State
for credentialing or licensing;
(II) demographic characteristics; and
(III) graduate student retention rates;
(iii) characteristics of students of the participating
high-need local educational agency, including performance on
any tests required by the State educational agency,
demographic characteristics, and graduation rates, as
appropriate;
(iv) an estimate of the annual implementation costs of the
pipeline program supported under the grant; and
(v) the number of public elementary and secondary school
students, public elementary and secondary schools, graduate
students, and institutions of higher education participating
in the pipeline program supported under the grant;
(B) outcomes that are consistent with the purpose of the
grant program under this title, including--
(i) internship and post-graduation placement of the
participating graduate students;
(ii) graduation and professional career readiness
indicators; and
(iii) characteristics of the participating high-need local
educational agency, including with respect to fully certified
and effective teachers and school-based mental health
services providers employed by such agency--
(I) changes in the rate of hiring and retention of such
teachers and providers (in the aggregate and disaggregated by
each such profession); and
(II) the demographics, including the race, ethnicity, and
gender, of such teachers and providers.
(C) the instruction, materials, and activities being funded
under the grant; and
(D) the effectiveness of any training and ongoing
professional development provided--
(i) to students and faculty in the appropriate departments
or schools of the participating eligible institution; and
(ii) to the teachers, paraprofessionals, school leaders,
school-based mental health services providers, and other
specialized instructional support personnel of the
participating high-need local educational agency.
(2) Publication.--The Secretary shall publish the annual
reports submitted under paragraph (1) on the website of the
Department of Education.
(h) Evaluation.--
(1) Interim evaluations.--The Secretary may conduct interim
evaluations to determine whether each eligible partnership
receiving a grant under this section is making adequate
progress as the Secretary considers appropriate. The contents
of the annual report submitted to the Secretary under
subsection (g) may be used by the Secretary to determine
whether an eligible partnership receiving a grant is
demonstrating adequate progress.
(2) Final evaluation.--The Secretary shall conduct a final
evaluation to--
(A) determine the effectiveness of the grant program in
carrying out the purpose of this title; and
(B) compare the relative effectiveness of each of the
various activities described in subsection (e) for which
grant funds may be used.
(i) Report.--Not earlier than 5 years, nor later than 6
years, after the date of enactment of this Act, the Secretary
shall submit to the Congress a report containing--
(1) the findings of the final evaluation conducted under
subsection (h)(2); and
(2) such recommendations as the Secretary considers
appropriate.
(j) Authorization of Appropriations.--There are authorized
to be appropriated to carry out this section $200,000,000 for
fiscal year 2023 and each succeeding fiscal year.
TITLE III--ELEMENTARY AND SECONDARY SCHOOL COUNSELING ACT
SEC. 301. SHORT TITLE.
This title may be cited as the ``Elementary and Secondary
School Counseling Act''.
SEC. 302. DEFINITIONS.
In this title:
(1) ESEA definitions.--The terms ``elementary school'',
``local educational agency'', and ``secondary school'' have
the meanings given the terms in section 8101 of the
Elementary and Secondary Education Act of 1965 (20 U.S.C.
7801).
(2) High-need school.--The term ``high-need school'' has
the meaning given the term in section 2211(b) of the
Elementary and Secondary Education Act of 1965 (20 U.S.C.
6631(b)).
(3) Indian tribe; tribal organization.--The terms ``Indian
tribe'' and ``tribal organization'' have the meanings given
those terms in section 4 of the Indian Self-Determination and
Education Assistance Act (25 U.S.C. 5304)).
(4) Outlying area.--The term ``outlying area'' means an
outlying area specified in section 8101(36)(A) of the
Elementary and Secondary Education Act of 1965 (20 U.S.C.
7801(36)(A)).
(5) School-based mental health services provider.--The term
``school-based mental health services provider'' has the
meaning given the term in section 4102 of the Elementary and
[[Page H8246]]
Secondary Education Act of 1965 (20 U.S.C. 7112).
(6) Secretary.--The term ``Secretary'' means the Secretary
of Education.
(7) State.--The term ``State'' means each of the 50 States,
the District of Columbia, and Puerto Rico.
SEC. 303. ALLOTMENTS TO STATES AND SUBGRANTS TO LOCAL
EDUCATIONAL AGENCIES.
(a) Program Authorized.--The Secretary shall carry out a
program under which the Secretary makes allotments to States,
in accordance with subsection (c), to enable the States to
award subgrants to local educational agencies in order to
increase access to school-based mental health services
providers at high-need schools served by the local
educational agencies.
(b) Reservations.--From the total amount made available
under section 304 for a fiscal year, the Secretary shall
reserve--
(1) one-half of 1 percent for the Secretary of the Interior
for programs under this title in schools operated or funded
by the Bureau of Indian Education, Indian tribes and tribal
organizations, or consortia of Indian tribes and tribal
organizations;
(2) one-half of 1 percent for allotments for the outlying
areas to be distributed among those outlying areas on the
basis of their relative need, as determined by the Secretary,
in accordance with the purpose of this title; and
(3) not more than 2 percent for the administration of the
program under this title and to provide technical assistance
relating to such program.
(c) Allotments to States.--
(1) In general.--
(A) Formula.--From the total amount made available under
section 304 for a fiscal year and not reserved under
subsection (b), the Secretary shall allot to each State that
submits a true and complete application under paragraph (3)
(as determined by the Secretary) an amount that bears the
same relationship to such total amount as the amount received
under part A of title I of the Elementary and Secondary
Education Act of 1965 (20 U.S.C. 6311 et seq.) by such State
for such fiscal year bears to the amount received under such
part for such fiscal year by all States that submit such
applications.
(B) Small state minimum.--No State receiving an allotment
under this paragraph shall receive less than one-half of 1
percent of the total amount allotted under this paragraph.
(2) Matching requirements.--In order to receive an
allotment under paragraph (1), a State shall agree to provide
matching funds, in an amount equal to 20 percent of the
amount of the allotment, toward the costs of the activities
carried out with the allotment.
(3) Application.--A State desiring an allotment under
paragraph (1) shall submit to the Secretary an application at
such time, in such manner, and containing such information as
the Secretary may require. Each application shall include, at
a minimum--
(A) an assurance that the State will use the allotment only
for the purposes specified in subsection (d)(1);
(B) a description of how the State will award subgrants to
local educational agencies under such subsection;
(C) a description of how the State will disseminate, in a
timely manner, information regarding the subgrants and the
application process for such subgrants to local educational
agencies; and
(D) the ratios, as of the date of application, of students
to school-based mental health services providers in each
public elementary school and secondary school in the State,
in the aggregate and disaggregated to include--
(i) the ratios of students to school counselors, school
psychologists, and school social workers; and
(ii) as applicable, the ratios of students to other school-
based mental health services providers not described in
clause (i), in the aggregate and disaggregated by type of
provider.
(4) Duration.--An allotment to a State under paragraph (1)
shall be for a 5-year period and may be renewed for
additional 5-year periods upon a showing of adequate progress
on meeting the goals of the program under this title, as
determined by the Secretary.
(d) Subgrants to Local Educational Agencies.--
(1) In general.--A State receiving an allotment under
subsection (c) shall use the allotment to award subgrants, on
a competitive basis, to local educational agencies in the
State, to enable the local educational agencies to--
(A) recruit and retain school-based mental health services
providers to work at high-need schools served by the local
educational agency; and
(B) work toward effectively staffing the high-need schools
of the local educational agency with school-based mental
health services providers, including by meeting the
recommended maximum ratios of--
(i) 250 students per school counselor;
(ii) 500 students per school psychologist; and
(iii) 250 students per school social worker.
(2) Priority.--In awarding subgrants under this subsection,
the State shall give priority to local educational agencies
that serve a significant number of high-need schools.
(3) Application.--A local educational agency desiring a
subgrant under this subsection shall submit an application to
the State at such time, in such manner, and containing such
information as the State may require, including information
on how the local educational agency will prioritize assisting
high-need schools with the largest numbers or percentages of
students from low-income families (as counted under section
1124(c) of the Elementary and Secondary Education Act of 1965
(20 U.S.C. 6333(c))).
(e) Allotment and Subgrant Requirements.--
(1) Supplement, not supplant.--Amounts received from an
allotment under subsection (c) or a subgrant under subsection
(d) shall supplement, and not supplant, any other funds
available to a State or local educational agency for school-
based mental health services.
(2) Combining funds allowed.--A local educational agency
receiving a subgrant under subsection (d) may combine such
subgrant with State or local funds to carry out the
activities described in subsection (d)(1).
(f) Reports.--
(1) Local educational agencies.--A local educational agency
that receives a subgrant under subsection (d) shall submit an
annual report to the State on the activities carried out with
the subgrant funds. Each such report shall--
(A) describe the activities carried out using subgrant
funds;
(B) enumerate the number of school-based mental health
services providers (in the aggregate and disaggregated by
profession) who--
(i) were employed by or otherwise served in high-need
public elementary and secondary schools under the
jurisdiction of the local educational agency over the year
covered by the report; and
(ii) were supported with funds from the subgrant or
matching funds during such year; and
(C) include the most recent student to provider ratios, in
the aggregate and disaggregated as provided in subsection
(c)(3)(D), for high-need schools under the jurisdiction of
the local educational agency that were supported with the
subgrant or matching funds.
(2) State.--A State receiving an allotment under subsection
(c) shall annually prepare and submit a report to the
Secretary that--
(A) evaluates the progress made in achieving the purposes
of the program under this title;
(B) includes the most recent student to provider ratios, in
the aggregate and disaggregated as provided in subsection
(c)(3)(D), for high-need schools in the State that were
assisted with subgrants under subsection (d); and
(C) describes any other resources needed to meet the
required recommended maximum student to school-based mental
health services provider ratios.
(3) Public availability.--The Secretary shall make all
reports submitted under this subsection available to the
public, including through the website of the Department.
SEC. 304. AUTHORIZATION OF APPROPRIATIONS.
There are authorized to be appropriated to carry out this
title--
(1) $5,000,000,000 for fiscal year 2023; and
(2) such sums as may be necessary for each succeeding
fiscal year.
TITLE IV--SUPPORTING TRAUMA-INFORMED EDUCATION PRACTICES ACT
SECTION 401. SHORT TITLE.
This title may be cited as the ``Supporting Trauma-Informed
Education Practices Act''.
SEC. 402. AMENDMENT TO THE SUPPORT FOR PATIENTS AND
COMMUNITIES ACT.
Section 7134 of the SUPPORT for Patients and Communities
Act (42 U.S.C. 280h-7) is amended to read as follows:
``SEC. 7134. GRANTS TO IMPROVE TRAUMA SUPPORT SERVICES AND
MENTAL HEALTH CARE FOR CHILDREN AND YOUTH IN
EDUCATIONAL SETTINGS.
``(a) Authorization of Grants.--
``(1) Grants, contracts, and cooperative agreements
authorized.--The Secretary, in coordination with the
Secretary of Health and Human Services, is authorized to
award grants to, or enter into contracts or cooperative
agreements with, an eligible entity for the purpose of
increasing student, teacher, school leader, and other school
personnel access to evidence-based trauma support services
and mental health services by developing innovative
initiatives, activities, or programs to connect schools and
local educational agencies, or tribal educational agencies,
as applicable, with community trauma-informed support and
mental health systems, including such systems under the
Indian Health Service.
``(2) Reservations.--From the total amount appropriated
under subsection (l) for a fiscal year, the Secretary shall
reserve--
``(A) not more than 3 percent to conduct the evaluation
under subsection (f); and
``(B) not more than 2 percent for technical assistance and
administration.
``(b) Duration.--With respect to a grant, contract, or
cooperative agreement awarded or entered into under this
section, the period during which payments under such grant,
contract or agreement are made to the recipient may not
exceed 5 years.
``(c) Use of Funds.--An eligible entity that receives or
enters into a grant, contract, or cooperative agreement under
this section shall use amounts made available through such
grant, contract, or cooperative agreement for evidence-based
initiatives, activities, or programs, which shall include at
least 1 of the following:
``(1) Enhancing, improving, or developing collaborative
efforts between schools, local educational agencies or tribal
educational agencies, as applicable, and community mental
health and trauma-informed service delivery systems to
provide, develop, or improve prevention, referral, treatment,
and support services to students.
``(2) Implementing trauma-informed models of support,
including trauma-informed, positive behavioral interventions
and supports in schools served by the eligible entity.
``(3) Providing professional development to teachers,
paraprofessionals, school leaders, school-based mental health
services providers, and other specialized instructional
support personnel employed by local educational agencies or
tribal educational agencies, as applicable or schools served
by the eligible entity that--
``(A) fosters safe and stable learning environments that
prevent and mitigate the effects of
[[Page H8247]]
trauma, including through social and emotional learning;
``(B) improves school capacity to identify, refer, and
provide services to students in need of trauma-informed
support or mental health services, including by helping
educators to identify the unique personal and contextual
variables that influence the manifestation of trauma; and
``(C) reflects the best practices for trauma-informed
identification, referral, and support developed by the
Interagency Task Force on Trauma-Informed Care (as
established by section 7132).
``(4) Providing trauma-informed support services and mental
health services to students at full-service community schools
served by the eligible entity.
``(5) Engaging families and communities to increase
awareness of child trauma, which may include sharing best
practices with law enforcement regarding trauma-informed
services and working with mental health professionals to
provide interventions and longer term coordinated care within
the community for children and youth who have experienced
trauma and the families of such children and youth.
``(6) Evaluating the effectiveness of the initiatives,
activities, or programs carried out under this section in
increasing student access to evidence-based trauma support
services and mental health services.
``(7) Establishing partnerships with or providing subgrants
to early childhood education programs or other eligible
entities, to include such entities in the evidence-based
trauma-informed or mental health initiatives, activities, and
support services established under this section in order to
provide, develop, or improve prevention, referral, treatment,
and support services to children and their families.
``(8) Establishing new, or enhancing existing, evidence-
based educational, awareness, and prevention programs to
improve mental health and resiliency among teachers,
paraprofessionals, school leaders, school-based mental health
services providers, and other specialized instructional
support personnel employed by local educational agencies or
tribal educational agencies, as applicable, or schools served
by the eligible entity.
``(d) Applications.--To be eligible to receive a grant,
contract, or cooperative agreement under this section, an
eligible entity shall submit an application to the Secretary
at such time, in such manner, and containing such information
as the Secretary may reasonably require, which shall include
the following:
``(1) A description of the innovative initiatives,
activities, or programs to be funded under the grant,
contract, or cooperative agreement, including how such
initiatives, activities, or programs will increase access to
evidence-based trauma-informed support services and mental
health services for students, and, as applicable, the
families of such students.
``(2) A description of how the initiatives, activities, or
programs will provide linguistically appropriate and
culturally competent services.
``(3) A description of how the initiatives, activities, or
programs will support schools served by the eligible entity
in improving school climate in order to support an
environment conducive to learning.
``(4) An assurance that--
``(A) persons providing services under the initiative,
activity, or program funded by the grant, contract, or
cooperative agreement are fully licensed or certified to
provide such services;
``(B) teachers, school leaders, administrators, school-
based mental health services providers and other specialized
instructional support personnel, representatives of local
Indian Tribes or tribal organizations as appropriate, other
school personnel, individuals who have experience receiving
mental health services as children, and parents of students
participating in services under this section will be engaged
and involved in the design and implementation of the
services; and
``(C) the eligible entity will comply with the evaluation
required under subsection (f).
``(5) A description of how the eligible entity will support
and integrate existing school-based services at schools
served by the eligible entity with the initiatives,
activities, or programs funded under this section in order to
provide trauma-informed support services or mental health
services for students, as appropriate.
``(6) A description of how the eligible entity will
incorporate peer support services into the initiatives,
activities, or programs to be funded under this section.
``(7) A description of how the eligible entity will ensure
that initiatives, activities, or programs funded under this
section are accessible to and include students with
disabilities.
``(8) An assurance that the eligible entity will establish
a local interagency agreement under subsection (e) and comply
with such agreement.
``(e) Interagency Agreements.--
``(1) Local interagency agreements.--In carrying out an
evidence-based initiative, activity, or program described in
subsection (c), an eligible entity that receives a grant,
contract, or cooperative agreement under this section, or a
designee of such entity, shall establish an interagency
agreement between local educational agencies, agencies
responsible for early childhood education programs, Head
Start agencies (including Early Head Start agencies),
juvenile justice authorities, mental health agencies, child
welfare agencies, and other relevant agencies, authorities,
or entities in the community that will be involved in the
provision of services under such initiative, activity, or
program.
``(2) Contents.--The local interagency agreement required
under paragraph (1) shall specify, with respect to each
agency, authority, or entity that is a party to such
agreement--
``(A) the financial responsibility for any services
provided by such entity;
``(B) the conditions and terms of responsibility for such
any services, including quality, accountability, and
coordination of the services; and
``(C) the conditions and terms of reimbursement of such
agencies, authorities, or entities, including procedures for
dispute resolution.
``(f) Evaluation.--The Secretary shall conduct a rigorous
and independent evaluation of the initiatives, activities,
and programs carried out by an eligible entity under this
section and disseminate evidence-based practices regarding
trauma-informed support services and mental health services.
``(g) Distribution of Awards.--The Secretary shall ensure
that grants, contracts, and cooperative agreements awarded or
entered into under this section are equitably distributed
among the geographical regions of the United States and among
tribal, urban, suburban, and rural populations.
``(h) Rule of Construction.--Nothing in this section shall
be construed--
``(1) to prohibit an entity involved with an initiative,
activity, or program carried out under this section from
reporting a crime that is committed by a student to
appropriate authorities; or
``(2) to prevent Federal, State, local, and tribal law
enforcement and judicial authorities from exercising their
responsibilities with regard to the application of Federal,
State, local, and tribal law to crimes committed by a
student.
``(i) Supplement, Not Supplant.--Federal funds provided
under this section shall be used to supplement, and not
supplant, other Federal, State, or local funds available to
carry out the initiatives, activities, and programs described
in this section.
``(j) Consultation Required.--In awarding or entering into
grants, contracts, and cooperative agreements under this
section, the Secretary shall, in a timely manner,
meaningfully consult with Indian Tribes, Regional
Corporations, Native Hawaiian Educational Organizations, and
their representatives to ensure notice of eligibility.
``(k) Definitions.--In this section:
``(1) Early childhood education program.--The term `early
childhood education program' has the meaning given such term
in section 103 of the Higher Education Act of 1965 (20 U.S.C.
1003).
``(2) Eligible entity.--The term `eligible entity' means--
``(A) a State educational agency;
``(B) a local educational agency;
``(C) an Indian Tribe (as defined in section 4 of the
Indian Self-Determination and Education Assistance Act) or
their tribal educational agency;
``(D) the Bureau of Indian Education;
``(E) a Regional Corporation;
``(F) a Native Hawaiian educational organization; and
``(G) State, Territory, and Tribal Lead Agencies
administering the Child Care and Development Fund as
described in section 658D(a) of the Child Care and
Development Block Grant Act (42 U.S.C. 9858b(a)).
``(3) ESEA terms.--
``(A) The terms `elementary school', `evidence-based',
`local educational agency', `paraprofessional', `parent',
`professional development', `school leader', `secondary
school', `Secretary', `specialized instructional support
personnel', and `State educational agency' have the meanings
given such terms in section 8101 of the Elementary and
Secondary Education Act of 1965 (20 U.S.C. 7801).
``(B) The term `full-service community school' has the
meaning given such term in section 4622 of the Elementary and
Secondary Education Act of 1965 (20 U.S.C. 7272).
``(C) The term `Native Hawaiian educational organization'
has the meaning given such term in section 6207 of the
Elementary and Secondary Education Act of 1965 (20 U.S.C.
7517).
``(D) The term `school-based mental health services
provider' has the meaning given the term in section 4102 of
the Elementary and Secondary Education Act of 1965 (20 U.S.C.
7112).
``(4) Regional corporation.--The term `Regional
Corporation' has the meaning given the term in section 3 of
the Alaska Native Claims Settlement Act (43 U.S.C. 1602)).
``(5) School.--The term `school' means a public elementary
school or public secondary school.
``(l) Authorization of Appropriations.--There are
authorized to be appropriated to carry out this section,
$50,000,000 for each of fiscal years 2023 through 2027.''.
TITLE V--RESPOND, INNOVATE, SUCCEED, AND EMPOWER ACT
SEC. 501. SHORT TITLE.
This title may be cited as the ``Respond, Innovate,
Succeed, and Empower Act'' or the ``RISE Act''.
SEC. 502. PERFECTING AMENDMENT TO THE DEFINITION OF
DISABILITY.
Section 103(6) of the Higher Education Act of 1965 (20
U.S.C. 1003(6)) is amended by striking ``section 3(2)'' and
inserting ``section 3''.
SEC. 503. SUPPORTING STUDENTS WITH DISABILITIES TO SUCCEED
ONCE ENROLLED IN COLLEGE.
Section 487(a) of the Higher Education Act of 1965 (20
U.S.C. 1094(a)) is amended by adding at the end the
following:
``(30)(A) The institution will carry out the following:
``(i) Adopt policies that make any of the following
documentation submitted by an individual sufficient to
establish that such individual is an individual with a
disability:
``(I) Documentation that the individual has had an
individualized education program (IEP) in accordance with
section 614(d) of the Individuals with Disabilities Education
Act (20 U.S.C. 1414(d)), including an IEP that may not be
current on the date of the determination that the
[[Page H8248]]
individual has a disability. The institution may ask for
additional documentation from an individual who had an IEP
but who was subsequently evaluated and determined to be
ineligible for services under the Individuals with
Disabilities Education Act, including an individual
determined to be ineligible during elementary school.
``(II) Documentation describing services or accommodations
provided to the individual pursuant to section 504 of the
Rehabilitation Act of 1973 (29 U.S.C. 794) (commonly referred
to as a `Section 504 plan').
``(III) A plan or record of service for the individual from
a private school, a local educational agency, a State
educational agency, or an institution of higher education
provided in accordance with the Americans with Disabilities
Act of 1990 (42 U.S.C. 12101 et seq.).
``(IV) A record or evaluation from a relevant licensed
professional finding that the individual has a disability.
``(V) A plan or record of disability from another
institution of higher education.
``(VI) Documentation of a disability due to service in the
uniformed services, as defined in section 484C(a).
``(ii) Adopt policies that are transparent and explicit
regarding information about the process by which the
institution determines eligibility for accommodations.
``(iii) Disseminate such information to students, parents,
and faculty in an accessible format, including during any
student orientation and making such information readily
available on a public website of the institution.
``(B) Nothing in this paragraph shall be construed to
preclude an institution from establishing less burdensome
criteria than that described in subparagraph (A) to establish
an individual as an individual with a disability and
therefore eligible for accommodations.''.
SEC. 504. AUTHORIZATION OF FUNDS FOR THE NATIONAL CENTER FOR
INFORMATION AND TECHNICAL SUPPORT FOR
POSTSECONDARY STUDENTS WITH DISABILITIES.
Section 777(a) of the Higher Education Act of 1965 (20
U.S.C. 1140q(a)) is amended--
(1) in paragraph (1), by striking ``From amounts
appropriated under section 778,'' and inserting ``From
amounts appropriated under paragraph (5),''; and
(2) by adding at the end the following:
``(5) Authorization of appropriations.--There is authorized
to be appropriated to carry out this subsection $2,000,000
for each of fiscal years 2023 through 2027.''.
SEC. 505. INCLUSION OF INFORMATION ON STUDENTS WITH
DISABILITIES.
Section 487(a) of the Higher Education Act of 1965 (20
U.S.C. 1094(a)), as amended by section 503, is further
amended by adding at the end the following:
``(31) The institution will submit, for inclusion in the
Integrated Postsecondary Education Data System (IPEDS) or any
other Federal postsecondary institution data collection
effort, key data related to undergraduate students enrolled
at the institution who are formally registered as students
with disabilities with the institution's office of disability
services (or the equivalent office), including the total
number of students with disabilities enrolled, the number of
students accessing or receiving accommodations, the
percentage of students with disabilities of all undergraduate
students, and the total number of undergraduate certificates
or degrees awarded to students with disabilities. An
institution shall not be required to submit the information
described in the preceding sentence if the number of such
students would reveal personally identifiable information
about an individual student.''.
SEC. 506. RULE OF CONSTRUCTION.
None of the amendments made by this title shall be
construed to affect the meaning of the terms ``reasonable
accommodation'' or ``record of impairment'' under the
Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et
seq.) or the rights or remedies provided under such Act.
TITLE VI--STRENGTHENING BEHAVIORAL HEALTH BENEFITS ACT
SECTION 601. SHORT TITLE.
This title may be cited as the ``Strengthening Behavioral
Health Benefits Act''.
SEC. 602. ENFORCEMENT OF MENTAL HEALTH AND SUBSTANCE USE
DISORDER REQUIREMENTS.
(a) Civil Monetary Penalties Relating to Parity in Mental
Health and Substance Use Disorders.--Section 502(c)(10) of
the Employee Retirement Income Security Act of 1974 (29
U.S.C. 1132(c)(10)(A)) is amended--
(1) in the heading, by striking ``use of genetic
information'' and inserting ``use of genetic information and
parity in mental health and substance use disorder
benefits''; and
(2) in subparagraph (A)--
(A) by striking ``any plan sponsor of a group health plan''
and inserting ``any plan sponsor or plan administrator of a
group health plan''; and
(B) by striking ``for any failure'' and all that follows
through ``in connection with the plan.'' and inserting ``for
any failure by such sponsor, administrator, or issuer, in
connection with the plan--
``(i) to meet the requirements of subsection (a)(1)(F),
(b)(3), (c), or (d) of section 702 or section 701 or
702(b)(1) with respect to genetic information; or
``(ii) to meet the requirements of subsection (a) of
section 712 with respect to parity in mental health and
substance use disorder benefits.''.
(b) Clarification of General Enforcement Authorities.--
(1) Actions brought by a participant, beneficiary, or
fiduciary.--Section 502(a)(3) of such Act (29 U.S.C.
1132(a)(3)) is amended--
(A) by striking ``or (B)'' and inserting ``(B)''; and
(B) by inserting before the semicolon at the end the
following: ``, or (C) to require re-adjudication and payment
of benefits to remedy violations of this title
notwithstanding the availability of relief under other
provisions of this title''.
(2) Actions brought by the secretary.--Section 502(a)(5) of
such Act (29 U.S.C. 1132(a)(5)) is amended--
(A) by striking ``or (B)'' and inserting ``(B)''; and
(B) by inserting before the semicolon at the end the
following: ``, or (C) to require re-adjudication and payment
of benefits to remedy violations of this title
notwithstanding the availability of relief under other
provisions of this title''.
(c) Exception to the General Prohibition on Enforcement.--
Section 502(b)(3) of such Act (29 U.S.C. 1132(b)(3)) is
amended--
(1) by inserting ``, and except with respect to enforcement
by the Secretary of section 712 or any other provision of
part 7 in any case relating to mental health benefits and
substance use disorder benefits (as such terms are defined in
section 712(e))'' after ``under subsection (c)(9))''; and
(2) by striking ``706(a)(1)'' and inserting ``733(a)(1)''.
(d) Authorization of Appropriations.--There are authorized
to be appropriated to the Department of Labor for audits and
investigations, enforcement actions, litigation expenses,
issuance of regulations or guidance, and any other
Departmental activities relating to section 712 of the
Employee Retirement Income Security Act of 1974 and any other
provision of title I of such Act relating to mental health
and substance use disorder benefits, $275,000,000, for the
period of fiscal years 2023 through 2032, of which--
(1) $240,000,000 is authorized to be appropriated to the
Employee Benefits Security Administration; and
(2) $35,000,000 is authorized to be appropriated to the
Office of the Solicitor.
(e) Effective Date.--The amendments made by subsection (a)
shall apply with respect to group health plans, or any health
insurance issuer offering health insurance coverage in
connection with such plan, for plan years beginning after the
date that is 1 year after the date of enactment of this Act.
TITLE VII--EMPLOYEE AND RETIREE ACCESS TO JUSTICE ACT
SECTION 701. SHORT TITLE.
This title may be cited as the ``Employee and Retiree
Access to Justice Act''.
SEC. 702. UNENFORCEABLE ARBITRATION CLAUSES, CLASS ACTION
WAIVERS, REPRESENTATION WAIVERS, AND
DISCRETIONARY CLAUSES.
(a) In General.--Section 502 of the Employee Retirement
Income Security Act of 1974 (29 U.S.C. 1132) is amended by
adding at the end the following:
``(n)(1) In any civil action brought by, or on behalf of, a
participant or beneficiary pursuant to this section or with
respect to a common law claim involving a plan or plan
benefit, notwithstanding any other provision of law--
``(A) no predispute arbitration provision shall be valid or
enforceable if it requires arbitration of a matter related to
a claim brought under this section;
``(B) no postdispute arbitration provision shall be valid
or enforceable unless--
``(i) the provision was not required by any person,
obtained by coercion or threat of adverse action, or made a
condition of participating in a plan, receiving benefits
under a plan, or receiving any other employment, work, or any
employment-related or work-related privilege or benefit;
``(ii) each participant or beneficiary agreeing to the
provision was informed, through a paper notice, in a manner
reasonably calculated to be understood by the average plan
participant, of the right of the participant or beneficiary
under subparagraph (C) to refuse to agree to the provision
without retaliation or threat of retaliation;
``(iii) each participant or beneficiary agreeing to the
provision so agreed after a waiting period of not fewer than
45 days, beginning on the date on which the participant or
beneficiary was provided both the final text of the provision
and the disclosures required under clause (ii); and
``(iv) each participant or beneficiary agreeing to the
provision affirmatively consented to the provision in
writing;
``(C) no covered provision shall be valid or enforceable,
if prior to a dispute to which the covered provision applies,
a participant or beneficiary undertakes or promises not to
pursue, bring, join, litigate, or support any kind of
individual, joint, class, representative, or collective claim
available under this section in any forum that, but for such
covered provision, is of competent jurisdiction;
``(D) no covered provision shall be valid or enforceable,
if after a dispute to which the covered provision applies
arises, a participant or beneficiary undertakes or promises
not to pursue, bring, join, litigate, or support any kind of
individual, joint, class, representative, or collective claim
under this section in any forum that, but for such covered
provision, is of competent jurisdiction, unless the covered
provision meets the requirements of subparagraph (B); and
``(E) no covered provision related to a plan other than a
multiemployer plan shall be valid or enforceable that
purports to confer discretionary authority to any person with
respect to benefit determinations or interpretation of plan
language, or to provide a standard of review of such
determinations or interpretation by a reviewing court in an
action brought under this section that would require anything
other than de novo review of such determinations or
interpretation.
``(2) In this subsection--
[[Page H8249]]
``(A) the term `covered provision' means any document,
instrument, or agreement related to a plan or plan benefit,
regardless of whether such provision appears in a plan
document or in a separate agreement;
``(B) the term `predispute arbitration provision' means a
covered provision, other than a covered provision that the
Secretary finds to be the product of bona fide collective
bargaining, that requires a participant or beneficiary to
arbitrate a dispute related to the plan or an amendment to
the plan that had not yet arisen at the time such provision
took effect;
``(C) the term `postdispute arbitration provision' means a
covered provision, other than a covered provision that the
Secretary finds to be the product of bona fide collective
bargaining, that requires a participant or beneficiary to
arbitrate a dispute related to the plan or an amendment to
the plan that arose before the time such provision took
effect; and
``(D) the term `retaliation' means any action in violation
of section 510.
``(3)(A) Any dispute as to whether a covered provision that
requires a participant or beneficiary to arbitrate a dispute
related to a plan is valid and enforceable shall be
determined by a court, rather than an arbitrator, regardless
of whether any contractual provision purports to delegate
such determinations to the arbitrator and irrespective of
whether the party resisting arbitration challenges the
arbitration agreement specifically or in conjunction with
other terms of the contract containing such agreement.
``(B) For purposes of this subsection, a dispute shall be
considered to arise only when a plaintiff has actual
knowledge (within the meaning of such term in section 413) of
a breach or violation giving rise to a claim under this
section.''.
(b) Regulations.--The Secretary of Labor may promulgate
such regulations as may be necessary to carry out the
amendment made by subsection (a), including providing for the
form and content of notices required pursuant to such
amendment.
SEC. 703. PROHIBITION ON MANDATORY ARBITRATION CLAUSES, CLASS
ACTION WAIVERS, REPRESENTATION WAIVERS, AND
DISCRETIONARY CLAUSES.
Section 402 of the Employee Retirement Income Security Act
of 1974 (29 U.S.C. 1102) is amended by adding at the end the
following:
``(d)(1) No covered person may--
``(A) require participants or beneficiaries to agree to a
predispute arbitration provision as a condition for
participation in, or receipt of benefits under, a plan;
``(B) agree to a postdispute arbitration provision with a
participant or beneficiary with respect to a plan or plan
benefit unless the conditions of clauses (i) through (iv) of
section 502(n)(1)(B) are satisfied with respect to such
provision; or
``(C) agree to any other covered provision with respect to
a plan or plan benefit under any circumstances under which
such provision would not be valid and enforceable under
subparagraphs (C) through (E) section 502(n)(1).
``(2) In this subsection--
``(A) the term `covered person' means--
``(i) a plan;
``(ii) a plan sponsor;
``(iii) an employer; or
``(iv) a person engaged by a plan for purposes of
administering or operating the plan; and
``(B) the terms `covered provision', `predispute
arbitration provision' and `postdispute arbitration
provision' have the meanings given such terms in section
502(n)(2).''.
SEC. 704. EFFECTIVE DATE.
(a) In General.--The amendments made by sections 702 and
703 shall take effect on the date of enactment of this Act
and shall apply with respect to any dispute or claim that
arises or accrues on or after such date, including any
dispute or claim to which a provision predating such date
applies, regardless of whether plan documents have been
updated in accordance with such amendments.
(b) Enforcement With Respect to Plan Document Updates.--
Notwithstanding subsection (a), no person shall be deemed to
be in violation of such amendments on account of plan
documents that have not been updated in accordance with such
amendments until after the beginning of the first plan year
that begins on or after the date that is 1 year after the
date of enactment of this Act, provided that such person acts
in accordance with such amendments during the period in which
the plan documents have not been updated.
The Acting CHAIR. No further amendment to the bill, as amended, shall
be in order except those printed in House Report 117-507. Each such
further amendment may be offered only in the order printed in the
report, by a Member designated in the report, shall be considered read,
shall be debatable for the time specified in the report, equally
divided and controlled by the proponent and an opponent, shall not be
subject to amendment, and shall not be subject to a demand for division
of the question.
amendment no. 1 offered by mr. trone
=========================== NOTE ===========================
September 29, 2022, on page H8249, in the second column, the
following appeared: AMENDMENT NO. 1 OFFERED BY MR. TRONE OF
MARYLAND
The online version has been corrected to read: AMENDMENT NO. 1
OFFERED BY MR. TRONE
========================= END NOTE =========================
The Acting CHAIR. It is now in order to consider amendment No. 1
printed in House Report 117-507.
Mr. TRONE. Mr. Chair, I rise as the designee of the gentlewoman from
California (Ms. Porter), and I have an amendment at the desk.
The Acting CHAIR. The Clerk will designate the amendment.
The text of the amendment is as follows:
Add at the end the following:
TITLE VIII--STUDENT MENTAL HEALTH RIGHTS
SEC. 801. SHORT TITLE.
This title may be cited as the ``Student Mental Health
Rights Act''.
SEC. 802. FINDINGS.
Congress finds the following:
(1) Nearly all institutions of higher education are subject
to--
(A) the Americans with Disabilities Act of 1990 (42 U.S.C.
12101 et seq.);
(B) section 504 of the Rehabilitation Act of 1973 (29
U.S.C. 794); or
(C) the Fair Housing Act (42 U.S.C. 3601 et seq.).
(2) The laws described in paragraph (1) prohibit
discrimination on the basis of disability, defined as ``with
respect to an individual, a physical or mental impairment
that substantially limits one or more major life activities
of such individual, a record of such an impairment, or being
regarded as having such an impairment'' under section 3(1) of
the Americans with Disabilities Act of 1990 (42 U.S.C.
12102(1)).
(3) Under section 2(a)(3) of the Americans with
Disabilities Act of 1990 (42 U.S.C. 12101(a)(3)), Congress
found that ``discrimination against individuals with
disabilities persists in such critical areas as employment,
housing, public accommodations, education, transportation,
communication, recreation, institutionalization, health
services, voting, and access to public services''.
(4) The laws described in paragraph (1) prohibit
institutions of higher education from discriminating against
students with disabilities, including by failing to provide
reasonable accommodations or reasonable modifications to such
students so that such students are able to fully participate
in postsecondary life.
(5) The laws described in paragraph (1) prohibit
institutions of higher education from discriminating against
students with mental health disabilities, including by
failing to provide reasonable accommodations or reasonable
modifications to such a student.
(6) The vast majority of institutions of higher education
lack a comprehensive plan for addressing and preventing
discrimination against students with mental health
disabilities or who are experiencing crises, in many cases--
(A) requiring such students to leave the institution of
higher education;
(B) evicting such students from on-campus housing; and
(C) establishing excessive and unnecessary impediments to
the re-enrollment of such students to the institution of
higher education.
SEC. 803. STUDY.
(a) Voluntary Reporting.--Not later than 120 days after the
date of the enactment of this Act, the Secretary shall
solicit from students at institutions of higher education
information, on a voluntary basis, with respect to mental
health disabilities and substance use disorders at such
institutions of higher education.
(b) Requirement.--Not later than 1 year after the date of
the enactment of this Act, the Secretary shall complete a
study on mental health disabilities and substance use
disorders at institutions of higher education, including--
(1) using the information voluntarily reported by students
under subsection (a), the prevalence of such disabilities and
disorders, disaggregated by type of disability or disorder
(including hearing difficulty, vision difficulty, cognitive
difficulty, ambulatory difficulty, self-care difficulty,
independent living difficulty, mental health difficulty, and
any other category deemed appropriate by the Secretary),
among students at institutions of higher education and
policies to support students with respect to such conditions;
(2) the policies of institutions of higher education with
respect to students who, due to such a condition, are
considering a voluntary leave of absence or are required to
take a mandatory or involuntary leave of absence, or return
from such an absence, and compliance by institutions of
higher education with such policies; and
(3) best practices for supporting students at institutions
of higher education in managing such conditions, including
the effect such practices have on graduation rates and degree
completion.
(c) Report.--The Secretary shall submit to the Committee on
Education and Labor of the House of Representatives and the
Committee on Health, Education, Labor and Pensions of the
Senate a report on the findings of the study required by
subsection (a).
SEC. 804. GUIDANCE.
Not later than 180 days after the date on which the report
is submitted under section 803(b), the Secretary shall, in
consultation with the Assistant Attorney General of the Civil
Rights Division of the Department of Justice, issue guidance
on--
(1) the compliance of institutions of higher education with
the Americans with Disabilities Act of 1990 (42 U.S.C. 12101
et seq.) and section 504 of the Rehabilitation Act of 1973
(29 U.S.C. 794) with respect to students with mental health
disabilities;
(2) the legal obligations of institutions of higher
education with respect to accommodating students with mental
health disabilities and students with substance use
disorders; and
(3) policies of institutions of higher education which may
have a discriminatory impact on students with mental health
disabilities and students with substance use disorders.
[[Page H8250]]
SEC. 805. DEFINITIONS.
In this title:
(1) Institution of higher education.--The term
``institution of higher education'' has the meaning given
that term in section 101(a) of the Higher Education Act of
1965 (20 U.S.C. 1001(a)).
(2) Secretary.--The term ``Secretary'' means the Secretary
of Education.
The Acting CHAIR. Pursuant to House Resolution 1396, the gentleman
from Maryland (Mr. Trone) and a Member opposed each will control 5
minutes.
The Chair recognizes the gentleman from Maryland.
Mr. TRONE. Mr. Chair, I yield myself such time as I may consume.
Mr. Chair, today I rise in support of the mental health of our
students at institutions of higher education.
Studies show that 73 percent of college students suffer a mental
health crisis during their time in college.
I came to Congress to improve the future outlook of our country.
Well, Mr. Chair, our children are that future.
How will our children succeed if they do not have the proper support
to flourish?
The underlying bill will benefit the mental health of our youth and
college-aged students, and my amendment seeks to provide additional
guidance to colleges that are trying to help.
My amendment would require the Department of Education to provide
recommendations on how to improve the mental health and substance use
disorder resources on college campuses and guidance on how to adhere to
the current Federal laws around access to mental health disability
services.
We owe our children the best possible opportunity to succeed, and
that means paying attention to their mental health in the same way we
pay attention to their grades, by keeping them mentality fit.
I thank Representative Porter for her continued advocacy for
students' mental health, and Representative Bonamici for cosponsoring
the amendment.
Mr. Chair, I urge my colleagues to support the amendment, and I
reserve the balance of my time.
Ms. FOXX. Mr. Chair, I claim the time in opposition.
The Acting CHAIR. The gentlewoman is recognized for 5 minutes.
Ms. FOXX. Mr. Chair, I yield myself such time as I may consume.
Mr. Chair, I rise today to oppose the amendment offered by
Representative Porter and Representative Trone.
Much of this amendment is well-intentioned. The amendment authorizes
the Department of Education to conduct a study to better understand the
prevalence of mental health disabilities and substance use disorders on
campus.
The amendment also authorizes the Department of Education, in
conjunction with the Department of Justice, to issue guidance to
institutions on how they can continue to comply with the Americans with
Disabilities Act, section 504 of the Rehabilitation Act, and other
legal obligations, when serving students with mental health
disabilities and substance use disorders.
However, this amendment has some issues. This amendment includes
broader language that could allow the Department of Education to
deviate from issuing guidance on complying with these existing laws and
open the door for the Department of Education to speculate on a variety
of other institution policies.
For example, language in this amendment could permit the Department
of Education to prohibit colleges and universities from enforcing their
codes of conduct when students engage in drug use that violate campus
policies, which would make campuses less safe and less able to support
students with mental health disabilities or substance use disorders.
Unfortunately, this amendment did not go through the normal committee
process, where it would be my hope that much of this language could
have been discussed and revised.
I believe we all want to ensure students struggling with mental
health disabilities are provided the appropriate legal accommodations
by their institutions. However, this amendment fails to do that.
Mr. Chair, I will oppose this amendment; I encourage my colleagues to
do the same, and I reserve the balance of my time.
Mr. TRONE. Mr. Chair, I yield myself such time as I may consume.
Mr. Chair, I sit on three college boards, and all the commentary of
the colleges' presidents is the same. We have a major issue dealing
with mental health in our colleges, and they would love to have
guidance from experts at the Department of Education.
Will this be perfect? No.
Is anything perfect? No.
We all know perfection is the enemy of the good.
I suggest we move forward and pass this amendment and I urge my
colleagues to support the amendment.
Mr. Chair, I yield back the balance of my time.
Ms. FOXX. Mr. Chair, I yield myself the balance of my time.
Mr. Chair, we are hearing a lot lately about how bills are imperfect,
but we should go ahead and pass them.
Mr. Chair, we have an opportunity to improve legislation before we
pass it, but there seems to be no appetite on the part of our
colleagues on the other side of the aisle to act in a bipartisan
fashion to improve legislation.
Why in the world do we want to vote for things that are imperfect but
could be improved when there is a will to do that on our side of the
aisle?
It makes no sense.
This amendment needs work done to it before we could possibly support
it, and I suggest that we set it aside--set the bill aside--and work on
those things that need to be improved, demand that the Department of
Education do its job. Clean this up. Then we could pass good
legislation, maybe not perfect, but certainly better than what we are
facing here today.
Mr. Chair, I agree, don't let perfect be the enemy of the good. For
heaven's sake, let's pass good legislation, not legislation that isn't
as good as it could be.
Mr. Chair, I urge my colleagues to vote ``no'' on this amendment,
``no'' on the underlying bill, and I yield back the balance of my time.
The Acting CHAIR. The question is on the amendment offered by the
gentleman from Maryland (Mr. Trone).
The amendment was agreed to.
amendment no. 2 offered by mr. desaulnier
=========================== NOTE ===========================
September 29, 2022, on page H8250, in the third column, the
following appeared: AMENDMENT NO. 2 OFFERED BY MR. DESAULNIER OF
CALIFORNIA
The online version has been corrected to read: AMENDMENT NO. 2
OFFERED BY MR. DESAULNIER
========================= END NOTE =========================
The Acting CHAIR. It is now in order to consider amendment No. 2
printed in House Report 117-507.
Mr. DeSAULNIER. Mr. Chair, I rise as the designee of the gentleman
from Indiana (Mr. Mrvan), and I have an amendment at the desk.
The Acting CHAIR. The Clerk will designate the amendment.
The text of the amendment is as follows:
Add at the end the following:
TITLE VIII--OCCUPATIONAL RESEARCH PROGRAM ON MENTAL HEALTH
SECTION 801. OCCUPATIONAL RESEARCH PROGRAM ON MENTAL HEALTH.
(a) In General.--The Director of the National Institute for
Occupational Safety and Health (in this section referred to
as the ``Institute'') shall establish a research program to
identify and apply comprehensive approaches to support
frontline, essential, and other affected workers across all
industries and occupations exposed to and affected by
workplace stressors that contribute to adverse mental health
outcomes, including traumatic stress, anxiety, depression,
suicide, and related mental health conditions. In designing
such research program, the Director shall, in consultation
with the heads of other Federal departments and agencies, as
appropriate, address workplace stressors such as--
(1) traumatic grief resulting from COVID-19-related death
or injury in the workplace;
(2) conditions of employment or places of employment,
including consecutive shifts, increases in shift duration,
changes in workplace protocols, or increases in workloads and
demands due to insufficient resources, which can result in
fatal, near-fatal, or other serious occupational injuries or
illnesses; or
(3) workplace violence or other physical and psychological
hazards that contribute to worker injury or illness on the
job, including poor mental health outcomes among workers.
(b) Best Practices and Recommendations.--As part of the
research program established under this section, the Director
shall develop best practices or recommendations for
organizational-level workplace interventions and support
services that would both prevent worker injury or illness and
reduce the risk of such adverse mental health outcomes among
frontline, essential, and other affected workers across all
industries and occupations, including wraparound services,
mental health awareness initiatives, workplace stress
prevention programs, and training programs to promote work-
related stress prevention and reduction and organizational
resilience, to include specific strategies for preventing
burnout among workers.
[[Page H8251]]
(c) Additional Support.--As part of such research program,
the Director shall also coordinate and support efforts
through other research programs carried out by the Institute,
including the Institute's Total Worker Health program, to
develop comprehensive, evidence-informed approaches to
support mental and behavioral health as a part of worker
wellbeing and related occupational safety and health
programs.
(d) Report.--Not later than 1 year after the date of
enactment of this Act, the Director shall--
(1) report to the Committee on Education and Labor of the
House of Representatives and the Committee on Health,
Education, Labor, and Pensions of the Senate on the extent to
which best practices or recommendations developed pursuant to
subsection (b) have been adopted by relevant stakeholders;
and
(2) engage in education and outreach activities with
employers, health care providers, nonprofit organizations,
workers, labor organizations, and related stakeholders to
support such adoption.
(e) Authorization of Appropriations.--To carry out this
section, there is authorized to be appropriated $10,000,000
for each of fiscal years 2023 through 2025.
The Acting CHAIR. Pursuant to House Resolution 1396, the gentleman
from California (Mr. DeSaulnier) and a Member opposed each will control
5 minutes.
The Chair recognizes the gentleman from California.
Mr. DeSAULNIER. Mr. Chair, I yield myself such time as I may consume.
Mr. Chair, for nearly 3 years, frontline and essential workers have
experienced traumatic stress while navigating different and difficult
barriers and new challenges in the workplace.
Studies have shown that nearly two-thirds of adults, 63 percent,
believe their lives have been irreversibly changed by the COVID-19
pandemic. Many reported worsening mental health, traumatic stress,
anxiety, depression, sleep disorders, and other negative health
outcomes.
For those who experience loss or workplace violence and harassment,
traumatic stress can make a demanding workload, longer shifts, repeated
staff shortages, and administrative challenges difficult to manage.
That is why Representative Mrvan introduced H.R. 8887, the
Prioritizing Workplace Mental Health and Resilience Act.
Throughout my career in public office, I have worked to ensure that
resources are available for those impacted by PTSD, anxiety,
depression, and other mental health conditions.
{time} 1215
The pandemic was particularly challenging for many members of
organized labor in the manufacturing and construction industries, who
continued to show up to work every day during that challenging time,
and this provision would aim to give them the support they deserve.
As Mr. Mrvan's designee, I am offering the text of his Prioritizing
Workplace Mental Health and Resilience Act as an amendment to H.R. 7780
today.
This amendment will ensure affected workers, who made it possible for
our Nation to recover from various challenges posed by COVID-19 in the
public health emergency, are afforded the adequate support services
during their times of need.
The amendment will establish a research program to identify and apply
comprehensive approaches to support frontline and essential workers
exposed to and affected by workplace stressors that contribute to
adverse mental health outcomes.
If adopted, this amendment will require NIOSH, the National Institute
of Occupational Safety and Health, to coordinate with other research
programs within the Institute to develop comprehensive, evidence-based
approaches to support mental health and behavioral health; inform NIOSH
on best practices and recommendations for organizational-level
workplace interventions; support the Institute's mission to prevent
worker injury or illness and reduce the risk of such mental health
outcomes among frontline, essential, and other affected workers.
I urge my colleagues to support this amendment, and I reserve the
balance of my time.
Ms. FOXX. Mr. Chair, I rise in opposition to the amendment.
The Acting CHAIR. The gentlewoman from North Carolina is recognized
for 5 minutes.
Ms. FOXX. Mr. Chair, I yield myself such time as I may consume.
Republicans are committed to addressing the Nation's mental health
crisis, including in the workplace. Unfortunately, this amendment,
while spending $30 million, puts the cart before the horse and does
nothing to address the serious flaws in H.R. 7780.
If Democrats were serious about improving mental health resources and
implementing best practices in the workplace, they would strike the
provisions in the underlying bill that will make it more difficult for
employers to offer mental health benefits.
Still, the amendment, as written, is not ready for prime time. First,
I have concerns about the program's bloated $30 million price tag over
3 years. It is all too common for Congress to throw money at a problem
without any oversight or accountability to ensure that taxpayer dollars
are spent in the most effective way possible.
The amendment also establishes inappropriate criteria for the
National Institute for Occupational Safety and Health, NIOSH, to
examine. This includes how changes in workplace protocols or traumatic
grief from COVID-19 in the workplace contributes to adverse worker
mental health.
These criteria are overly prescriptive. Congress should let NIOSH do
its job in determining what kinds of workplace factors contribute to
poor mental health.
Further, the amendment directs NIOSH to report to Congress within a
year on whether the best practices have been developed and adopted by
relevant stakeholders. However, the Department of Labor's vague and
unclear guidance on mental health parity makes it challenging for
employers to offer mental health benefits; and H.R. 7780 would only
increase the risk for employers offering mental health benefits.
I am disappointed by the lack of effort to develop a workable
bipartisan solution to study the mental health of our Nation's workers
before this flawed legislation was rushed to the floor by Democrats.
This is a partisan amendment to a partisan bill, and a missed
opportunity to improve healthcare for workers.
I urge a ``no'' vote on the amendment and the underlying bill, and I
reserve the balance of my time.
Mr. DeSAULNIER. Mr. Chair, I yield myself such time as I may consume.
In closing, I will just say it is vital that we address the adverse
mental health outcomes that stem from work environments and provide
resources to workers living with PTSD, anxiety, depression, and other
mental health conditions. I urge my colleagues to support this
amendment, and I yield back the balance of my time.
Ms. FOXX. Mr. Chair, I yield myself the balance of my time.
As I stated on the last amendment, this bill needs a lot of work.
Republicans are more than willing to work with our colleagues across
the aisle to make the bill better, to make this amendment better.
Again, Democrats' favorite ploy to solve a problem is to throw money
at it, but not have clear standards, not hold agencies accountable, and
not have a clear plan.
Republicans have plans for how to get things done better in this
country, and we would be so much better off if we could work in a
bipartisan manner to bring bills to the floor; have them go through
regular order; and spend time debating them together.
We want legislation that helps our situations in the country; not
throw money at it; not just say, well, let's try this imperfect
approach and see what will happen. Throw something against the wall and
see if it will stick. That is a rotten way to run this country, Mr.
Chairman. We can do better.
I yield back the balance of my time.
The Acting CHAIR. The question is on the amendment offered by the
gentleman from California (Mr. DeSaulnier).
The amendment was agreed to.
The Acting CHAIR. There being no further amendments, the Committee
rises.
Accordingly, the Committee rose; and the Speaker pro tempore (Mr.
Cicilline) having assumed the chair, Mr. Crow, Acting Chair of the
Committee of the Whole House on the state of the Union, reported that
that Committee, having had under consideration the bill (H.R. 7780) to
support the behavioral needs of students and youth,
[[Page H8252]]
invest in the school-based behavioral health workforce, and ensure
access to mental health and substance use disorder benefits, and,
pursuant to House Resolution 1396, he reported the bill back to the
House with sundry amendments adopted in the Committee of the Whole.
The SPEAKER pro tempore. Under the rule, the previous question is
ordered.
Pursuant to House Resolution 1396, the question on adoption of the
further amendments will be put en gros. The question is on the
amendments.
The amendments were agreed to.
The SPEAKER pro tempore. The question is on the engrossment and third
reading of the bill.
The bill was ordered to be engrossed and read a third time, and was
read the third time.
Motion to Recommit
Mrs. McCLAIN. Mr. Speaker, I have a motion to recommit at the desk.
The SPEAKER pro tempore. The Clerk will report the motion to
recommit.
The Clerk read as follows:
Mrs. McClain of Michigan moves to recommit the bill (H.R.
7780) to the Committee on Education and Labor.
The SPEAKER pro tempore. Pursuant to clause 2(b) of rule XIX, the
previous question is ordered on the motion to recommit.
The question is on the motion to recommit.
The question was taken; and the Speaker pro tempore announced that
the noes appeared to have it.
Mrs. McCLAIN. Mr. Speaker, on that I demand the yeas and nays.
The yeas and nays were ordered.
The SPEAKER pro tempore. Pursuant to section 8 of rule XX, further
proceedings on this question are postponed.
____________________