[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\
---------------------------------------------------------------------------
    \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.
---------------------------------------------------------------------------
    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\
---------------------------------------------------------------------------
    \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).
---------------------------------------------------------------------------
    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.

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     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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