[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.

                          ____________________