[House Report 116-553]
[From the U.S. Government Publishing Office]
116th Congress } { Report
HOUSE OF REPRESENTATIVES
2d Session } { 116-553
======================================================================
MENTAL HEALTH SERVICES FOR STUDENTS ACT OF 2020
_______
September 29, 2020.--Committed to the Committee of the Whole House on
the State of the Union and ordered to be printed
_______
Mr. Pallone, from the Committee on Energy and Commerce, submitted the
following
R E P O R T
[To accompany H.R. 1109]
The Committee on Energy and Commerce, to whom was referred
the bill (H.R. 1109) to amend the Public Health Service Act to
revise and extend projects relating to children and to provide
access to school-based comprehensive mental health programs,
having considered the same, reports favorably thereon with an
amendment and recommends that the bill as amended do pass.
CONTENTS
Page
I. Purpose and Summary..............................................3
II. Background and Need for the Legislation..........................4
III. Committee Hearings...............................................5
IV. Committee Consideration..........................................5
V. Committee Votes..................................................6
VI. Oversight Findings...............................................6
VII. New Budget Authority, Entitlement Authority, and Tax Expenditures6
VIII.Federal Mandates Statement.......................................6
IX. Statement of General Performance Goals and Objectives............6
X. Duplication of Federal Programs..................................6
XI. Committee Cost Estimate..........................................6
XII. Earmarks, Limited Tax Benefits, and Limited Tariff Benefits......7
XIII.Advisory Committee Statement.....................................7
XIV. Applicability to Legislative Branch..............................7
XV. Section-by-Section Analysis of the Legislation...................7
XVI. Changes in Existing Law Made by the Bill, as Reported............8
The amendment is as follows:
Strike all after the enacting clause and insert the
following:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Mental Health Services for Students
Act of 2020''.
SEC. 2. AMENDMENTS TO THE PUBLIC HEALTH SERVICE ACT.
(a) Technical Amendments.--The second part G (relating to services
provided through religious organizations) of title V of the Public
Health Service Act (42 U.S.C. 290kk et seq.) is amended--
(1) by redesignating such part as part J; and
(2) by redesignating sections 581 through 584 as sections 596
through 596C, respectively.
(b) School-Based Mental Health and Children.--Section 581 of the
Public Health Service Act (42 U.S.C. 290hh) (relating to children and
violence) is amended to read as follows:
``SEC. 581. SCHOOL-BASED MENTAL HEALTH; CHILDREN AND ADOLESCENTS.
``(a) In General.--The Secretary, in consultation with the Secretary
of Education, shall, through grants, contracts, or cooperative
agreements awarded to eligible entities described in subsection (c),
provide comprehensive school-based mental health services and supports
to assist children in local communities and schools (including schools
funded by the Bureau of Indian Education) dealing with traumatic
experiences, grief, bereavement, risk of suicide, and violence. Such
services and supports shall be--
``(1) developmentally, linguistically, and culturally
appropriate;
``(2) trauma-informed; and
``(3) incorporate positive behavioral interventions and
supports.
``(b) Activities.--Grants, contracts, or cooperative agreements
awarded under subsection (a), shall, as appropriate, be used for--
``(1) implementation of school and community-based mental
health programs that--
``(A) build awareness of individual trauma and the
intergenerational, continuum of impacts of trauma on
populations;
``(B) train appropriate staff to identify, and screen
for, signs of trauma exposure, mental health disorders,
or risk of suicide; and
``(C) incorporate positive behavioral interventions,
family engagement, student treatment, and
multigenerational supports to foster the health and
development of children, prevent mental health
disorders, and ameliorate the impact of trauma;
``(2) technical assistance to local communities with respect
to the development of programs described in paragraph (1);
``(3) facilitating community partnerships among families,
students, law enforcement agencies, education agencies, mental
health and substance use disorder service systems, family-based
mental health service systems, child welfare agencies, health
care providers (including primary care physicians, mental
health professionals, and other professionals who specialize in
children's mental health such as child and adolescent
psychiatrists), institutions of higher education, faith-based
programs, trauma networks, and other community-based systems to
address child and adolescent trauma, mental health issues, and
violence; and
``(4) establishing mechanisms for children and adolescents to
report incidents of violence or plans by other children,
adolescents, or adults to commit violence.
``(c) Requirements.--
``(1) In general.--To be eligible for a grant, contract, or
cooperative agreement under subsection (a), an entity shall be
a partnership that includes--
``(A) a State educational agency, as defined in
section 8101 of the Elementary and Secondary Education
Act of 1965, in coordination with one or more local
educational agencies, as defined in section 8101 of the
Elementary and Secondary Education Act of 1965, or a
consortium of any entities described in subparagraph
(B), (C), (D), or (E) of section 8101(30) of such Act;
and
``(B) at least 1 community-based mental health
provider, including a public or private mental health
entity, health care entity, family-based mental health
entity, trauma network, or other community-based
entity, as determined by the Secretary (and which may
include additional entities such as a human services
agency, law enforcement or juvenile justice entity,
child welfare agency, agency, an institution of higher
education, or another entity, as determined by the
Secretary).
``(2) Compliance with hipaa.--Any patient records developed
by covered entities through activities under the grant shall
meet the regulations promulgated under section 264(c) of the
Health Insurance Portability and Accountability Act of 1996.
``(3) Compliance with ferpa.--Section 444 of the General
Education Provisions Act (commonly known as the `Family
Educational Rights and Privacy Act of 1974') shall apply to any
entity that is a member of the partnership in the same manner
that such section applies to an educational agency or
institution (as that term is defined in such section).
``(d) Geographical Distribution.--The Secretary shall ensure that
grants, contracts, or cooperative agreements under subsection (a) will
be distributed equitably among the regions of the country and among
urban and rural areas.
``(e) Duration of Awards.--With respect to a grant, contract, or
cooperative agreement under subsection (a), the period during which
payments under such an award will be made to the recipient shall be 5
years, with options for renewal.
``(f) Evaluation and Measures of Outcomes.--
``(1) Development of process.--The Assistant Secretary shall
develop a fiscally appropriate process for evaluating
activities carried out under this section. Such process shall
include--
``(A) the development of guidelines for the
submission of program data by grant, contract, or
cooperative agreement recipients;
``(B) the development of measures of outcomes (in
accordance with paragraph (2)) to be applied by such
recipients in evaluating programs carried out under
this section; and
``(C) the submission of annual reports by such
recipients concerning the effectiveness of programs
carried out under this section.
``(2) Measures of outcomes.--The Assistant Secretary shall
develop measures of outcomes to be applied by recipients of
assistance under this section to evaluate the effectiveness of
programs carried out under this section, including outcomes
related to the student, family, and local educational systems
supported by this Act.
``(3) Submission of annual data.--An eligible entity
described in subsection (c) that receives a grant, contract, or
cooperative agreement under this section shall annually submit
to the Assistant Secretary a report that includes data to
evaluate the success of the program carried out by the entity
based on whether such program is achieving the purposes of the
program. Such reports shall utilize the measures of outcomes
under paragraph (2) in a reasonable manner to demonstrate the
progress of the program in achieving such purposes.
``(4) Evaluation by assistant secretary.--Based on the data
submitted under paragraph (3), the Assistant Secretary shall
annually submit to Congress a report concerning the results and
effectiveness of the programs carried out with assistance
received under this section.
``(5) Limitation.--An eligible entity shall use not more than
20 percent of amounts received under a grant under this section
to carry out evaluation activities under this subsection.
``(g) Information and Education.--The Secretary shall disseminate
best practices based on the findings of the knowledge development and
application under this section.
``(h) Amount of Grants and Authorization of Appropriations.--
``(1) Amount of grants.--A grant under this section shall be
in an amount that is not more than $2,000,000 for each of the
first 5 fiscal years following the date of enactment of the
Mental Health Services for Students Act of 2019. The Secretary
shall determine the amount of each such grant based on the
population of children up to age 21 of the area to be served
under the grant.
``(2) Authorization of appropriations.--There is authorized
to be appropriated to carry out this section, $130,000,000 for
each of fiscal years 2021 through 2024.''.
(c) Conforming Amendment.--Part G of title V of the Public Health
Service Act (42 U.S.C. 290hh et seq.), as amended by subsection (b), is
further amended by striking the part designation and heading and
inserting the following:
``PART G--SCHOOL-BASED MENTAL HEALTH''.
I. Purpose and Summary
H.R. 1109, the ``Mental Health Services for Students Act of
2019'', introduced on February 8, 2019, by Representatives
Grace F. Napolitano (D-CA), John Katko (R-NY), and 56 other
House Members, authorizes a program that supports grants to
fund school-based mental health services. The program would
support screening for social, emotional, mental, and behavioral
issues, including suicide or substance use disorders; treatment
and referral for these issues; development of evidence-based
programs for students experiencing these issues; and other
strategies for schools to support students and the communities
that surround them. The goal of the program is to create
partnerships between schools and community-based mental health
professionals across the country. The bill requires the
Substance Abuse and Mental Health Services Administration
(SAMHSA) to measure the student, family, and educational
outcomes of services supported by the program. Each grant is
initially funded at $2 million per year for five years and the
program is authorized at $130 million for fiscal years 2021
through 2025.
II. Background and Need for Legislation
Research shows that half of all lifetime mental illness
begins by the age of 14.\1\ According to the Centers for
Disease Control and Prevention (CDC), about 3 in 4 children
aged 3 to 17 years with depression also have anxiety and almost
half have behavior problems.\2\ Additionally, suicide is the
second leading cause of death for young Americans between the
age of 10 and 34.\3\ Recent data also show that among
adolescents with mental health needs, more than 80 percent did
not receive needed care.\4\ For those who did receive services,
just 15 percent received mental health services in a school
setting.\5\
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\1\Kessler, Ronald C et al. Lifetime prevalence and age-of-onset
distributions of DSM-IV disorders in the National Comorbidity Survey
Replication. Archives of general psychiatry vol. 62,6 (2005).
\2\Centers for Disease Control and Prevention, Children's Mental
Health Data & Statistics (www.cdc.gov/childrensmentalhealth/data.html)
(accessed September 18, 2020).
\3\National Center for Health Statistics, Leading Causes of Death
Reports, 1981-2018 (accessed September 19, 2020).
\4\Substance Abuse and Mental Health Services Administration. Key
substance use and mental health indicators in the United States:
Results from the 2019 National Survey on Drug Use and Health (2020).
\5\Id.
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The need to address mental health services and prevent
suicide or other self-harm was raised in the testimony before
the Committee of Arriana Gross, a high school student from
Covington, Georgia, who said, ``in our school, a year doesn't
go by without a student dying by suicide. I've even known of
elementary kids who died by suicide. I am concerned that youth
suicide has become so common that my school community and our
Nation is stuck in a pattern of mourning and accepting these
deaths as something that is normal, instead of seeing them as
preventable and tragic.''\6\
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\6\House Committee on Energy and Commerce, Testimony of Arriana
Gross, National Youth Advisory Board Member, Sandy Hook Promise
Students Against Violence Everywhere (SAVE) Promise Club, (June 30,
2020).
---------------------------------------------------------------------------
The American Academy of Pediatrics Committee on School
Health recognized the increasing mental health needs of
children and adolescents and stated that ``[s]chool-based
mental health services offer the potential for prevention
efforts as well as intervention strategies.''\7\ For example,
when Dallas Public Schools incorporated a multidisciplinary
team of health professionals, including mental health
providers, into its school-based health centers, they found
that the students who received services had fewer disciplinary
problems, course failures, and school absences.\8\ While
researchers found that there is a need to measure outcomes more
frequently, a review of available data suggested that mental
health treatment is associated with improved overall
educational outcomes for children.\9\
---------------------------------------------------------------------------
\7\American Academy of Pediatrics Committee on School Health,
School-Based Mental Health Services, Pediatrics (Jun 2004).
\8\Jennings, J et al, Implementing and maintaining school-based
mental health services in a large, urban school district. The Journal
of school health (2000).
\9\Rachel Salinger, Mental health perceptions and school-based
treatments in the United States, International Journal of School &
Educational Psychology. (2019).
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H.R. 1109 would help to expand or establish comprehensive
mental health programs at schools in the United States with the
goal of placing on-site licensed mental health professionals in
schools across the country. Funding would be made available
through SAMHSA to support prevention screening, treatment, and
development of evidence-based programs for social, emotional,
mental, and behavioral issues among students.
III. Committee Hearings
For the purposes of section 103(i) of H. Res. 6 of the
116th Congress, the following hearing was used to develop or
consider H.R. 1109:
The Subcommittee on Health held a virtual legislative
hearing on June 30, 2020, entitled, ``High Anxiety and Stress:
Legislation to Improve Mental Health During Crisis.'' The
hearing focused on H.R. 1109, the ``Mental Health Services for
Students Act of 2019'', and 21 other bills. The Subcommittee
received testimony from the following witnesses:
The Honorable Patrick J. Kennedy, Founder of
the Kennedy Forum and former Member of Congress;
Arthur C. Evans, Jr. Ph.D., Chief Executive
Officer, American Psychological Association;
Jeffrey L. Geller, M.D., M.P.H., President,
American Psychiatric Association, Professor of
Psychiatry and Director of Public Sector Psychiatry at
the University of Massachusetts Medical School
Worcester Recovery Center and Hospital;
Ms. Arriana Gross, National Youth Advisory
Board Member, Sandy Hook Promise Students Against
Violence Everywhere (SAVE) Promise Club.
IV. Committee Consideration
H.R. 1109, the ``Mental Health Services for Students Act of
2019'', was introduced on February 8, 2019, by Representatives
Napolitano (D-CA), Katko (R-NY), and 56 other House Members,
and was referred to the Committee on Energy and Commerce. The
bill was then referred to the Subcommittee on Health on
February 9, 2019. A legislative hearing was held on June 30,
2020.
On September 9, 2020, H.R. 1109 was discharged from further
consideration by the Subcommittee on Health as the bill was
called up for markup by the full Committee on Energy and
Commerce. The full Committee met in virtual open markup
session, pursuant to notice, on September 9, 2020, to consider
H.R. 1109. An amendment in the nature of a substitute offered
by Mr. Tonko of New York was agreed to by a voice vote. The
Committee then agreed to a motion on final passage offered by
Mr. Pallone, Chairman of the committee, to order H.R. 1109
reported favorably to the House, amended, by a voice vote, a
quorum being present.
V. Committee Votes
Clause 3(b) of rule XIII of the Rules of the House of
Representatives requires the Committee to list each record vote
on the motion to report legislation and amendments thereto. The
Committee advises that there were no record votes taken on H.R.
1109, including the motion on final passage.
VI. Oversight Findings
Pursuant to clause 3(c)(1) of rule XIII and clause 2(b)(1)
of rule X of the Rules of the House of Representatives, the
oversight findings and recommendations of the Committee are
reflected in the descriptive portion of the report.
VII. New Budget Authority, Entitlement Authority,
and Tax Expenditures
Pursuant to 3(c)(2) of rule XIII of the Rules of the House
of Representatives, the Committee adopts as its own the
estimate of new budget authority, entitlement authority, or tax
expenditures or revenues contained in the cost estimate
prepared by the Director of the Congressional Budget Office
pursuant to section 402 of the Congressional Budget Act of
1974.
The Committee has requested but not received from the
Director of the Congressional Budget Office a statement as to
whether this bill contains any new budget authority, spending
authority, credit authority, or an increase or decrease in
revenues or tax expenditures.
VIII. Federal Mandates Statement
The Committee adopts as its own the estimate of Federal
mandates prepared by the Director of the Congressional Budget
Office pursuant to section 423 of the Unfunded Mandates Reform
Act.
IX. Statement of General Performance Goals and Objectives
Pursuant to clause 3(c)(4) of rule XIII, the general
performance goal or objective of this legislation is to provide
access to school-based comprehensive mental health programs.
X. Duplication of Federal Programs
Pursuant to clause 3(c)(5) of rule XIII, no provision of
H.R. 1109 is known to be duplicative of another Federal
program, including any program that was included in a report to
Congress pursuant to section 21 of Public Law 111-139 or the
most recent Catalog of Federal Domestic Assistance.
XI. Committee Cost Estimate
Pursuant to clause 3(d)(1) of rule XIII, the Committee
adopts as its own the cost estimate prepared by the Director of
the Congressional Budget Office pursuant to section 402 of the
Congressional Budget Act of 1974.
XII. Earmarks, Limited Tax Benefits, and Limited
Tariff Benefits
Pursuant to clause 9(e), 9(f), and 9(g) of rule XXI, the
Committee finds that H.R. 1109 contains no earmarks, limited
tax benefits, or limited tariff benefits.
XIII. Advisory Committee Statement
No advisory committee within the meaning of section 5(b) of
the Federal Advisory Committee Act was created by this
legislation.
XIV. Applicability to Legislative Branch
The Committee finds that the legislation does not relate to
the terms and conditions of employment or access to public
services or accommodations within the meaning of section
102(b)(3) of the Congressional Accountability Act.
XV. Section-by-Section Analysis of the Legislation
Section 1. Short title
Section 1 designates that the short title may be cited as
the ``Mental Health Services for Students Act of 2020''.
Sec. 2. Amendments to the Public Health Service Act
Section 2 executes technical amendments to the Public
Health Service Act and inserts a new section 581 on school
based mental health, directing the Secretary of Health and
Human Services (the Secretary), in consultation with the
Secretary of Education, to support comprehensive school-based
mental health services and supports. Such services and supports
must be developmentally, linguistically and culturally
appropriate, trauma-informed, and incorporate positive
behavioral interventions. Such activities should include
implementing school and community-based mental health programs;
providing technical assistance to local communities;
facilitating community partnerships; and establishing
mechanisms for reporting for children and adolescents.
A partnership between a State agency in coordination with
one or more local education agencies and at least one
community-based mental health provider is a prerequisite for
program eligibility. Any patient records developed under the
program must meet Health Insurance Portability and
Accountability Act regulations and be compliant with the Family
Education Rights and Privacy Act. The Secretary is directed to
ensure an equal distribution of support across the country and
should provide awards for five years with the option of
renewal. Support shall be not more than $2 million for the
first five years.
Section 2 requires an evaluation of program activities, as
well as development of measures to evaluate student, family,
and local educational outcomes supported by this Act. Such data
and reporting are to be submitted to SAMHSA and evaluated by
the Assistant Secretary. The Secretary must also disseminate
best practice based on the findings of the knowledge
development and application of this section. Section 2 also
authorizes $130 million for each of the fiscal years 2021
through 2025.
XVI. Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets, new
matter is printed in italics, and existing law in which no
change is proposed is shown in roman):
PUBLIC HEALTH SERVICE ACT
* * * * * * *
TITLE V--SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION
* * * * * * *
[Part G--Projects for Children and Violence
[SEC. 581. CHILDREN AND VIOLENCE.
[(a) In General.--The Secretary, in consultation with the
Secretary of Education and the Attorney General, shall carry
out directly or through grants, contracts or cooperative
agreements with public entities a program to assist local
communities in developing ways to assist children in dealing
with violence.
[(b) Activities.--Under the program under subsection (a), the
Secretary may--
[(1) provide financial support to enable local
communities to implement programs to foster the health
and development of children;
[(2) provide technical assistance to local
communities with respect to the development of programs
described in paragraph (1);
[(3) provide assistance to local communities in the
development of policies to address violence when and if
it occurs;
[(4) assist in the creation of community partnerships
among law enforcement, education systems and mental
health and substance abuse service systems; and
[(5) establish mechanisms for children and
adolescents to report incidents of violence or plans by
other children or adolescents to commit violence.
[(c) Requirements.--An application for a grant, contract or
cooperative agreement under subsection (a) shall demonstrate
that--
[(1) the applicant will use amounts received to
create a partnership described in subsection (b)(4) to
address issues of violence in schools;
[(2) the activities carried out by the applicant will
provide a comprehensive method for addressing violence,
that will include--
[(A) security;
[(B) educational reform;
[(C) the review and updating of school
policies;
[(D) alcohol and drug abuse prevention and
early intervention services;
[(E) mental health prevention and treatment
services; and
[(F) early childhood development and
psychosocial services; and
[(3) the applicant will use amounts received only for
the services described in subparagraphs (D), (E), and
(F) of paragraph (2).
[(d) Geographical Distribution.--The Secretary shall ensure
that grants, contracts or cooperative agreements under
subsection (a) will be distributed equitably among the regions
of the country and among urban and rural areas.
[(e) Duration of Awards.--With respect to a grant, contract
or cooperative agreement under subsection (a), the period
during which payments under such an award will be made to the
recipient may not exceed 5 years.
[(f) Evaluation.--The Secretary shall conduct an evaluation
of each project carried out under this section and shall
disseminate the results of such evaluations to appropriate
public and private entities.
[(g) Information and Education.--The Secretary shall
establish comprehensive information and education programs to
disseminate the findings of the knowledge development and
application under this section to the general public and to
health care professionals.
[(h) Authorization of Appropriations.--There is authorized to
be appropriated to carry out this section, $100,000,000 for
fiscal year 2001, and such sums as may be necessary for each of
fiscal years 2002 and 2003.]
PART G --SCHOOL-BASED MENTAL HEALTH
SEC. 581. SCHOOL-BASED MENTAL HEALTH; CHILDREN AND ADOLESCENTS.
(a) In general.--The Secretary, in consultation with the
Secretary of Education, shall, through grants, contracts, or
cooperative agreements awarded to eligible entities described
in subsection (c), provide comprehensive school-based mental
health services and supports to assist children in local
communities and schools (including schools funded by the Bureau
of Indian Education) dealing with traumatic experiences, grief,
bereavement, risk of suicide, and violence. Such services and
supports shall be--
(1) developmentally, linguistically, and culturally
appropriate;
(2) trauma-informed; and
(3) incorporate positive behavioral interventions and
supports.
(b) Activities.--Grants, contracts, or cooperative agreements
awarded under subsection (a), shall, as appropriate, be used
for--
(1) implementation of school and community-based
mental health programs that--
(A) build awareness of individual trauma and
the intergenerational, continuum of impacts of
trauma on populations;
(B) train appropriate staff to identify, and
screen for, signs of trauma exposure, mental
health disorders, or risk of suicide; and
(C) incorporate positive behavioral
interventions, family engagement, student
treatment, and multigenerational supports to
foster the health and development of children,
prevent mental health disorders, and ameliorate
the impact of trauma;
(2) technical assistance to local communities with
respect to the development of programs described in
paragraph (1);
(3) facilitating community partnerships among
families, students, law enforcement agencies, education
agencies, mental health and substance use disorder
service systems, family-based mental health service
systems, child welfare agencies, health care providers
(including primary care physicians, mental health
professionals, and other professionals who specialize
in children's mental health such as child and
adolescent psychiatrists), institutions of higher
education, faith-based programs, trauma networks, and
other community-based systems to address child and
adolescent trauma, mental health issues, and violence;
and
(4) establishing mechanisms for children and
adolescents to report incidents of violence or plans by
other children, adolescents, or adults to commit
violence.
(c) Requirements.--
(1) In general.--To be eligible for a grant,
contract, or cooperative agreement under subsection
(a), an entity shall be a partnership that includes--
(A) a State educational agency, as defined in
section 8101 of the Elementary and Secondary
Education Act of 1965, in coordination with one
or more local educational agencies, as defined
in section 8101 of the Elementary and Secondary
Education Act of 1965, or a consortium of any
entities described in subparagraph (B), (C),
(D), or (E) of section 8101(30) of such Act;
and
(B) at least 1 community-based mental health
provider, including a public or private mental
health entity, health care entity, family-based
mental health entity, trauma network, or other
community-based entity, as determined by the
Secretary (and which may include additional
entities such as a human services agency, law
enforcement or juvenile justice entity, child
welfare agency, agency, an institution of
higher education, or another entity, as
determined by the Secretary).
(2) Compliance with HIPAA.--Any patient records
developed by covered entities through activities under
the grant shall meet the regulations promulgated under
section 264(c) of the Health Insurance Portability and
Accountability Act of 1996.
(3) Compliance with FERPA.--Section 444 of the
General Education Provisions Act (commonly known as the
``Family Educational Rights and Privacy Act of 1974'')
shall apply to any entity that is a member of the
partnership in the same manner that such section
applies to an educational agency or institution (as
that term is defined in such section).
(d) Geographical distribution.--The Secretary shall ensure
that grants, contracts, or cooperative agreements under
subsection (a) will be distributed equitably among the regions
of the country and among urban and rural areas.
(e) Duration of awards.--With respect to a grant, contract,
or cooperative agreement under subsection (a), the period
during which payments under such an award will be made to the
recipient shall be 5 years, with options for renewal.
(f) Evaluation and measures of outcomes.--
(1) Development of process.--The Assistant Secretary
shall develop a fiscally appropriate process for
evaluating activities carried out under this section.
Such process shall include--
(A) the development of guidelines for the
submission of program data by grant, contract,
or cooperative agreement recipients;
(B) the development of measures of outcomes
(in accordance with paragraph (2)) to be
applied by such recipients in evaluating
programs carried out under this section; and
(C) the submission of annual reports by such
recipients concerning the effectiveness of
programs carried out under this section.
(2) Measures of outcomes.--The Assistant Secretary
shall develop measures of outcomes to be applied by
recipients of assistance under this section to evaluate
the effectiveness of programs carried out under this
section, including outcomes related to the student,
family, and local educational systems supported by this
Act.
(3) Submission of annual data.--An eligible entity
described in subsection (c) that receives a grant,
contract, or cooperative agreement under this section
shall annually submit to the Assistant Secretary a
report that includes data to evaluate the success of
the program carried out by the entity based on whether
such program is achieving the purposes of the program.
Such reports shall utilize the measures of outcomes
under paragraph (2) in a reasonable manner to
demonstrate the progress of the program in achieving
such purposes.
(4) Evaluation by assistant secretary.--Based on the
data submitted under paragraph (3), the Assistant
Secretary shall annually submit to Congress a report
concerning the results and effectiveness of the
programs carried out with assistance received under
this section.
(5) Limitation.--An eligible entity shall use not
more than 20 percent of amounts received under a grant
under this section to carry out evaluation activities
under this subsection.
(g) Information and education.--The Secretary shall
disseminate best practices based on the findings of the
knowledge development and application under this section.
(h) Amount of grants and authorization of appropriations.--
(1) Amount of grants.--A grant under this section
shall be in an amount that is not more than $2,000,000
for each of the first 5 fiscal years following the date
of enactment of the Mental Health Services for Students
Act of 2019. The Secretary shall determine the amount
of each such grant based on the population of children
up to age 21 of the area to be served under the grant.
(2) Authorization of appropriations.--There is
authorized to be appropriated to carry out this
section, $130,000,000 for each of fiscal years 2021
through 2024.
* * * * * * *
Part [G] J--Services Provided Through Religious Organizations
SEC. [581.] 596. APPLICABILITY TO DESIGNATED PROGRAMS.
(a) Designated Programs.--Subject to subsection (b), this
part applies to discretionary and formula grant programs
administered by the Substance Abuse and Mental Health Services
Administration that make awards of financial assistance to
public or private entities for the purpose of carrying out
activities to prevent or treat substance abuse (in this part
referred to as a ``designated program''). Designated programs
include the program under subpart II of part B of title XIX
(relating to formula grants to the States).
(b) Limitation.--This part does not apply to any award of
financial assistance under a designated program for a purpose
other than the purpose specified in subsection (a).
(c) Definitions.--For purposes of this part (and subject to
subsection (b)):
(1) The term ``designated program'' has the meaning
given such term in subsection (a).
(2) The term ``financial assistance'' means a grant,
cooperative agreement, or contract.
(3) The term ``program beneficiary'' means an
individual who receives program services.
(4) The term ``program participant'' means a public
or private entity that has received financial
assistance under a designated program.
(5) The term ``program services'' means treatment for
substance abuse, or preventive services regarding such
abuse, provided pursuant to an award of financial
assistance under a designated program.
(6) The term ``religious organization'' means a
nonprofit religious organization.
SEC. [582.] 596A. RELIGIOUS ORGANIZATIONS AS PROGRAM PARTICIPANTS.
(a) In General.--Notwithstanding any other provision of law,
a religious organization, on the same basis as any other
nonprofit private provider--
(1) may receive financial assistance under a
designated program; and
(2) may be a provider of services under a designated
program.
(b) Religious Organizations.--The purpose of this section is
to allow religious organizations to be program participants on
the same basis as any other nonprofit private provider without
impairing the religious character of such organizations, and
without diminishing the religious freedom of program
beneficiaries.
(c) Nondiscrimination Against Religious Organizations.--
(1) Eligibility as program participants.--Religious
organizations are eligible to be program participants
on the same basis as any other nonprofit private
organization as long as the programs are implemented
consistent with the Establishment Clause and Free
Exercise Clause of the First Amendment to the United
States Constitution. Nothing in this Act shall be
construed to restrict the ability of the Federal
Government, or a State or local government receiving
funds under such programs, to apply to religious
organizations the same eligibility conditions in
designated programs as are applied to any other
nonprofit private organization.
(2) Nondiscrimination.--Neither the Federal
Government nor a State or local government receiving
funds under designated programs shall discriminate
against an organization that is or applies to be a
program participant on the basis that the organization
has a religious character.
(d) Religious Character and Freedom.--
(1) Religious organizations.--Except as provided in
this section, any religious organization that is a
program participant shall retain its independence from
Federal, State, and local government, including such
organization's control over the definition,
development, practice, and expression of its religious
beliefs.
(2) Additional safeguards.--Neither the Federal
Government nor a State shall require a religious
organization to--
(A) alter its form of internal governance; or
(B) remove religious art, icons, scripture,
or other symbols,
in order to be a program participant.
(e) Employment Practices.--Nothing in this section shall be
construed to modify or affect the provisions of any other
Federal or State law or regulation that relates to
discrimination in employment. A religious organization's
exemption provided under section 702 of the Civil Rights Act of
1964 regarding employment practices shall not be affected by
its participation in, or receipt of funds from, a designated
program.
(f) Rights of Program Beneficiaries.--
(1) In general.--If an individual who is a program
beneficiary or a prospective program beneficiary
objects to the religious character of a program
participant, within a reasonable period of time after
the date of such objection such program participant
shall refer such individual to, and the appropriate
Federal, State, or local government that administers a
designated program or is a program participant shall
provide to such individual (if otherwise eligible for
such services), program services that--
(A) are from an alternative provider that is
accessible to, and has the capacity to provide
such services to, such individual; and
(B) have a value that is not less than the
value of the services that the individual would
have received from the program participant to
which the individual had such objection.
Upon referring a program beneficiary to an alternative
provider, the program participant shall notify the
appropriate Federal, State, or local government agency
that administers the program of such referral.
(2) Notices.--Program participants, public agencies
that refer individuals to designated programs, and the
appropriate Federal, State, or local governments that
administer designated programs or are program
participants shall ensure that notice is provided to
program beneficiaries or prospective program
beneficiaries of their rights under this section.
(3) Additional requirements.--A program participant
making a referral pursuant to paragraph (1) shall--
(A) prior to making such referral, consider
any list that the State or local government
makes available of entities in the geographic
area that provide program services; and
(B) ensure that the individual makes contact
with the alternative provider to which the
individual is referred.
(4) Nondiscrimination.--A religious organization that
is a program participant shall not in providing program
services or engaging in outreach activities under
designated programs discriminate against a program
beneficiary or prospective program beneficiary on the
basis of religion or religious belief.
(g) Fiscal Accountability.--
(1) In general.--Except as provided in paragraph (2),
any religious organization that is a program
participant shall be subject to the same regulations as
other recipients of awards of Federal financial
assistance to account, in accordance with generally
accepted auditing principles, for the use of the funds
provided under such awards.
(2) Limited audit.--With respect to the award
involved, a religious organization that is a program
participant shall segregate Federal amounts provided
under award into a separate account from non-Federal
funds. Only the award funds shall be subject to audit
by the government.
(h) Compliance.--With respect to compliance with this section
by an agency, a religious organization may obtain judicial
review of agency action in accordance with chapter 7 of title
5, United States Code.
SEC. [583.] 596B. LIMITATIONS ON USE OF FUNDS FOR CERTAIN PURPOSES.
No funds provided under a designated program shall be
expended for sectarian worship, instruction, or
proselytization.
SEC. [584.] 596C. EDUCATIONAL REQUIREMENTS FOR PERSONNEL IN DRUG
TREATMENT PROGRAMS.
(a) Findings.--The Congress finds that--
(1) establishing unduly rigid or uniform educational
qualification for counselors and other personnel in
drug treatment programs may undermine the effectiveness
of such programs; and
(2) such educational requirements for counselors and
other personnel may hinder or prevent the provision of
needed drug treatment services.
(b) Nondiscrimination.--In determining whether personnel of a
program participant that has a record of successful drug
treatment for the preceding three years have satisfied State or
local requirements for education and training, a State or local
government shall not discriminate against education and
training provided to such personnel by a religious
organization, so long as such education and training includes
basic content substantially equivalent to the content provided
by nonreligious organizations that the State or local
government would credit for purposes of determining whether the
relevant requirements have been satisfied.
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