[House Report 117-484]
[From the U.S. Government Publishing Office]


117th Congress    }                                  {      Report
                        HOUSE OF REPRESENTATIVES
 2d Session       }                                  {      117-484

======================================================================

 
                       MENTAL HEALTH MATTERS ACT

                                _______
                                

 September 22, 2022.--Committed to the Committee of the Whole House on 
            the State of the Union and ordered to be printed

                                _______
                                

   Mr. Scott of Virginia, from the Committee on Education and Labor, 
                        submitted the following

                              R E P O R T

                             together with

                             MINORITY VIEWS

                        [To accompany H.R. 7780]

    The Committee on Education and Labor, to whom was referred 
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, having considered the same, 
reports favorably thereon with an amendment and recommends that 
the bill as amended do pass.

                                CONTENTS

                                                                   Page
Purpose and Summary..............................................    18
Committee Action.................................................    19
Committee Views..................................................    21
Section-by-Section Analysis......................................    41
Explanation of Amendments........................................    49
Application of Law to the Legislative Branch.....................    49
Unfunded Mandate Statement.......................................    49
Earmark Statement................................................    49
Roll Call Votes..................................................    49
Statement of Performance Goals and Objectives....................    55
Duplication of Federal Programs..................................    55
Hearings.........................................................    55
Statement of Oversight Findings and Recommendations of the 
  Committee......................................................    55
New Budget Authority and CBO Cost Estimate.......................    55
Committee Cost Estimate..........................................    56
Changes in Existing Law Made by the Bill, as Reported............    56
Minority Views...................................................   119

    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 Matters Act''.

SEC. 2. TABLE OF CONTENTS.

  The table of contents of this Act is as follows:

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, 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;
                  (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 
        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 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 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) In General.--Section 502(a) of the Employee Retirement Income 
Security Act of 1974 (29 U.S.C. 1132(a)) is amended--
          (1) in paragraph (10), by striking ``or'' at the end;
          (2) in paragraph (11), by striking the period at the end and 
        inserting ``; or''; and
          (3) by adding at the end the following:
          ``(12) in any case relating to the provision of mental health 
        benefits and substance use disorder benefits under a group 
        health plan or under group health insurance coverage offered by 
        a health insurance issuer in connection with a group health 
        plan (as such terms are defined in section 733), by the 
        Secretary, or by a participant, beneficiary, or fiduciary, to 
        enforce any provision of this title or the terms of the plan or 
        coverage relating to such benefits against a group health plan, 
        a health insurance issuer, a fiduciary of a plan, or any other 
        person that contracts with a group health plan to provide group 
        health insurance coverage or assistance in the administration 
        of a group health plan (including a third party administrator, 
        managed behavioral health organization, and a pharmacy benefit 
        manager), if such person participates in or conceals a 
        violation of any requirement of part 7 relating to such 
        benefits or a wrongful denial of a claim for mental health 
        benefits or substance use disorder benefits under the terms of 
        the plan or coverage, to obtain appropriate relief, in addition 
        to any other relief otherwise available under this section, 
        including--
                  ``(A) to recover all losses to participants and 
                beneficiaries;
                  ``(B) to reform impermissible plan or coverage terms 
                and policies (as written or in operation) in accordance 
                with the requirements of this title and its 
                implementing regulations; or
                  ``(C) to ensure the readjudication of claims and 
                payment of benefits in accordance with the plan or 
                coverage terms without any impermissible limitation, 
                plan or coverage term, or policy.''.
  (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'' after ``under subsection (c)(9))''; and
          (2) by striking ``706(a)(1)'' and inserting ``733(a)(1)''.
  (d) Definitions.--Part 7 of title I of such Act (29 U.S.C. 1181 et 
seq.) is amended--
          (1) in section 712(e), in the matter preceding paragraph (1), 
        by inserting ``and section 502(a)(12)'' after ``this section''; 
        and
          (2) in section 733--
                  (A) in subsection (a), in the matter preceding 
                paragraph (1), by inserting ``and section 502(a)(12)'' 
                after ``this part''; and
                  (B) in subsection (b), in the matter preceding 
                paragraph (1), by inserting ``and section 502(a)(12)'' 
                after ``this part''.
  (e) Funding.--
          (1) In general.--In addition to amounts otherwise available, 
        there are appropriated (out of any money in the Treasury not 
        otherwise appropriated) to the Department of Labor for fiscal 
        year 2023, to remain available until September 30, 2032, 
        $275,000,000, of which--
                  (A) $240,000,000 shall be for the Employee Benefits 
                Security Administration; and
                  (B) $35,000,000 shall be for the Solicitor of Labor.
          (2) Use of appropriated funds.--Amounts made available under 
        paragraph (1) may be used 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.

         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--
          ``(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 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 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.

                          Purpose and Summary

    The purpose of H.R. 7780, the Mental Health Matters Act, is 
to improve access to behavioral health services for children, 
students, and workers. H.R. 7780 responds to the growing 
behavioral health needs of communities across the country by 
investing in access to behavioral health services, equipping 
schools to better respond to the needs of students, and 
improving access to behavioral health benefits in job-based 
health coverage.

                            Committee Action


                             116TH CONGRESS

    On February 6, 2019, the Committee held a hearing titled 
``Examining Threats to Workers with Preexisting Conditions'' 
which discussed in part mental health benefits. The Committee 
heard testimony from: Ms. Sabrina Corlette, Research Professor 
with the Center on Health Insurance Reforms, Georgetown 
University Health Policy Institute, Washington, D.C.; Mr. Chad 
Riedy, Alexandria, VA; Ms. Grace-Marie Turner, President, Galen 
Institute, Paeonian Springs, VA; and Dr. Rahul Gupta, Senior 
Vice President and Chief Medical and Health Officer, March of 
Dimes, Arlington, VA.
    On September 11, 2019, the Early Childhood, Elementary, and 
Secondary Education (ECESE) Subcommittee held a hearing titled 
``The Importance of Trauma-Informed Practices in Education to 
Assist Students Impacted by Gun Violence and Other 
Adversities'' which discussed the trauma students bring to and 
experience in school, and how it effects their behavioral 
health and school performance. The Committee heard testimony 
from: Dr. Nadine Burke Harris, Surgeon General for the State of 
California, San Francisco, CA; Dr. Ingrida Barker, Associate 
Superintendent, McDowell County Schools, Welch, WV; Ms. Joy 
Hofmeister, State Superintendent of Public Instruction, 
Oklahoma State Department of Education, Oklahoma City, OK; and 
Dr. Janice K. Jackson, Chief Executive Officer, Chicago Public 
Schools, Chicago, IL.
    On June 22, 2020, the Committee held a hearing titled 
``Inequities Exposed: How COVID-19 Widened Racial Inequities in 
Education, Health, and the Workforce'' on how existing 
disparities in health and education fields have been 
exacerbated by the COVID-19 pandemic. The Committee heard 
testimony from Dr. Camara P. Jones, Adjunct Professor, Rollins 
School of Public Health at Emory University; Senior Fellow and 
Adjunct Associate Professor, Morehouse School of Medicine; Past 
President, American Public Health Association, Atlanta, GA; Dr. 
Valerie Rawlston Wilson, Director, Program on Race, Ethnicity, 
and the Economy, Economic Policy Institute, Silver Spring, MD; 
Mr. Avid Roy, Co-Founder and President, The Foundation for 
Research on Equal Opportunity, Austin, TX; and Mr. John B. 
King, Jr., President and CEO, The Education Trust, Washington, 
D.C.

                             117TH CONGRESS

    On March 25, 2021, the Early Childhood, Elementary, and 
Secondary Education (ECESE) Subcommittee held a hearing titled 
``Lessons Learned: Charting the Path to Educational Equity 
Post-COVID-19'' to examine how the COVID-19 pandemic has 
impacted communities and discuss the most effective methods of 
ensuring the nation's public schools reopen and recover 
equitably. The Subcommittee heard testimony from Mr. Mark 
Morial J.D., President and Chief Executive Officer, National 
Urban League, New York, NY; Mrs. Jennifer Dale, Parent, Lake 
Oswego, OR; Selene Almazan, Esq., Legal Director, Council of 
Parent Attorneys and Advocates, Inc., Towson, MD; and Alberto 
Carvalho, Superintendent of Schools, Miami-Dade County Public 
Schools, Miami, FL.
    On April 15, 2021, the Subcommittee on Health, Employment, 
Labor, and Pensions (HELP Subcommittee) held a hearing titled 
``Meeting the Moment: Improving Access to Behavioral and Mental 
Health Care'' to examine barriers to access to behavioral 
health care, particularly limited coverage of mental health and 
substance use disorder treatment and the importance of 
improving enforcement of mental health parity laws. The 
Subcommittee heard testimony from Dr. Brian Smedley, Chief of 
Psychology in the Public Interest, American Psychological 
Association, Washington, DC; Dr. Christine Yu Moutier, Chief 
Medical Officer, American Foundation for Suicide Prevention, 
New York, NY; Mr. James Gelfand, Senior Vice President, Health 
Policy, The ERISA Industry Committee, Washington, DC; and Dr. 
Meiram Bendat, Founder, Psych-Appeal, Santa Barbara, CA.
    On September 9, 2021, the ECESE Subcommittee held a hearing 
titled, ``Back to School: Highlighting Best Practices for 
Safely Reopening Schools'' which discussed the conditions under 
which schools were beginning to reopen nationally, and the 
state of students and teachers returning to school. The 
Subcommittee heard testimony from Dr. Jesus F. Jara, 
Superintendent of Schools, Clark County School District, Las 
Vegas, NV; Ms. Denise Forte, Interim Chief Executive Officer, 
The Education Trust, Washington, D.C.; Mr. David Zweig, 
Journalist, The Atlantic, New York Magazine, Wired Magazine, 
Hudson, NY; and Dr. Ashish K. Jha, Dean & Professor of Health 
Services, Policy & Practice, Brown University, Providence, RI.
    On February 16, 2022, the ECESE Subcommittee held a hearing 
titled ``Serving All Students: Promoting a Healthier, More 
Supportive School Environment'' to discuss practices in use in 
public schools that are harmful to the mental health of 
students. The Subcommittee heard testimony from: Ms. Kristen 
Harper, Vice President for Public Policy and Engagement, Child 
Trends; Mr. Guy Stephens, Founder and Executive Director, 
Alliance Against Seclusion and Restraint; Ms. Morgan Craven, 
J.D., National Director of Policy, Advocacy and Community 
Engagement, Intercultural Development Research Association; 
and, Mr. Max Eden, Research Fellow, American Enterprise 
Institute.
    On March 1, 2022, the HELP Subcommittee held a hearing 
titled ``Improving Retirement Security and Access to Mental 
Health Benefits'' to examine issues affecting access to 
benefits under private sector employee retirement and health 
benefit plans, including barriers to coverage of mental health 
services. The Subcommittee heard testimony from Ms. Amy Matsui, 
Director of Income Security and Senior Counsel, National 
Women's Law Center, Washington, DC; Ms. Karen Handorf, Senior 
Counsel, Berger Montague, Alexandria, VA; Mr. Andrew Biggs, 
Senior Fellow, American Enterprise Institute, Washington, DC; 
and Mr. Aron Szapiro, Head of Retirement Studies and Public 
Policy, Morningstar, Inc. and Morningstar Investment Management 
LLC, Chicago, IL.
    On May 17, 2022, Rep. Mark DeSaulnier (D-CA-11) introduced 
H.R. 7780, the Mental Health Matters Act. The bill was referred 
to the Committee on Education and Labor.
    On May 18, 2022, the Committee considered H.R. 7780 in 
legislative session and reported it favorably, as amended, to 
the House of Representatives by a vote of 26 Yeas to 18 Nays. 
The Committee considered the following amendments to H.R. 7780:
           Rep. DeSaulnier offered an amendment in the 
        nature of a substitute to make conforming and technical 
        changes. The amendment was adopted by voice vote.
           Rep. Rick Allen (R-GA-12) offered an 
        amendment in the nature of a substitute to strike the 
        bill text and replace it with a new program 
        administered by the Department of Education that would 
        award competitive grants to state educational agencies 
        to address the mental health needs of school. The 
        amendment was defeated by a vote of 17 Yeas and 26 
        Nays.
           Rep. Mary Miller (R-IL-15) offered an 
        amendment to strike language regarding preparing mental 
        health service providers to meet the needs of LGBTQ+ 
        students. The amendment was defeated by a vote of 17 
        Yeas and 26 Nays.
           Rep. Allen offered an amendment to make 
        implementation of the Strengthening Behavioral Health 
        Benefits Act conditional on the Department of Labor 
        issuing a rule on mental health parity requirements. 
        The amendment also strikes the additional funding for 
        parity enforcement. The amendment was defeated by a 
        vote of 17 Yeas and 27 Nays.
           Rep. Diana Harshbarger (R-TN-01) offered an 
        amendment to remove the bill's multiemployer benefits 
        plan exemption from the bill's prohibition on 
        discretionary clauses in employee benefit plans. The 
        amendment was defeated by a vote of 18 Yeas and 26 
        Nays.

                            Committee Views

    Communities across the United States are grappling with a 
devastating mental health crisis, which has only been 
exacerbated in recent years due to two public health 
emergencies--the opioid crisis and the COVID-19 pandemic. 
Barriers to access to behavioral health services vary and 
create complex challenges for vulnerable families, but Congress 
has tools at its disposal to better support students, workers, 
and communities. H.R. 7780 takes important steps to reduce the 
inequities caused by these barriers and include policies and 
priorities to meet the needs of our communities. Specifically, 
H.R. 7780 includes language from bills championed by members of 
the Committee, which are described below.

          SUPPORTING THE BEHAVIORAL HEALTH NEEDS OF STUDENTS 
                               AND YOUTH

    According to a recent CDC report, every year, 20 percent of 
all children are identified with a mental health condition, 
while 40 percent of all children will meet criteria for a 
mental health condition by age 18.\1\ Examining data from 2013 
to 2019, the same report found that among adolescents aged 12-
17 years, 1 in 5 had experienced a major depressive episode.\2\ 
A separate CDC report highlighted the increase in poor mental 
health and suicide behaviors among U.S. high school students 
over roughly the last decade.\3\ Among high school students in 
2019, the report found that more than 1 in 3 reported feeling 
sad or hopeless, an increase of 40 percent over the 2009 
figure.\4\ Equally distressing, nearly 1 in 5 high school 
students in 2019 had seriously considered attempting 
suicide.\5\ On the other end of the age spectrum, findings 
indicate that there is evidence that even very young children 
experience mental health conditions.\6\
---------------------------------------------------------------------------
    \1\Rebecca Bitsko et al., Mental Health Surveillance Among 
Children--United States, @013-2019, 71 Mortality & Morbidity Wkly. 
Rpt., Feb. 25, 2022, at 4, https://www.cdc.gov/mmwr/
volumes/71/su/pdfs/su7102a1-H.pdf.
    \2\Id. at 2.
    \3\Ctrs. for Disease Control & Prevention, Youth Risk Behavior 
Survey Data Summary & Trends Report: 2009-2019 6 (2019), https://
www.cdc.gov/healthyyouth/data/yrbs/pdf/YRBSDataSummaryTrendsReport2019-
508.pdf.
    \4\Id. at 60-61.
    \5\Id. at 62.
    \6\See Ruth Shim, et al., Epidemic Rates of Child and Adolescent 
Mental Health Disorders Require an Urgent Response, 149 Pediatrics 5 
April 26, 2022 at 1, https://publications.aap.org/pediatrics/article/
149/5/e2022056611/184904/Epidemic-Rates-of-Child-and-Adolescent-Mental.
---------------------------------------------------------------------------
    Members of marginalized communities often face additional 
challenges that impact mental health. Between 2009 and 2019, 
lesbian, gay, and bisexual students were four times more likely 
to have attempted suicide than their heterosexual peers.\7\ 
Focusing specifically on transgender youth, a national 
quantitative cross-sectional survey published in 2020, found 
they are twice as likely to experience depression, seriously 
consider suicide, and attempt suicide compared to cisgender, 
lesbian, gay, bisexual, queer and questioning youth.\8\ It is 
important to note that LGBTQ+ identities are not in themselves 
the cause of such challenges. Rather, these higher rates likely 
reflect the impact of bias, discrimination, family rejection, 
and other stressors.\9\ COVID-19 has placed additional 
stressors on many children and young people and has 
disproportionately impacted communities of color. Over 150,000 
children have lost a parent or caregiver to COVID-19, and about 
65 percent of all youth experiencing COVID-19 orphanhood are 
children of color.\10\
---------------------------------------------------------------------------
    \7\See Id. at 684.
    \8\Myeshia Price-Feeney et al., Understanding the Mental Health of 
Transgender and Nonbinary Youth, 66 J. of Adolescent Health 684, 689 
(2020), https://www.jahonline.org/article/S1054-139X(19)30922-X/
fulltext.
    \9\See, e.g., Joanna Almeida, et al., Emotional Distress Among LGBT 
Youth: The Influence of Perceived Discrimination Based on Sexual 
Orientation, 38 J. of Youth & Adolescence 1001-14 (2009).
    \10\See, Dan Treglia, et al, Hidden Pain: Children Who Lost a 
Parent or Caregiver to COVID-19 and What the Nation Can Do to Help 
Them, COVID Collaborative, (Dec. 2021), https://
www.covidcollaborative.us/assets/uploads/img/HIDDEN-PAIN-FINAL.pdf; 
Press Release, Ctrs. for Disease Control & Prevention, The Hidden U.S. 
COVID-19 Pandemic: Orphaned Children--More than 140,000 U.S. Children 
Lost a Primary or Secondary Caregiver Due to the COVID-19 Pandemic 
(October 2021), https://www.cdc.gov/media/releases/2021/p1007-covid-19-
orphaned-children.html.
---------------------------------------------------------------------------
    In addition to losing parents\11\ family members,\12\ 
children of color have been disproportionately impacted by 
long-term COVID-19 complications,\13\ food insecurity,\14\ 
housing instability,\15\ and community violence\16\--all 
factors that contribute to adverse mental health outcomes. 
Improving equitable access to quality mental health services 
will provide critical support to children experiencing 
traumatic stress, anxiety, depression, and other mental health 
conditions.\17\
---------------------------------------------------------------------------
    \11\See Susan D. Hillis, et al., COVID-19-Associated Orphanhood and 
Caregiver Death in the United States. Pediatrics, https://
publications.aap.org/pediatrics/article/148/6/e2021053760/183446/COVID-
19-Associated-Orphanhood-and-Caregiver-Death.
    \12\Mike Stobbe, More than 120,000 U.S. kids had caregivers die 
during pandemic, (October 7, 2021), Associated Press, https://
apnews.com/article/coronavirus-pandemic-science-pandemics-covid-19-
pandemic-race-and-ethnicity-72ab35ef81250e5007f5674d7e0af73d.
    \13\Jason Kane, Rising number of children struggle with COVID's 
effects, especially in Black and Latino communities, PBS News Hour, 
(July 23, 2021), https://www.pbs.org/newshour/show/rising-number-of-
children-have-long-haul-covid-especially-in-black-and-latino-
communities.
    \14\Jiying Ling, Paige Duren, Lorraine Robbins, Food Insecurity and 
Mental Well-Being Among Low-Income Families During COVID-19 Pandemic, 
(September 2022), American Journal of Health Promotion, https://
www.ncbi.nlm.nih.gov/pmc/articles/PMC9014344/pdf/
10.1177_08901171221089627.pdf.
    \15\U.S. Department of Housing and Urban Development, Office of 
Policy Development and Research, Promoting Mental Health Through 
Housing Stability, (May 13, 2022), https://www.huduser.gov/portal/
pdredge/pdr-edge-trending-053122.html.
    \16\Eunice Larbi, Hannah Berendzen, et al., Substance Abuse and 
Mental Health Services Administration, Coping with Community Violence 
Together, (July 27, 2022), https://www.samhsa.gov/blog/coping-
community-violence-together.
    \17\Cf. The Nat'l Child Traumatic Stress Network, What is Child 
Traumatic Stress? (2003), https://www.samhsa.gov/sites/default/files/
programs_campaigns/childrens_mental_health/what-is-child-traumatic-
stress.pdf (highlighting the epidemic of childhood traumatic stress).
---------------------------------------------------------------------------
    To highlight the urgent mental health needs of children and 
youth, the American Academy of Pediatrics, the American Academy 
of Child and Adolescent Psychiatry, and the Children's Hospital 
Association declared a national emergency in child and 
adolescent mental health in October 2021.\18\ In order to 
respond to this national emergency, H.R. 7780 includes 
important Committee priorities to better support our nation's 
students, children, and educators during this national 
emergency.
---------------------------------------------------------------------------
    \18\Am. Acad. of Pediatrics, AAP-AACAP-CHA Declaration of a 
National Emergency in Child and Adolescent Mental Health, (Oct. 19, 
2021) https://www.aap.org/en/advocacy/child-and-
adolescent-healthy-mental-development/aap-aacap-cha-declaration-of-a-
national-emergency-in-child-and-adolescent-mental-health/.
---------------------------------------------------------------------------

Supporting Early Childhood Mental Health

    H.R. 7780 includes the text of the Early Childhood Mental 
Health Support Act, which was first introduced in the 116th 
Congress by Rep. Mark DeSaulnier (D-CA-11), Rep. Doris Matsui 
(D-CA-06) and Rep. Joe Kennedy III (D-MA-04). The bill was 
reintroduced in the 117th Congress by Rep. DeSaulnier, Rep. 
Matsui, and Rep. Ayanna Pressley (D-MA-07). The legislation 
aims to improve access to mental health supports for both 
children and staff in Head Start programs by requiring the U.S. 
Department of Health and Human Services (HHS) to identify 
evidence-based interventions for Head Start programs and help 
Head Start agencies implement these interventions to improve 
the health of children and staff.
    The targeted funding and support of the Early Childhood 
Mental Health Support Act comes at a critical time for Head 
Start programs. The COVID-19 pandemic and opioid crisis have 
taken a serious toll on students' social and emotional 
development, leading to an increase in the number of children 
experiencing trauma entering Head Start.\19\ As a result, 
children are entering Head Start with higher needs and 
contributing to stressful working conditions for staff; these 
factors, coupled with low compensation, are leading to high 
staff turnover.\20\ Head Start was founded to help break the 
cycle of poverty and provide young children from low-income 
families comprehensive services that meet their emotional, 
social, health, nutritional, and educational needs.\21\ 
Providing access to mental health services to young children is 
an important part of Head Start's work. In 2016, roughly one in 
six U.S. children between the ages of two and eight years had a 
diagnosed mental, behavioral, or developmental disorder.\22\ 
Given the life-long consequences of adverse experiences and 
trauma on children, it is crucial that Congress develop 
policies to improve the mental health of our nation's young 
people.
---------------------------------------------------------------------------
    \19\See Early Childhood & Knowledge Learning Ctr., Admin. for 
Child. & Families, U.S. Dep't of Health & Hum. Svcs., Introduction to 
Head Start and the Opioid Crisis, (2020) https://eclkc.ohs.acf.hhs.gov/
mental-health/article/head-start-opioid-crisis; Nat'l Head Start Assn., 
Confronting Head Start's Workforce Crisis 2-5 (2022), https://nhsa.org/
wp-content/uploads/2022/05/2022.05-Workforce-Brief.pdf?source=email.
    \20\See Nat'l Head Start Assn., supra note 15, at 2-5.
    \21\Early Childhood & Knowledge Learning Ctr., Admin. for Child. & 
Families, U.S. Dep't of Health & Hum. Svcs. Head Start History, (2018), 
https://eclkc.ohs.acf.hhs.gov/about-us/article/head-start-history.
    \22\Ctrs. for Disease Control & Prevention, Data and Statistics on 
Children's Mental Health, (2022), https://www.cdc.gov/
childrensmentalhealth/data.html.
---------------------------------------------------------------------------
    A 2022 survey of over 900 Head Start staff states that 
classrooms are overrun with children exhibiting challenging 
behaviors, social-emotional needs, and trauma.\23\ The 
Administration for Children and Families, the office within HHS 
that administers Head Start, needs additional resources both to 
address the increased need from the vulnerable populations of 
children Head Start serves and to identify the best 
interventions to set children on a path to school readiness and 
lifelong mental health wellness. The evidence is clear: the 
sooner children receive support, the more they thrive.\24\
---------------------------------------------------------------------------
    \23\See Nat'l Head Start Assn., supra note 15, at 5.
    \24\E.g., Ctr. on the Developing Child, Harvard University, The 
Impact of Early Adversity on Children's Development, 2 (2007), https://
developingchild.harvard.edu/resources/inbrief-the-
impact-of-early-adversity-on-childrens-development/ (``While there is 
no `magic age' for intervention, it is clear that, in most cases, 
intervening as early as possible is significantly more effective than 
waiting.'').
---------------------------------------------------------------------------

Recognizing the Need to Support Children Impacted by Trauma

    Trauma is not merely a factor in the lives of young 
children--it affects between half and two-thirds of all 
children in the United States.\25\ Described simply by the 
American Psychological Association as ``an emotional response 
to a terrible event'', traumatic events may include the 
experience of child abuse, community or school violence, or the 
sudden loss of a loved one.\26\ According to a CDC study 
analyzing the long-term effects of childhood and adolescent 
traumatic experiences (also known as adverse childhood 
experiences, or ACEs) on adult health, health care costs, and 
life expectancy, the effects of trauma are predictive of poor 
mental health across an individual's lifespan.\27\ Furthermore, 
it is estimated that the social and economic costs of trauma 
exposure are hundreds of billions of dollars per year.\28\
---------------------------------------------------------------------------
    \25\Substance Abuse & Mental Health Svcs. Admin., Understanding 
Childhood Trauma 1, (2016), https://store.samhsa.gov/sites/default/
files/d7/priv/sma16_4923_0.pdf.
    \26\Am. Psych. Assn., Trauma (Sept. 13, 2022, 8:15 PM), https://
www.apa.org/topics/trauma#.
    \27\See Ctrs. for Disease Control & Prevention, About the CDC-
Kaiser ACE Study, (Sept. 13, 2022, 8:24 PM) https://www.cdc.gov/
violenceprevention/aces/about.html (linking adverse childhood 
experiences to increased risk of other negative health outcomes from 
injury to chronic disease, infections disease, and risky behaviors 
generally).
    \28\Ctrs. for Disease Control & Prevention, Preventing Childhood 
Adverse Experiences (ACEs): Leveraging the Best Available Evidence 7, 
(2019), https://www.cdc.gov/violenceprevention/pdf/preventingACES.pdf.
---------------------------------------------------------------------------
    As a result of experiencing trauma, children may experience 
difficulties with concentration, memory, organization, and 
language skills that can make it difficult to adjust to a 
classroom setting.\29\ There is also a strong correlation 
between students who have experienced trauma and poor learning 
outcomes.\30\ Further, teachers, school leaders, and 
specialized instructional support personnel can be deeply 
impacted by the traumas students bring with them into the 
classroom each day and sustain secondary traumatic stress.\31\ 
Given the staggering reach of trauma and widespread concerns 
for both student and teacher wellbeing and academic learning, 
it is crucial that teachers, school leaders, paraprofessionals, 
school-based mental health services providers, and other 
specialized instructional support personnel are equipped to 
successfully work with students who have been impacted by 
trauma.
---------------------------------------------------------------------------
    \29\See e.g., Kohske Ogata, Maltreatment Related Trauma Symptoms 
Affect Academic Achievement Through Cognitive Functioning: A 
Preliminary Examination in Japan, 5 J. of Intel. 5 (2017) https://
www.mdpi.com/2079-3200/5/4/32.
    \30\Rachael D. Goodman, et al., Traumatic Stress, Socioeconomic 
Status, and Academic Achievement Among Primary School Students 256, 
(2012) https://www.researchgate.net/profile/Rachael-Goodman-2/
publication/232560514_Traumatic-Stress_Socioeconomic_Status_and_
Academic-Achievement_Among_Primary_School_Students/links/
0a85e538fdecdbdf10000000/Traumatic-Stress-Socioeconomic-Status-and-
Academic-Achievement-Among-Primary-School-Students.pdf.
    \31\The Nat'l Child Traumatic Stress Network, Secondary Traumatic 
Stress, http://www.nctsn.org/resources/topics/secondary-traumatic-
stress.
---------------------------------------------------------------------------
    Effective trauma-informed approaches will go beyond trauma-
sensitive teaching practices employed by a single teacher in a 
classroom and will encompass school wide practices designed to 
foster safe and stable environments, cultivating a space in 
which students, educators, and staff members can thrive.\32\ 
Professional development programs on trauma-informed best 
practices direct school staff to work together to identify 
student needs for referral to licensed or certified school-
based mental health services providers, such as school 
counselors, social workers, and psychologists. These 
professional development activities also enable teachers and 
school leaders to support student mental health in ways that 
are effective yet appropriate given their roles.\33\
---------------------------------------------------------------------------
    \32\Alex Shevrin Venet, The How and Why of Trauma Informed 
Teaching, Edutopia (Aug. 3, 2018), https://www.edutopia.org/article/
how-and-why-trauma-informed-teaching.
    \33\See First Book, The Impact of COVID-19 on Student Mental Health 
in Communities of Need, 24 (Mar. 2022) https://firstbook.org/wp-
content/uploads/2022/03/FirstBook_RI_Mental_ 
Health_Final.pdf?utm_source=firstbook&utm_medium=page&utm_campaign=menta
lhealth.
---------------------------------------------------------------------------
    Recognizing trauma's outsized role as a root cause of major 
American public health issues, during the 115th Congress, Reps. 
Danny K. Davis (D-IL-07) and Mike Gallagher (R-WI-08) launched 
the Trauma-Informed Care Caucus in the U.S. House of 
Representatives to increase congressional awareness of trauma-
informed care.\34\ Representatives Davis and Gallagher were 
then joined by Senator Richard Durbin (D-NY) and Senator Lisa 
Murkowski (R-AK) in introducing the Trauma-Informed Care for 
Children and Families Act\35\ in both the House and Senate, to 
support children who have been exposed to ACEs and other 
traumas. This legislation, designed to respond to needs 
revealed by a Government Accountability Office (GAO) study 
requested by Senator Durbin and Rep. Davis,\36\ was the basis 
for trauma-related provisions included in the Substance Use-
Disorder Prevention that Promotes Opioid Recovery and Treatment 
(SUPPORT) for Patients and Communities Act. The SUPPORT 
Patients and Communities Act passed the House by a bipartisan 
vote of 396-14, with the support of then-Committee Chairwoman 
Virginia Foxx (R-NC-05)\37\; it passed the Senate and was 
enacted into law in 2018.\38\ However, the programs in SUPPORT 
derived from the Trauma-Informed Care for Children and Families 
Act have not yet received funding.
---------------------------------------------------------------------------
    \34\Press Release, Office or Rep. Mike Gallagher, Gallagher 
Launches Bipartisan Trauma-Informed Care Caucus (May 21, 2018) https://
gallagher.house.gov/media/press-releases/gallagher-launches-bipartisan-
trauma-informed-care-caucus.
    \35\S. 774 & H.R. 1757, 115th Cong. (2017).
    \36\U.S. Gov't Accountability Off., GAO-19-388, Children Affected 
by Trauma, Selected States Report Various Approaches and Challenges to 
Supporting Children (2019) https://www.gao.gov/assets/gao-19-388.pdf.
    \37\H.R. 6, 115th Cong., 2d sess., House Roll Call Vote #288, (June 
22, 2018), https://clerk.house.gov/Votes/2018288.
    \38\H.R. 6, 115th Cong., 2d sess., Senate Roll Call Vote #221, 
(Oct. 3, 2018), https://www.senate.gov/legislative/LIS/roll_call_votes/
vote1152/vote_115_2_00221.htm.
---------------------------------------------------------------------------
    In the 116th Congress, Rep. Jahana Hayes (D-CT-05) 
introduced H.R. 4835, the Supporting Trauma-Informed Education 
Practices Act,\39\ which sought to provide mandatory funding 
for the programs in SUPPORT derived from the Trauma-Informed 
Care for Children and Families Act. H.R. 4835 was eventually 
included in the Elijah E. Cummings Lower Drug Costs Now Act 
(H.R. 3), which passed the House of Representatives in December 
2019.\40\ In the same Congress, Reps. Davis and Gallagher 
continued to champion trauma-informed care, and introduced new 
legislation, H.R. 3180, the Resilience Investment, Support, and 
Expansion (RISE) from Trauma Act, to increase support for 
children and adults who have been exposed to trauma by building 
out the trauma-informed workforce and increasing resources for 
communities to support children who have experienced trauma.
---------------------------------------------------------------------------
    \39\H.R. 4835, 116th Cong. (2019).
    \40\H.R. 3, 116th Cong., 1st sess., House Roll Call Vote #682 (Dec. 
12, 2019), https://clerk.house.gov/Votes/2019682.
---------------------------------------------------------------------------
    In the 117th Congress, Rep. Hayes reintroduced the 
Supporting Trauma-Informed Education Practices Act with several 
crucial revisions, such as including early childhood education 
programs as eligible entities to carry out evidence-based 
trauma-informed practices, as well as adding evidence-based 
programs to improve mental health and resiliency among 
teachers, school leaders, and other school personnel as an 
allowable use of grant funds. This was in line with 
recommendations the Early Childhood, Elementary, and Secondary 
Education (ECESE) Subcommittee heard from Kristen Harper, Vice 
President for Policy and Engagement of Child Trends, at a 
February 16, 2022 hearing who said, ``Schools'' primary 
strategy should be prevention, with health, mental health, and 
social services and relationship-building as schools' primary 
tactics.''\41\ The Supporting Trauma-Informed Education 
Practices Act was included in H.R. 7780.
---------------------------------------------------------------------------
    \41\Serving All Students: Promoting a Healthier, More Supportive 
School Environment: Hearing Before the Subcomm. on Early Childhood, 
Elementary & Secondary Educ. of the H. Comm. on Educ. & Lab., 117th 
Cong. (2022).
---------------------------------------------------------------------------
    Based on longstanding bipartisan support for trauma-
informed practices, and previous support for the authorization 
of trauma informed programs in SUPPORT, it is disappointing to 
see how these practices were considered during the markup to 
H.R. 7780. Under now-Ranking Member Foxx`s leadership, the 
proposed Republican Amendment in the Nature of a Substitute 
(ANS) to the Mental Health Matters Act entirely removed 
competitive grants to increase student access to trauma-
informed support from the legislation. In fact, the Republican 
ANS went so far as to strike the mere mentions of ``trauma'' 
and ``trauma-informed practices'' from the bill.
    Finally, as a result of the SUPPORT Patients and 
Communities Act`s passage in the 115th Congress, and the 
longtime efforts of the Congressional Black Caucus` Emergency 
Taskforce on Youth Suicide and Mental Health, an Interagency 
Task Force on Trauma-Informed Care, led by the Substance Abuse 
and Mental Health Services Administration (SAMHSA), was 
established to ``harness the expertise, reach, and resources of 
the federal government to address the impact that trauma can 
have on the healthy development of children.''\42\ The 
Committee looks forward to the Task Force's forthcoming report 
and recommendations. Furthermore, under the Mental Health 
Matters Act, initiatives, activities, and programs carried out 
under the bill's Supporting Trauma-Informed Education Practices 
Act provisions must reflect the best practices for trauma-
informed identification, referral and support developed by the 
Task Force. The Committee is eager for these efforts to serve 
as further exemplars of evidence-based trauma-informed support 
services and mental health services.
---------------------------------------------------------------------------
    \42\Substance Abuse & Mental Health Svcs. Admin., National Strategy 
for Trauma-Informed Care Operating Plan, https://www.samhsa.gov/sites/
default/files/trauma-informed-care-operating-plan.pdf.
---------------------------------------------------------------------------

       INVESTING IN THE SCHOOL-BASED BEHAVIORAL HEALTH WORKFORCE

    Despite the increasing mental, emotional, and behavioral 
health needs of children, students, and youth, only 20 percent 
of children with mental, emotional, or behavioral health 
disorders receive care from a specialized mental health care 
provider.\43\ Among the 4.1 million adolescents ages 12-17 who 
reported a major depressive episode in 2020, only 41.6 percent 
received treatment, according to SAMHSA.\44\ Of those who did 
receive treatment, many received access via school-based mental 
health services.\45\ Students are more likely to visit school-
based health centers for mental health services than community 
mental health centers.\46\ For students living in low-income 
school districts, school-based mental health services may be 
one of few resources available in communities with limited 
access to health .
---------------------------------------------------------------------------
    \43\American Academy of Child and Adolescent Psychiatry, Press 
Release: Severe Shortage of Child and Adolescent Psychiatrists 
Illustrated in AACAP Workforce Maps, (May 4, 2022), https://
www.aacap.org/AACAP/zLatest_News/
Severe_Shortage_Child_Adolescent_Psychiatrists_Illustrated_AACAP_Workfor
ce_Maps; See Richard Martini, et al., Best Principles for Integration 
of Child Psychiatry into the Pediatric Health Home: Financing 
Collaborative Care, 3 American Academy of Child and Adolescent 
Psychiatry, (June 2012), https://www.aacap.org/App_Themes/AACAP/docs/
clinical_practice_center/ systems_of_care/
best_principles_for_integration_of_child_psychiatry_into_the_pediatric_h
ealth_home_2012.pdf (``Almost 20% of children in the United States 
suffer from some form of a mental illness--only 20% of these children 
receive treatment.'').
    \44\Substance Abuse & Mental Health Svcs. Admin., Ctr. for 
Behavioral Health Stats. & Quality, Key Substance Use and Mental Health 
Indicators in the United States: Results from the 2020 National Survey 
on Drug Use and Health, 41 (October 21, 2021), https://www.samhsa.gov/
data/sites/default/files/reports/rpt35325/NSDUHFFRPDFWHTMLFiles2020/
2020NSDUHFFR1PDFW102121.pdf.
    \45\See Id. at 42-43.
    \46\Michael Arenson, et al., The evidence on School-Based Center: A 
Review, 6 Global Pediatric Health 1, 3-4 (2019), https://
www.ncbi.nlm.nih.gov/pmc/articles/PMC6381423/pdf/
10.1177_2333794X19828745.pdf.
---------------------------------------------------------------------------
    Students of color also face additional barriers when 
seeking quality mental health services. People of color in the 
U.S. are more likely to delay or avoid seeking mental health 
treatment,\47\ and one of the theorized reasons for this delay 
is lack of access to mental health providers from diverse 
backgrounds and linguistically and culturally appropriate 
mental health services. While more people of color are training 
to become mental health providers, racial and ethnic minorities 
represent only 26 percent of psychologists under the age of 36 
and 8 percent of those over age 50, according to the American 
Psychological Association.\48\
---------------------------------------------------------------------------
    \47\Thomas G. McGuire & Jeanne Miranda, Racial and ethnic 
Disparities in Mental Health Care: Evidence and Policy Implications, 3, 
NIH Public Access, available at https://www.ncbi.nlm.nih.gov/pmc/
articles/PMC3928067/.
    \48\American Psychological Association. (2019). Demographics of the 
U.S. Psychology Workforce. https://www.apa.org/workforce/data-tools/
demographics.
---------------------------------------------------------------------------
    School-based mental health services providers, which 
include school counselors, social workers, and psychologists, 
are trained professionals with the appropriate licensure, 
certification and/or credentials to serve on the frontlines of 
the student mental health crisis and meet student mental health 
needs. Research has shown that school-based mental health 
providers improve school climate and other positive outcomes 
for students.\49\ Schools served by more school-based mental 
health services providers see a host of improvements, including 
increased attendance rates, lower rates of school disciplinary 
incidents,\50\ as well as improved academic achievement and 
career readiness,\51\ and improved graduation rates.\52\
---------------------------------------------------------------------------
    \49\See, e.g., Richard E. Cleveland & Christopher A. Sink, Student 
Happiness, School Climate, and School Improvement Plans: Implications 
for School Counseling Practice, 21 Professional School Counselling 1-10 
(2018); Thomas J. Hernandez & Susan R. Seem. A Safe School Climate: A 
Systemic Approach and the School Counselor, 7 Professional School 
Counseling 256-62 (2004); Joseph G. Kosciw, et al., Who, what, where, 
when, and why: Demographic and ecological factors contributing to 
hostile school climate for lesbian, gay, bisexual, and transgender 
youth, 38 Journal of Youth Adolescent 976-88 (2009).
    \50\Richard T. Lapan et al., Connecticut professional school 
counselors: College and career counseling services and smaller ratios 
benefit students, 16 Professional School Counseling 117-124. (2012).
    \51\Richard T. Lapan, et al., The impact of more fully implemented 
guidance programs on the school experiences of high school students: A 
statewide evaluation study, 75 J. of Counseling & Development, 292-302 
(1997).
    \52\Kevin Tan, et al., The impact of school social workers on high 
school freshman graduation among the one hundred largest school 
districts in the United States, 39 Sch. Soc. Work J., 1-14 (2015).
---------------------------------------------------------------------------
    As part of the its 2015-16 U.S. Department of Education's 
Civil Rights Data Collection (CRDC), the Department's Office 
for Civil Rights (OCR) required, for the first time, that all 
public schools report the number of social workers, nurses, and 
psychologists employed, to supplement existing data collection 
on the number of school counselors.\53\ A comparison of the 
resulting CRDC data and recommended student to school-based 
mental health services provider ratios indicate an concerning 
shortage of such professionals in schools. The 2015-16 data 
revealed that only two states on average met the 250:1 student-
to-social worker ratio recommended by the School Social Work 
Association of America (SSWAA).\54\ Likewise, only three states 
met the 250:1 student-to-school counselor ratio recommended by 
the American School Counselor Association.\55\ For the 2020-21 
school year, the national average ratio was 415 students to 
every one school counselor. Further, the National Association 
of School Psychologists (NASP) recommends a 500:1 student-to-
school psychologist ratio in order to provide comprehensive 
school-based psychological services.\56\ However, the actual 
national ratio for the 2020-21 school year was 1,211 students 
to one school psychologist.\57\ Schools are entering the 
student mental health crisis woefully understaffed.
---------------------------------------------------------------------------
    \53\U.S. Dept. of Educ., Civil Rights Data Collection, Master List 
of 2015-16 Definitions, https://ocrdata.ed.gov/assets/downloads/CRDC-
Definitions-2015-16.pdf.
    \54\Pooja Patel & Melissa Clinedinst, State-By-State Student-To-
Counselor Ratio Maps By School District, Nat'l Ass'n, for Coll. 
Admission Counseling, ii, (2021) https://www.nacacnet.org/globalassets/
documents/publications/research/researchstateratiosreport.pdf.
    \55\ASCA National Model A Framework For School Counseling Programs, 
https://schoolcounselor.org/getmedia/bd376246-0b4f-413f-b3e0-
1b9938f36e68/ANM-executive-summary-4th-ed.pdf.
    \56\Nat'l Ass'n of Sch. Psychs., Shortage of School Psychologists, 
https://www.nasponline.org/research-and-policy/policy-priorities/
critical-policy-issues/shortage-of-school-psychologists#::text=
NASP%20recommends%20a%20ratio%20of,a%20ratio%20of%201%3A5000.
    \57\Id.
---------------------------------------------------------------------------
    The Committee recognizes the pronounced need schools face 
to respond to COVID-19-related stress and trauma as well as 
existing and projected student needs for mental health 
services. Thanks to passage of the American Rescue Plan Act 
(ARPA), schools have more resources to address student mental 
health.\58\ Congress provided more than $120 billion to K-12 
schools through the ARPA Elementary and Secondary School 
Emergency Relief (ESSER) Fund. This legislation required that 
states target at least 20 percent to address learning loss and 
efforts to address the disproportionate impact of the COVID-19 
pandemic on underserved student groups' academic, social and 
emotional needs.\59\ Local educational agencies may use ARPA 
funds to provide mental health services and supports.\60\ As of 
March 2022, with the help of ESSER funds, schools have already 
seen a 65 percent increase in social workers, and a 17 percent 
increase in counselors.\61\ But we must do more.
---------------------------------------------------------------------------
    \58\Pub. L. No. 117-2, 135 Stat. 4 (2021).
    \59\Id. at Sec.  2001(a), (e)(1).
    \60\Id.
    \61\Fact Sheet, The White House, President Biden to Announce 
Strategy to Address Our National Mental Health Crisis, As Part of Unity 
Agenda in his First State of the Union, (Mar. 01, 2022), https://
www.whitehouse.gov/briefing-room/statements-releases/2022/03/01/fact-
sheet-
president-biden-to-announce-strategy-to-address-our-national-mental-
health-crisis-as-part-of-unity-agenda-in-his-first-state-of-the-union/.
---------------------------------------------------------------------------

Building and Sustaining Pipeline of School-Based Mental Health Service 
                               Providers

    The Committee believes strengthening school-based mental 
health programs is necessary to respond to the needs that have 
been present and documented since at least 2015-16, and to 
respond to added stress and trauma brought on by the COVID-19 
and the opioid crisis. H.R. 7780 is designed to meet both the 
existing and projected student needs for mental health services 
by investing in the pipeline of school-based mental health 
services providers and targeting funding for the recruitment 
and retention of providers. These policies are aligned with 
recommendations from NASP for addressing the shortage of school 
psychologists, recommendations which could be adapted and 
applied across school-based mental health services 
professions.\62\ These recommendations include a focus on 
recruitment, more opportunities for re-specialization within 
graduate programs, and a focus on retention of currently 
practicing school psychologists.\63\ H.R. 7780 also allows for 
models that have proven successful to increase the teacher 
workforce to be used to increase the school mental health 
workforce. At least one state has shown that by collaborating 
with school psychology faculty and professionals from two 
different educational service agencies the state could 
successfully develop a ``Grow Your Own'' program for mental 
health services personnel.\64\
---------------------------------------------------------------------------
    \62\Nat'l Ass'n of Sch. Psychs., supra note 56.
    \63\Id.
    \64\Stephanie L. Schmitz et al., Increasing School-Based Mental 
Health Services with a ``Grow Your Own'' School Psychology Program, 26 
Contemporary Sch. Psych. 22-33 (2022) https://link.springer.com/
article/10.1007/s40688-020-00348-z.
---------------------------------------------------------------------------
    To address the outlined student mental health needs, Title 
II of the Mental Health Matters Act includes language which 
would expand the pipeline of school-based mental health 
services providers by establishing a competitive grant program 
supporting partnerships between eligible institutions of higher 
education and high-need local education agencies. The 
legislative language for this grant program is from the 
bipartisan Increasing Access to Mental Health in Schools Act 
(H.R. 3572), introduced by Rep. Judy Chu (D-CA-27) and Rep. 
Brian Fitzpatrick (R-PA-01), with Committee member Rep. Hayes 
as an original co-sponsor.
    Crucially, Title II of the Mental Health Matters Act 
recognizes the importance of recruiting a diverse school-based 
mental health services provider workforce by including a new 
priority for partnerships which include Historically Black 
Colleges and Universities (HBCUs), Minority-Serving 
Institutions (MSIs) and Tribally Controlled Colleges and 
Universities (TCCUs). Title II also allows for grant funds to 
be used to increase the diversity of school-based mental health 
services providers. It also requires graduates of these 
programs who wish to serve in schools to be trained to meet the 
needs of LGBTQ+ students as well as students who have been 
victims of or witnesses to human trafficking. It is worth 
noting that in FY2019, the U.S. Department of Education used a 
portion of School Safety National Activities funds to award the 
first (and thus far only) cohort of Mental Health Demonstration 
Grant Program funds, which have a similar aim to that of Title 
II's proposed grant program. However, this program has not been 
authorized in statute.
    Title III of the Mental Health Matters Act includes 
language which would direct the U.S. Department of Education to 
award grants to state educational agencies to recruit and 
retain school-based mental health services providers at high-
need public elementary and secondary schools. This language is 
from the Elementary and Secondary School Counseling Act (H.R. 
6214), introduced by Reps. Katherine Clark (D-MA-05), with 
Committee member Rep. Jahana Hayes as an original co-sponsor.
    Title III also updates the Elementary and Secondary 
Counseling Act to include crucial reservations for schools 
operated or funded by the Bureau of Indian Education (BIE) and 
schools in the Outlying Areas to ensure these schools have 
resources necessary to hire and retain school counselors. Title 
III also requires that as a condition of receiving funding, 
states provide an assurance to the Secretary of Education that 
the state will award subgrants to LEAs that serve a significant 
number of high-need schools. It is worth noting that ED awarded 
six state educational agencies School-Based Mental Health 
Services Grants, with purposes aligned with Title III of the 
Mental Health Matters Act, in FY2020 after Congress increased 
appropriations for the School Safety National Activities 
program and directed that $10 million be used to increase the 
number of counselors, social workers, psychologists, or other 
service providers who provide school-based mental health 
services to students. However, this Demonstration Grant program 
has not yet been authorized in statute.\65\
---------------------------------------------------------------------------
    \65\The Committee supports efforts to increase resources and 
support for the school-based mental health workforce via 
congressionally-directed funding, or through existing authority at the 
Department of Education. But passage of the Mental Health Matters Act 
lays the groundwork for a robust authorization of programs to address 
the dire need in our schools for mental health services professionals. 
In doing so, the Committee recognizes it is building off of policies 
and practices undertaken by the School-Based Mental Health Services 
Demonstration Grant program and the Mental Health Services Professional 
Grant program, and hopes that if made in to law authorizations in H.R. 
7780 to expand the school-based mental health workforce would receive 
robust appropriations in line with the requisite need.
---------------------------------------------------------------------------
    With the Mental Health Matters Act including such bold 
attempts to increase the much-needed school mental health work 
force, it is unfortunate that the Republican ANS aimed to 
significantly gut key provisions of both Title II and Title 
III. Had it passed, the Republican ANS would have removed key 
targeting provisions, ones the Committee believes are necessary 
to support the mental health needs of students in high-poverty 
schools and school districts. It is also worth noting that the 
Republican ANS would have weakened provisions to build the 
pipeline of certified and licensed mental health professionals 
and removed references to the specific professions constituting 
school-based mental health services providers, and requirements 
for their appropriate licensure, certification, and 
credentialing.
    Further, flying in the face of growing evidence that LGBTQ+ 
students face disproportionate levels of trauma, an amendment 
offered at markup by Rep. Miller proposed to remove all mention 
of LGBTQ+ students from the bill. LGBTQ+ students, and the 
unique traumas they face trying to live their lives, cannot be 
erased; removing all traces of LGBTQ+ students from the Mental 
Health Matters Act would in no way address the pronounced and 
disproportionate trauma LGBTQ+ students face, nor would it 
resolve the barriers they face in accessing care to deal with 
that trauma.
    Finally, in discussing trauma and school-based mental 
health services, the Committee must address the trauma produced 
by the nationwide epidemic of gun violence in and around our 
schools and its effect on the mental health needs of students. 
On May 25, 2022, just one week after the Committee marked up 
the Mental Health Matters Act, 19 students and two teachers 
were tragically slain by a gunman in Uvalde, Texas, in the 
second-deadliest school shooting in U.S. history.\66\ The grief 
and trauma experienced by students and the wider community in 
Uvalde has resonated nationwide, and demands both immediate 
support by school-based mental health services providers, as 
well as further investments in consistent supports, which 
acknowledge the ongoing mental health needs resulting from mass 
shootings such as school shootings.\67\ The Committee would be 
remiss not to state that research has shown that most people 
with mental illness are not violent.\68\ In fact, individuals 
with mental illness are more likely to be victims rather than 
perpetrators of violence.\69\ Therefore, while it is important 
to increase access to mental health services, such actions 
should not be seen as a substitute for much needed common-sense 
gun control policies.
---------------------------------------------------------------------------
    \66\See generally, e.g., Uvalde School Shooting, Texas Tribune, 
(2022), https://www.texastribune.org/series/uvalde-texas-school-
shooting/ (offering compendium of stories about the shooting and 
aftermath).
    \67\Amy Novotney, Am. Psych. Assn., What Happens to the Survivors, 
(Sept. 2018), https://www.apa.org/monitor/2018/09/survivors.
    \68\Tori DeAngelis, Am. Psych. Assn., Mental illness and violence: 
Debunking myths, addressing realities, (Apr. 2021), https://
www.apa.org/monitor/2021/04/ce-mental-illness.
    \69\Id.
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                 SUPPORTING STUDENTS WITH DISABILITIES

    Section 504 of the Rehabilitation Act of 1973 (Section 
504)\70\ and Title II of the Americans with Disabilities Act 
(ADA)\71\ provide that college students with disabilities are 
entitled to accommodations that eliminate barriers to equal 
access to learning opportunities. Although disability is fairly 
prevalent among college students--approximately 19 percent of 
all enrolled undergraduates reported having a disability\72\--
only a third of these students inform their college or seek any 
accommodations.\73\ Research indicates that graduation rates 
for these students are lower than their non-disabled peers, and 
failure to seek accommodations may play a part in that gap.\74\ 
Reducing impediments to students receiving disability 
accommodations will help students with disabilities succeed in 
post-secondary education.
---------------------------------------------------------------------------
    \70\29 U.S.C. Sec. 794.
    \71\42 U.S.C. Sec. 12132.
    \72\U.S. Dept. of Educ. Institute of Educ. Sciences, Nat'l Ctr. for 
Educ. Stats, https://nces.ed.gov/fastfacts/display.asp?id=60 (last 
visited May, 25th, 2022).
    \73\U.S. Dept. of Educ. Institute of Educ. Sciences, Nat'l Ctr. for 
Educ. Stats, https://nces.ed.gov/whatsnew/press_releases/4_26_2022.asp 
(last visited May, 25th, 2022).
    \74\Fact Sheet, Postsecondary Nat'l Pol'y Inst., Students with 
Disabilities in Higher Education, https://pnpi.org/students-with-
disabilities-in-higher-education/.
---------------------------------------------------------------------------
    Under current law, in order to receive accommodations 
(e.g., extended time on tests, note-taking services, permission 
to record classes), students must first demonstrate that they 
have a disability that is covered by section 504 and the ADA. 
Once that is established, the school and the student must 
determine a reasonable accommodation that enables the student 
to perform the essential functions of the academic program or 
to enjoy the equal benefits of the program. While many students 
with disabilities receive accommodations throughout their 
elementary and secondary education, when they transition to 
post-secondary education, they must navigate new requirements 
to document their disability. Schools generally require the 
diagnosis of a disability to be `recent', within six months for 
psychiatric disabilities.\75\ This is true even if when student 
has a lifelong disability and received services through the 
Individuals with Disabilities Education Act or accommodations 
under section 504 when they were in elementary and secondary 
school. Evaluations for learning disabilities can be especially 
costly and time-consuming for students and their families, and 
long waitlists to even receive an evaluation and diagnosis can 
lead to delays or to the student abandoning the effort 
altogether and not receiving the needed accommodation.\76\
---------------------------------------------------------------------------
    \75\Ass'n on Higher Educ. & Disability, Documentation Guidelines, 
Psychiatric Disorders, (2008) https://www.ahead.org/about-ahead/about-
overview/affiliates/connecticut/documentation
#H.
    \76\Nat'l Ctr. for Learning Disabilities, Life with LD: Navigating 
the Transition to College, https://www.ncld.org/news/policy-and-
advocacy/life-with-ld-navigating-the-transition-to-college/.
---------------------------------------------------------------------------
    To help, H.R. 7780 includes the text of the Respond, 
Innovate, Support, and Empower (RISE) Act--first introduced in 
the Senate in the 114th Congress by Senator Bob Casey (D-PA) 
and first introduced in the House in the 115th Congress by Rep. 
Suzanne Bonamici (D-OR-01) and a bipartisan group of 
legislators in order to help students with disabilities, 
including mental health disabilities, who are transitioning 
from high school to college.
    As incorporated in H.R. 7780, the RISE Act makes it easier 
for college students with disabilities to access the reasonable 
accommodations they need and to which they are legally 
entitled. Under H.R. 7780, colleges and universities would be 
required to accept a student's existing Individualized 
Education Plan (IEP), 504 plan or other qualifying 
documentation from their elementary or secondary school as 
sufficient to establish that the student has a disability which 
may need accommodation. Additionally, covered institutions must 
adopt policies that are transparent and detailed regarding the 
process for determining eligibility for accommodations and make 
that information available in an accessible format during 
orientation and on the college or university's public-facing 
website. To facilitate students receiving accommodations, H.R. 
7780 authorizes $10 million in funding over five years for the 
National Center for College Students with Disabilities (NCCSD). 
The NCCSD provides students and families with information about 
available disability services and offers faculty training and 
resources on best practices to support students with 
disabilities. Finally, the legislation requires covered 
institutions to report on the number of students with 
disabilities being served, the accommodations provided, and the 
outcomes for these students.

  ENSURING ACCESS TO MENTAL HEALTH AND SUBSTANCE USE DISORDER BENEFITS

    Access to behavioral health care--including treatment for 
both mental health and substance use disorder--is an important 
part of maintaining overall health and wellness. Mental 
illnesses are closely linked to physical health problems, such 
as diabetes, stroke, and heart disease.\77\ Individuals living 
with serious mental illness experience significantly higher 
mortality rates than the overall population, dying as much as 
25 years earlier, usually as a result of treatable 
conditions.\78\ With respect to substance use disorder, a 
treatable behavioral health condition, SAMHSA at HHS has found 
that about 40.3 million people aged 12 or older had a substance 
use disorder within the past year, and more than four out of 
five Americans who need treatment for substance misuse do not 
receive it.\79\ As the COVID-19 pandemic continues to 
underscore the importance of equitable access to quality 
behavioral health care services, the number of individuals 
reporting symptoms of depression or anxiety increased from 11 
percent to 41.1 percent during the height of the pandemic.\80\
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    \77\Ctrs. for Disease Control & Prevention, Mental Health: Learn 
About Mental Health, https://www.cdc.gov/mentalhealth/learn/index.htm.
    \78\Joe Parks, et al., Morbidity and Mortality in People with 
Serious Mental Illness, National Association of State Mental Health 
Program Directors (NASMHPD) Medical Directors Council at 4 (Oct. 2006), 
https://www.nasmhpd.org/sites/default/files/
Mortality%20and%20Morbidity%20 Final%20Report%208.18.08_0.pdf; see also 
Nancy H. Liu et al., Excess Mortality in Persons with Severe Mental 
Disorders: A Multilevel Intervention Framework and Priorities for 
Clinical Practice, Policy and Research Agendas, 16 World Psychiatry 30 
(Jan. 26, 2017), https://onlinelibrary.wiley.com/doi/full/10.1002/
wps.20384.
    \79\Press Release, SAMHSA Releases 2020 National Survey on Drug Use 
and Health, Substance Abuse & Mental Health Svcs. Admin, (Oct. 26, 
2021), https://www.samhsa.gov/newsroom/press-announcements/
202110260320.
    \80\Nirmita Panchal et al., The Implications of COVID-19 for Mental 
Health and Substance Use, Kaiser Family Foundation (Feb. 10, 2021), 
https://www.kff.org/coronavirus-covid-19/issue-brief/the-implications-
of-covid-19-for-mental-health-and-substance-use/.
---------------------------------------------------------------------------
    Having affordable health coverage is critical to accessing 
care in America. With the nation's increasing behavioral health 
needs, it is imperative to ensure that health coverage 
adequately covers behavioral health. The long-standing tenet of 
``parity'' in behavioral health care refers to the principle 
that coverage of mental health and substance use disorder (MH/
SUD) services should be no more restrictive than coverage of 
medical and surgical health services. Congress has taken 
several steps to improve parity, beginning in 1996 with the 
Mental Health Parity Act\81\ (MHPA), which provided that annual 
or lifetime dollar limits for mental health benefits could not 
be more restrictive than those imposed on medical and surgical 
benefits. In 2008, the Paul Wellstone and Pete Domenici Mental 
Health Parity and Addiction Equity Act\82\ (MHPAEA) greatly 
expanded the parity protections existing in law. In general, 
MHPAEA requires that financial requirements and treatment 
limitations imposed by a group health plan or health insurance 
issuer on mental health or substance use disorder benefits must 
be in parity with the treatment limitations that apply to 
medical and surgical benefits. The requirements of MHPAEA and 
its implementing regulations extend parity to SUD services and 
apply to both quantitative treatment limitations (QTLs), such 
as co-payments, as well as non-quantitative treatment 
limitations (NQTLs), such as step therapy, prior authorization, 
formulary design, or medical management.\83\ These requirements 
are applicable to private sector employer-sponsored plans 
through amendments made by MHPAEA to the Employee Retirement 
Income Security Act (ERISA).\84\
---------------------------------------------------------------------------
    \81\Pub. L. No. 104-204, title VII (1996).
    \82\Pub. L. No. 110-343, div. C, title V, subtitle B (2008).
    \83\See Colleen L. Barry et al., A Political History of Federal 
Mental Health and Addiction Insurance Parity, 88 Milbank Quarterly 404, 
406-407 (2010).
    \84\29 U.S.C. 1185a.
---------------------------------------------------------------------------
    The Patient Protection and Affordable Care Act\85\ (ACA) 
also advanced parity further in several respects. Most 
directly, the ACA applied MHPAEA to the individual market\86\ 
and qualified health plans,\87\ and further required that non-
grandfathered plans in the individual and small group markets 
cover essential health benefits, including treatment for MH/SUD 
services.\88\ Notably, several of the ACA's consumer 
protections, including the preventive services mandate\89\ and 
the prohibitions on annual and lifetime limits,\90\ also apply 
to MH/SUD services, thereby extending additional protections to 
the large group market. Congress has taken additional steps to 
improve parity in recent years. In 2016, the 21st Century Cures 
Act\91\ mandated that federal agencies issue additional 
guidance, develop an action plan to improve enforcement, and 
audit plans that commit five or more parity violations. The 
Consolidated Appropriations Act, 2021\92\ enhanced audit 
requirements and required health plans and issuers to perform 
comparative analyses of NQTLs and make such analyses available 
to regulators upon request.
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    \85\Pub. L. No. 111-148 (as amended by Pub. L. No. 111-152).
    \86\42 U.S.C. Sec. 300gg-26(c)(4)(A).
    \87\42 U.S.C. Sec. 18031(j).
    \88\42 U.S.C. Sec. 18022.
    \89\42 U.S.C. Sec. 300gg-13.
    \90\42 U.S.C. Sec. 300gg-11.
    \91\Pub. L. No. 144-255, title X (2016).
    \92\Pub. L. No. 116-260, div. BB, title II (2020).
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    Despite progress, parity in health benefits remains a 
challenge--made all the more pressing by the COVID-19 public 
health emergency and the associated stressors that the pandemic 
has placed on communities around the country.

H.R. 7780 Provides the Department of Labor Clearer Authority to Enforce 
        Laws to Protect Access to Mental Health and Substance Use 
        Disorder Benefits for Americans with Job-Based Coverage

    On January 25, 2022, the Department of Labor (DOL), in 
conjunction with the Departments of Health and Human Services 
(HHS) and the Treasury, issued a report to Congress (2022 
Report) about implementation and enforcement of MHPAEA.\93\ 
Notably, the 2022 Report summarized findings of widespread 
noncompliance with MHPAEA based on reviews conducted by the 
Departments. The 2022 Report also included several 
recommendations for legislative action that would bolster 
efforts to enforce the law. In part, it recommended that 
Congress amend ERISA to (1) expressly provide the DOL with the 
authority to directly pursue parity violations caused by health 
insurance issuers, and (2) to ``expressly provide that 
participants and beneficiaries, as well as the DOL on their 
behalf, may recover amounts lost by participants and 
beneficiaries who had their claims denied'' due to parity 
violations, ensuring that they are made whole.\94\
---------------------------------------------------------------------------
    \93\2022 MHPAEA Report to Congress: Realizing Parity, Reducing 
Stigma, and Raising Awareness: Increasing Access to Mental Health and 
Substance Use Disorder Coverage, available at https://www.dol.gov/
sites/dolgov/files/EBSA/laws-and-regulations/laws/mental-health-parity/
report-to-congress-2022-realizing-parity-reducing-stigma-and-raising-
awareness.pdf.
    \94\Id. at 51-2. The report also recommended that the DOL be given 
authority assess civil monetary penalties for MHPAEA noncompliance. 
Representative Norcross introduced H.R. 1364, the ``Parity Enforcement 
Act of 2021'' earlier in the 117th Congress that would provide the DOL 
with this authority if enacted.
---------------------------------------------------------------------------
    The 2022 Report is not the first instance that legislative 
action has been recommended to authorize the DOL to directly 
enforce parity requirements against issuers. The Health, 
Employment, Labor, and Pensions (HELP) Subcommittee heard 
testimony from witnesses in multiple hearings arguing that this 
would be an effective way of bolstering DOL's enforcement 
authority and incentivizing more widespread compliance with the 
law.\95\ The same recommendation was also made during the Trump 
Administration by the President's Commission on Combatting Drug 
Addiction and the Opioid Crisis, chaired by then-Governor Chris 
Christie (R-NJ).\96\
---------------------------------------------------------------------------
    \95\Improving Retirement Security and Access to Mental Health 
Benefits: Hearing Before the Subcomm. On Health, Employment, Labor, and 
Pensions, 117th Cong. (2022) (statement of Karen Handorf, Senior 
Counsel, Berger Montague P.C.) at 5, available at https://
edlabor.house.gov/download/handordkarentestimony030122; Meeting the 
Moment: Improving Access to Behavioral and Mental Health Care: Hearing 
Before the Subcomm. On Health, Employment, Labor, and Pensions, 117th 
Cong. (2021) (statement of Dr. Meiram Bendat, Founder, Psych Appeal, 
Inc.) at 7, available at https://edlabor.house.gov/download/
moutierchristinetestimony041521.
    \96\Final Report from The President's Commission On Combating Drug 
Addiction And The Opioid Crisis, at 72, available at https://
trumpwhitehouse.archives.gov/sites/whitehouse.gov/files/images/
Final_Report_Draft_11-915-2017.pdf.
---------------------------------------------------------------------------
    On May 13, 2022, Rep. Joe Courtney (D-CT-02) introduced 
H.R. 7767, the Strengthening Behavioral Health Benefits Act 
with Committee Member Rep. Donald Norcross (D-NJ-01) as an 
original cosponsor. The Strengthening Behavioral Health 
Benefits Act amends ERISA to adopt the recommendations from the 
2022 Report and also provides $275 million over ten years in 
mandatory funding to support oversight, compliance, and 
enforcement efforts by DOL. The provisions of the Strengthening 
Behavioral Health Benefits Act are incorporated into Title VI 
of the Mental Health Matters Act.
    The Mental Health Matters Act provides meaningful authority 
to DOL to address some of the legal loopholes that continue to 
deny full parity between MH/SUD services and medical and 
surgical health services. DOL is responsible for enforcing 
ERISA, including the mental health parity provisions, with 
respect to more than 2 million private employer-sponsored 
plans.\97\ About one-third of individuals who receive job-based 
health benefits are covered by an insured plan.\98\ For insured 
plans, benefits offered by the plan are funded through a group 
insurance policy sold to the plan by a health insurance issuer 
and the issuer is also responsible for processing claims and 
administering the plan. The other two-thirds of these 
individuals are covered by a self-funded plan.\99\ For self-
funded plans, the employer or other plan sponsor retains the 
financial responsibility for paying benefits under the plan, 
but generally contracts with a health insurance issuer or other 
administrative service provider to process claims and 
administer the plan. Most employers with self-insured plans 
purchase prototype plans from the same issuers that offer 
identical coverage to insured plans.\100\
---------------------------------------------------------------------------
    \97\U.S. Department of Labor, FY 2023 Congressional Budget 
Justification Employee Benefits Security Administration (2022), https:/
/www.dol.gov/sites/dolgov/files/general/budget/2023/CBJ-2023-V2-01.pdf.
    \98\Employer Health Benefits 2021 Annual Survey, Kaiser Family 
Foundation, November 10, 2021 at 9, available at https://www.kff.org/
health-costs/report/2021-employer-health-benefits-
survey/.
    \99\Id.
    \100\Improving Retirement Security and Access to Mental Health 
Benefits: Hearing Before the Subcomm. on Health, Labor, and Pensions, 
117th Cong. (2022) (statement of Karen Handorf, Senior Counsel, Berger 
Montague P.C.) at 5, available at https://edlabor.house.gov/download/
handordkarentestimony030122. See also Meeting the Moment: Improving 
Access to Behavioral and Mental Health Care: Hearing Before the 
Subcomm. On Health, Labor, and Pensions, 117th Cong. (2021) (statement 
of Dr. Meiram Bendat, Founder, Psych Appeal, Inc.) at 5, https://
edlabor.house.gov/imo/media/doc/BendatMeiramTestimony041521.pdf.
---------------------------------------------------------------------------
    Unfortunately, ERISA's civil enforcement scheme fails to 
sufficiently account for issuers' significant role with respect 
to administration of both self-funded and insured plans.\101\ 
Even though issuers are often the entity responsible for 
causing plans' parity violations, ERISA expressly prohibits the 
DOL from enforcing parity requirements against issuers 
directly.\102\ If the DOL were able to directly enforce mental 
health parity requirements against issuers, the agency would be 
able to more effectively leverage its resources and better 
protect participants. In part, this is because whenever 
possible the agency tries to work with plan service providers 
to achieve global corrections, not just for the particular 
plans it investigates but for all other plans that contract 
with the same service providers.\103\ If the DOL could compel 
issuers to make corrections for noncompliant coverage offered 
to ERISA-covered plans, they would be able to obtain global 
corrections for self-funded and insured plans alike.
---------------------------------------------------------------------------
    \101\Section 2726 of the Public Health Service (PHS) Act imposes 
requirements on health insurance issuers that are substantively 
identical to the parity requirements in ERISA. State insurance 
regulators are generally responsible for enforcement of these 
requirements under section 2723 of the PHS Act. State-level enforcement 
efforts vary widely from state to state. See U.S. Gov't Accountability 
Off., GAO-20-150, Mental Health and Substance Use: State and Federal 
Oversight of Compliance with Parity Requirements Varies, available at 
https://www.gao.gov/products/gao-20-150.
    \102\29 U.S.C. 1132(b)(3).
    \103\See FY 2021 MHPAEA Enforcement Fact Sheet at 3, available at 
https://www.dol.gov/sites/dolgov/files/EBSA/laws-and-regulations/laws/
mental-health-parity/mhpaea-enforcement-2021.pdf.
---------------------------------------------------------------------------
    In addition to providing DOL with clearer direct 
enforcement authority to enforce MHPAEA violations, H.R. 7780 
also amends ERISA to make it clear that individuals, and DOL 
acting on their behalf, may obtain retrospective relief in any 
case involving mental health or other benefits that they are 
entitled to under ERISA.
    Case law regarding parties' ability to file lawsuits to 
recover mental health and other benefits wrongly denied due to 
a plan not complying with ERISA has become muddled and is ripe 
for clarification. ERISA's civil enforcement framework includes 
a private right of action for participants and beneficiaries, 
which means that they are generally able to file lawsuits to 
ensure that they receive the benefits that they are entitled to 
and compel their plan to comply with the law. ERISA also 
generally provides the DOL with authority to bring these types 
of lawsuits on participants and beneficiaries' behalf. There 
are three interconnected statutory provisions in ERISA that 
fulfill this purpose:
          1. Section 502(a)(1)(B) enables any plan participant 
        or beneficiary to sue to ``recover benefits due to him 
        under the terms of the plan, to enforce his rights 
        under the terms of the plan, or to clarify his rights 
        to future benefits under the plan.''\104\
---------------------------------------------------------------------------
    \104\29 U.S.C. 1132(a)(1)(B).
---------------------------------------------------------------------------
          2. Section 502(a)(3) enables any plan participant or 
        beneficiary to sue ``(A) to enjoin any act or practice 
        which violates any provision of [ERISA] or the terms of 
        the plan, or (B) to obtain other appropriate equitable 
        relief (i) to redress such violations, or (ii) to 
        enforce any provisions of [ERISA] or the terms of the 
        plan.''\105\
---------------------------------------------------------------------------
    \105\29 U.S.C. 1132(a)(3).
---------------------------------------------------------------------------
          3. Section 502(a)(5) similarly enables the DOL to sue 
        ``(A) to enjoin any act or practice which violates any 
        provision of [ERISA] or the terms of the plan, or (B) 
        to obtain other appropriate equitable relief (i) to 
        redress such violations, or (ii) to enforce any 
        provisions of [ERISA].''\106\
---------------------------------------------------------------------------
    \106\29 U.S.C. 1132(a)(5).
---------------------------------------------------------------------------
    Courts have sometimes recognized a distinction between 
section 502(a)(1)(B) and section 502(a)(3) by reading them in 
tandem to create a two-step process for resolving disputes over 
benefits that were wrongfully denied due to a violation of 
ERISA's requirements. For Step 1, participants or beneficiaries 
can bring a claim under section 502(a)(3) to have any terms of 
their plan that violate ERISA reformed and, for Step 2, they 
may also bring claims under section 502(a)(1)(B) to recover the 
benefits provided by the terms of the plan, as reformed through 
relief obtained under section 502(a)(3).\107\ However, in some 
cases, courts have taken a simpler approach and held that plan 
terms that violate ERISA cannot supersede the law and so they 
are unenforceable and do not need to be reformed prior to 
consideration of claims to recover denied benefits under 
section 502(a)(1)(B).\108\ However, under either approach, 
section 502(a)(1)(B) is the only provision that can be used to 
address recovery of denied benefits by participants.
---------------------------------------------------------------------------
    \107\E.g., Cigna Corp. v. Amara et al., 563 U.S. 421 (2011).
    \108\See e.g., N.R. v. Raytheon, 24 F.4th 740 (1st Cir. 2022).
---------------------------------------------------------------------------
    In Secretary of Labor v. Macy's, et al., the U.S. District 
Court for the Southern District of Ohio recently found new 
limits on the DOL's authority to enforce ERISA 
requirements.\109\ In Macy's, the DOL attempted to exercise its 
authority to seek ``appropriate equitable relief'' under 
section 502(a)(5) to require the defendants to re-adjudicate 
claims that it alleges were improperly decided. However, the 
court held that re-adjudication was not a remedy available 
under 502(a)(5). Although Macy's only represents the 
interpretation of one district court and others may rightly 
find that DOL has the authority to obtain re-adjudication of 
benefits as a remedy for violations of ERISA, the Committee 
sees an interest in making clear that it is the intent of 
Congress that this relief be available to the Secretary. 
Without this authority, DOL's ability to fulfill its mission to 
protect the rights of participants and beneficiaries would be 
significantly curtailed. The success of participants and 
beneficiaries' claims should not hinge on whether their claims 
are properly brought under ERISA section 502(a)(1)(b) or 
section 502(a)(3). As such, H.R. 7780 eradicates any ambiguity 
and ensures that both of ERISA's remedial authority provisions 
in sections 502 can fully protect participants and 
beneficiaries.
---------------------------------------------------------------------------
    \109\See Secretary of Labor v. Macy's, et al., 1:17-cv-541 (S.D. 
Ohio Nov. 17, 2021).
---------------------------------------------------------------------------

Discretionary Clauses Inhibit the Ability of Workers and Retirees to 
        Enforce their Rights to Mental Health and Other Benefits Under 
        ERISA-Covered Plans

    H.R. 7780, in part, enhances access to mental health and 
substance use disorder benefits for individuals with job-based 
health coverage by prohibiting discretionary clauses that 
unfairly advantage plan administrators by denying claimants the 
opportunity for de novo review by courts of their benefit 
denials. H.R. 7780 incorporates these protections by including 
provisions of bicameral legislation, the Employee and Retiree 
Access to Justice Act of 2022, introduced by Rep. DeSaulnier 
and Sen. Tina Smith (D-MN) on May 12, 2022.
    During the HELP Subcommittee's March 1, 2022, hearing 
titled ``Improving Retirement Security and Access to Mental 
Health Benefits'' (March 1st Hearing), witnesses testified 
regarding clauses in group health plan documents that give plan 
administrators authority to interpret the terms of the plan and 
effectively deny plan participants and beneficiaries from 
having their claims for denied benefits reviewed de novo by 
courts if they choose to bring a lawsuit under ERISA. In 
Firestone Tire & Rubber Co. v. Bruch, the Supreme Court held 
that if the plan documents for an ERISA-covered employee 
benefit plan expressly provide the plan administrator with 
authority to interpret the terms of the plan, then lawsuits 
challenging a denial of benefits must be reviewed by courts 
under an abuse of discretion standard, rather than the de novo 
standard that is ordinarily the default under ERISA.\110\
---------------------------------------------------------------------------
    \110\Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 1010 (1989).
---------------------------------------------------------------------------
    In the March 1st Hearing, the Committee heard testimony 
stating that because of Firestone, there has been a 
proliferation of ``discretionary clauses'' in employee benefit 
plans that purport to grant discretion to entities, often 
health insurance companies, regarding benefit determinations 
and plan interpretation.\111\ Karen Handorf, a veteran ERISA 
attorney, testified that:

    \111\Improving Retirement Security And Access To Mental Health 
Benefits: Hearing Before the Subcomm. On Health, Labor, and Pensions, 
117th Cong. (2022) at 7-8 (statement of Karen Handorf, Senior Counsel, 
Berger Montague P.C.), available at https://edlabor.house.gov/download/
handordkarentestimony030122.
---------------------------------------------------------------------------
          [t]hese clauses change the default de novo review 
        standard that courts would otherwise apply in reviewing 
        benefit denials to an abuse of discretion standard that 
        is extremely deferential to the plan fiduciaries . . . 
        In practice, this deferential standard of review makes 
        it very difficult for participants and beneficiaries, 
        particularly those challenging health care or 
        disability denials, to obtain promised benefits even if 
        the court determines that it would decide the matter 
        differently under a de novo standard of review.

    Ms. Handorf further explained that this standard ``severely 
limits the scope of discovery'' in these of cases because 
courts may only consider the same evidence that was considered 
by the plan administrator when deciding whether to approve or 
deny the benefit claim.\112\ Indeed, the deferential standard 
of review creates such a strong presumption in favor of the 
plan administrator's decision to deny benefits that not even a 
structural conflict of interest will generally be sufficient to 
defeat the presumption that a deferential standard of review is 
required.\113\
---------------------------------------------------------------------------
    \112\Id. at 7; see also Meeting the Moment: Improving Access to 
Behavioral and Mental Health Care: Hearing Before the Subcomm. On 
Health, Labor, and Pensions, 117th Cong. (2021) (statement of Dr. 
Meiram Bendat, Founder, Psych Appeal, Inc.), available at https://
edlabor.house.gov/imo/media/doc/BendatMeiramTestimony041521.pdf 
(providing similar commentary on the effect of discretionary clauses).
    \113\Metro. Life Ins. Co. v. Glenn, 554 U.S. 105, 128 (2008) (``The 
significance of the conflict of interest factor will depend on the 
circumstances of the particular case'').
---------------------------------------------------------------------------
    The Committee strongly believes a general prohibition on 
discretionary clauses in ERISA-covered plans would 
significantly enhance participants' and beneficiaries' ability 
to prevail when they are challenge a wrongful denial of mental 
health benefits. Consider, for example, the case of Wit. v. 
United Behavioral Health, a large class action lawsuit 
regarding coverage of mental health benefits. In Wit, the U.S. 
District Court for the Northern District of California ruled 
that United Behavioral Health (``UBH'') breached its fiduciary 
duties under ERISA because the terms of the plans it 
administered stated that medical necessity determinations were 
based on guidelines that were consistent with generally 
accepted standards of care when, in fact, UBH had adopted 
guidelines that were much narrower.\114\ When the district 
court's ruling was issued, the case earned national attention 
and was celebrated as a watershed moment by mental health 
advocates.\115\ However, UBH appealed and the Ninth Circuit 
Court of Appeals recently overturned the district court's 
decision.\116\ In its reversal, the Ninth Circuit held that the 
lower court had misapplied the standard of review (for abuse of 
discretion, rather de novo review) by substituting the court's 
interpretation of plan terms for UBHs, which the court 
determined was not unreasonable. If plaintiffs in the Wit case 
were able to have their claims reviewed by the court under a de 
novo standard it would mean that UBH`s interpretation of plan 
terms would not be given deference and the plaintiffs' claims 
would not have to clear such a high bar to prevail.
---------------------------------------------------------------------------
    \114\Wit v. United Behav. Health, No. 14-CV-02346-JCS (N.D. Cal. 
Mar. 5, 2019), rev`d, No. 20-17363, 9th Cir. Mar. 22, 2022).
    \115\See Reed Abelson, Mental Health Treatment Denied to Customers 
by Giant Insurer`s Policies, Judge Rules, N.Y. Times, Mar. 9, 2019, 
available at https://www.nytimes.com/2019/03/05/health/unitedhealth-
mental-health-parity.html?searchResultPosition=1.
    \116\Wit v. United Behav. Health, No. 20-17363, (9th Cir. Mar. 22, 
2022).
---------------------------------------------------------------------------
    Notably, courts do not always seem to agree that giving 
deference to a plan administrators' denial of benefits is just, 
even under the Supreme Court`s precedent. For example, one 
judicial opinion explained that ``[t]he masks of the law in 
this case conceals the person at risk of dying by a deferential 
standard of review and the rules of legal interpretation. The 
result is a determination that [defendant`s] denial of benefits 
was legally, but perhaps not morally, reasonable.''\117\ In 
another decision, a court explained that because of the 
requirement that they apply deferential review, ``the die was 
essentially cast'' against the participant's claim and ``the 
claimant may lose even if a preponderance of the evidence 
supports a finding of disability, so long as the decision has 
`rational support in the record.'''\118\
---------------------------------------------------------------------------
    \117\Robertson v. Blue Cross & Blue Shield of Texas, 99 F. Supp. 3d 
1249, 1261 (D. Mont.), aff`d sub nom. Robertson v. Blue Cross, 612 F. 
App'x 478 (9th Cir. 2015).
    \118\Fessenden v. Reliance Standard Life Ins. Co., No. 3:15CV370-
PPS, 2018 WL 461105, at *13 (N.D. Ind. Jan. 17, 2018), vacated and 
remanded, 927 F.3d 998 (7th Cir. 2019).
---------------------------------------------------------------------------
    Without a de novo standard of review, individuals are 
unfairly disadvantaged when they challenge a benefit denial in 
court. H.R. 7780 would take an important step toward resolving 
this imbalance of power and improving access to behavioral 
health benefits for workers and their families by prohibiting 
single-employer plan discretionary clauses and any plan 
provisions that would require a standard of review other than 
de novo.

Forced Arbitration Clauses That Purport to Govern ERISA Claims Are 
        Increasingly Common and Interfere with Workers` Ability to 
        Enforce Their Rights with Respect to Mental Health and 
        Substance Use Disorder Benefits

    By amending ERISA to expressly prohibit arbitration clauses 
that preclude plan participants and beneficiaries from bringing 
suit in federal court to challenge mental health benefit 
denials and fiduciary breaches, H.R. 7780 would help workers 
covered by ERISA plans enforce their rights with respect to 
mental health benefits and remove barriers that conflict with 
ERISA`s stated purpose of ``providing for appropriate remedies, 
sanctions, and ready access to the Federal courts.''\119\
---------------------------------------------------------------------------
    \119\29 U.S.C. 1001(b).
---------------------------------------------------------------------------
    In its March 1st Hearing, the HELP Subcommittee heard 
testimony that ``plan sponsors are increasingly including 
provisions in their employee benefit plans requiring 
participants to arbitrate'' challenges to benefit denials and 
fiduciary breach claims against plan administrators and other 
plan service providers ``instead of bringing suit in federal 
court as permitted under ERISA.''\120\ The HELP Subcommittee 
also heard about the effect forced arbitration clauses on 
coverage for mental health treatment during its April 15, 2021 
hearing titled ``Meeting the Moment: Improving Access to 
Behavioral and Mental Health Care'' during which Dr. Meiram 
Bendat testified that such clauses ``. . . . make things 
secret, so DOL doesn`t find out about potential allegations and 
findings. Arbitrations don`t always follow the law in a way 
that courts do, and arbitrations can also potentially limit the 
types of relief sought, so [they are] a real danger.''\121\ 
Forced arbitration clauses take a variety of forms and may 
either be embedded in plan documents or participants' 
employment agreements. They sometimes also purport to require 
plan participants to waive their ability to participate in 
class action or maintain confidentiality regarding any actions 
they might bring.\122\ The case law on whether these clauses 
are enforceable is mixed and seems to vary based on the 
specific facts and circumstances of each particular case.\123\ 
The express prohibition in H.R. 7780 eliminates such ambiguity.
---------------------------------------------------------------------------
    \120\Improving Retirement Security and Access to Mental Health 
Benefits: Hearing Before the Subcomm. On Health, Labor, and Pensions, 
117th Cong. (2022) at 8 (statement of Karen Handorf, Senior Counsel, 
Berger Montague P.C.), available at https://edlabor.house.gov/download/
handordkarentestimony030122.
    \121\Dr. Meiram Bendat, Meeting the Moment: Improving Access to 
Behavioral and Mental Health Care: Hearing Before the Subcomm. On 
Health, Labor, and Pensions, 117th Cong. (2021) available at https://
edlabor.house.gov/hearings/meeting-the-moment-improving-access-to-
behavioral-and-mental-health-care.
    \122\Improving Retirement Security and Access to Mental Health 
Benefits: Hearing Before the Subcomm. On Health, Labor, and Pensions, 
117th Cong. (2022) at 8 (statement of Karen Handorf, Senior Counsel, 
Berger Montague P.C.), available at https://edlabor.house.gov/download/
handordkarentestimony030122.
    \123\See Pamela Reynolds, Are ERISA Breach of Fiduciary Duty Claims 
Arbitrable? (June 2, 2021), available at https://www.littler.com/
publication-press/publication/are-erisa-breach-
fiduciary-duty-claims-arbitrable, (providing a robust discussion of 
relevant case law).
---------------------------------------------------------------------------
    At the March 1st Hearing, Ms. Handorf testified that forced 
arbitration clauses ``potentially make plan fiduciaries subject 
to conflicting arbitration decisions, even when the behavior in 
question impacts all plan participants equally, violating 
ERISA's goal of consistent and uniform application of fiduciary 
standards among plan participants.''\124\ In addition, ``[t]he 
cost of pursuing an individual participant`s claim may outweigh 
the value of the individual claim. Thus, these restrictions may 
defeat the ability of participants and beneficiaries who have a 
small-dollar claim from obtaining redress even if the violation 
at issue is systemic and many other participants or 
beneficiaries would have similar claims that could be addressed 
on a class or representative basis.''\125\
---------------------------------------------------------------------------
    \124\Handorf, supra note 52, citing 29 U.S.C 1002(b).
    \125\Id.
---------------------------------------------------------------------------
    Taken together, the provisions of H.R. 7780 bring us closer 
to making the promise of parity a reality for the millions of 
people with job-based health coverage.\126\
---------------------------------------------------------------------------
    \126\Several of the amendments to ERISA made by H.R. 7780 would 
also help participants and beneficiaries in employee pension benefit 
plans to enforce their rights under the law. Forced arbitration 
clauses, for example, have been a barrier to bringing lawsuits alleging 
breach of fiduciary duties related to the administration of defined 
contribution retirement plans. See e.g., Dorman v. Charles Schwab 
Corp., 780 F. App'x 510 (9th Cir. 2019).
---------------------------------------------------------------------------

                               CONCLUSION

    The Mental Health Matters Act is a comprehensive measure 
designed to ensure that federal policies and programs are 
meeting the behavioral health needs of students, workers, and 
families. As the country continues to recognize the importance 
of mental health, Congress must put policies in place to 
support our mental health workforce, ensure students get access 
to mental health services in their schools, and protect rights 
to access mental health and substance abuse services. The 
Committee reports H.R. 7780 to the House and hopes that the 
House can take action on it this Congress to send the message 
that mental health truly matters.

                      Section-by-Section Analysis


Section 1. Short title

    This section states that the title of the bill is the 
Mental Health Matters Act.

Sec. 2. Table of Contents

               TITLE I--EARLY CHILDHOOD MENTAL HEALTH ACT

Section 101. Short title

    This section states that the title may be cited as the 
Early Childhood Mental Health Support Act.

Section 102. Identification of effective interventions in Head Start 
        Programs

    This section requires the U.S. Secretary of Health and 
Human Services (HHS), acting through the Assistant Secretary 
for the Administration for Children and Families (ACF), to 
identify and review interventions, best practices, curricula, 
and staff trainings that are evidence-based and improve the 
behavioral health of children. This section requires that the 
Secretary focus on interventions that can be delivered by a 
provider or other staff, are demonstrated to improve social-
emotional development, demonstrate effectiveness across racial, 
ethnic, and geographic populations, and offer a tiered approach 
to addressing need. This section also requires the Secretary to 
identify interventions that support staff wellness and the 
appropriate credentials for individuals who deliver such 
interventions.

Sec. 103. Implementing the interventions in Head Start Programs

    This section authorizes the Assistant Secretary for ACF to 
award grants to Head Start agencies to implement the 
interventions identified in section 102 and ensure grants are 
awarded to grantees representing a diversity of geographic 
areas.

Sec. 104. Evaluating implementation of interventions in Head Start 
        Programs

    This section requires the Office of the Assistant Secretary 
for Planning and Evaluation, in coordination with the Assistant 
Secretary for ACF, in HHS to determine if the interventions 
under section 103 are effectively implemented and yield long-
term savings, develop a method for making such determination, 
and ensure such method includes competency and testing 
approaches, performance or outcome measures, or other methods, 
and solicits public input. The Assistant Secretary is required 
to develop a method for such determination not later than 2 
years after enactment and update such method and determination 
at least every 5 years.

Sec. 105. Implementing the evaluation framework for Head Start Program

    The section requires the Assistant Secretary for ACF to 
implement the evaluation developed in section 104(a) to 
determine the effectiveness of the interventions, best 
practices, curricula, and staff trainings under section 102. 
This section also directs the Assistant Secretary for the ACF 
to provide technical assistance for grantees implementing and 
evaluating interventions under section 102.

Sec. 106. Best Practices Centers

    This section authorizes the Assistant Secretary for ACF to 
fund up to five Best Practice Centers in Early Childhood 
Training to prepare Head Start agencies and staff to deliver 
the interventions identified in section 102.

Sec. 107. Funding

    This section authorizes $100 million over ten years between 
FY 2023 through FY 2032 to carry out sections 103(b), 104, and 
106.

   TITLE II--BUILDING PIPELINE OF SCHOOL-BASED MENTAL HEALTH SERVICE 
                               PROVIDERS

Sec. 201. Short title

    This section states that the title may be cited as the 
Building Pipeline of School-Based Mental Health Service 
Providers Act.

Sec. 202. Definitions

    This section specifies definitions for ``Best Practices,'' 
``Eligible Institution,'' ``Eligible Partnership,'' ``High-Need 
Local Educational Agency,'' ``Historically Black College or 
University,'' ``Homeless Children and Youths,'' ``Indian Tribe; 
Tribal Organization,'' ``Institution of Higher Education,'' 
``Local Educational Agency,'' ``Minority-Serving Institution,'' 
``Outlying Area,'' ``Participating Eligible Institution,'' 
``Participating Graduate,'' ``Participating High-Need Local 
Educational Agency,'' ``School-Based Mental Health Field,'' 
``School-Based Mental Health Services Provider,'' 
``Secretary,'' ``State Educational Agency,'' ``Student Support 
Personnel Target Ratios,'' ``Tribally Controlled College or 
University,'' and ``Unaccompanied Youth.''

Sec. 203. Grant program to increase the number of school-based mental 
        health services provides serving in high-need local educational 
        agencies

    This section authorizes the Secretary of Education to award 
grants to eligible partnerships to enable the eligible 
partnership to carry out pipeline programs to increase the 
number of school-based mental health services providers 
employed by high-need local educational agencies. This section 
also requires several reservations from the total of amounts 
appropriated: half of one percent to the Secretary of the 
Interior; half of one percent for allotments to outlying areas; 
not more than three percent to conduct evaluations under 
subsection (h); and not more than two percent for 
administration and technical assistance.
    This section outlines the application process. Eligible 
partnerships must submit an application to the Secretary of 
Education including an assessment of existing ratios of school-
based mental health services providers to students, and a 
detailed descriptions of a plan to carry out a pipeline program 
and the proposed allocation and use of grant funds. Further 
this section outlines how grant funds awarded may be used.
    The section requires the Secretary of Education to award 
grants to ensure grants are distributed to eligible entities 
that will serve geographically diverse areas and give priority 
to eligible partnerships that: have the highest numbers or 
percentages of low-income students; include one or more high-
need local educational agencies that have fewer school-based 
mental health services providers than other eligible 
partnerships; include one or more eligible institutions of high 
education; propose to collaborate with another institution of 
high education; and propose to use grant funds to increase the 
diversity of school-based mental health services providers.
    This section states that funds under this section shall be 
used to supplement, not supplant, other Federal, State, or 
local funds available.
    This section further requires that each eligible 
partnership receiving a grant prepare and submit an annual 
report to the Secretary of Education. The annual report must 
include: actual service delivery provided through the grant 
funds; outcomes that are consistent with the purpose of the 
grant program; the instruction, materials, and activities being 
funded; and the effectiveness of any training and ongoing 
professional development provided. The Secretary of Education 
will make public the annual reports on the website of the 
Department of Education.
    This section requires the Secretary of Education to conduct 
interim evaluations to ensure eligible partnerships are making 
adequate progress and a final evaluation to determine the 
effectiveness of the grant program. Further, the Secretary of 
Education will submit a report to Congress not earlier than 
five years nor later than six years after enactment pertaining 
the findings of the final evaluation.
    This section also authorizes $200 million for FY 2023 and 
each succeeding fiscal year.

            TITLE III--THE ELEMENTARY AND SECONDARY SCHOOL 
                             COUNSELING ACT

Sec. 301. Short title

    This section states that the title may be cited as the 
Elementary and Secondary School Counseling Act.

Sec. 302. Definitions

    This section specifies definitions for ``ESEA 
Definitions,'' ``High-Need School,'' ``Outlying Area,'' 
``School-Based Mental Health Services Provider,'' 
``Secretary,'' and ``State.''

Sec. 303. Allotments to States and subgrants to local educational 
        agencies

    This section authorizes the Secretary of Education to make 
allotments to States. States will award subgrants to local 
educational agencies in order to increase access to school-
based mental health services providers at high-need schools.
    This section requires several reservations from the total 
of amounts appropriated: half of one percent for the Secretary 
of the Interior; half of one percent for allotments for the 
outlying areas; and not more than two percent for 
administration and technical assistance.
    This section requires the Secretary to make allotments to 
each State based on the formula under part A of title I of the 
Elementary and Secondary Education Act of 1965. Additionally, 
this section outlines the minimum state allotment for small 
states and matching requirements. This section further outlines 
the application process for States. States are eligible to 
receive an allotment for a period of 5-years and may be renewed 
for an additional 5-year period.
    This section outlines the process for States to make 
subgrants to local educational agencies to recruit and retain 
school-based mental health services providers and work toward 
effectively staffing high-need schools with school-based mental 
health services providers. States are required to give priority 
to local educational agencies that serve a significant number 
of high-need schools. Local educational agencies must submit an 
application to the State regarding how the agency will 
prioritize assisting high-need schools with the largest numbers 
or percentages of students from low-income families. This 
section states that funds under this section shall be used to 
supplement, not supplant, other funds available to a state or 
local educational agency for school-based mental health 
services. Funds can be combined with State or local funds to 
carry out activities under this section.
    This section requires that local educational agencies 
receiving a subgrant under this section submit an annual report 
to the State describing the activities carried out, enumerate 
the number of school-based mental health services providers, 
and include the most recent student to provider ratios. The 
Secretary of Education will make public the annual reports on 
the website of the Department of Education.

Sec. 304. Authorization of Appropriations

    This section authorizes $5 billion for FY 2023 and such 
sums as necessary for each succeeding fiscal year.

            TITLE IV--SUPPORTING TRAUMA-INFORMED EDUCATION 
                             PRACTICES ACT

Sec. 401. Short title

    This section states that the title may be cited as the 
Supporting Trauma-Informed Education Practices Act.

Sec. 402. Amendment to the SUPPORT for Patients and Communities Act

    This section amends section 7134 of the SUPPORT for 
Patients and Communities Act.
    This section authorizes the Secretary of Education, in 
coordination with the Secretary of HHS, to award grants to an 
eligible entity to increase school personnel access to 
evidence-based trauma support services and mental health 
services. This section also requires several reservations from 
the total of amounts appropriated: not more than three percent 
to conduct the evaluation under this section; and not more than 
two percent to technical assistance and administration. 
Eligible entities who receive funds under this section may not 
exceed a 5-year period.
    This section outlines a list of initiatives, activities, 
and programs for which an eligible entity may use the funds 
under this section. Eligible entities must submit an 
application to the Secretary of Education in order to receive a 
grant, contract, or cooperative agreement under this section. 
In carrying out an evidence-based initiative described under 
the use of funds section, an eligible entity will 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.
    This section requires that the Secretary of Education 
conduct a rigorous evaluation of the initiatives and activities 
carried out by an eligible entity under this section and 
disseminate evidence-based practices regarding trauma-informed 
support services and mental health services.
    The section requires the Secretary of Education to ensure 
grants, contracts, and cooperative agreements under this 
section are distributed equitably to eligible entities that 
will serve geographically diverse areas. This section states 
that funds under this section shall be used to supplement, not 
supplant, other Federal, State, or local funds available to 
carry out the initiatives and activities described in this 
section. Further this section requires the Secretary of 
Education to consult with Indian Tribes, Regional Corporations, 
Native Hawaiian Educational Organizations, and their 
representatives to ensure notice of eligibility.
    This section specifies definitions for ``Early Childhood 
Education Program,'' ``Eligible Entity,'' ``ESEA Terms,'' 
``Regional Corporation,'' and ``School.''
    This section authorizes $50 million between FY 2023 through 
FY 2027 to carry out this section.

        TITLE V--RESPOND, INNOVATE, SUCCEED, AND EMPOWER (RISE)

Sec. 501. Short title

    This section states that the 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

    This section amends Section 103(6) of the Higher Education 
Act of 1965 by striking ``section 3(2)'' and inserting 
``section 3.''

Sec. 503. Supporting students with disabilities to succeed once 
        enrolled in college

    This section amends section 487(a) of the Higher Education 
Act of 1965 to add that institutions will adopt policies 
providing that individualized education plans (IEPs) and 
similar documentation developed during primary and secondary 
education will be considered sufficient to establish that the 
student has a disability for which they may need an 
accommodation. Additionally, institutions are required to 
develop, disseminate and publish policies that are transparent 
and explicit regarding the process through which a student with 
a disability can obtain reasonable accommodations.

Sec. 504. Authorization of the funds for the national center for the 
        information and technical support for postsecondary students 
        with disabilities

    This section amends section 777(a) of the Higher Education 
Act of 1965 by striking the previous amounts appropriated and 
adding new paragraph (5) indicating appropriations. This 
section authorizes $2 million for each fiscal year between FY 
2023 and FY 2027 to carry out this subsection.

Sec. 505. Inclusion of information on students with disabilities

    This section amends Section 487(a) of the Higher Education 
Act of 1965, as amended by section 503, to add a new paragraph 
(31) at the end. This section outlines that institutions will 
submit key data related to undergraduate students who are 
formally registered as students with disabilities with the 
institution`s office of disability services. Institutions will 
not submit such information if the information would reveal 
personally identifiable information.

Sec. 506. Rule of construction

    This section states that none of the amendments made by 
this title shall not be construed to affect the meaning of the 
terms ``reasonable accommodation'' or ``record of impairment'' 
under the Americans with Disabilities Act of 1990.

           TITLE VI--STRENGTHENING BEHAVIORAL HEALTH BENEFITS

Sec. 601. Short title

    This section states that the title may be cited as the 
Strengthening Behavioral Health Benefits Act.

Sec. 602. Enforcement of mental health and substance use disorder 
        requirements

    This section amends section 502(a) of the Employee 
Retirement Income Security Act of 1974 to add a new paragraph 
(12). This section authorizes the Secretary of Labor or a plan 
participant, beneficiary, or fiduciary to bring a civil action 
regarding mental health and substance use disorder benefits 
against a plan, health insurance issuer, fiduciary, or other 
individual who participates in or conceals a statutory 
violation or wrongful denial of benefits relating to mental 
health and substance use disorder. This section specifies that 
relief available under paragraph (12) includes recovery of all 
losses to participants or beneficiaries, reformation of 
impermissible plan or coverage terms, and re-adjudication of 
claims and payment of benefits.
    This section further amends section 502(a)of the Employee 
Retirement Income Security Act of 1974 to clarify that relief 
available to the Secretary of Labor or any participant or 
beneficiary includes re-adjudication and payment of benefits.
    This section amends section 502(b)(3) of the Employee 
Retirement Income Security Act of 1974 to authorize the 
Secretary of Labor to enforce requirements regarding mental 
health and substance use disorder benefits against health 
insurance issuers.
    This section amends part 7 of title I of the Employee 
Retirement Income Security Act of 1974 to make a technical 
amendment to account for amendments made by this legislation.
    This section authorizes $275 million to remain available 
until FY 2032 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 or other requirements relating to mental health and 
substance use disorder benefits.

           TITLE VII--EMPLOYEE AND RETIREE ACCESS TO JUSTICE

Sec. 701. Short title

    This section states that the title may be cited as the 
Employee and Retiree Access to Justice Act of 2022.

Sec. 702. Unenforceable arbitration clauses, class action waivers, 
        representation waivers, and discretionary clauses

    This section amends section 502 of the Employee Retirement 
Income Security Act of 1974 to provide that pre-dispute or 
coerced post-dispute arbitration clauses, class action waivers, 
and representation waivers are unenforceable in any civil 
action brought by or on behalf of a participant or beneficiary 
under section 502 or under a common law claim relating to plan 
benefits.
    This section amends section 502 of the Employee Retirement 
Income Security Act of 1974 to provide that covered provisions 
that give discretionary authority in benefit determinations or 
plan interpretation (or otherwise deny de novo review of 
benefit denial claims) are unenforceable with respect to 
single-employer plans in any civil action brought by or on 
behalf of a participant or beneficiary under section 502 or 
under a common law claim relating to plan benefits.
    This section specifies definitions for ``covered 
provision,'' ``pre-dispute arbitration provision,'' ``post-
dispute arbitration provision,'' and ``retaliation.''
    This section authorizes the Secretary of Labor to issue 
regulations related to these provisions.

Sec. 703. Prohibition on mandatory arbitration clauses, class action 
        waivers, representation waivers, and discretionary clauses

    This section amends section 402 of the Employee Retirement 
Income Security Act of 1974 to prohibit covered persons from 
including in plan documents any pre-dispute arbitration 
provision, post-dispute arbitration provision, class action 
waiver, representation waiver, or discretionary clause 
described in section 702.
    This section specifies definitions for ``covered person'' 
as well as ``covered provision,'' ``pre-dispute arbitration 
provision,'' and ``post-dispute arbitration provision.''

Sec. 704. Effective date

    This section specifies that the provisions in sections 702 
and 703 apply as of the date of enactment.
    This section further specifies that plans will have an 
additional year following the enactment of this legislation to 
update plan documents, provided that they otherwise comply with 
the requirements of sections 702 and 703 starting on the date 
of enactment.

                       Explanation of Amendments

    The amendments, including the amendment in the nature of a 
substitute, are explained in the descriptive portions of this 
report.

              Application of Law to the Legislative Branch

    Pursuant to section 102(b)(3) of the Congressional 
Accountability Act of 1995, Pub. L. No. 104-1, H.R. 7780 does 
not apply to terms and conditions of employment or to access to 
public services or accommodations within the legislative 
branch.

                       Unfunded Mandate Statement

    Pursuant to Section 423 of the Congressional Budget and 
Impoundment Control Act of 1974, Pub. L. No. 93-344 (as amended 
by Section 101(a)(2) of the Unfunded Mandates Reform Act of 
1995, Pub. L. No. 104-4), the Committee traditionally adopts as 
its own the cost estimate prepared by the Director of the 
Congressional Budget Office (CBO) pursuant to section 402 of 
the Congressional Budget and Impoundment Control Act of 1974, 
which includes an estimate of federal mandates. The Committee 
reports that because this cost estimate was not timely 
submitted to the Committee before the filing of this report, 
the Committee is not in a position to make a statement on 
federal mandates for H.R. 7780, as amended.

                           Earmark Statement

    In accordance with clause 9 of rule XXI of the Rules of the 
House of Representatives, H.R. 7780 does not contain any 
congressional earmarks, limited tax benefits, or limited tariff 
benefits as described in clauses 9(e), 9(f), and 9(g) of rule 
XXI.

                            Roll Call Votes

    In compliance with clause 3(b) of rule XIII of the Rules of 
the House of Representatives, the Committee advises that the 
following roll call votes occurred during the Committee`s 
consideration of H.R. 7780:


	[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

             Statement of Performance Goals and Objectives

    Pursuant to clause (3)(c) of rule XIII of the Rules of the 
House of Representatives, the goals of H.R. 7780 are to improve 
access to behavioral health services for children, students, 
and workers.

                    Duplication of Federal Programs

    Pursuant to clause 3(c)(5) of rule XIII of the Rules of the 
House of Representatives, the Committee states that no 
provision of H.R. 7780 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 Pub. L. No. 111-
139 or the most recent Catalog of Federal Domestic Assistance.

                                Hearings

    Pursuant to clause 3(c)(6) of rule XIII of the Rules of the 
House of Representatives--
          (1) the following hearing was used to develop H.R. 
        7780: the HELP Subcommittee hearing titled ``Meeting 
        the Moment: Improving Access to Behavioral and Mental 
        Health Care'' held on April 15, 2021. The hearing 
        examined barriers to access to behavioral health care, 
        particularly limited coverage of mental health and 
        substance use disorder treatment and the importance of 
        improving enforcement of mental health parity laws. The 
        Subcommittee heard testimony from Dr. Brian Smedley, 
        Chief of Psychology in the Public Interest, American 
        Psychological Association, Washington, DC; Dr. 
        Christine Yu Moutier, Chief Medical Officer, American 
        Foundation for Suicide Prevention, New York, NY; Mr. 
        James Gelfand, Senior Vice President, Health Policy, 
        The ERISA Industry Committee, Washington, DC; and Dr. 
        Meiram Bendat, Founder, Psych-Appeal, Santa Barbara, 
        CA.
          (2) Other related hearings held are listed in the 
        Committee History section of this report.

  Statement of Oversight Findings and Recommendations of the Committee

    In compliance with clause 3(c)(1) of rule XIII and clause 
2(b)(1) of rule X of the Rules of the House of Representatives, 
the Committee`s oversight findings and recommendations are 
reflected in the descriptive portions of this report.

               New Budget Authority and CBO Cost Estimate

    Pursuant to clause 3(c)(2) of rule XIII of the Rules of the 
House of Representatives and section 308(a) of the 
Congressional Budget and Impoundment Control Act of 1974, and 
pursuant to clause 3(c)(3) of rule XIII of the Rules of the 
House of Representatives and section 402 of the Congressional 
Budget and Impoundment Control Act of 1974, the Committee has 
requested but not received a cost estimate for H.R. 7780 from 
the Director of the Congressional Budget Office.

                        Committee Cost Estimate

    Clause 3(d)(1) of rule XIII of the Rules of the House of 
Representatives requires an estimate and a comparison of the 
costs that would be incurred in carrying out H.R. 7780. 
However, clause 3(d)(2)(B) of that rule provides that this 
requirement does not apply when the committee has included in 
its report a timely submitted cost estimate of the bill 
prepared by the Director of the Congressional Budget Office 
under section 402 of the Congressional Budget and Impoundment 
Control Act of 1974. The Committee reports that because this 
cost estimate was not timely submitted to the Committee before 
the filing of this report, the Committee is not in a position 
to make a cost estimate for H.R. 7780, as amended.

         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, H.R. 7780 as reported, are shown as follows:

         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):

                SUPPORT FOR PATIENTS AND COMMUNITIES ACT




           *       *       *       *       *       *       *
TITLE VII--PUBLIC HEALTH PROVISIONS

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Subtitle N--Trauma-Informed Care

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[SEC. 7134. GRANTS TO IMPROVE TRAUMA SUPPORT SERVICES AND MENTAL HEALTH 
                    CARE FOR CHILDREN AND YOUTH IN EDUCATIONAL 
                    SETTINGS.

  [(a) Grants, Contracts, and Cooperative Agreements 
Authorized.--The Secretary, in coordination with the Assistant 
Secretary for Mental Health and Substance Use, is authorized to 
award grants to, or enter into contracts or cooperative 
agreements with, State educational agencies, local educational 
agencies, Indian Tribes (as defined in section 4 of the Indian 
Self-Determination and Education Assistance Act) or their 
tribal educational agencies, a school operated by the Bureau of 
Indian Education, a Regional Corporation, or a Native Hawaiian 
educational organization, for the purpose of increasing student 
access to evidence-based trauma support services and mental 
health care by developing innovative initiatives, activities, 
or programs to link local school systems with local trauma-
informed support and mental health systems, including those 
under the Indian Health Service.
  [(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 
4 years.
  [(c) Use of Funds.--An entity that receives a grant, 
contract, or cooperative agreement under this section shall use 
amounts made available through such grant, contract, or 
cooperative agreement for evidence-based activities, which 
shall include any of the following:
          [(1) Collaborative efforts between school-based 
        service systems and trauma-informed support and mental 
        health service systems to provide, develop, or improve 
        prevention, screening, referral, and treatment and 
        support services to students, such as providing trauma 
        screenings to identify students in need of specialized 
        support.
          [(2) To implement schoolwide positive behavioral 
        interventions and supports, or other trauma-informed 
        models of support.
          [(3) To provide professional development to teachers, 
        teacher assistants, school leaders, specialized 
        instructional support personnel, and mental health 
        professionals that--
                  [(A) fosters safe and stable learning 
                environments that prevent and mitigate the 
                effects of trauma, including through social and 
                emotional learning;
                  [(B) improves school capacity to identify, 
                refer, and provide services to students in need 
                of trauma support or behavioral health 
                services; or
                  [(C) reflects the best practices for trauma-
                informed identification, referral, and support 
                developed by the Task Force under section 7132.
          [(4) Services at a full-service community school that 
        focuses on trauma-informed supports, which may include 
        a full-time site coordinator, or other activities 
        consistent with section 4625 of the Elementary and 
        Secondary Education Act of 1965 (20 U.S.C. 7275).
          [(5) Engaging families and communities in efforts to 
        increase awareness of child and youth trauma, which may 
        include sharing best practices with law enforcement 
        regarding trauma-informed care and working with mental 
        health professionals to provide interventions, as well 
        as longer term coordinated care within the community 
        for children and youth who have experienced trauma and 
        their families.
          [(6) To provide technical assistance to school 
        systems and mental health agencies.
          [(7) To evaluate the effectiveness of the program 
        carried out under this section in increasing student 
        access to evidence-based trauma support services and 
        mental health care.
          [(8) To establish partnerships with or provide 
        subgrants to Head Start agencies (including Early Head 
        Start agencies), public and private preschool programs, 
        child care programs (including home-based providers), 
        or other entities described in subsection (a), to 
        include such entities described in this paragraph in 
        the evidence-based trauma initiatives, activities, 
        support services, and mental health systems established 
        under this section in order to provide, develop, or 
        improve prevention, screening, referral, and treatment 
        and support services to young children and their 
        families.
  [(d) Applications.--To be eligible to receive a grant, 
contract, or cooperative agreement under this section, an 
entity described in subsection (a) 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 
        program will increase access to evidence-based trauma 
        support services and mental health care for students, 
        and, as applicable, the families of such students.
          [(2) A description of how the program will provide 
        linguistically appropriate and culturally competent 
        services.
          [(3) A description of how the program will support 
        students and the school in improving the school climate 
        in order to support an environment conducive to 
        learning.
          [(4) An assurance that--
                  [(A) persons providing services under the 
                grant, contract, or cooperative agreement are 
                adequately trained to provide such services; 
                and
                  [(B) teachers, school leaders, 
                administrators, specialized instructional 
                support personnel, representatives of local 
                Indian Tribes or tribal organizations as 
                appropriate, other school personnel, and 
                parents or guardians of students participating 
                in services under this section will be engaged 
                and involved in the design and implementation 
                of the services.
          [(5) A description of how the applicant will support 
        and integrate existing school-based services with the 
        program in order to provide mental health services for 
        students, as appropriate.
          [(6) A description of the entities in the community 
        with which the applicant will partner or to which the 
        applicant will provide subgrants in accordance with 
        subsection (c)(8).
  [(e) Interagency Agreements.--
          [(1) Local interagency agreements.--To ensure the 
        provision of the services described in subsection (c), 
        a recipient of a grant, contract, or cooperative 
        agreement under this section, or their designee, shall 
        establish a local interagency agreement among 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 such services.
          [(2) Contents.--In ensuring the provision of the 
        services described in subsection (c), the local 
        interagency agreement shall specify with respect to 
        each agency, authority, or entity that is a party to 
        such agreement--
                  [(A) the financial responsibility for the 
                services;
                  [(B) the conditions and terms of 
                responsibility for the services, including 
                quality, accountability, and coordination of 
                the services; and
                  [(C) the conditions and terms of 
                reimbursement among such agencies, authorities, 
                or entities, including procedures for dispute 
                resolution.
  [(f) Evaluation.--The Secretary shall reserve not more than 3 
percent of the funds made available under subsection (l) for 
each fiscal year to--
          [(1) conduct a rigorous, independent evaluation of 
        the activities funded under this section; and
          [(2) disseminate and promote the utilization of 
        evidence-based practices regarding trauma support 
        services and mental health care.
  [(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 a 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, and tribal law 
        enforcement and judicial authorities from exercising 
        their responsibilities with regard to the application 
        of Federal, tribal, and State law to crimes committed 
        by a student.
  [(i) Supplement, Not Supplant.--Any services provided through 
programs carried out under this section shall supplement, and 
not supplant, existing mental health services, including any 
special education and related services provided under the 
Individuals with Disabilities Education Act (20 U.S.C. 1400 et 
seq.).
  [(j) Consultation With Indian Tribes.--In carrying out 
subsection (a), the Secretary shall, in a timely manner, 
meaningfully consult with Indian Tribes and their 
representatives to ensure notice of eligibility.
  [(k) Definitions.--In this section:
          [(1) Elementary school.--The term ``elementary 
        school'' has the meaning given such term in section 
        8101 of the Elementary and Secondary Education Act of 
        1965 (20 U.S.C. 7801).
          [(2) Evidence-based.--The term ``evidence-based'' has 
        the meaning given such term in section 8101(21)(A)(i) 
        of the Elementary and Secondary Education Act of 1965 
        (20 U.S.C. 7801(21)(A)(i)).
          [(3) Native hawaiian educational organization.--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).
          [(4) 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).
          [(5) 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)).
          [(6) School.--The term ``school'' means a public 
        elementary school or public secondary school.
          [(7) School leader.--The term ``school leader'' has 
        the meaning given such term in section 8101 of the 
        Elementary and Secondary Education Act of 1965 (20 
        U.S.C. 7801).
          [(8) Secondary school.--The term ``secondary school'' 
        has the meaning given such term in section 8101 of the 
        Elementary and Secondary Education Act of 1965 (20 
        U.S.C. 7801).
          [(9) Secretary.--The term ``Secretary'' means the 
        Secretary of Education.
          [(10) Specialized instructional support personnel.--
        The term ``specialized instructional support 
        personnel'' has the meaning given such term in section 
        8101 of the Elementary and Secondary Education Act of 
        1965 (20 U.S.C. 7801).
          [(11) State educational agency.--The term ``State 
        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).
  [(l) Authorization of Appropriations.--There is authorized to 
be appropriated to carry out this section, $50,000,000 for each 
of fiscal years 2019 through 2023.]

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 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.

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                      HIGHER EDUCATION ACT OF 1965




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                      TITLE I--GENERAL PROVISIONS

PART A--DEFINITIONS

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SEC. 103. ADDITIONAL DEFINITIONS.

   In this Act:
          (1) Authorizing committees.--The term ``authorizing 
        committees'' means the Committee on Health, Education, 
        Labor, and Pensions of the Senate and the Committee on 
        Education and Labor of the House of Representatives.
          (2) Combination of institutions of higher 
        education.--The term ``combination of institutions of 
        higher education'' means a group of institutions of 
        higher education that have entered into a cooperative 
        arrangement for the purpose of carrying out a common 
        objective, or a public or private nonprofit agency, 
        organization, or institution designated or created by a 
        group of institutions of higher education for the 
        purpose of carrying out a common objective on the 
        group`s behalf.
          (3) Critical foreign language.--Except as otherwise 
        provided, the term ``critical foreign language'' means 
        each of the languages contained in the list of critical 
        languages designated by the Secretary in the Federal 
        Register on August 2, 1985 (50 Fed. Reg. 31412; 
        promulgated under the authority of section 212(d) of 
        the Education for Economic Security Act (repealed by 
        section 2303 of the Augustus F. Hawkins-Robert T. 
        Stafford Elementary and Secondary School Improvement 
        Amendments of 1988)), as updated by the Secretary from 
        time to time and published in the Federal Register, 
        except that in the implementation of this definition 
        with respect to a specific title, the Secretary may set 
        priorities according to the purposes of such title and 
        the national security, economic competitiveness, and 
        educational needs of the United States.
          (4) Department.--The term ``Department'' means the 
        Department of Education.
          (5) Diploma mill.--The term ``diploma mill'' means an 
        entity that--
                  (A)(i) offers, for a fee, degrees, diplomas, 
                or certificates, that may be used to represent 
                to the general public that the individual 
                possessing such a degree, diploma, or 
                certificate has completed a program of 
                postsecondary education or training; and
                  (ii) requires such individual to complete 
                little or no education or coursework to obtain 
                such degree, diploma, or certificate; and
                  (B) lacks accreditation by an accrediting 
                agency or association that is recognized as an 
                accrediting agency or association of 
                institutions of higher education (as such term 
                is defined in section 102) by--
                          (i) the Secretary pursuant to subpart 
                        2 of part H of title IV; or
                          (ii) a Federal agency, State 
                        government, or other organization or 
                        association that recognizes accrediting 
                        agencies or associations.
          (6) Disability.--The term ``disability'' has the same 
        meaning given that term under [section 3(2)] section 3 
        of the Americans With Disabilities Act of 1990.
          (7) Distance education.--
                  (A) In general.--Except as otherwise 
                provided, the term``distance education''means 
                education that uses one or more of the 
                technologies described in subparagraph (B)--
                          (i) to deliver instruction to 
                        students who are separated from the 
                        instructor; and
                          (ii) to support regular and 
                        substantive interaction between the 
                        students and the instructor, 
                        synchronously or asynchronously.
                  (B) Inclusions.--For the purposes of 
                subparagraph (A), the technologies used may 
                include--
                          (i) the Internet;
                          (ii) one-way and two-way 
                        transmissions through open broadcast, 
                        closed circuit, cable, microwave, 
                        broadband lines, fiber optics, 
                        satellite, or wireless communications 
                        devices;
                          (iii) audio conferencing; or
                          (iv) video cassettes, DVDs, and CD-
                        ROMs, if the cassettes, DVDs, or CD-
                        ROMs are used in a course in 
                        conjunction with any of the 
                        technologies listed in clauses (i) 
                        through (iii).
          (8) Early childhood education program.--The term 
        ``early childhood education program'' means--
                  (A) a Head Start program or an Early Head 
                Start program carried out under the Head Start 
                Act (42 U.S.C. 9831 et seq.), including a 
                migrant or seasonal Head Start program, an 
                Indian Head Start program, or a Head Start 
                program or an Early Head Start program that 
                also receives State funding;
                  (B) a State licensed or regulated child care 
                program; or
                  (C) a program that--
                          (i) serves children from birth 
                        through age six that addresses the 
                        children`s cognitive (including 
                        language, early literacy, and early 
                        mathematics), social, emotional, and 
                        physical development; and
                          (ii) is--
                                  (I) a State prekindergarten 
                                program;
                                  (II) a program authorized 
                                under section 619 or part C of 
                                the Individuals with 
                                Disabilities Education Act; or
                                  (III) a program operated by a 
                                local educational agency.
          (9) Elementary school.--The term ``elementary 
        school'' has the same meaning given that term under 
        section 8101 of the Elementary and Secondary Education 
        Act of 1965.
          (10) Gifted and talented.--The term ``gifted and 
        talented'' has the same meaning given that term under 
        section 8101 of the Elementary and Secondary Education 
        Act of 1965.
          (11) Local educational agency.--The term ``local 
        educational agency'' has the same meaning given that 
        term under section 8101 of the Elementary and Secondary 
        Education Act of 1965.
          (12) New borrower.--The term ``new borrower'' when 
        used with respect to any date means an individual who 
        on that date has no outstanding balance of principal or 
        interest owing on any loan made, insured, or guaranteed 
        under title IV.
          (13) Nonprofit.--The term ``nonprofit'' as applied to 
        a school, agency, organization, or institution means a 
        school, agency, organization, or institution owned and 
        operated by one or more nonprofit corporations or 
        associations, no part of the net earnings of which 
        inures, or may lawfully inure, to the benefit of any 
        private shareholder or individual.
          (14) Poverty line.--The term ``poverty line'' means 
        the poverty line (as defined in section 673(2) of the 
        Community Services Block Grant Act (42 U.S.C. 9902(2)) 
        applicable to a family of the size involved.
          (15) School or department of divinity.--The term 
        ``school or department of divinity'' means an 
        institution, or a department or a branch of an 
        institution, the program of instruction of which is 
        designed for the education of students--
                  (A) to prepare the students to become 
                ministers of religion or to enter upon some 
                other religious vocation (or to provide 
                continuing training for any such vocation); or
                  (B) to prepare the students to teach 
                theological subjects.
          (16) Secondary school.--The term ``secondary school'' 
        has the same meaning given that term under section 8101 
        of the Elementary and Secondary Education Act of 1965.
          (17) Secretary.--The term ``Secretary'' means the 
        Secretary of Education.
          (18) Service-learning.--The term ``service-learning'' 
        has the same meaning given that term under section 
        101(23) of the National and Community Service Act of 
        1990.
          (19) Special education teacher.--The term ``special 
        education teacher'' means teachers who teach children 
        with disabilities as defined in section 602 of the 
        Individuals with Disabilities Education Act.
          (20) State; freely associated states.--
                  (A) State.--The term ``State'' includes, in 
                addition to the several States of the United 
                States, the Commonwealth of Puerto Rico, the 
                District of Columbia, Guam, American Samoa, the 
                United States Virgin Islands, the Commonwealth 
                of the Northern Mariana Islands, and the Freely 
                Associated States.
                  (B) Freely associated states.--The term 
                ``Freely Associated States'' means the Republic 
                of the Marshall Islands, the Federated States 
                of Micronesia, and the Republic of Palau.
          (21) State educational agency.--The term ``State 
        educational agency'' has the same meaning given that 
        term under section 8101 of the Elementary and Secondary 
        Education Act of 1965.
          (22) State higher education agency.--The term ``State 
        higher education agency'' means the officer or agency 
        primarily responsible for the State supervision of 
        higher education.
          (23) Universal design.--The term``universal 
        design''has the meaning given the term in section 3 of 
        the Assistive Technology Act of 1998 (29 U.S.C. 3002).
          (24) Universal design for learning.--The term 
        ``universal design for learning'' means a 
        scientifically valid framework for guiding educational 
        practice that--
                  (A) provides flexibility in the ways 
                information is presented, in the ways students 
                respond or demonstrate knowledge and skills, 
                and in the ways students are engaged; and
                  (B) reduces barriers in instruction, provides 
                appropriate accommodations, supports, and 
                challenges, and maintains high achievement 
                expectations for all students, including 
                students with disabilities and students who are 
                limited English proficient.

           *       *       *       *       *       *       *


TITLE IV--STUDENT ASSISTANCE

           *       *       *       *       *       *       *



Part G--General Provisions Relating to Student Assistance Programs

           *       *       *       *       *       *       *



SEC. 487. PROGRAM PARTICIPATION AGREEMENTS.

  (a) Required for Programs of Assistance; Contents.--In order 
to be an eligible institution for the purposes of any program 
authorized under this title, an institution must be an 
institution of higher education or an eligible institution (as 
that term is defined for the purpose of that program) and 
shall, except with respect to a program under subpart 4 of part 
A, enter into a program participation agreement with the 
Secretary. The agreement shall condition the initial and 
continuing eligibility of an institution to participate in a 
program upon compliance with the following requirements:
          (1) The institution will use funds received by it for 
        any program under this title and any interest or other 
        earnings thereon solely for the purpose specified in 
        and in accordance with the provision of that program.
          (2) The institution shall not charge any student a 
        fee for processing or handling any application, form, 
        or data required to determine the student`s eligibility 
        for assistance under this title or the amount of such 
        assistance.
          (3) The institution will establish and maintain such 
        administrative and fiscal procedures and records as may 
        be necessary to ensure proper and efficient 
        administration of funds received from the Secretary or 
        from students under this title, together with 
        assurances that the institution will provide, upon 
        request and in a timely fashion, information relating 
        to the administrative capability and financial 
        responsibility of the institution to--
                  (A) the Secretary;
                  (B) the appropriate guaranty agency; and
                  (C) the appropriate accrediting agency or 
                association.
          (4) The institution will comply with the provisions 
        of subsection (c) of this section and the regulations 
        prescribed under that subsection, relating to fiscal 
        eligibility.
          (5) The institution will submit reports to the 
        Secretary and, in the case of an institution 
        participating in a program under part B or part E, to 
        holders of loans made to the institution`s students 
        under such parts at such times and containing such 
        information as the Secretary may reasonably require to 
        carry out the purpose of this title.
          (6) The institution will not provide any student with 
        any statement or certification to any lender under part 
        B that qualifies the student for a loan or loans in 
        excess of the amount that student is eligible to borrow 
        in accordance with sections 425(a), 428(a)(2), and 
        428(b)(1) (A) and (B).
          (7) The institution will comply with the requirements 
        of section 485.
          (8) In the case of an institution that advertises job 
        placement rates as a means of attracting students to 
        enroll in the institution, the institution will make 
        available to prospective students, at or before the 
        time of application (A) the most recent available data 
        concerning employment statistics, graduation 
        statistics, and any other information necessary to 
        substantiate the truthfulness of the advertisements, 
        and (B) relevant State licensing requirements of the 
        State in which such institution is located for any job 
        for which the course of instruction is designed to 
        prepare such prospective students.
          (9) In the case of an institution participating in a 
        program under part B or D, the institution will inform 
        all eligible borrowers enrolled in the institution 
        about the availability and eligibility of such 
        borrowers for State grant assistance from the State in 
        which the institution is located, and will inform such 
        borrowers from another State of the source for further 
        information concerning such assistance from that State.
          (10) The institution certifies that it has in 
        operation a drug abuse prevention program that is 
        determined by the institution to be accessible to any 
        officer, employee, or student at the institution.
          (11) In the case of any institution whose students 
        receive financial assistance pursuant to section 
        484(d), the institution will make available to such 
        students a program proven successful in assisting 
        students in obtaining a certificate of high school 
        equivalency.
          (12) The institution certifies that--
                  (A) the institution has established a campus 
                security policy; and
                  (B) the institution has complied with the 
                disclosure requirements of section 485(f).
          (13) The institution will not deny any form of 
        Federal financial aid to any student who meets the 
        eligibility requirements of this title on the grounds 
        that the student is participating in a program of study 
        abroad approved for credit by the institution.
          (14)(A) The institution, in order to participate as 
        an eligible institution under part B or D, will develop 
        a Default Management Plan for approval by the Secretary 
        as part of its initial application for certification as 
        an eligible institution and will implement such Plan 
        for two years thereafter.
          (B) Any institution of higher education which changes 
        ownership and any eligible institution which changes 
        its status as a parent or subordinate institution 
        shall, in order to participate as an eligible 
        institution under part B or D, develop a Default 
        Management Plan for approval by the Secretary and 
        implement such Plan for two years after its change of 
        ownership or status.
          (C) This paragraph shall not apply in the case of an 
        institution in which (i) neither the parent nor the 
        subordinate institution has a cohort default rate in 
        excess of 10 percent, and (ii) the new owner of such 
        parent or subordinate institution does not, and has 
        not, owned any other institution with a cohort default 
        rate in excess of 10 percent.
          (15) The institution acknowledges the authority of 
        the Secretary, guaranty agencies, lenders, accrediting 
        agencies, the Secretary of Veterans Affairs, and the 
        State agencies under subpart 1 of part H to share with 
        each other any information pertaining to the 
        institution`s eligibility to participate in programs 
        under this title or any information on fraud and abuse.
          (16)(A) The institution will not knowingly employ an 
        individual in a capacity that involves the 
        administration of programs under this title, or the 
        receipt of program funds under this title, who has been 
        convicted of, or has pled nolo contendere or guilty to, 
        a crime involving the acquisition, use, or expenditure 
        of funds under this title, or has been judicially 
        determined to have committed fraud involving funds 
        under this title or contract with an institution or 
        third party servicer that has been terminated under 
        section 432 involving the acquisition, use, or 
        expenditure of funds under this title, or who has been 
        judicially determined to have committed fraud involving 
        funds under this title.
          (B) The institution will not knowingly contract with 
        or employ any individual, agency, or organization that 
        has been, or whose officers or employees have been--
                  (i) convicted of, or pled nolo contendere or 
                guilty to, a crime involving the acquisition, 
                use, or expenditure of funds under this title; 
                or
                  (ii) judicially determined to have committed 
                fraud involving funds under this title.
          (17) The institution will complete surveys conducted 
        as a part of the Integrated Postsecondary Education 
        Data System (IPEDS) or any other Federal postsecondary 
        institution data collection effort, as designated by 
        the Secretary, in a timely manner and to the 
        satisfaction of the Secretary.
          (18) The institution will meet the requirements 
        established pursuant to section 485(g).
          (19) The institution will not impose any penalty, 
        including the assessment of late fees, the denial of 
        access to classes, libraries, or other institutional 
        facilities, or the requirement that the student borrow 
        additional funds, on any student because of the 
        student`s inability to meet his or her financial 
        obligations to the institution as a result of the 
        delayed disbursement of the proceeds of a loan made 
        under this title due to compliance with the provisions 
        of this title, or delays attributable to the 
        institution.
          (20) The institution will not provide any commission, 
        bonus, or other incentive payment based directly or 
        indirectly on success in securing enrollments or 
        financial aid to any persons or entities engaged in any 
        student recruiting or admission activities or in making 
        decisions regarding the award of student financial 
        assistance, except that this paragraph shall not apply 
        to the recruitment of foreign students residing in 
        foreign countries who are not eligible to receive 
        Federal student assistance.
          (21) The institution will meet the requirements 
        established by the Secretary and accrediting agencies 
        or associations, and will provide evidence to the 
        Secretary that the institution has the authority to 
        operate within a State.
          (22) The institution will comply with the refund 
        policy established pursuant to section 484B.
          (23)(A) The institution, if located in a State to 
        which section 4(b) of the National Voter Registration 
        Act of 1993 (42 U.S.C. 1973gg-2(b)) does not apply, 
        will make a good faith effort to distribute a mail 
        voter registration form, requested and received from 
        the State, to each student enrolled in a degree or 
        certificate program and physically in attendance at the 
        institution, and to make such forms widely available to 
        students at the institution.
          (B) The institution shall request the forms from the 
        State 120 days prior to the deadline for registering to 
        vote within the State. If an institution has not 
        received a sufficient quantity of forms to fulfill this 
        section from the State within 60 days prior to the 
        deadline for registering to vote in the State, the 
        institution shall not be held liable for not meeting 
        the requirements of this section during that election 
        year.
          (C) This paragraph shall apply to general and special 
        elections for Federal office, as defined in section 
        301(3) of the Federal Election Campaign Act of 1971 (2 
        U.S.C. 431(3)), and to the elections for Governor or 
        other chief executive within such State).
                  (D) The institution shall be considered in 
                compliance with the requirements of 
                subparagraph (A) for each student to whom the 
                institution electronically transmits a message 
                containing a voter registration form acceptable 
                for use in the State in which the institution 
                is located, or an Internet address where such a 
                form can be downloaded, if such information is 
                in an electronic message devoted exclusively to 
                voter registration.
          (24) In the case of a proprietary institution of 
        higher education (as defined in section 102(b)), such 
        institution will derive not less than ten percent of 
        such institution`s revenues from sources other than 
        Federal funds that are disbursed or delivered to or on 
        behalf of a student to be used to attend such 
        institution (referred to in this paragraph and 
        subsection (d) as ``Federal education assistance 
        funds''), as calculated in accordance with subsection 
        (d)(1), or will be subject to the sanctions described 
        in subsection (d)(2).
          (25) In the case of an institution that participates 
        in a loan program under this title, the institution 
        will--
                  (A) develop a code of conduct with respect to 
                such loans with which the institution`s 
                officers, employees, and agents shall comply, 
                that--
                          (i) prohibits a conflict of interest 
                        with the responsibilities of an 
                        officer, employee, or agent of an 
                        institution with respect to such loans; 
                        and
                          (ii) at a minimum, includes the 
                        provisions described in subsection (e);
                  (B) publish such code of conduct prominently 
                on the institution`s website; and
                  (C) administer and enforce such code by, at a 
                minimum, requiring that all of the 
                institution`s officers, employees, and agents 
                with responsibilities with respect to such 
                loans be annually informed of the provisions of 
                the code of conduct.
          (26) The institution will, upon written request, 
        disclose to the alleged victim of any crime of violence 
        (as that term is defined in section 16 of title 18, 
        United States Code), or a nonforcible sex offense, the 
        report on the results of any disciplinary proceeding 
        conducted by such institution against a student who is 
        the alleged perpetrator of such crime or offense with 
        respect to such crime or offense. If the alleged victim 
        of such crime or offense is deceased as a result of 
        such crime or offense, the next of kin of such victim 
        shall be treated as the alleged victim for purposes of 
        this paragraph.
          (27) In the case of an institution that has entered 
        into a preferred lender arrangement, the institution 
        will at least annually compile, maintain, and make 
        available for students attending the institution, and 
        the families of such students, a list, in print or 
        other medium, of the specific lenders for loans made, 
        insured, or guaranteed under this title or private 
        education loans that the institution recommends, 
        promotes, or endorses in accordance with such preferred 
        lender arrangement. In making such list, the 
        institution shall comply with the requirements of 
        subsection (h).
          (28)(A) The institution will, upon the request of an 
        applicant for a private education loan, provide to the 
        applicant the form required under section 128(e)(3) of 
        the Truth in Lending Act (15 U.S.C. 1638(e)(3)), and 
        the information required to complete such form, to the 
        extent the institution possesses such information.
          (B) For purposes of this paragraph, the term 
        ``private education loan'' has the meaning given such 
        term in section 140 of the Truth in Lending Act.
          (29) The institution certifies that the institution--
                  (A) has developed plans to effectively combat 
                the unauthorized distribution of copyrighted 
                material, including through the use of a 
                variety of technology-based deterrents; and
                  (B) will, to the extent practicable, offer 
                alternatives to illegal downloading or peer-to-
                peer distribution of intellectual property, as 
                determined by the institution in consultation 
                with the chief technology officer or other 
                designated officer of the institution.
          (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 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.
          (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.
  (b) Hearings.--(1) An institution that has received written 
notice of a final audit or program review determination and 
that desires to have such determination reviewed by the 
Secretary shall submit to the Secretary a written request for 
review not later than 45 days after receipt of notification of 
the final audit or program review determination.
  (2) The Secretary shall, upon receipt of written notice under 
paragraph (1), arrange for a hearing and notify the institution 
within 30 days of receipt of such notice the date, time, and 
place of such hearing. Such hearing shall take place not later 
than 120 days from the date upon which the Secretary notifies 
the institution.
  (c) Audits; Financial Responsibility; Enforcement of 
Standards.--(1) Notwithstanding any other provisions of this 
title, the Secretary shall prescribe such regulations as may be 
necessary to provide for--
          (A)(i) except as provided in clauses (ii) and (iii), 
        a financial audit of an eligible institution with 
        regard to the financial condition of the institution in 
        its entirety, and a compliance audit of such 
        institution with regard to any funds obtained by it 
        under this title or obtained from a student or a parent 
        who has a loan insured or guaranteed by the Secretary 
        under this title, on at least an annual basis and 
        covering the period since the most recent audit, 
        conducted by a qualified, independent organization or 
        person in accordance with standards established by the 
        Comptroller General for the audit of governmental 
        organizations, programs, and functions, and as 
        prescribed in regulations of the Secretary, the results 
        of which shall be submitted to the Secretary and shall 
        be available to cognizant guaranty agencies, eligible 
        lenders, State agencies, and the appropriate State 
        agency notifying the Secretary under subpart 1 of part 
        H, except that the Secretary may modify the 
        requirements of this clause with respect to 
        institutions of higher education that are foreign 
        institutions, and may waive such requirements with 
        respect to a foreign institution whose students receive 
        less than $500,000 in loans under this title during the 
        award year preceding the audit period;
          (ii) with regard to an eligible institution which is 
        audited under chapter 75 of title 31, United States 
        Code, deeming such audit to satisfy the requirements of 
        clause (i) for the period covered by such audit; or
          (iii) at the discretion of the Secretary, with regard 
        to an eligible institution (other than an eligible 
        institution described in section 102(a)(1)(C)) that has 
        obtained less than $200,000 in funds under this title 
        during each of the 2 award years that precede the audit 
        period and submits a letter of credit payable to the 
        Secretary equal to not less than \1/2\ of the annual 
        potential liabilities of such institution as determined 
        by the Secretary, deeming an audit conducted every 3 
        years to satisfy the requirements of clause (i), except 
        for the award year immediately preceding renewal of the 
        institution`s eligibility under section 498(g);
          (B) in matters not governed by specific program 
        provisions, the establishment of reasonable standards 
        of financial responsibility and appropriate 
        institutional capability for the administration by an 
        eligible institution of a program of student financial 
        aid under this title, including any matter the 
        Secretary deems necessary to the sound administration 
        of the financial aid programs, such as the pertinent 
        actions of any owner, shareholder, or person exercising 
        control over an eligible institution;
          (C)(i) except as provided in clause (ii), a 
        compliance audit of a third party servicer (other than 
        with respect to the servicer`s functions as a lender if 
        such functions are otherwise audited under this part 
        and such audits meet the requirements of this clause), 
        with regard to any contract with an eligible 
        institution, guaranty agency, or lender for 
        administering or servicing any aspect of the student 
        assistance programs under this title, at least once 
        every year and covering the period since the most 
        recent audit, conducted by a qualified, independent 
        organization or person in accordance with standards 
        established by the Comptroller General for the audit of 
        governmental organizations, programs, and functions, 
        and as prescribed in regulations of the Secretary, the 
        results of which shall be submitted to the Secretary; 
        or
          (ii) with regard to a third party servicer that is 
        audited under chapter 75 of title 31, United States 
        Code, such audit shall be deemed to satisfy the 
        requirements of clause (i) for the period covered by 
        such audit;
          (D)(i) a compliance audit of a secondary market with 
        regard to its transactions involving, and its servicing 
        and collection of, loans made under this title, at 
        least once a year and covering the period since the 
        most recent audit, conducted by a qualified, 
        independent organization or person in accordance with 
        standards established by the Comptroller General for 
        the audit of governmental organizations, programs, and 
        functions, and as prescribed in regulations of the 
        Secretary, the results of which shall be submitted to 
        the Secretary; or
          (ii) with regard to a secondary market that is 
        audited under chapter 75 of title 31, United States 
        Code, such audit shall be deemed to satisfy the 
        requirements of clause (i) for the period covered by 
        the audit;
          (E) the establishment, by each eligible institution 
        under part B responsible for furnishing to the lender 
        the statement required by section 428(a)(2)(A)(i), of 
        policies and procedures by which the latest known 
        address and enrollment status of any student who has 
        had a loan insured under this part and who has either 
        formally terminated his enrollment, or failed to re-
        enroll on at least a half-time basis, at such 
        institution, shall be furnished either to the holder 
        (or if unknown, the insurer) of the note, not later 
        than 60 days after such termination or failure to re-
        enroll;
          (F) the limitation, suspension, or termination of the 
        participation in any program under this title of an 
        eligible institution, or the imposition of a civil 
        penalty under paragraph (3)(B) whenever the Secretary 
        has determined, after reasonable notice and opportunity 
        for hearing, that such institution has violated or 
        failed to carry out any provision of this title, any 
        regulation prescribed under this title, or any 
        applicable special arrangement, agreement, or 
        limitation, except that no period of suspension under 
        this section shall exceed 60 days unless the 
        institution and the Secretary agree to an extension or 
        unless limitation or termination proceedings are 
        initiated by the Secretary within that period of time;
          (G) an emergency action against an institution, under 
        which the Secretary shall, effective on the date on 
        which a notice and statement of the basis of the action 
        is mailed to the institution (by registered mail, 
        return receipt requested), withhold funds from the 
        institution or its students and withdraw the 
        institution`s authority to obligate funds under any 
        program under this title, if the Secretary--
                  (i) receives information, determined by the 
                Secretary to be reliable, that the institution 
                is violating any provision of this title, any 
                regulation prescribed under this title, or any 
                applicable special arrangement, agreement, or 
                limitation,
                  (ii) determines that immediate action is 
                necessary to prevent misuse of Federal funds, 
                and
                  (iii) determines that the likelihood of loss 
                outweighs the importance of the procedures 
                prescribed under subparagraph (D) for 
                limitation, suspension, or termination,
        except that an emergency action shall not exceed 30 
        days unless limitation, suspension, or termination 
        proceedings are initiated by the Secretary against the 
        institution within that period of time, and except that 
        the Secretary shall provide the institution an 
        opportunity to show cause, if it so requests, that the 
        emergency action is unwarranted;
          (H) the limitation, suspension, or termination of the 
        eligibility of a third party servicer to contract with 
        any institution to administer any aspect of an 
        institution`s student assistance program under this 
        title, or the imposition of a civil penalty under 
        paragraph (3)(B), whenever the Secretary has 
        determined, after reasonable notice and opportunity for 
        a hearing, that such organization, acting on behalf of 
        an institution, has violated or failed to carry out any 
        provision of this title, any regulation prescribed 
        under this title, or any applicable special 
        arrangement, agreement, or limitation, except that no 
        period of suspension under this subparagraph shall 
        exceed 60 days unless the organization and the 
        Secretary agree to an extension, or unless limitation 
        or termination proceedings are initiated by the 
        Secretary against the individual or organization within 
        that period of time; and
          (I) an emergency action against a third party 
        servicer that has contracted with an institution to 
        administer any aspect of the institution`s student 
        assistance program under this title, under which the 
        Secretary shall, effective on the date on which a 
        notice and statement of the basis of the action is 
        mailed to such individual or organization (by 
        registered mail, return receipt requested), withhold 
        funds from the individual or organization and withdraw 
        the individual or organization`s authority to act on 
        behalf of an institution under any program under this 
        title, if the Secretary--
                  (i) receives information, determined by the 
                Secretary to be reliable, that the individual 
                or organization, acting on behalf of an 
                institution, is violating any provision of this 
                title, any regulation prescribed under this 
                title, or any applicable special arrangement, 
                agreement, or limitation,
                  (ii) determines that immediate action is 
                necessary to prevent misuse of Federal funds, 
                and
                  (iii) determines that the likelihood of loss 
                outweighs the importance of the procedures 
                prescribed under subparagraph (F), for 
                limitation, suspension, or termination,
        except that an emergency action shall not exceed 30 
        days unless the limitation, suspension, or termination 
        proceedings are initiated by the Secretary against the 
        individual or organization within that period of time, 
        and except that the Secretary shall provide the 
        individual or organization an opportunity to show 
        cause, if it so requests, that the emergency action is 
        unwarranted.
  (2) If an individual who, or entity that, exercises 
substantial control, as determined by the Secretary in 
accordance with the definition of substantial control in 
subpart 3 of part H, over one or more institutions 
participating in any program under this title, or, for purposes 
of paragraphs (1) (H) and (I), over one or more organizations 
that contract with an institution to administer any aspect of 
the institution`s student assistance program under this title, 
is determined to have committed one or more violations of the 
requirements of any program under this title, or has been 
suspended or debarred in accordance with the regulations of the 
Secretary, the Secretary may use such determination, 
suspension, or debarment as the basis for imposing an emergency 
action on, or limiting, suspending, or terminating, in a single 
proceeding, the participation of any or all institutions under 
the substantial control of that individual or entity.
  (3)(A) Upon determination, after reasonable notice and 
opportunity for a hearing, that an eligible institution has 
engaged in substantial misrepresentation of the nature of its 
educational program, its financial charges, or the 
employability of its graduates, the Secretary may suspend or 
terminate the eligibility status for any or all programs under 
this title of any otherwise eligible institution, in accordance 
with procedures specified in paragraph (1)(D) of this 
subsection, until the Secretary finds that such practices have 
been corrected.
  (B)(i) Upon determination, after reasonable notice and 
opportunity for a hearing, that an eligible institution--
          (I) has violated or failed to carry out any provision 
        of this title or any regulation prescribed under this 
        title; or
          (II) has engaged in substantial misrepresentation of 
        the nature of its educational program, its financial 
        charges, and the employability of its graduates,
the Secretary may impose a civil penalty upon such institution 
of not to exceed $25,000 for each violation or 
misrepresentation.
  (ii) Any civil penalty may be compromised by the Secretary. 
In determining the amount of such penalty, or the amount agreed 
upon in compromise, the appropriateness of the penalty to the 
size of the institution of higher education subject to the 
determination, and the gravity of the violation, failure, or 
misrepresentation shall be considered. The amount of such 
penalty, when finally determined, or the amount agreed upon in 
compromise, may be deducted from any sums owing by the United 
States to the institution charged.
  (4) The Secretary shall publish a list of State agencies 
which the Secretary determines to be reliable authority as to 
the quality of public postsecondary vocational education in 
their respective States for the purpose of determining 
eligibility for all Federal student assistance programs.
  (5) The Secretary shall make readily available to appropriate 
guaranty agencies, eligible lenders, State agencies notifying 
the Secretary under subpart 1 of part H, and accrediting 
agencies or associations the results of the audits of eligible 
institutions conducted pursuant to paragraph (1)(A).
  (6) The Secretary is authorized to provide any information 
collected as a result of audits conducted under this section, 
together with audit information collected by guaranty agencies, 
to any Federal or State agency having responsibilities with 
respect to student financial assistance, including those 
referred to in subsection (a)(15) of this section.
  (7) Effective with respect to any audit conducted under this 
subsection after December 31, 1988, if, in the course of 
conducting any such audit, the personnel of the Department of 
Education discover, or are informed of, grants or other 
assistance provided by an institution in accordance with this 
title for which the institution has not received funds 
appropriated under this title (in the amount necessary to 
provide such assistance), including funds for which 
reimbursement was not requested prior to such discovery or 
information, such institution shall be permitted to offset that 
amount against any sums determined to be owed by the 
institution pursuant to such audit, or to receive reimbursement 
for that amount (if the institution does not owe any such 
sums).
  (d) Implementation of Non-Federal Revenue Requirement.--
          (1) Calculation.--In making calculations under 
        subsection (a)(24), a proprietary institution of higher 
        education shall--
                  (A) use the cash basis of accounting, except 
                in the case of loans described in subparagraph 
                (D)(i) that are made by the proprietary 
                institution of higher education;
                  (B) consider as revenue only those funds 
                generated by the institution from--
                          (i) tuition, fees, and other 
                        institutional charges for students 
                        enrolled in programs eligible for 
                        assistance under this title;
                          (ii) activities conducted by the 
                        institution that are necessary for the 
                        education and training of the 
                        institution`s students, if such 
                        activities are--
                                  (I) conducted on campus or at 
                                a facility under the control of 
                                the institution;
                                  (II) performed under the 
                                supervision of a member of the 
                                institution`s faculty; and
                                  (III) required to be 
                                performed by all students in a 
                                specific educational program at 
                                the institution; and
                          (iii) funds paid by a student, or on 
                        behalf of a student by a party other 
                        than the institution, for an education 
                        or training program that is not 
                        eligible for funds under this title, if 
                        the program--
                                  (I) is approved or licensed 
                                by the appropriate State 
                                agency;
                                  (II) is accredited by an 
                                accrediting agency recognized 
                                by the Secretary; or
                                  (III) provides an industry-
                                recognized credential or 
                                certification;
                  (C) presume that any Federal education 
                assistance funds that are disbursed or 
                delivered to or on behalf of a student will be 
                used to pay the student`s tuition, fees, or 
                other institutional charges, regardless of 
                whether the institution credits those funds to 
                the student`s account or pays those funds 
                directly to the student, except to the extent 
                that the student`s tuition, fees, or other 
                institutional charges are satisfied by--
                          (i) grant funds provided by non-
                        Federal public agencies or private 
                        sources independent of the institution;
                          (ii) funds provided under a 
                        contractual arrangement with a Federal, 
                        State, or local government agency for 
                        the purpose of providing job training 
                        to low-income individuals who are in 
                        need of that training;
                          (iii) funds used by a student from 
                        savings plans for educational expenses 
                        established by or on behalf of the 
                        student and which qualify for special 
                        tax treatment under the Internal 
                        Revenue Code of 1986; or
                          (iv) institutional scholarships 
                        described in subparagraph (D)(iii);
                  (D) include institutional aid as revenue to 
                the school only as follows:
                          (i) in the case of loans made by a 
                        proprietary institution of higher 
                        education on or after July 1, 2008 and 
                        prior to July 1, 2012, the net present 
                        value of such loans made by the 
                        institution during the applicable 
                        institutional fiscal year accounted for 
                        on an accrual basis and estimated in 
                        accordance with generally accepted 
                        accounting principles and related 
                        standards and guidance, if the loans--
                                  (I) are bona fide as 
                                evidenced by enforceable 
                                promissory notes;
                                  (II) are issued at intervals 
                                related to the institution`s 
                                enrollment periods; and
                                  (III) are subject to regular 
                                loan repayments and 
                                collections;
                          (ii) in the case of loans made by a 
                        proprietary institution of higher 
                        education on or after July 1, 2012, 
                        only the amount of loan repayments 
                        received during the applicable 
                        institutional fiscal year, excluding 
                        repayments on loans made and accounted 
                        for as specified in clause (i); and
                          (iii) in the case of scholarships 
                        provided by a proprietary institution 
                        of higher education, only those 
                        scholarships provided by the 
                        institution in the form of monetary aid 
                        or tuition discounts based upon the 
                        academic achievements or financial need 
                        of students, disbursed during each 
                        fiscal year from an established 
                        restricted account, and only to the 
                        extent that funds in that account 
                        represent designated funds from an 
                        outside source or from income earned on 
                        those funds;
                  (E) in the case of each student who receives 
                a loan on or after July 1, 2008, and prior to 
                July 1, 2011, that is authorized under section 
                428H or that is a Federal Direct Unsubsidized 
                Stafford Loan, treat as revenue received by the 
                institution from sources other than funds 
                received under this title, the amount by which 
                the disbursement of such loan received by the 
                institution exceeds the limit on such loan in 
                effect on the day before the date of enactment 
                of the Ensuring Continued Access to Student 
                Loans Act of 2008; and
                  (F) exclude from revenues--
                          (i) the amount of funds the 
                        institution received under part C, 
                        unless the institution used those funds 
                        to pay a student`s institutional 
                        charges;
                          (ii) the amount of funds the 
                        institution received under subpart 4 of 
                        part A;
                          (iii) the amount of funds provided by 
                        the institution as matching funds for a 
                        program under this title;
                          (iv) the amount of funds provided by 
                        the institution for a program under 
                        this title that are required to be 
                        refunded or returned; and
                          (v) the amount charged for books, 
                        supplies, and equipment, unless the 
                        institution includes that amount as 
                        tuition, fees, or other institutional 
                        charges.
          (2) Sanctions.--
                  (A) Ineligibility.--A proprietary institution 
                of higher education that fails to meet a 
                requirement of subsection (a)(24) for two 
                consecutive institutional fiscal years shall be 
                ineligible to participate in the programs 
                authorized by this title for a period of not 
                less than two institutional fiscal years. To 
                regain eligibility to participate in the 
                programs authorized by this title, a 
                proprietary institution of higher education 
                shall demonstrate compliance with all 
                eligibility and certification requirements 
                under section 498 for a minimum of two 
                institutional fiscal years after the 
                institutional fiscal year in which the 
                institution became ineligible.
                  (B) Additional enforcement.--In addition to 
                such other means of enforcing the requirements 
                of this title as may be available to the 
                Secretary, if a proprietary institution of 
                higher education fails to meet a requirement of 
                subsection (a)(24) for any institutional fiscal 
                year, then the institution`s eligibility to 
                participate in the programs authorized by this 
                title becomes provisional for the two 
                institutional fiscal years after the 
                institutional fiscal year in which the 
                institution failed to meet the requirement of 
                subsection (a)(24), except that such 
                provisional eligibility shall terminate--
                          (i) on the expiration date of the 
                        institution`s program participation 
                        agreement under this subsection that is 
                        in effect on the date the Secretary 
                        determines that the institution failed 
                        to meet the requirement of subsection 
                        (a)(24); or
                          (ii) in the case that the Secretary 
                        determines that the institution failed 
                        to meet a requirement of subsection 
                        (a)(24) for two consecutive 
                        institutional fiscal years, on the date 
                        the institution is determined 
                        ineligible in accordance with 
                        subparagraph (A).
          (3) Publication on college navigator website.--The 
        Secretary shall publicly disclose on the College 
        Navigator website--
                  (A) the identity of any proprietary 
                institution of higher education that fails to 
                meet a requirement of subsection (a)(24); and
                  (B) the extent to which the institution 
                failed to meet such requirement.
          (4) Report to congress.--Not later than July 1, 2009, 
        and July 1 of each succeeding year, the Secretary shall 
        submit to the authorizing committees a report that 
        contains, for each proprietary institution of higher 
        education that receives assistance under this title, as 
        provided in the audited financial statements submitted 
        to the Secretary by each institution pursuant to the 
        requirements of subsection (a)(24)--
                  (A) the amount and percentage of such 
                institution`s revenues received from sources 
                under this title; and
                  (B) the amount and percentage of such 
                institution`s revenues received from other 
                sources.
  (e) Code of Conduct Requirements.--An institution of higher 
education`s code of conduct, as required under subsection 
(a)(25), shall include the following requirements:
          (1) Ban on revenue-sharing arrangements.--
                  (A) Prohibition.--The institution shall not 
                enter into any revenue-sharing arrangement with 
                any lender.
                  (B) Definition.--For purposes of this 
                paragraph, the term ``revenue-sharing 
                arrangement'' means an arrangement between an 
                institution and a lender under which--
                          (i) a lender provides or issues a 
                        loan that is made, insured, or 
                        guaranteed under this title to students 
                        attending the institution or to the 
                        families of such students; and
                          (ii) the institution recommends the 
                        lender or the loan products of the 
                        lender and in exchange, the lender pays 
                        a fee or provides other material 
                        benefits, including revenue or profit 
                        sharing, to the institution, an officer 
                        or employee of the institution, or an 
                        agent.
          (2) Gift ban.--
                  (A) Prohibition.--No officer or employee of 
                the institution who is employed in the 
                financial aid office of the institution or who 
                otherwise has responsibilities with respect to 
                education loans, or agent who has 
                responsibilities with respect to education 
                loans, shall solicit or accept any gift from a 
                lender, guarantor, or servicer of education 
                loans.
                  (B) Definition of gift.--
                          (i) In general.--In this paragraph, 
                        the term ``gift'' means any gratuity, 
                        favor, discount, entertainment, 
                        hospitality, loan, or other item having 
                        a monetary value of more than a de 
                        minimus amount. The term includes a 
                        gift of services, transportation, 
                        lodging, or meals, whether provided in 
                        kind, by purchase of a ticket, payment 
                        in advance, or reimbursement after the 
                        expense has been incurred.
                          (ii) Exceptions.--The term ``gift'' 
                        shall not include any of the following:
                                  (I) Standard material, 
                                activities, or programs on 
                                issues related to a loan, 
                                default aversion, default 
                                prevention, or financial 
                                literacy, such as a brochure, a 
                                workshop, or training.
                                  (II) Food, refreshments, 
                                training, or informational 
                                material furnished to an 
                                officer or employee of an 
                                institution, or to an agent, as 
                                an integral part of a training 
                                session that is designed to 
                                improve the service of a 
                                lender, guarantor, or servicer 
                                of education loans to the 
                                institution, if such training 
                                contributes to the professional 
                                development of the officer, 
                                employee, or agent.
                                  (III) Favorable terms, 
                                conditions, and borrower 
                                benefits on an education loan 
                                provided to a student employed 
                                by the institution if such 
                                terms, conditions, or benefits 
                                are comparable to those 
                                provided to all students of the 
                                institution.
                                  (IV) Entrance and exit 
                                counseling services provided to 
                                borrowers to meet the 
                                institution`s responsibilities 
                                for entrance and exit 
                                counseling as required by 
                                subsections (b) and (l) of 
                                section 485, as long as--
                                          (aa) the 
                                        institution`s staff are 
                                        in control of the 
                                        counseling, (whether in 
                                        person or via 
                                        electronic 
                                        capabilities); and
                                          (bb) such counseling 
                                        does not promote the 
                                        products or services of 
                                        any specific lender.
                                  (V) Philanthropic 
                                contributions to an institution 
                                from a lender, servicer, or 
                                guarantor of education loans 
                                that are unrelated to education 
                                loans or any contribution from 
                                any lender, guarantor, or 
                                servicer that is not made in 
                                exchange for any advantage 
                                related to education loans.
                                  (VI) State education grants, 
                                scholarships, or financial aid 
                                funds administered by or on 
                                behalf of a State.
                          (iii) Rule for gifts to family 
                        members.--For purposes of this 
                        paragraph, a gift to a family member of 
                        an officer or employee of an 
                        institution, to a family member of an 
                        agent, or to any other individual based 
                        on that individual`s relationship with 
                        the officer, employee, or agent, shall 
                        be considered a gift to the officer, 
                        employee, or agent if--
                                  (I) the gift is given with 
                                the knowledge and acquiescence 
                                of the officer, employee, or 
                                agent; and
                                  (II) the officer, employee, 
                                or agent has reason to believe 
                                the gift was given because of 
                                the official position of the 
                                officer, employee, or agent.
          (3) Contracting arrangements prohibited.--
                  (A) Prohibition.--An officer or employee who 
                is employed in the financial aid office of the 
                institution or who otherwise has 
                responsibilities with respect to education 
                loans, or an agent who has responsibilities 
                with respect to education loans, shall not 
                accept from any lender or affiliate of any 
                lender any fee, payment, or other financial 
                benefit (including the opportunity to purchase 
                stock) as compensation for any type of 
                consulting arrangement or other contract to 
                provide services to a lender or on behalf of a 
                lender relating to education loans.
                  (B) Exceptions.--Nothing in this subsection 
                shall be construed as prohibiting--
                          (i) an officer or employee of an 
                        institution who is not employed in the 
                        institution`s financial aid office and 
                        who does not otherwise have 
                        responsibilities with respect to 
                        education loans, or an agent who does 
                        not have responsibilities with respect 
                        to education loans, from performing 
                        paid or unpaid service on a board of 
                        directors of a lender, guarantor, or 
                        servicer of education loans;
                          (ii) an officer or employee of the 
                        institution who is not employed in the 
                        institution`s financial aid office but 
                        who has responsibility with respect to 
                        education loans as a result of a 
                        position held at the institution, or an 
                        agent who has responsibility with 
                        respect to education loans, from 
                        performing paid or unpaid service on a 
                        board of directors of a lender, 
                        guarantor, or servicer of education 
                        loans, if the institution has a written 
                        conflict of interest policy that 
                        clearly sets forth that officers, 
                        employees, or agents must recuse 
                        themselves from participating in any 
                        decision of the board regarding 
                        education loans at the institution; or
                          (iii) an officer, employee, or 
                        contractor of a lender, guarantor, or 
                        servicer of education loans from 
                        serving on a board of directors, or 
                        serving as a trustee, of an 
                        institution, if the institution has a 
                        written conflict of interest policy 
                        that the board member or trustee must 
                        recuse themselves from any decision 
                        regarding education loans at the 
                        institution.
          (4) Interaction with borrowers.--The institution 
        shall not--
                  (A) for any first-time borrower, assign, 
                through award packaging or other methods, the 
                borrower`s loan to a particular lender; or
                  (B) refuse to certify, or delay certification 
                of, any loan based on the borrower`s selection 
                of a particular lender or guaranty agency.
          (5) Prohibition on offers of funds for private 
        loans.--
                  (A) Prohibition.--The institution shall not 
                request or accept from any lender any offer of 
                funds to be used for private education loans 
                (as defined in section 140 of the Truth in 
                Lending Act), including funds for an 
                opportunity pool loan, to students in exchange 
                for the institution providing concessions or 
                promises regarding providing the lender with--
                          (i) a specified number of loans made, 
                        insured, or guaranteed under this 
                        title;
                          (ii) a specified loan volume of such 
                        loans; or
                          (iii) a preferred lender arrangement 
                        for such loans.
                  (B) Definition of opportunity pool loan.--In 
                this paragraph, the term ``opportunity pool 
                loan'' means a private education loan made by a 
                lender to a student attending the institution 
                or the family member of such a student that 
                involves a payment, directly or indirectly, by 
                such institution of points, premiums, 
                additional interest, or financial support to 
                such lender for the purpose of such lender 
                extending credit to the student or the family.
          (6) Ban on staffing assistance.--
                  (A) Prohibition.--The institution shall not 
                request or accept from any lender any 
                assistance with call center staffing or 
                financial aid office staffing.
                  (B) Certain assistance permitted.--Nothing in 
                paragraph (1) shall be construed to prohibit 
                the institution from requesting or accepting 
                assistance from a lender related to--
                          (i) professional development training 
                        for financial aid administrators;
                          (ii) providing educational counseling 
                        materials, financial literacy 
                        materials, or debt management materials 
                        to borrowers, provided that such 
                        materials disclose to borrowers the 
                        identification of any lender that 
                        assisted in preparing or providing such 
                        materials; or
                          (iii) staffing services on a short-
                        term, nonrecurring basis to assist the 
                        institution with financial aid-related 
                        functions during emergencies, including 
                        State-declared or federally declared 
                        natural disasters, federally declared 
                        national disasters, and other localized 
                        disasters and emergencies identified by 
                        the Secretary.
          (7) Advisory board compensation.--Any employee who is 
        employed in the financial aid office of the 
        institution, or who otherwise has responsibilities with 
        respect to education loans or other student financial 
        aid of the institution, and who serves on an advisory 
        board, commission, or group established by a lender, 
        guarantor, or group of lenders or guarantors, shall be 
        prohibited from receiving anything of value from the 
        lender, guarantor, or group of lenders or guarantors, 
        except that the employee may be reimbursed for 
        reasonable expenses incurred in serving on such 
        advisory board, commission, or group.
  (f) Institutional Requirements for Teach-Outs.--
          (1) In general.--In the event the Secretary initiates 
        the limitation, suspension, or termination of the 
        participation of an institution of higher education in 
        any program under this title under the authority of 
        subsection (c)(1)(F) or initiates an emergency action 
        under the authority of subsection (c)(1)(G) and its 
        prescribed regulations, the Secretary shall require 
        that institution to prepare a teach-out plan for 
        submission to the institution`s accrediting agency or 
        association in compliance with section 496(c)(3), the 
        Secretary`s regulations on teach-out plans, and the 
        standards of the institution`s accrediting agency or 
        association.
          (2) Teach-out plan defined.--In this subsection, the 
        term ``teach-out plan'' means a written plan that 
        provides for the equitable treatment of students if an 
        institution of higher education ceases to operate 
        before all students have completed their program of 
        study, and may include, if required by the 
        institution`s accrediting agency or association, an 
        agreement between institutions for such a teach-out 
        plan.
  (g) Inspector General Report on Gift Ban Violations.--The 
Inspector General of the Department shall--
          (1) submit an annual report to the authorizing 
        committees identifying all violations of an 
        institution`s code of conduct that the Inspector 
        General has substantiated during the preceding year 
        relating to the gift ban provisions described in 
        subsection (e)(2); and
          (2) make the report available to the public through 
        the Department`s website.
  (h) Preferred Lender List Requirements.--
          (1) In general.--In compiling, maintaining, and 
        making available a preferred lender list as required 
        under subsection (a)(27), the institution will--
                  (A) clearly and fully disclose on such 
                preferred lender list--
                          (i) not less than the information 
                        required to be disclosed under section 
                        153(a)(2)(A);
                          (ii) why the institution has entered 
                        into a preferred lender arrangement 
                        with each lender on the preferred 
                        lender list, particularly with respect 
                        to terms and conditions or provisions 
                        favorable to the borrower; and
                          (iii) that the students attending the 
                        institution, or the families of such 
                        students, do not have to borrow from a 
                        lender on the preferred lender list;
                  (B) ensure, through the use of the list of 
                lender affiliates provided by the Secretary 
                under paragraph (2), that--
                          (i) there are not less than three 
                        lenders of loans made under part B that 
                        are not affiliates of each other 
                        included on the preferred lender list 
                        and, if the institution recommends, 
                        promotes, or endorses private education 
                        loans, there are not less than two 
                        lenders of private education loans that 
                        are not affiliates of each other 
                        included on the preferred lender list; 
                        and
                          (ii) the preferred lender list under 
                        this paragraph--
                                  (I) specifically indicates, 
                                for each listed lender, whether 
                                the lender is or is not an 
                                affiliate of each other lender 
                                on the preferred lender list; 
                                and
                                  (II) if a lender is an 
                                affiliate of another lender on 
                                the preferred lender list, 
                                describes the details of such 
                                affiliation;
                  (C) prominently disclose the method and 
                criteria used by the institution in selecting 
                lenders with which to enter into preferred 
                lender arrangements to ensure that such lenders 
                are selected on the basis of the best interests 
                of the borrowers, including--
                          (i) payment of origination or other 
                        fees on behalf of the borrower;
                          (ii) highly competitive interest 
                        rates, or other terms and conditions or 
                        provisions of loans under this title or 
                        private education loans;
                          (iii) high-quality servicing for such 
                        loans; or
                          (iv) additional benefits beyond the 
                        standard terms and conditions or 
                        provisions for such loans;
                  (D) exercise a duty of care and a duty of 
                loyalty to compile the preferred lender list 
                under this paragraph without prejudice and for 
                the sole benefit of the students attending the 
                institution, or the families of such students;
                  (E) not deny or otherwise impede the 
                borrower`s choice of a lender or cause 
                unnecessary delay in loan certification under 
                this title for those borrowers who choose a 
                lender that is not included on the preferred 
                lender list; and
                  (F) comply with such other requirements as 
                the Secretary may prescribe by regulation.
          (2) Lender affiliates list.--
                  (A) In general.--The Secretary shall maintain 
                and regularly update a list of lender 
                affiliates of all eligible lenders, and shall 
                provide such list to institutions for use in 
                carrying out paragraph (1)(B).
                  (B) Use of most recent list.--An institution 
                shall use the most recent list of lender 
                affiliates provided by the Secretary under 
                subparagraph (A) in carrying out paragraph 
                (1)(B).
  (i) Definitions.--For the purpose of this section:
          (1) Agent.--The term ``agent'' has the meaning given 
        the term in section 151.
          (2) Affiliate.--The term ``affiliate'' means a person 
        that controls, is controlled by, or is under common 
        control with another person. A person controls, is 
        controlled by, or is under common control with another 
        person if--
                  (A) the person directly or indirectly, or 
                acting through one or more others, owns, 
                controls, or has the power to vote five percent 
                or more of any class of voting securities of 
                such other person;
                  (B) the person controls, in any manner, the 
                election of a majority of the directors or 
                trustees of such other person; or
                  (C) the Secretary determines (after notice 
                and opportunity for a hearing) that the person 
                directly or indirectly exercises a controlling 
                interest over the management or policies of 
                such other person`s education loans.
          (3) Education loan.--The term ``education loan'' has 
        the meaning given the term in section 151.
          (4) Eligible institution.--The term ``eligible 
        institution'' means any such institution described in 
        section 102 of this Act.
          (5) Officer.--The term ``officer'' has the meaning 
        given the term in section 151.
          (6) Preferred lender arrangement.--The term 
        ``preferred lender arrangement'' has the meaning given 
        the term in section 151.
  (j) Construction.--Nothing in the amendments made by the 
Higher Education Amendments of 1992 shall be construed to 
prohibit an institution from recording, at the cost of the 
institution, a hearing referred to in subsection (b)(2), 
subsection (c)(1)(D), or subparagraph (A) or (B)(i) of 
subsection (c)(2), of this section to create a record of the 
hearing, except the unavailability of a recording shall not 
serve to delay the completion of the proceeding. The Secretary 
shall allow the institution to use any reasonable means, 
including stenographers, of recording the hearing.

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TITLE VII--GRADUATE AND POSTSECONDARY IMPROVEMENT PROGRAMS

           *       *       *       *       *       *       *


 PART D--PROGRAMS TO PROVIDE STUDENTS WITH DISABILITIES WITH A QUALITY 
HIGHER EDUCATION

           *       *       *       *       *       *       *


Subpart 4--National Technical Assistance Center; Coordinating Center

           *       *       *       *       *       *       *


SEC. 777. NATIONAL TECHNICAL ASSISTANCE CENTER; COORDINATING CENTER.

  (a) National Center.--
          (1) In general.--[From amounts appropriated under 
        section 778,] From amounts appropriated under paragraph 
        (5), the Secretary shall award a grant to, or enter 
        into a contract or cooperative agreement with, an 
        eligible entity to provide for the establishment and 
        support of a National Center for Information and 
        Technical Support for Postsecondary Students with 
        Disabilities (in this subsection referred to as the 
        ``National Center''). The National Center shall carry 
        out the duties set forth in paragraph (4).
          (2) Administration.--The program under this section 
        shall be administered by the office in the Department 
        that administers other postsecondary education 
        programs.
          (3) Eligible entity.--In this subpart, the term 
        ``eligible entity'' means an institution of higher 
        education, a nonprofit organization, or partnership of 
        two or more such institutions or organizations, with 
        demonstrated expertise in--
                  (A) supporting students with disabilities in 
                postsecondary education;
                  (B) technical knowledge necessary for the 
                dissemination of information in accessible 
                formats;
                  (C) working with diverse types of 
                institutions of higher education, including 
                community colleges; and
                  (D) the subjects supported by the grants, 
                contracts, or cooperative agreements authorized 
                in subparts 1, 2, and 3.
          (4) Duties.--The duties of the National Center shall 
        include the following:
                  (A) Assistance to students and families.--The 
                National Center shall provide information and 
                technical assistance to students with 
                disabilities and the families of students with 
                disabilities to support students across the 
                broad spectrum of disabilities, including--
                          (i) information to assist individuals 
                        with disabilities who are prospective 
                        students of an institution of higher 
                        education in planning for postsecondary 
                        education while the students are in 
                        secondary school;
                          (ii) information and technical 
                        assistance provided to individualized 
                        education program teams (as defined in 
                        section 614(d)(1) of the Individuals 
                        with Disabilities Education Act) for 
                        secondary school students with 
                        disabilities, and to early outreach and 
                        student services programs, including 
                        programs authorized under subparts 2, 
                        4, and 5 of part A of title IV, to 
                        support students across a broad 
                        spectrum of disabilities with the 
                        successful transition to postsecondary 
                        education;
                          (iii) research-based supports, 
                        services, and accommodations which are 
                        available in postsecondary settings, 
                        including services provided by other 
                        agencies such as vocational 
                        rehabilitation;
                          (iv) information on student mentoring 
                        and networking opportunities for 
                        students with disabilities; and
                          (v) effective recruitment and 
                        transition programs at postsecondary 
                        educational institutions.
                  (B) Assistance to institutions of higher 
                education.--The National Center shall provide 
                information and technical assistance to 
                faculty, staff, and administrators of 
                institutions of higher education to improve the 
                services provided to, the accommodations for, 
                the retention rates of, and the completion 
                rates of, students with disabilities in higher 
                education settings, which may include--
                          (i) collection and dissemination of 
                        best and promising practices and 
                        materials for accommodating and 
                        supporting students with disabilities, 
                        including practices and materials 
                        supported by the grants, contracts, or 
                        cooperative agreements authorized under 
                        subparts 1, 2, and 3;
                          (ii) development and provision of 
                        training modules for higher education 
                        faculty on exemplary practices for 
                        accommodating and supporting 
                        postsecondary students with 
                        disabilities across a range of academic 
                        fields, which may include universal 
                        design for learning and practices 
                        supported by the grants, contracts, or 
                        cooperative agreements authorized under 
                        subparts 1, 2, and 3; and
                          (iii) development of technology-based 
                        tutorials for higher education faculty 
                        and staff, including new faculty and 
                        graduate students, on best and 
                        promising practices related to support 
                        and retention of students with 
                        disabilities in postsecondary 
                        education.
                  (C) Information collection and 
                dissemination.--The National Center shall be 
                responsible for building, maintaining, and 
                updating a database of disability support 
                services information with respect to 
                institutions of higher education, or for 
                expanding and updating an existing database of 
                disabilities support services information with 
                respect to institutions of higher education. 
                Such database shall be available to the general 
                public through a website built to high 
                technical standards of accessibility 
                practicable for the broad spectrum of 
                individuals with disabilities. Such database 
                and website shall include available information 
                on--
                          (i) disability documentation 
                        requirements;
                          (ii) support services available;
                          (iii) links to financial aid;
                          (iv) accommodations policies;
                          (v) accessible instructional 
                        materials;
                          (vi) other topics relevant to 
                        students with disabilities; and
                          (vii) the information in the report 
                        described in subparagraph (E).
                  (D) Disability support services.--The 
                National Center shall work with organizations 
                and individuals with proven expertise related 
                to disability support services for 
                postsecondary students with disabilities to 
                evaluate, improve, and disseminate information 
                related to the delivery of high quality 
                disability support services at institutions of 
                higher education.
                  (E) Review and report.--Not later than three 
                years after the establishment of the National 
                Center, and every two years thereafter, the 
                National Center shall prepare and disseminate a 
                report to the Secretary and the authorizing 
                committees analyzing the condition of 
                postsecondary success for students with 
                disabilities. Such report shall include--
                          (i) a review of the activities and 
                        the effectiveness of the programs 
                        authorized under this part;
                          (ii) annual enrollment and graduation 
                        rates of students with disabilities in 
                        institutions of higher education from 
                        publicly reported data;
                          (iii) recommendations for effective 
                        postsecondary supports and services for 
                        students with disabilities, and how 
                        such supports and services may be 
                        widely implemented at institutions of 
                        higher education;
                          (iv) recommendations on reducing 
                        barriers to full participation for 
                        students with disabilities in higher 
                        education; and
                          (v) a description of strategies with 
                        a demonstrated record of effectiveness 
                        in improving the success of such 
                        students in postsecondary education.
                  (F) Staffing of the center.--In hiring 
                employees of the National Center, the National 
                Center shall consider the expertise and 
                experience of prospective employees in 
                providing training and technical assistance to 
                practitioners.
          (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.
  (b) Coordinating Center.--
          (1) Definition of eligible entity.--In this 
        subsection, the term ``eligible entity'' means an 
        entity, or a partnership of entities, that has 
        demonstrated expertise in the fields of--
                  (A) higher education;
                  (B) the education of students with 
                intellectual disabilities;
                  (C) the development of comprehensive 
                transition and postsecondary programs for 
                students with intellectual disabilities; and
                  (D) evaluation and technical assistance.
          (2) In general.--From amounts appropriated under 
        section 778, the Secretary shall enter into a 
        cooperative agreement, on a competitive basis, with an 
        eligible entity for the purpose of establishing a 
        coordinating center for institutions of higher 
        education that offer inclusive comprehensive transition 
        and postsecondary programs for students with 
        intellectual disabilities, including institutions 
        participating in grants authorized under subpart 2, to 
        provide--
                  (A) recommendations related to the 
                development of standards for such programs;
                  (B) technical assistance for such programs; 
                and
                  (C) evaluations for such programs.
          (3) Administration.--The program under this 
        subsection shall be administered by the office in the 
        Department that administers other postsecondary 
        education programs.
          (4) Duration.--The Secretary shall enter into a 
        cooperative agreement under this subsection for a 
        period of five years.
          (5) Requirements of cooperative agreement.--The 
        eligible entity entering into a cooperative agreement 
        under this subsection shall establish and maintain a 
        coordinating center that shall--
                  (A) serve as the technical assistance entity 
                for all comprehensive transition and 
                postsecondary programs for students with 
                intellectual disabilities;
                  (B) provide technical assistance regarding 
                the development, evaluation, and continuous 
                improvement of such programs;
                  (C) develop an evaluation protocol for such 
                programs that includes qualitative and 
                quantitative methodologies for measuring 
                student outcomes and program strengths in the 
                areas of academic enrichment, socialization, 
                independent living, and competitive or 
                supported employment;
                  (D) assist recipients of grants under subpart 
                2 in efforts to award a meaningful credential 
                to students with intellectual disabilities upon 
                the completion of such programs, which 
                credential shall take into consideration unique 
                State factors;
                  (E) develop recommendations for the necessary 
                components of such programs, such as--
                          (i) academic, vocational, social, and 
                        independent living skills;
                          (ii) evaluation of student progress;
                          (iii) program administration and 
                        evaluation;
                          (iv) student eligibility; and
                          (v) issues regarding the equivalency 
                        of a student`s participation in such 
                        programs to semester, trimester, 
                        quarter, credit, or clock hours at an 
                        institution of higher education, as the 
                        case may be;
                  (F) analyze possible funding streams for such 
                programs and provide recommendations regarding 
                the funding streams;
                  (G) develop model memoranda of agreement for 
                use between or among institutions of higher 
                education and State and local agencies 
                providing funding for such programs;
                  (H) develop mechanisms for regular 
                communication, outreach and dissemination of 
                information about comprehensive transition and 
                postsecondary programs for students with 
                intellectual disabilities under subpart 2 
                between or among such programs and to families 
                and prospective students;
                  (I) host a meeting of all recipients of 
                grants under subpart 2 not less often than once 
                each year; and
                  (J) convene a workgroup to develop and 
                recommend model criteria, standards, and 
                components of such programs as described in 
                subparagraph (E), that are appropriate for the 
                development of accreditation standards, which 
                workgroup shall include--
                          (i) an expert in higher education;
                          (ii) an expert in special education;
                          (iii) a disability organization that 
                        represents students with intellectual 
                        disabilities;
                          (iv) a representative from the 
                        National Advisory Committee on 
                        Institutional Quality and Integrity; 
                        and
                          (v) a representative of a regional or 
                        national accreditation agency or 
                        association.
          (6) Report.--Not later than five years after the date 
        of the establishment of the coordinating center under 
        this subsection, the coordinating center shall report 
        to the Secretary, the authorizing committees, and the 
        National Advisory Committee on Institutional Quality 
        and Integrity on the recommendations of the workgroup 
        described in paragraph (5)(J).

           *       *       *       *       *       *       *

                              ----------                              


            EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974




           *       *       *       *       *       *       *
TITLE I--PROTECTION OF EMPLOYEE BENEFIT RIGHTS

           *       *       *       *       *       *       *



Subtitle B--Regulatory Provisions

           *       *       *       *       *       *       *



Part 4--Fiduciary Responsibility

           *       *       *       *       *       *       *



                         ESTABLISHMENT OF PLAN

  Sec. 402. (a)(1) Every employee benefit plan shall be 
established and maintained pursuant to a written instrument. 
Such instrument shall provide for one or more named fiduciaries 
who jointly or severally shall have authority to control and 
manage the operation and administration of the plan.
  (2) For purposes of this title, the term ``named fiduciary'' 
means a fiduciary who is named in the plan instrument, or who, 
pursuant to a procedure specified in the plan, is identified as 
a fiduciary (A) by a person who is an employer or employee 
organization with respect to the plan or (B) by such an 
employer and such an employee organization acting jointly.
  (b) Every employee benefit plan shall--
          (1) provide a procedure for establishing and carrying 
        out a funding policy and method consistent with the 
        objectives of the plan and the requirements of this 
        title,
          (2) describe any procedure under the plan for the 
        allocation of responsibilities for the operation and 
        administration of the plan (including any procedure 
        described in section 405(c)(1)),
          (3) provide a procedure for amending such plan, and 
        for identifying the persons who have authority to amend 
        the plan, and
          (4) specify the basis on which payments are made to 
        and from the plan.
  (c) Any employee benefit plan may provide--
          (1) that any person or group of persons may serve in 
        more than one fiduciary capacity with respect to the 
        plan (including service both as trustee and 
        administrator);
          (2) that a named fiduciary, or a fiduciary designated 
        by a named fiduciary pursuant to a plan procedure 
        described in section 405(c)(1), may employ one or more 
        persons to render advice with regard to any 
        responsibility such fiduciary has under the plan; or
          (3) that a person who is a named fiduciary with 
        respect to control or management of the assets of the 
        plan may appoint an investment manager or managers to 
        manage (including the power to acquire and dispose of) 
        any assets of a plan.
  (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).

           *       *       *       *       *       *       *


Part 5--Administration and Enforcement

           *       *       *       *       *       *       *



                           civil enforcement

  Sec. 502. (a) A civil action may be brought--
          (1) by a participant or beneficiary--
                  (A) for the relief provided for in subsection 
                (c) of this section, or
                  (B) to recover benefits due to him under the 
                terms of his plan, to enforce his rights under 
                the terms of the plan, or to clarify his rights 
                to future benefits under the terms of the plan;
          (2) by the Secretary, or by a participant, 
        beneficiary or fiduciary for appropriate relief under 
        section 409;
          (3) by a participant, beneficiary, or fiduciary (A) 
        to enjoin any act or practice which violates any 
        provision of this title or the terms of the plan, [or 
        (B)] (B) to obtain other appropriate equitable relief 
        (i) to redress such violations or (ii) to enforce any 
        provisions of this title or the terms of the plan, 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;
          (4) by the Secretary, or by a participant, or 
        beneficiary for appropriate relief in the case of a 
        violation of 105(c);
          (5) except as otherwise provided in subsection (b), 
        by the Secretary (A) to enjoin any act or practice 
        which violates any provision of this title, [or (B)] 
        (B) to obtain other appropriate equitable relief (i) to 
        redress such violation or (ii) to enforce any provision 
        of this title, 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;
          (6) by the Secretary to collect any civil penalty 
        under paragraph (2), (4), (5), (6), (7), (8), or (9) of 
        subsection (c) or under subsection (i) or (l);
          (7) by a State to enforce compliance with a qualified 
        medical child support order (as defined in section 
        609(a)(2)(A));
          (8) by the Secretary, or by an employer or other 
        person referred to in section 101(f)(1), (A) to enjoin 
        any act or practice which violates subsection (f) of 
        section 101, or (B) to obtain appropriate equitable 
        relief (i) to redress such violation or (ii) to enforce 
        such subsection;
          (9) in the event that the purchase of an insurance 
        contract or insurance annuity in connection with 
        termination of an individual`s status as a participant 
        covered under a pension plan with respect to all or any 
        portion of the participant`s pension benefit under such 
        plan constitutes a violation of part 4 of this title or 
        the terms of the plan, by the Secretary, by any 
        individual who was a participant or beneficiary at the 
        time of the alleged violation, or by a fiduciary, to 
        obtain appropriate relief, including the posting of 
        security if necessary, to assure receipt by the 
        participant or beneficiary of the amounts provided or 
        to be provided by such insurance contract or annuity, 
        plus reasonable prejudgment interest on such amounts;
          (10) in the case of a multiemployer plan that has 
        been certified by the actuary to be in endangered or 
        critical status under section 305, if the plan 
        sponsor--
                  (A) has not adopted a funding improvement or 
                rehabilitation plan under that section by the 
                deadline established in such section, or
                  (B) fails to update or comply with the terms 
                of the funding improvement or rehabilitation 
                plan in accordance with the requirements of 
                such section,
        by an employer that has an obligation to contribute 
        with respect to the multiemployer plan or an employee 
        organization that represents active participants in the 
        multiemployer plan, for an order compelling the plan 
        sponsor to adopt a funding improvement or 
        rehabilitation plan or to update or comply with the 
        terms of the funding improvement or rehabilitation plan 
        in accordance with the requirements of such section and 
        the funding improvement or rehabilitation plan; [or]
          (11) in the case of a multiemployer plan, by an 
        employee representative, or any employer that has an 
        obligation to contribute to the plan, (A) to enjoin any 
        act or practice which violates subsection (k) of 
        section 101 (or, in the case of an employer, subsection 
        (l) of such section), or (B) to obtain appropriate 
        equitable relief (i) to redress such violation or (ii) 
        to enforce such subsection[.]; or
          (12) in any case relating to the provision of mental 
        health benefits and substance use disorder benefits 
        under a group health plan or under group health 
        insurance coverage offered by a health insurance issuer 
        in connection with a group health plan (as such terms 
        are defined in section 733), by the Secretary, or by a 
        participant, beneficiary, or fiduciary, to enforce any 
        provision of this title or the terms of the plan or 
        coverage relating to such benefits against a group 
        health plan, a health insurance issuer, a fiduciary of 
        a plan, or any other person that contracts with a group 
        health plan to provide group health insurance coverage 
        or assistance in the administration of a group health 
        plan (including a third party administrator, managed 
        behavioral health organization, and a pharmacy benefit 
        manager), if such person participates in or conceals a 
        violation of any requirement of part 7 relating to such 
        benefits or a wrongful denial of a claim for mental 
        health benefits or substance use disorder benefits 
        under the terms of the plan or coverage, to obtain 
        appropriate relief, in addition to any other relief 
        otherwise available under this section, including--
                  (A) to recover all losses to participants and 
                beneficiaries;
                  (B) to reform impermissible plan or coverage 
                terms and policies (as written or in operation) 
                in accordance with the requirements of this 
                title and its implementing regulations; or
                  (C) to ensure the readjudication of claims 
                and payment of benefits in accordance with the 
                plan or coverage terms without any 
                impermissible limitation, plan or coverage 
                term, or policy.
  (b)(1) In the case of a plan which is qualified under section 
401(a), 403(a), or 405(a) of the Internal Revenue Code of 1986 
(or with respect to which an application to so qualify has been 
filed and has not been finally determined) the Secretary may 
exercise his authority under subsection (a)(5) with respect to 
a violation of, or the enforcement of, parts 2 and 3 of this 
subtitle (relating to participation, vesting, and funding), 
only if--
          (A) requested by the Secretary of the Treasury, or
          (B) one or more participants, beneficiaries, or 
        fiduciaries, of such plan request in writing (in such 
        manner as the Secretary shall prescribe by regulation) 
        that he exercise such authority on their behalf. In the 
        case of such a request under this paragraph he may 
        exercise such authority only if he determines that such 
        violation affects, or such enforcement is necessary to 
        protect, claims of participants or beneficiaries to 
        benefits under the plan.
  (2) The Secretary shall not initiate an action to enforce 
section 515.
  (3) Except as provided in subsections (c)(9) and (a)(6) (with 
respect to collecting civil penalties under subsection (c)(9)), 
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, the Secretary is not authorized to enforce under this 
part any requirement of part 7 against a health insurance 
issuer offering health insurance coverage in connection with a 
group health plan (as defined in section [706(a)(1)] 
733(a)(1)). Nothing in this paragraph shall affect the 
authority of the Secretary to issue regulations to carry out 
such part.
  (c)(1) Any administrator (A) who fails to meet the 
requirements of paragraph (1) or (4) of section 606, section 
101(e)(1), section 101(f), or section 105(a) with respect to a 
participant or beneficiary, or (B) who fails or refuses to 
comply with a request for any information which such 
administrator is required by this title to furnish to a 
participant or beneficiary (unless such failure or refusal 
results from matters reasonably beyond the control of the 
administrator) by mailing the material requested to the last 
known address of the requesting participant or beneficiary 
within 30 days after such request may in the court`s discretion 
be personally liable to such participant or beneficiary in the 
amount of up to $100 a day from the date of such failure or 
refusal, and the court may in its discretion order such other 
relief as it deems proper. For purposes of this paragraph, each 
violation described in subparagraph (A) with respect to any 
single participant, and each violation described in 
subparagraph (B) with respect to any single participant or 
beneficiary, shall be treated as a separate violation.
  (2) The Secretary may assess a civil penalty against any plan 
administrator of up to $1,000 a day from the date of such plan 
administrator`s failure or refusal to file the annual report 
required to be filed with the Secretary under section 
101(b)(1). For purposes of this paragraph, an annual report 
that has been rejected under section 104(a)(4) for failure to 
provide material information shall not be treated as having 
been filed with the Secretary.
  (3) Any employer maintaining a plan who fails to meet the 
notice requirement of section 101(d) with respect to any 
participant or beneficiary or who fails to meet the 
requirements of section 101(e)(2) with respect to any person or 
who fails to meet the requirements of section 302(d)(12)(E) 
with respect to any person may in the court`s discretion be 
liable to such participant or beneficiary or to such person in 
the amount of up to $100 a day from the date of such failure, 
and the court may in its discretion order such other relief as 
it deems proper.
  (4) The Secretary may assess a civil penalty of not more than 
$1,000 a day for each violation by any person of subsection 
(j), (k), or (l) of section 101 or section 514(e)(3).
  (5) The Secretary may assess a civil penalty against any 
person of up to $1,000 a day from the date of the person`s 
failure or refusal to file the information required to be filed 
by such person with the Secretary under regulations prescribed 
pursuant to section 101(g).
  (6) If, within 30 days of a request by the Secretary to a 
plan administrator for documents under section 104(a)(6), the 
plan administrator fails to furnish the material requested to 
the Secretary, the Secretary may assess a civil penalty against 
the plan administrator of up to $100 a day from the date of 
such failure (but in no event in excess of $1,000 per request). 
No penalty shall be imposed under this paragraph for any 
failure resulting from matters reasonably beyond the control of 
the plan administrator.
  (7) The Secretary may assess a civil penalty against a plan 
administrator of up to $100 a day from the date of the plan 
administrator`s failure or refusal to provide notice to 
participants and beneficiaries in accordance with subsection 
(i) or (m) of section 101. For purposes of this paragraph, each 
violation with respect to any single participant or beneficiary 
shall be treated as a separate violation.
          (8) The Secretary may assess against any plan sponsor 
        of a multiemployer plan a civil penalty of not more 
        than $1,100 per day--
                  (A) for each violation by such sponsor of the 
                requirement under section 305 to adopt by the 
                deadline established in that section a funding 
                improvement plan or rehabilitation plan with 
                respect to a multiemployer plan which is in 
                endangered or critical status, or
                  (B) in the case of a plan in endangered 
                status which is not in seriously endangered 
                status, for failure by the plan to meet the 
                applicable benchmarks under section 305 by the 
                end of the funding improvement period with 
                respect to the plan.
  (9)(A) The Secretary may assess a civil penalty against any 
employer of up to $100 a day from the date of the employer`s 
failure to meet the notice requirement of section 
701(f)(3)(B)(i)(I). For purposes of this subparagraph, each 
violation with respect to any single employee shall be treated 
as a separate violation.
  (B) The Secretary may assess a civil penalty against any plan 
administrator of up to $100 a day from the date of the plan 
administrator`s failure to timely provide to any State the 
information required to be disclosed under section 
701(f)(3)(B)(ii). For purposes of this subparagraph, each 
violation with respect to any single participant or beneficiary 
shall be treated as a separate violation.
          (10) Secretarial enforcement authority relating to 
        use of genetic information.--
                  (A) General rule.--The Secretary may impose a 
                penalty against any plan sponsor of a group 
                health plan, or any health insurance issuer 
                offering health insurance coverage in 
                connection with the plan, for any failure by 
                such sponsor or issuer 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, in connection 
                with the plan.
                  (B) Amount.--
                          (i) In general.--The amount of the 
                        penalty imposed by subparagraph (A) 
                        shall be $100 for each day in the 
                        noncompliance period with respect to 
                        each participant or beneficiary to whom 
                        such failure relates.
                          (ii) Noncompliance period.--For 
                        purposes of this paragraph, the term 
                        ``noncompliance period'' means, with 
                        respect to any failure, the period--
                                  (I) beginning on the date 
                                such failure first occurs; and
                                  (II) ending on the date the 
                                failure is corrected.
                  (C) Minimum penalties where failure 
                discovered.--Notwithstanding clauses (i) and 
                (ii) of subparagraph (D):
                          (i) In general.--In the case of 1 or 
                        more failures with respect to a 
                        participant or beneficiary--
                                  (I) which are not corrected 
                                before the date on which the 
                                plan receives a notice from the 
                                Secretary of such violation; 
                                and
                                  (II) which occurred or 
                                continued during the period 
                                involved;
                        the amount of penalty imposed by 
                        subparagraph (A) by reason of such 
                        failures with respect to such 
                        participant or beneficiary shall not be 
                        less than $2,500.
                          (ii) Higher minimum penalty where 
                        violations are more than de minimis.--
                        To the extent violations for which any 
                        person is liable under this paragraph 
                        for any year are more than de minimis, 
                        clause (i) shall be applied by 
                        substituting ``$15,000'' for ``$2,500'' 
                        with respect to such person.
                  (D) Limitations.--
                          (i) Penalty not to apply where 
                        failure not discovered exercising 
                        reasonable diligence.--No penalty shall 
                        be imposed by subparagraph (A) on any 
                        failure during any period for which it 
                        is established to the satisfaction of 
                        the Secretary that the person otherwise 
                        liable for such penalty did not know, 
                        and exercising reasonable diligence 
                        would not have known, that such failure 
                        existed.
                          (ii) Penalty not to apply to failures 
                        corrected within certain periods.--No 
                        penalty shall be imposed by 
                        subparagraph (A) on any failure if--
                                  (I) such failure was due to 
                                reasonable cause and not to 
                                willful neglect; and
                                  (II) such failure is 
                                corrected during the 30-day 
                                period beginning on the first 
                                date the person otherwise 
                                liable for such penalty knew, 
                                or exercising reasonable 
                                diligence would have known, 
                                that such failure existed.
                          (iii) Overall limitation for 
                        unintentional failures.--In the case of 
                        failures which are due to reasonable 
                        cause and not to willful neglect, the 
                        penalty imposed by subparagraph (A) for 
                        failures shall not exceed the amount 
                        equal to the lesser of--
                                  (I) 10 percent of the 
                                aggregate amount paid or 
                                incurred by the plan sponsor 
                                (or predecessor plan sponsor) 
                                during the preceding taxable 
                                year for group health plans; or
                                  (II) $500,000.
                  (E) Waiver by secretary.--In the case of a 
                failure which is due to reasonable cause and 
                not to willful neglect, the Secretary may waive 
                part or all of the penalty imposed by 
                subparagraph (A) to the extent that the payment 
                of such penalty would be excessive relative to 
                the failure involved.
                  (F) Definitions.--Terms used in this 
                paragraph which are defined in section 733 
                shall have the meanings provided such terms in 
                such section.
  (11) The Secretary and the Secretary of Health and Human 
Services shall maintain such ongoing consultation as may be 
necessary and appropriate to coordinate enforcement under this 
subsection with enforcement under section 1144(c)(8) of the 
Social Security Act.
          (12) The Secretary may assess a civil penalty against 
        any sponsor of a CSEC plan of up to $100 a day from the 
        date of the plan sponsor`s failure to comply with the 
        requirements of section 306(j)(3) to establish or 
        update a funding restoration plan.
  (d)(1) An employee benefit plan may sue or be sued under this 
title as an entity. Service of summons, subpena, or other legal 
process of a court upon a trustee or an administrator of an 
employee benefit plan in his capacity as such shall constitute 
service upon the employee benefit plan. In a case where a plan 
has not designated in the summary plan description of the plan 
an individual as agent for the service of legal process, 
service upon the Secretary shall constitute such service. The 
Secretary, not later than 15 days after receipt of service 
under the preceding sentence, shall notify the administrator or 
any trustee of the plan of receipt of such service.
  (2) Any money judgment under this title against an employee 
benefit plan shall be enforceable only against the plan as an 
entity and shall not be enforceable against any other person 
unless liability against such person is established in his 
individual capacity under this title.
  (e)(1) Except for actions under subsection (a)(1)(B) of this 
section, the district courts of the United States shall have 
exclusive jurisdiction of civil actions under this title 
brought by the Secretary or by a participant, beneficiary, 
fiduciary, or any person referred to in section 101(f)(1). 
State courts of competent jurisdiction and district courts of 
the United States shall have concurrent jurisdiction of actions 
under paragraphs (1)(B) and (7) of subsection (a) of this 
section.
  (2) Where an action under this title is brought in a district 
court of the United States, it may be brought in the district 
where the plan is administered, where the breach took place, or 
where a defendant resides or may be found, and process may be 
served in any other district where a defendant resides or may 
be found.
  (f) The district courts of the United States shall have 
jurisdiction, without respect to the amount in controversy or 
the citizenship of the parties, to grant the relief provided 
for in subsection (a) of this section in any action.
  (g)(1) In any action under this title (other than an action 
described in paragraph (2)) by a participant, beneficiary, or 
fiduciary, the court in its discretion may allow a reasonable 
attorney`s fee and costs of action to either party.
  (2) In any action under this title by a fiduciary for or on 
behalf of a plan to enforce section 515 in which a judgment in 
favor of the plan is awarded, the court shall award the plan--
          (A) the unpaid contributions,
          (B) interest on the unpaid contributions,
          (C) an amount equal to the greater of--
                  (i) interest on the unpaid contributions, or
                  (ii) liquidated damages provided for under 
                the plan in an amount not in excess of 20 
                percent (or such higher percentage as may be 
                permitted under Federal or State law) of the 
                amount determined by the court under 
                subparagraph (A),
          (D) reasonable attorney`s fees and costs of the 
        action, to be paid by the defendant, and
          (E) such other legal or equitable relief as the court 
        deems appropriate.
For purposes of this paragraph, interest on unpaid 
contributions shall be determined by using the rate provided 
under the plan, or, if none, the rate prescribed under section 
6621 of the Internal Revenue Code of 1986.
  (h) A copy of the complaint in any action under this title by 
a participant, beneficiary, or fiduciary (other than an action 
brought by one or more participants or beneficiaries under 
subsection (a)(1)(B) which is solely for the purpose of 
recovering benefits due such participants under the terms of 
the plan) shall be served upon the Secretary and the Secretary 
of the Treasury by certified mail. Either Secretary shall have 
the right in his discretion to intervene in any action, except 
that the Secretary of the Treasury may not intervene in any 
action under part 4 of this subtitle. If the Secretary brings 
an action under subsection (a) on behalf of a participant or 
beneficiary, he shall notify the Secretary of the Treasury.
  (i) In the case of a transaction prohibited by section 406 by 
a party in interest with respect to a plan to which this part 
applies, the Secretary may assess a civil penalty against such 
party in interest. The amount of such penalty may not exceed 5 
percent of the amount involved in each such transaction (as 
defined in section 4975(f)(4) of the Internal Revenue Code of 
1986) for each year or part thereof during which the prohibited 
transaction continues, except that, if the transaction is not 
corrected (in such manner as the Secretary shall prescribe in 
regulations which shall be consistent with section 4975(f)(5) 
of such Code) within 90 days after notice from the Secretary 
(or such longer period as the Secretary may permit), such 
penalty may be in an amount not more than 100 percent of the 
amount involved. This subsection shall not apply to a 
transaction with respect to a plan described in section 
4975(e)(1) of such Code.
  (j) In all civil actions under this title, attorneys 
appointed by the Secretary may represent the Secretary (except 
as provided in section 518(a) of title 28, United States Code), 
but all such litigation shall be subject to the direction and 
control of the Attorney General.
  (k) Suits by an administrator, fiduciary, participant, or 
beneficiary of an employee benefit plan to review a final order 
of the Secretary, to restrain the Secretary from taking any 
action contrary to the provisions of this Act, or to compel him 
to take action required under this title, may be brought in the 
district court of the United States for the district where the 
plan has its principal office, or in the United States District 
Court for the District of Columbia.
  (l)(1) In the case of--
          (A) any breach of fiduciary responsibility under (or 
        other violation of) part 4 by a fiduciary, or
          (B) any knowing participation in such a breach or 
        violation by any other person,
the Secretary shall assess a civil penalty against such 
fiduciary or other person in an amount equal to 20 percent of 
the applicable recovery amount.
  (2) For purposes of paragraph (1), the term ``applicable 
recovery amount'' means any amount which is recovered from a 
fiduciary or other person with respect to a breach or violation 
described in paragraph (1)--
          (A) pursuant to any settlement agreement with the 
        Secretary, or
          (B) ordered by a court to be paid by such fiduciary 
        or other person to a plan or its participants and 
        beneficiaries in a judicial proceeding instituted by 
        the Secretary under subsection (a)(2) or (a)(5).
  (3) The Secretary may, in the Secretary`s sole discretion, 
waive or reduce the penalty under paragraph (1) if the 
Secretary determines in writing that--
          (A) the fiduciary or other person acted reasonably 
        and in good faith, or
          (B) it is reasonable to expect that the fiduciary or 
        other person will not be able to restore all losses to 
        the plan (or to provide the relief ordered pursuant to 
        subsection (a)(9)) without severe financial hardship 
        unless such waiver or reduction is granted.
  (4) The penalty imposed on a fiduciary or other person under 
this subsection with respect to any transaction shall be 
reduced by the amount of any penalty or tax imposed on such 
fiduciary or other person with respect to such transaction 
under subsection (i) of this section and section 4975 of the 
Internal Revenue Code of 1986.
  (m) In the case of a distribution to a pension plan 
participant or beneficiary in violation of section 206(e) by a 
plan fiduciary, the Secretary shall assess a penalty against 
such fiduciary in an amount equal to the value of the 
distribution. Such penalty shall not exceed $10,000 for each 
such distribution.
  (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--
          (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 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 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.

           *       *       *       *       *       *       *


Part 7--Group Health Plan Requirements

           *       *       *       *       *       *       *



Subpart B--Other Requirements

           *       *       *       *       *       *       *



SEC. 712. PARITY IN MENTAL HEALTH AND SUBSTANCE USE DISORDER BENEFITS.

  (a) In General.--
          (1) Aggregate lifetime limits.--In the case of a 
        group health plan (or health insurance coverage offered 
        in connection with such a plan) that provides both 
        medical and surgical benefits and mental health or 
        substance use disorder benefits--
                  (A) No lifetime limit.--If the plan or 
                coverage does not include an aggregate lifetime 
                limit on substantially all medical and surgical 
                benefits, the plan or coverage may not impose 
                any aggregate lifetime limit on mental health 
                or substance use disorder benefits.
                  (B) Lifetime limit.--If the plan or coverage 
                includes an aggregate lifetime limit on 
                substantially all medical and surgical benefits 
                (in this paragraph referred to as the 
                ``applicable lifetime limit''), the plan or 
                coverage shall either--
                          (i) apply the applicable lifetime 
                        limit both to the medical and surgical 
                        benefits to which it otherwise would 
                        apply and to mental health and 
                        substance use disorder benefits and not 
                        distinguish in the application of such 
                        limit between such medical and surgical 
                        benefits and mental health and 
                        substance use disorder benefits; or
                          (ii) not include any aggregate 
                        lifetime limit on mental health or 
                        substance use disorder benefits that is 
                        less than the applicable lifetime 
                        limit.
                  (C) Rule in case of different limits.--In the 
                case of a plan or coverage that is not 
                described in subparagraph (A) or (B) and that 
                includes no or different aggregate lifetime 
                limits on different categories of medical and 
                surgical benefits, the Secretary shall 
                establish rules under which subparagraph (B) is 
                applied to such plan or coverage with respect 
                to mental health and substance use disorder 
                benefits by substituting for the applicable 
                lifetime limit an average aggregate lifetime 
                limit that is computed taking into account the 
                weighted average of the aggregate lifetime 
                limits applicable to such categories.
          (2) Annual limits.--In the case of a group health 
        plan (or health insurance coverage offered in 
        connection with such a plan) that provides both medical 
        and surgical benefits and mental health or substance 
        use disorder benefits--
                  (A) No annual limit.--If the plan or coverage 
                does not include an annual limit on 
                substantially all medical and surgical 
                benefits, the plan or coverage may not impose 
                any annual limit on mental health or substance 
                use disorder benefits.
                  (B) Annual limit.--If the plan or coverage 
                includes an annual limit on substantially all 
                medical and surgical benefits (in this 
                paragraph referred to as the ``applicable 
                annual limit''), the plan or coverage shall 
                either--
                          (i) apply the applicable annual limit 
                        both to medical and surgical benefits 
                        to which it otherwise would apply and 
                        to mental health and substance use 
                        disorder benefits and not distinguish 
                        in the application of such limit 
                        between such medical and surgical 
                        benefits and mental health and 
                        substance use disorder benefits; or
                          (ii) not include any annual limit on 
                        mental health or substance use disorder 
                        benefits that is less than the 
                        applicable annual limit.
                  (C) Rule in case of different limits.--In the 
                case of a plan or coverage that is not 
                described in subparagraph (A) or (B) and that 
                includes no or different annual limits on 
                different categories of medical and surgical 
                benefits, the Secretary shall establish rules 
                under which subparagraph (B) is applied to such 
                plan or coverage with respect to mental health 
                and substance use disorder benefits by 
                substituting for the applicable annual limit an 
                average annual limit that is computed taking 
                into account the weighted average of the annual 
                limits applicable to such categories.
          (3) Financial requirements and treatment 
        limitations.--
                  (A) In general.--In the case of a group 
                health plan (or health insurance coverage 
                offered in connection with such a plan) that 
                provides both medical and surgical benefits and 
                mental health or substance use disorder 
                benefits, such plan or coverage shall ensure 
                that--
                          (i) the financial requirements 
                        applicable to such mental health or 
                        substance use disorder benefits are no 
                        more restrictive than the predominant 
                        financial requirements applied to 
                        substantially all medical and surgical 
                        benefits covered by the plan (or 
                        coverage), and there are no separate 
                        cost sharing requirements that are 
                        applicable only with respect to mental 
                        health or substance use disorder 
                        benefits; and
                          (ii) the treatment limitations 
                        applicable to such mental health or 
                        substance use disorder benefits are no 
                        more restrictive than the predominant 
                        treatment limitations applied to 
                        substantially all medical and surgical 
                        benefits covered by the plan (or 
                        coverage) and there are no separate 
                        treatment limitations that are 
                        applicable only with respect to mental 
                        health or substance use disorder 
                        benefits.
                  (B) Definitions.--In this paragraph:
                          (i) Financial requirement.--The term 
                        ``financial requirement'' includes 
                        deductibles, copayments, coinsurance, 
                        and out-of-pocket expenses, but 
                        excludes an aggregate lifetime limit 
                        and an annual limit subject to 
                        paragraphs (1) and (2),
                          (ii) Predominant.--A financial 
                        requirement or treatment limit is 
                        considered to be predominant if it is 
                        the most common or frequent of such 
                        type of limit or requirement.
                          (iii) Treatment limitation.--The term 
                        ``treatment limitation'' includes 
                        limits on the frequency of treatment, 
                        number of visits, days of coverage, or 
                        other similar limits on the scope or 
                        duration of treatment.
          (4) Availability of plan information.--The criteria 
        for medical necessity determinations made under the 
        plan with respect to mental health or substance use 
        disorder benefits (or the health insurance coverage 
        offered in connection with the plan with respect to 
        such benefits) shall be made available by the plan 
        administrator (or the health insurance issuer offering 
        such coverage) in accordance with regulations to any 
        current or potential participant, beneficiary, or 
        contracting provider upon request. The reason for any 
        denial under the plan (or coverage) of reimbursement or 
        payment for services with respect to mental health or 
        substance use disorder benefits in the case of any 
        participant or beneficiary shall, on request or as 
        otherwise required, be made available by the plan 
        administrator (or the health insurance issuer offering 
        such coverage) to the participant or beneficiary in 
        accordance with regulations.
          (5) Out-of-network providers.--In the case of a plan 
        or coverage that provides both medical and surgical 
        benefits and mental health or substance use disorder 
        benefits, if the plan or coverage provides coverage for 
        medical or surgical benefits provided by out-of-network 
        providers, the plan or coverage shall provide coverage 
        for mental health or substance use disorder benefits 
        provided by out-of-network providers in a manner that 
        is consistent with the requirements of this section.
          (6) Compliance program guidance document.--
                  (A) In general.--The Secretary, the Secretary 
                of Health and Human Services, and the Secretary 
                of the Treasury, in consultation with the 
                Inspector General of the Department of Health 
                and Human Services, the Inspector General of 
                the Department of Labor, and the Inspector 
                General of the Department of the Treasury, 
                shall issue a compliance program guidance 
                document to help improve compliance with this 
                section, section 2726 of the Public Health 
                Service Act, and section 9812 of the Internal 
                Revenue Code of 1986, as applicable. In 
                carrying out this paragraph, the Secretaries 
                may take into consideration the 2016 
                publication of the Department of Health and 
                Human Services and the Department of Labor, 
                entitled ``Warning Signs - Plan or Policy Non-
                Quantitative Treatment Limitations (NQTLs) that 
                Require Additional Analysis to Determine Mental 
                Health Parity Compliance''.
                  (B) Examples illustrating compliance and 
                noncompliance.--
                          (i) In general.--The compliance 
                        program guidance document required 
                        under this paragraph shall provide 
                        illustrative, de-identified examples 
                        (that do not disclose any protected 
                        health information or individually 
                        identifiable information) of previous 
                        findings of compliance and 
                        noncompliance with this section, 
                        section 2726 of the Public Health 
                        Service Act, or section 9812 of the 
                        Internal Revenue Code of 1986, as 
                        applicable, based on investigations of 
                        violations of such sections, 
                        including--
                                  (I) examples illustrating 
                                requirements for information 
                                disclosures and nonquantitative 
                                treatment limitations; and
                                  (II) descriptions of the 
                                violations uncovered during the 
                                course of such investigations.
                          (ii) Nonquantitative treatment 
                        limitations.--To the extent that any 
                        example described in clause (i) 
                        involves a finding of compliance or 
                        noncompliance with regard to any 
                        requirement for nonquantitative 
                        treatment limitations, the example 
                        shall provide sufficient detail to 
                        fully explain such finding, including a 
                        full description of the criteria 
                        involved for approving medical and 
                        surgical benefits and the criteria 
                        involved for approving mental health 
                        and substance use disorder benefits.
                          (iii) Access to additional 
                        information regarding compliance.--In 
                        developing and issuing the compliance 
                        program guidance document required 
                        under this paragraph, the Secretaries 
                        specified in subparagraph (A)--
                                  (I) shall enter into 
                                interagency agreements with the 
                                Inspector General of the 
                                Department of Health and Human 
                                Services, the Inspector General 
                                of the Department of Labor, and 
                                the Inspector General of the 
                                Department of the Treasury to 
                                share findings of compliance 
                                and noncompliance with this 
                                section, section 2726 of the 
                                Public Health Service Act, or 
                                section 9812 of the Internal 
                                Revenue Code of 1986, as 
                                applicable; and
                                  (II) shall seek to enter into 
                                an agreement with a State to 
                                share information on findings 
                                of compliance and noncompliance 
                                with this section, section 2726 
                                of the Public Health Service 
                                Act, or section 9812 of the 
                                Internal Revenue Code of 1986, 
                                as applicable.
                  (C) Recommendations.--The compliance program 
                guidance document shall include recommendations 
                to advance compliance with this section, 
                section 2726 of the Public Health Service Act, 
                or section 9812 of the Internal Revenue Code of 
                1986, as applicable, and encourage the 
                development and use of internal controls to 
                monitor adherence to applicable statutes, 
                regulations, and program requirements. Such 
                internal controls may include illustrative 
                examples of nonquantitative treatment 
                limitations on mental health and substance use 
                disorder benefits, which may fail to comply 
                with this section, section 2726 of the Public 
                Health Service Act, or section 9812 of the 
                Internal Revenue Code of 1986, as applicable, 
                in relation to nonquantitative treatment 
                limitations on medical and surgical benefits.
                  (D) Updating the compliance program guidance 
                document.--The Secretary, the Secretary of 
                Health and Human Services, and the Secretary of 
                the Treasury, in consultation with the 
                Inspector General of the Department of Health 
                and Human Services, the Inspector General of 
                the Department of Labor, and the Inspector 
                General of the Department of the Treasury, 
                shall update the compliance program guidance 
                document every 2 years to include illustrative, 
                de-identified examples (that do not disclose 
                any protected health information or 
                individually identifiable information) of 
                previous findings of compliance and 
                noncompliance with this section, section 2726 
                of the Public Health Service Act, or section 
                9812 of the Internal Revenue Code of 1986, as 
                applicable.
          (7) Additional guidance.--
                  (A) In general.--The Secretary, the Secretary 
                of Health and Human Services, and the Secretary 
                of the Treasury shall issue guidance to group 
                health plans and health insurance issuers 
                offering group health insurance coverage to 
                assist such plans and issuers in satisfying the 
                requirements of this section, section 2726 of 
                the Public Health Service Act, or section 9812 
                of the Internal Revenue Code of 1986, as 
                applicable.
                  (B) Disclosure.--
                          (i) Guidance for plans and issuers.--
                        The guidance issued under this 
                        paragraph shall include clarifying 
                        information and illustrative examples 
                        of methods that group health plans and 
                        health insurance issuers offering group 
                        or individual health insurance coverage 
                        may use for disclosing information to 
                        ensure compliance with the requirements 
                        under this section, section 2726 of the 
                        Public Health Service Act, or section 
                        9812 of the Internal Revenue Code of 
                        1986, as applicable, (and any 
                        regulations promulgated pursuant to 
                        such sections, as applicable).
                          (ii) Documents for participants, 
                        beneficiaries, contracting providers, 
                        or authorized representatives.--The 
                        guidance issued under this paragraph 
                        shall include clarifying information 
                        and illustrative examples of methods 
                        that group health plans and health 
                        insurance issuers offering group health 
                        insurance coverage may use to provide 
                        any participant, beneficiary, 
                        contracting provider, or authorized 
                        representative, as applicable, with 
                        documents containing information that 
                        the health plans or issuers are 
                        required to disclose to participants, 
                        beneficiaries, contracting providers, 
                        or authorized representatives to ensure 
                        compliance with this section, section 
                        2726 of the Public Health Service Act, 
                        or section 9812 of the Internal Revenue 
                        Code of 1986, as applicable, compliance 
                        with any regulation issued pursuant to 
                        such respective section, or compliance 
                        with any other applicable law or 
                        regulation. Such guidance shall include 
                        information that is comparative in 
                        nature with respect to--
                                  (I) nonquantitative treatment 
                                limitations for both medical 
                                and surgical benefits and 
                                mental health and substance use 
                                disorder benefits;
                                  (II) the processes, 
                                strategies, evidentiary 
                                standards, and other factors 
                                used to apply the limitations 
                                described in subclause (I); and
                                  (III) the application of the 
                                limitations described in 
                                subclause (I) to ensure that 
                                such limitations are applied in 
                                parity with respect to both 
                                medical and surgical benefits 
                                and mental health and substance 
                                use disorder benefits.
                  (C) Nonquantitative treatment limitations.--
                The guidance issued under this paragraph shall 
                include clarifying information and illustrative 
                examples of methods, processes, strategies, 
                evidentiary standards, and other factors that 
                group health plans and health insurance issuers 
                offering group health insurance coverage may 
                use regarding the development and application 
                of nonquantitative treatment limitations to 
                ensure compliance with this section, section 
                2726 of the Public Health Service Act, or 
                section 9812 of the Internal Revenue Code of 
                1986, as applicable, (and any regulations 
                promulgated pursuant to such respective 
                section), including--
                          (i) examples of methods of 
                        determining appropriate types of 
                        nonquantitative treatment limitations 
                        with respect to both medical and 
                        surgical benefits and mental health and 
                        substance use disorder benefits, 
                        including nonquantitative treatment 
                        limitations pertaining to--
                                  (I) medical management 
                                standards based on medical 
                                necessity or appropriateness, 
                                or whether a treatment is 
                                experimental or investigative;
                                  (II) limitations with respect 
                                to prescription drug formulary 
                                design; and
                                  (III) use of fail-first or 
                                step therapy protocols;
                          (ii) examples of methods of 
                        determining--
                                  (I) network admission 
                                standards (such as 
                                credentialing); and
                                  (II) factors used in provider 
                                reimbursement methodologies 
                                (such as service type, 
                                geographic market, demand for 
                                services, and provider supply, 
                                practice size, training, 
                                experience, and licensure) as 
                                such factors apply to network 
                                adequacy;
                          (iii) examples of sources of 
                        information that may serve as 
                        evidentiary standards for the purposes 
                        of making determinations regarding the 
                        development and application of 
                        nonquantitative treatment limitations;
                          (iv) examples of specific factors, 
                        and the evidentiary standards used to 
                        evaluate such factors, used by such 
                        plans or issuers in performing a 
                        nonquantitative treatment limitation 
                        analysis;
                          (v) examples of how specific 
                        evidentiary standards may be used to 
                        determine whether treatments are 
                        considered experimental or 
                        investigative;
                          (vi) examples of how specific 
                        evidentiary standards may be applied to 
                        each service category or classification 
                        of benefits;
                          (vii) examples of methods of reaching 
                        appropriate coverage determinations for 
                        new mental health or substance use 
                        disorder treatments, such as evidence-
                        based early intervention programs for 
                        individuals with a serious mental 
                        illness and types of medical management 
                        techniques;
                          (viii) examples of methods of 
                        reaching appropriate coverage 
                        determinations for which there is an 
                        indirect relationship between the 
                        covered mental health or substance use 
                        disorder benefit and a traditional 
                        covered medical and surgical benefit, 
                        such as residential treatment or 
                        hospitalizations involving voluntary or 
                        involuntary commitment; and
                          (ix) additional illustrative examples 
                        of methods, processes, strategies, 
                        evidentiary standards, and other 
                        factors for which the Secretary 
                        determines that additional guidance is 
                        necessary to improve compliance with 
                        this section, section 2726 of the 
                        Public Health Service Act, or section 
                        9812 of the Internal Revenue Code of 
                        1986, as applicable.
                  (D) Public comment.--Prior to issuing any 
                final guidance under this paragraph, the 
                Secretary shall provide a public comment period 
                of not less than 60 days during which any 
                member of the public may provide comments on a 
                draft of the guidance.
          (8) Compliance requirements.--
                  (A) Nonquantitative treatment limitation 
                (nqtl) requirements.--In the case of a group 
                health plan or a health insurance issuer 
                offering group health insurance coverage that 
                provides both medical and surgical benefits and 
                mental health or substance use disorder 
                benefits and that imposes nonquantitative 
                treatment limitations (referred to in this 
                section as ``NQTLs'') on mental health or 
                substance use disorder benefits, such plan or 
                issuer shall perform and document comparative 
                analyses of the design and application of NQTLs 
                and, beginning 45 days after the date of 
                enactment of the Consolidated Appropriations 
                Act, 2021, make available to the Secretary, 
                upon request, the comparative analyses and the 
                following information:
                          (i) The specific plan or coverage 
                        terms or other relevant terms regarding 
                        the NQTLs, that applies to such plan or 
                        coverage, and a description of all 
                        mental health or substance use disorder 
                        and medical or surgical benefits to 
                        which each such term applies in each 
                        respective benefits classification.
                          (ii) The factors used to determine 
                        that the NQTLs will apply to mental 
                        health or substance use disorder 
                        benefits and medical or surgical 
                        benefits.
                          (iii) The evidentiary standards used 
                        for the factors identified in clause 
                        (ii), when applicable, provided that 
                        every factor shall be defined, and any 
                        other source or evidence relied upon to 
                        design and apply the NQTLs to mental 
                        health or substance use disorder 
                        benefits and medical or surgical 
                        benefits.
                          (iv) The comparative analyses 
                        demonstrating that the processes, 
                        strategies, evidentiary standards, and 
                        other factors used to apply the NQTLs 
                        to mental health or substance use 
                        disorder benefits, as written and in 
                        operation, are comparable to, and are 
                        applied no more stringently than, the 
                        processes, strategies, evidentiary 
                        standards, and other factors used to 
                        apply the NQTLs to medical or surgical 
                        benefits in the benefits 
                        classification.
                          (v) The specific findings and 
                        conclusions reached by the group health 
                        plan or health insurance issuer with 
                        respect to the health insurance 
                        coverage, including any results of the 
                        analyses described in this subparagraph 
                        that indicate that the plan or coverage 
                        is or is not in compliance with this 
                        section.
                  (B) Secretary request process.--
                          (i) Submission upon request.--The 
                        Secretary shall request that a group 
                        health plan or a health insurance 
                        issuer offering group health insurance 
                        coverage submit the comparative 
                        analyses described in subparagraph (A) 
                        for plans that involve potential 
                        violations of this section or 
                        complaints regarding noncompliance with 
                        this section that concern NQTLs and any 
                        other instances in which the Secretary 
                        determines appropriate. The Secretary 
                        shall request not fewer than 20 such 
                        analyses per year.
                          (ii) Additional information.--In 
                        instances in which the Secretary has 
                        concluded that the group health plan or 
                        health insurance issuer with respect to 
                        group health insurance coverage has not 
                        submitted sufficient information for 
                        the Secretary to review the comparative 
                        analyses described in subparagraph (A), 
                        as requested under clause (i), the 
                        Secretary shall specify to the plan or 
                        issuer the information the plan or 
                        issuer must submit to be responsive to 
                        the request under clause (i) for the 
                        Secretary to review the comparative 
                        analyses described in subparagraph (A) 
                        for compliance with this section. 
                        Nothing in this paragraph shall require 
                        the Secretary to conclude that a group 
                        health plan or health insurance issuer 
                        is in compliance with this section 
                        solely based upon the inspection of the 
                        comparative analyses described in 
                        subparagraph (A), as requested under 
                        clause (i).
                          (iii) Required action.--
                                  (I) In general.--In instances 
                                in which the Secretary has 
                                reviewed the comparative 
                                analyses described in 
                                subparagraph (A), as requested 
                                under clause (i), and 
                                determined that the group 
                                health plan or health insurance 
                                issuer is not in compliance 
                                with this section, the plan or 
                                issuer--
                                          (aa) shall specify to 
                                        the Secretary the 
                                        actions the plan or 
                                        issuer will take to be 
                                        in compliance with this 
                                        section and provide to 
                                        the Secretary 
                                        additional comparative 
                                        analyses described in 
                                        subparagraph (A) that 
                                        demonstrate compliance 
                                        with this section not 
                                        later than 45 days 
                                        after the initial 
                                        determination by the 
                                        Secretary that the plan 
                                        or issuer is not in 
                                        compliance; and
                                          (bb) following the 
                                        45-day corrective 
                                        action period under 
                                        item (aa), if the 
                                        Secretary makes a final 
                                        determination that the 
                                        plan or issuer still is 
                                        not in compliance with 
                                        this section, not later 
                                        than 7 days after such 
                                        determination, shall 
                                        notify all individuals 
                                        enrolled in the plan or 
                                        applicable health 
                                        insurance coverage 
                                        offered by the issuer 
                                        that the plan or 
                                        issuer, with respect to 
                                        such coverage, has been 
                                        determined to be not in 
                                        compliance with this 
                                        section.
                                  (II) Exemption from 
                                disclosure.--Documents or 
                                communications produced in 
                                connection with the Secretary`s 
                                recommendations to a group 
                                health plan or health insurance 
                                issuer shall not be subject to 
                                disclosure pursuant to section 
                                552 of title 5, United States 
                                Code.
                          (iv) Report.--Not later than 1 year 
                        after the date of enactment of this 
                        paragraph, and not later than October 1 
                        of each year thereafter, the Secretary 
                        shall submit to Congress, and make 
                        publicly available, a report that 
                        contains--
                                  (I) a summary of the 
                                comparative analyses requested 
                                under clause (i), including the 
                                identity of each group health 
                                plan or health insurance 
                                issuer, with respect to certain 
                                health insurance coverage that 
                                is determined to be not in 
                                compliance after the final 
                                determination by the Secretary 
                                described in clause 
                                (iii)(I)(bb);
                                  (II) the Secretary`s 
                                conclusions as to whether each 
                                group health plan or health 
                                insurance issuer submitted 
                                sufficient information for the 
                                Secretary to review the 
                                comparative analyses requested 
                                under clause (i) for compliance 
                                with this section;
                                  (III) for each group health 
                                plan or health insurance issuer 
                                that did submit sufficient 
                                information for the Secretary 
                                to review the comparative 
                                analyses requested under clause 
                                (i), the Secretary`s 
                                conclusions as to whether and 
                                why the plan or issuer is in 
                                compliance with the disclosure 
                                requirements under this 
                                section;
                                  (IV) the Secretary`s 
                                specifications described in 
                                clause (ii) for each group 
                                health plan or health insurance 
                                issuer that the Secretary 
                                determined did not submit 
                                sufficient information for the 
                                Secretary to review the 
                                comparative analyses requested 
                                under clause (i) for compliance 
                                with this section; and
                                  (V) the Secretary`s 
                                specifications described in 
                                clause (iii) of the actions 
                                each group health plan or 
                                health insurance issuer that 
                                the Secretary determined is not 
                                in compliance with this section 
                                must take to be in compliance 
                                with this section, including 
                                the reason why the Secretary 
                                determined the plan or issuer 
                                is not in compliance.
                  (C) Compliance program guidance document 
                update process.--
                          (i) In general.--The Secretary shall 
                        include instances of noncompliance that 
                        the Secretary discovers upon reviewing 
                        the comparative analyses requested 
                        under subparagraph (B)(i) in the 
                        compliance program guidance document 
                        described in paragraph (6), as it is 
                        updated every 2 years, except that such 
                        instances shall not disclose any 
                        protected health information or 
                        individually identifiable information.
                          (ii) Guidance and regulations.--Not 
                        later than 18 months after the date of 
                        enactment of this paragraph, the 
                        Secretary shall finalize any draft or 
                        interim guidance and regulations 
                        relating to mental health parity under 
                        this section. Such draft guidance shall 
                        include guidance to clarify the process 
                        and timeline for current and potential 
                        participants and beneficiaries (and 
                        authorized representatives and health 
                        care providers of such participants and 
                        beneficiaries) with respect to plans to 
                        file complaints of such plans or 
                        issuers being in violation of this 
                        section, including guidance, by plan 
                        type, on the relevant State, regional, 
                        or national office with which such 
                        complaints should be filed.
                          (iii) State.--The Secretary shall 
                        share information on findings of 
                        compliance and noncompliance discovered 
                        upon reviewing the comparative analyses 
                        requested under subparagraph (B)(i) 
                        shall be shared with the State where 
                        the group health plan is located or the 
                        State where the health insurance issuer 
                        is licensed to do business for coverage 
                        offered by a health insurance issuer in 
                        the group market, in accordance with 
                        paragraph (6)(B)(iii)(II).
  (b) Construction.--Nothing in this section shall be 
construed--
          (1) as requiring a group health plan (or health 
        insurance coverage offered in connection with such a 
        plan) to provide any mental health or substance use 
        disorder benefits; or
          (2) in the case of a group health plan (or health 
        insurance coverage offered in connection with such a 
        plan) that provides mental health or substance use 
        disorder benefits, as affecting the terms and 
        conditions of the plan or coverage relating to such 
        benefits under the plan or coverage, except as provided 
        in subsection (a).
  (c) Exemptions.--
          (1) Small employer exemption.--
                  (A) In general.--This section shall not apply 
                to any group health plan (and group health 
                insurance coverage offered in connection with a 
                group health plan) for any plan year of a small 
                employer.
                  (B) Small employer.--For purposes of 
                subparagraph (A), the term ``small employer'' 
                means, in connection with a group health plan 
                with respect to a calendar year and a plan 
                year, an employer who employed an average of at 
                least 2 (or 1 in the case of an employer 
                residing in a State that permits small groups 
                to include a single individual) but not more 
                than 50 employees on business days during the 
                preceding calendar year.
                  (C) Application of certain rules in 
                determination of employer size.--For purposes 
                of this paragraph--
                          (i) Application of aggregation rule 
                        for employers.--Rules similar to the 
                        rules under subsections (b), (c), (m), 
                        and (o) of section 414 of the Internal 
                        Revenue Code of 1986 shall apply for 
                        purposes of treating persons as a 
                        single employer.
                          (ii) Employers not in existence in 
                        preceding year.--In the case of an 
                        employer which was not in existence 
                        throughout the preceding calendar year, 
                        the determination of whether such 
                        employer is a small employer shall be 
                        based on the average number of 
                        employees that it is reasonably 
                        expected such employer will employ on 
                        business days in the current calendar 
                        year.
                          (iii) Predecessors.--Any reference in 
                        this paragraph to an employer shall 
                        include a reference to any predecessor 
                        of such employer.
          (2) Cost exemption.--
                  (A) In general.--With respect to a group 
                health plan (or health insurance coverage 
                offered in connection with such a plan), if the 
                application of this section to such plan (or 
                coverage) results in an increase for the plan 
                year involved of the actual total costs of 
                coverage with respect to medical and surgical 
                benefits and mental health and substance use 
                disorder benefits under the plan (as determined 
                and certified under subparagraph (C)) by an 
                amount that exceeds the applicable percentage 
                described in subparagraph (B) of the actual 
                total plan costs, the provisions of this 
                section shall not apply to such plan (or 
                coverage) during the following plan year, and 
                such exemption shall apply to the plan (or 
                coverage) for 1 plan year. An employer may 
                elect to continue to apply mental health and 
                substance use disorder parity pursuant to this 
                section with respect to the group health plan 
                (or coverage) involved regardless of any 
                increase in total costs.
                  (B) Applicable percentage.--With respect to a 
                plan (or coverage), the applicable percentage 
                described in this subparagraph shall be--
                          (i) 2 percent in the case of the 
                        first plan year in which this section 
                        is applied; and
                          (ii) 1 percent in the case of each 
                        subsequent plan year.
                  (C) Determinations by actuaries.--
                Determinations as to increases in actual costs 
                under a plan (or coverage) for purposes of this 
                section shall be made and certified by a 
                qualified and licensed actuary who is a member 
                in good standing of the American Academy of 
                Actuaries. All such determinations shall be in 
                a written report prepared by the actuary. The 
                report, and all underlying documentation relied 
                upon by the actuary, shall be maintained by the 
                group health plan or health insurance issuer 
                for a period of 6 years following the 
                notification made under subparagraph (E).
                  (D) 6-month determinations.--If a group 
                health plan (or a health insurance issuer 
                offering coverage in connection with a group 
                health plan) seeks an exemption under this 
                paragraph, determinations under subparagraph 
                (A) shall be made after such plan (or coverage) 
                has complied with this section for the first 6 
                months of the plan year involved.
                  (E) Notification.--
                          (i) In general.--A group health plan 
                        (or a health insurance issuer offering 
                        coverage in connection with a group 
                        health plan) that, based upon a 
                        certification described under 
                        subparagraph (C), qualifies for an 
                        exemption under this paragraph, and 
                        elects to implement the exemption, 
                        shall promptly notify the Secretary, 
                        the appropriate State agencies, and 
                        participants and beneficiaries in the 
                        plan of such election.
                          (ii) Requirement.--A notification to 
                        the Secretary under clause (i) shall 
                        include--
                                  (I) a description of the 
                                number of covered lives under 
                                the plan (or coverage) involved 
                                at the time of the 
                                notification, and as 
                                applicable, at the time of any 
                                prior election of the cost-
                                exemption under this paragraph 
                                by such plan (or coverage);
                                  (II) for both the plan year 
                                upon which a cost exemption is 
                                sought and the year prior, a 
                                description of the actual total 
                                costs of coverage with respect 
                                to medical and surgical 
                                benefits and mental health and 
                                substance use disorder benefits 
                                under the plan; and
                                  (III) for both the plan year 
                                upon which a cost exemption is 
                                sought and the year prior, the 
                                actual total costs of coverage 
                                with respect to mental health 
                                and substance use disorder 
                                benefits under the plan.
                          (iii) Confidentiality.--A 
                        notification to the Secretary under 
                        clause (i) shall be confidential. The 
                        Secretary shall make available, upon 
                        request and on not more than an annual 
                        basis, an anonymous itemization of such 
                        notifications, that includes--
                                  (I) a breakdown of States by 
                                the size and type of employers 
                                submitting such notification; 
                                and
                                  (II) a summary of the data 
                                received under clause (ii).
                  (F) Audits by appropriate agencies.--To 
                determine compliance with this paragraph, the 
                Secretary may audit the books and records of a 
                group health plan or health insurance issuer 
                relating to an exemption, including any 
                actuarial reports prepared pursuant to 
                subparagraph (C), during the 6 year period 
                following the notification of such exemption 
                under subparagraph (E). A State agency 
                receiving a notification under subparagraph (E) 
                may also conduct such an audit with respect to 
                an exemption covered by such notification.
  (d) Separate Application to Each Option Offered.--In the case 
of a group health plan that offers a participant or beneficiary 
two or more benefit package options under the plan, the 
requirements of this section shall be applied separately with 
respect to each such option.
  (e) Definitions.--For purposes of this section and section 
502(a)(12)--
          (1) Aggregate lifetime limit.--The term ``aggregate 
        lifetime limit'' means, with respect to benefits under 
        a group health plan or health insurance coverage, a 
        dollar limitation on the total amount that may be paid 
        with respect to such benefits under the plan or health 
        insurance coverage with respect to an individual or 
        other coverage unit.
          (2) Annual limit.--The term ``annual limit'' means, 
        with respect to benefits under a group health plan or 
        health insurance coverage, a dollar limitation on the 
        total amount of 
        benefits that may be paid with respect to such benefits 
        in a 12-month period under the plan or health insurance 
        coverage with respect to an individual or other 
        coverage unit.
          (3) Medical or surgical benefits.--The term ``medical 
        or surgical benefits'' means benefits with respect to 
        medical or surgical services, as defined under the 
        terms of the plan or coverage (as the case may be), but 
        does not include mental health or substance use 
        disorder benefits.
          (4) Mental health benefits.--The term ``mental health 
        benefits'' means benefits with respect to services for 
        mental health conditions, as defined under the terms of 
        the plan and in accordance with applicable Federal and 
        State law.
          (5) Substance use disorder benefits.--The term 
        ``substance use disorder benefits'' means benefits with 
        respect to services for substance use disorders, as 
        defined under the terms of the plan and in accordance 
        with applicable Federal and State law.
  (f) Secretary Report.--The Secretary shall, by January 1, 
2012, and every two years thereafter, submit to the appropriate 
committees of Congress a report on compliance of group health 
plans (and health insurance coverage offered in connection with 
such plans) with the requirements of this section. Such report 
shall include the results of any surveys or audits on 
compliance of group health plans (and health insurance coverage 
offered in connection with such plans) with such requirements 
and an analysis of the reasons for any failures to comply.
  (g) Notice and Assistance.--The Secretary, in cooperation 
with the Secretaries of Health and Human Services and Treasury, 
as appropriate, shall publish and widely disseminate guidance 
and information for group health plans, participants and 
beneficiaries, applicable State and local regulatory bodies, 
and the National Association of Insurance Commissioners 
concerning the requirements of this section and shall provide 
assistance concerning such requirements and the continued 
operation of applicable State law. Such guidance and 
information shall inform participants and beneficiaries of how 
they may obtain assistance under this section, including, where 
appropriate, assistance from State consumer and insurance 
agencies.

           *       *       *       *       *       *       *


Subpart C--General Provisions

           *       *       *       *       *       *       *



SEC. 733. DEFINITIONS.

  (a) Group Health Plan.--For purposes of this part and section 
502(a)(12)--
          (1) In general.--The term ``group health plan'' means 
        an employee welfare benefit plan to the extent that the 
        plan provides medical care (as defined in paragraph (2) 
        and including items and services paid for as medical 
        care) to employees or their dependents (as defined 
        under the terms of the plan) directly or through 
        insurance, reimbursement, or otherwise. Such term shall 
        not include any qualified small employer health 
        reimbursement arrangement (as defined in section 
        9831(d)(2) of the Internal Revenue Code of 1986).
          (2) Medical care.--The term ``medical care'' means 
        amounts paid for--
                  (A) the diagnosis, cure, mitigation, 
                treatment, or prevention of disease, or amounts 
                paid for the purpose of affecting any structure 
                or function of the body,
                  (B) amounts paid for transportation primarily 
                for and essential to medical care referred to 
                in subparagraph (A), and
                  (C) amounts paid for insurance covering 
                medical care referred to in subparagraphs (A) 
                and (B).
  (b) Definitions Relating to Health Insurance.--For purposes 
of this part and section 502(a)(12)--
          (1) Health insurance coverage.--The term ``health 
        insurance coverage'' means benefits consisting of 
        medical care (provided directly, through insurance or 
        reimbursement, or otherwise and including items and 
        services paid for as medical care) under any hospital 
        or medical service policy or certificate, hospital or 
        medical service plan contract, or health maintenance 
        organization contract offered by a health insurance 
        issuer.
          (2) Health insurance issuer.--The term ``health 
        insurance issuer'' means an insurance company, 
        insurance service, or insurance organization (including 
        a health maintenance organization, as defined in 
        paragraph (3)) which is licensed to engage in the 
        business of insurance in a State and which is subject 
        to State law which regulates insurance (within the 
        meaning of section 514(b)(2)). Such term does not 
        include a group health plan.
          (3) Health maintenance organization.--The term 
        ``health maintenance organization'' means--
                  (A) a federally qualified health maintenance 
                organization (as defined in section 1301(a) of 
                the Public Health Service Act (42 U.S.C. 
                300e(a))),
                  (B) an organization recognized under State 
                law as a health maintenance organization, or
                  (C) a similar organization regulated under 
                State law for solvency in the same manner and 
                to the same extent as such a health maintenance 
                organization.
          (4) Group health insurance coverage.--The term 
        ``group health insurance coverage'' means, in 
        connection with a group health plan, health insurance 
        coverage offered in connection with such plan.
  (c) Excepted Benefits.--For purposes of this part, the term 
``excepted benefits'' means benefits under one or more (or any 
combination thereof) of the following:
          (1) Benefits not subject to requirements.--
                  (A) Coverage only for accident, or disability 
                income insurance, or any combination thereof.
                  (B) Coverage issued as a supplement to 
                liability insurance.
                  (C) Liability insurance, including general 
                liability insurance and automobile liability 
                insurance.
                  (D) Workers` compensation or similar 
                insurance.
                  (E) Automobile medical payment insurance.
                  (F) Credit-only insurance.
                  (G) Coverage for on-site medical clinics.
                  (H) Other similar insurance coverage, 
                specified in regulations, under which benefits 
                for medical care are secondary or incidental to 
                other insurance benefits.
          (2) Benefits not subject to requirements if offered 
        separately.--
                  (A) Limited scope dental or vision benefits.
                  (B) Benefits for long-term care, nursing home 
                care, home health care, community-based care, 
                or any combination thereof.
                  (C) Such other similar, limited benefits as 
                are specified in regulations.
          (3) Benefits not subject to requirements if offered 
        as independent, noncoordinated benefits.--
                  (A) Coverage only for a specified disease or 
                illness.
                  (B) Hospital indemnity or other fixed 
                indemnity insurance.
          (4) Benefits not subject to requirements if offered 
        as separate insurance policy.--Medicare supplemental 
        health insurance (as defined under section 1882(g)(1) 
        of the Social Security Act), coverage supplemental to 
        the coverage provided under chapter 55 of title 10, 
        United States Code, and similar supplemental coverage 
        provided to coverage under a group health plan.
  (d) Other Definitions.--For purposes of this part--
          (1) COBRA continuation provision.--The term ``COBRA 
        continuation provision'' means any of the following:
                  (A) Part 6 of this subtitle.
                  (B) Section 4980B of the Internal Revenue 
                Code of 1986, other than subsection (f)(1) of 
                such section insofar as it relates to pediatric 
                vaccines.
                  (C) Title XXII of the Public Health Service 
                Act.
          (2) Health status-related factor.--The term ``health 
        status-related factor'' means any of the factors 
        described in section 702(a)(1).
          (3) Network plan.--The term ``network plan'' means 
        health insurance coverage offered by a health insurance 
        issuer under which the financing and delivery of 
        medical care (including items and services paid for as 
        medical care) are provided, in whole or in part, 
        through a defined set of providers under contract with 
        the issuer.
          (4) Placed for adoption.--The term ``placement'', or 
        being ``placed'', for adoption, has the meaning given 
        such term in section 609(c)(3)(B).
          (5) Family member.--The term ``family member'' means, 
        with respect to an individual--
                  (A) a dependent (as such term is used for 
                purposes of section 701(f)(2)) of such 
                individual, and
                  (B) any other individual who is a first-
                degree, second-degree, third-degree, or fourth-
                degree relative of such individual or of an 
                individual described in subparagraph (A).
          (6) Genetic information.--
                  (A) In general.--The term ``genetic 
                information'' means, with respect to any 
                individual, information about--
                          (i) such individual`s genetic tests,
                          (ii) the genetic tests of family 
                        members of such individual, and
                          (iii) the manifestation of a disease 
                        or disorder in family members of such 
                        individual.
                  (B) Inclusion of genetic services and 
                participation in genetic research.--Such term 
                includes, with respect to any individual, any 
                request for, or receipt of, genetic services, 
                or participation in clinical research which 
                includes genetic services, by such individual 
                or any family member of such individual.
                  (C) Exclusions.--The term ``genetic 
                information'' shall not include information 
                about the sex or age of any individual.
          (7) Genetic test.--
                  (A) In general.--The term ``genetic test'' 
                means an analysis of human DNA, RNA, 
                chromosomes, proteins, or metabolites, that 
                detects genotypes, mutations, or chromosomal 
                changes.
                  (B) Exceptions.--The term ``genetic test'' 
                does not mean--
                          (i) an analysis of proteins or 
                        metabolites that does not detect 
                        genotypes, mutations, or chromosomal 
                        changes; or
                          (ii) an analysis of proteins or 
                        metabolites that is directly related to 
                        a manifested disease, disorder, or 
                        pathological condition that could 
                        reasonably be detected by a health care 
                        professional with appropriate training 
                        and expertise in the field of medicine 
                        involved.
          (8) Genetic services.--The term ``genetic services'' 
        means--
                  (A) a genetic test;
                  (B) genetic counseling (including obtaining, 
                interpreting, or assessing genetic 
                information); or
                  (C) genetic education.
          (9) Underwriting purposes.--The term ``underwriting 
        purposes'' means, with respect to any group health 
        plan, or health insurance coverage offered in 
        connection with a group health plan--
                  (A) rules for, or determination of, 
                eligibility (including enrollment and continued 
                eligibility) for benefits under the plan or 
                coverage;
                  (B) the computation of premium or 
                contribution amounts under the plan or 
                coverage;
                  (C) the application of any pre-existing 
                condition exclusion under the plan or coverage; 
                and
                  (D) other activities related to the creation, 
                renewal, or replacement of a contract of health 
                insurance or health benefits.

           *       *       *       *       *       *       *


                             MINORITY VIEWS

                              Introduction

    We continue to see the terrible consequences of students 
and young adults suffering from mental health issues. In the 
wake of prolonged school closures, Democrats have received a 
giant warning: stop playing to the base and start working 
across the aisle to save lives.
    School closures were particularly damaging for young 
people. In 2021, more than one-third of high school students 
reported they experienced poor mental health during the COVID-
19 pandemic, and over 40 percent reported persistent feelings 
of sadness or hopelessness during the preceding year.\1\ 
Studies show that the prolonged shutdown of schools exacerbated 
students' mental health issues.\2\ The pandemic created a 
pervasive sense of fear, economic instability, and forced 
physical distancing, which significantly worsened the stresses 
young people already faced. School closures caried high social 
and economic costs, and the impact was particularly severe for 
the most vulnerable students and families.\3\ According to the 
Centers for Disease Control and Prevention, fewer than half of 
youth reported feeling close to peers and teachers at school 
during the pandemic.\4\ Youth who were more disconnected from 
school were found to be more likely to have feelings of 
hopelessness, serious considerations of suicide, or attempts of 
suicide.\5\ Additionally, fifteen percent of youth reported 
suffering from at least one major depressive episode in the 
preceding year.\6\ Childhood depression is more likely to 
persist into adulthood if gone untreated.\7\ Suicide is the 
fourth leading cause of death among teens and young adults 
globally and the second leading cause of death in youth in the 
United States.\8\
---------------------------------------------------------------------------
    \1\https://www.cdc.gov/media/releases/2022/p0331-youth-mental-
health-covid-19.html.
    \2\Student anxiety, depression increasing during school closures, 
survey finds | EdSource.
    \3\Student anxiety, depression increasing during school closures, 
survey finds | EdSource.
    \4\https://www.cdc.gov/media/releases/2022/p0331-youth-mental-
health-covid-19.html.
    \5\https://www.cdc.gov/mmwr/volumes/69/wr/mm6945a3.htm.
    \6\https://www.cdc.gov/mmwr/volumes/69/wr/mm6945a3.htm.
    \7\Youth Data 2021 | Mental Health America (mhanational.org).
    \8\https://www.nimh.nih.gov/health/statistics/suicide.
---------------------------------------------------------------------------

                              TITLES I-IV

    Democrats included two currently funded programs and two 
new programs related to education and Head Start programs in 
H.R. 7780 as the base for their proposal to address mental 
health challenges in schools. While these were a good start to 
addressing the mental health needs of students, there are 
improvements that could be made to better target this support. 
To truly work for the students, these programs should be better 
connected to the needs on the ground.
    Despite current funding for these efforts being just under 
$125 million, H.R. 7780 authorizes over $5 billion in 
additional spending, an irresponsible amount with no guarantee 
that the Department can award those funds to high-quality 
programs.
    That is why Republicans took a more practical, reliable, 
and responsible approach to help local school and community 
leaders address the mental health needs for students. First, 
the Republican proposal is funded at $125 million over five 
years. This corresponds to the existing funding and, with the 
legislative improvements proposed, would be real funds 
available for states and school districts to use to address 
mental health. In the time since this bill was marked up, 
Congress hastily passed other legislation that included these 
programs, thus making this bill obsolete before the report was 
filed. Unfortunately, that legislation included significant new 
funding for these programs without addressing the basic concern 
of ensuring these taxpayer funds will be used in an effective 
manner to meet its intended purpose: to help students.
Republican Amendment
    Beyond addressing funding levels, Republicans streamlined 
the existing programs to avoid duplication of effort. By 
streamlining funding, eligible entities can spend less time 
filling out paperwork and tracking duplicative requirements and 
more time meeting the mental health needs of students. Further, 
the Republican proposal is structured around actual needs on 
the ground. By requiring a need analysis by the state, the 
program allows the state to use the funds to address the actual 
needs they are facing rather than forcing the state to use 
those funds on whatever needs Washington, D.C. has determined 
to be significant. There is also a requirement for the local 
eligible entity to have a need analysis which can either be a 
part of the state analysis or can be conducted by the eligible 
entity. The Republican plan makes it clear that these funds are 
intended to help all students in need, whether they be 
traditional public school students, charter school students, or 
private school students. As previously noted, the school 
closures had a severe, negative impact on students, increasing 
the mental health crisis communities are facing. The Republican 
proposal would ensure local school leaders have access to 
funding to address the particular needs of their community.
    The Republican proposal also recognizes the need for 
coordination of programs. Rather than layer program on top of 
program like the Democrat proposal does, the Republican plan 
provides grants to states which in turn provide grants to local 
eligible entities. This ensures the state is aware of the needs 
in each community that receives funding and can both better 
support those efforts and can avoid wasteful and duplicative 
work. Further, the Republican plan provides the state with 
funding to support the local grantees through technical 
assistance and other support. This protects the taxpayer`s 
investment to ensure the funds are well spent. The plan also 
includes funding for states to offer statewide programs to 
address the mental health needs students face; these programs 
must be tied to the need analysis. Finally, by including 
statewide activities, Republicans ensure greater support to 
students across the state.
    Finally, the Republican proposal includes important 
accountability metrics and would restrict any funds from going 
to states or local entities if they cannot demonstrate adequate 
progress toward the stated goals in the application. In other 
words, if the state or local grantee is not doing what they 
said they would or if what they are doing simply does not work, 
the taxpayer would stop funding it. This plan would support 
success and cut off failed projects.

                           TITLE V: RISE ACT

    Title V of the Mental Health Matters Act contains the 
Respond, Innovate, Succeed, and Empower (RISE) Act. Republicans 
support the intent of this language: we agree that students 
with disabilities should face fewer hoops to jump through when 
documenting their disability to their college or university and 
receiving their legally required accommodations. Unfortunately, 
the RISE Act has unintended consequences that should be 
addressed before this package proceeds. These flaws are the 
inevitable result when the majority rushes legislation through 
the process without taking the time either to engage with 
outside stakeholders or to reach across the aisle to understand 
the impact of a bill.
    First, this bill could force colleges and universities to 
accept long-outdated documentation from students who are 
claiming disability status but who do not in fact have a 
qualifying disability under federal disability law. Second, the 
bill removes almost all discretion from colleges and 
universities in determining if a student qualifies as a student 
with a disability. The Individuals with Disabilities Education 
Act, which imposes a stricter legal framework on elementary and 
secondary schools than colleges and universities face under 
section 504 of the Rehabilitation Act of 1973 or the Americans 
with Disabilities Act, gives elementary and secondary schools 
more discretion than this bill provides colleges and 
universities. Whether this is an admirable feature of the bill 
or a concerning one is debatable--and that is the point: we 
should debate it, among ourselves and with outside experts, so 
that we can fully understand the consequences of such a 
decision before we move forward.
    Committee Republicans would happily engage with 
stakeholders and our friends across the aisle to come to a 
bipartisan resolution on this bill. And perhaps we will be able 
to do that in the next Congress in the context of a 
comprehensive reform of the Higher Education Act. 
Unfortunately, until the majority allows that process to play 
out, we must urge opposition to this language.

                     TITLES VI AND VII OF H.R. 7780

    Titles VI and VII of H.R. 7780 include the text of two 
bills\9\ introduced less than a week before the markup of H.R. 
7780 and that were never discussed at a Committee hearing. 
Committee Republicans are dedicated to improving access to 
employee benefits and reducing the burdens on employers who 
offer such benefits. That is why Committee Republicans worked 
with Committee Democrats on a bipartisan basis to pass H.R. 
5891, the Retirement Improvement and Savings Enhancement Act 
(RISE Act) as part of H.R. 2954, the Securing a Strong 
Retirement Act (SSRA). Rather than push partisan legislation 
like H.R. 7780, which will threaten access and affordability of 
workplace benefits, the Committee should focus on enacting the 
bipartisan reforms in the RISE Act and SSRA.
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    \9\H.R. 7767, the Strengthening Behavioral Health Benefits Act, was 
introduced by Rep. Joe Courtney (D-CT) on May 13, 2022, and H.R. 7740, 
the Employee and Retiree Access to Justice Act of 2022, was introduced 
by Rep. Mark DeSaulnier (D-CA) on May 12, 2022.
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      H.R. 7780 THREATENS AND DELAYS ACCESS TO WORKPLACE BENEFITS

DOL Enforcement Authority
    Committee Republicans support mental health parity, which 
is why Congress has passed multiple laws to ensure employers 
are able to meet mental health parity requirements under the 
Mental Health Parity and Addiction Equity Act (MHPAEA). 
Unfortunately, Title VI of H.R. 7780 inappropriately expands 
DOL's ability to bring civil actions against plans governed by 
the Employee Retirement Income Security Act of 1974 (ERISA) 
that voluntarily offer mental health benefits. Allowing 
recoveries for ``all losses'' is ambiguous and overly broad, 
especially given the difficulty of determining what would be 
required to make the plan participant whole. Such a change to 
ERISA could cause employers to drop mental health and substance 
use disorder benefits altogether for fear of excessive 
litigation. The Partnership for Employer-Sponsored Coverage 
stated as follows:

          Two proposals in H.R. 7780 (to encourage individual 
        and DOL [Department of Labor]/EBSA [Employee Benefits 
        Security Administration] enforcement of parity 
        standards; and to ban arbitration and other 
        discretionary clauses) essentially weaponize the 
        relationship between employers that sponsor health 
        coverage and their covered employees as regards to 
        mental health care and substance abuse disorder and 
        coverage. Litigation will add to the cost of coverage 
        for employees and employers without meaningfully 
        improving coverage.\10\
---------------------------------------------------------------------------
    \10\Letter from Partnership for Employer-Sponsored Coverage to 
Reps. Bobby Scott and Virginia Foxx (May 17, 2022).

    There is great value in providing patients with robust 
mental health coverage, which is why many employers voluntarily 
include mental health coverage as part of a benefits package. 
However, despite receiving explicit direction from Congress 
outlining the information DOL must provide plans, the 
Department has yet to issue guidance illustrating how plans may 
demonstrate compliance with the law. DOL's 2020 MHPAEA report 
to Congress stated that 100 percent of plans were out of 
compliance with the Department's mental health parity analysis 
requirements.\11\ If DOL believes that every plan is out of 
compliance, the Department has clearly failed to explain to 
plans what is required and to assist them in adhering to those 
requirements.
---------------------------------------------------------------------------
    \11\2022 MHPAEA Report to Congress, https://www.dol.gov/sites/
dolgov/files/EBSA/laws-and-regulations/laws/mental-health-parity/ 
report-to-congress-2022-realizing-parity-reducing-stigma-and-raising-
awareness.pdf.
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Discretionary Clauses
    Most ERISA benefit plans, including health and retirement 
plans, adopt discretionary clauses which grant the plan 
administrator discretionary authority to interpret the plan 
documents and resolve disputes pursuant to DOL regulations.\12\ 
This ability to delegate authority to the plan administrator is 
born out of ERISA's goal of encouraging employers to sponsor 
and implement benefit plans. Further, ERISA`s claims process is 
meant to be expedited, and factual determinations need to be 
made about the terms of the plan.
---------------------------------------------------------------------------
    \12\Firestone Tire and Rubber Co. v. Bruch, 489 U.S. 101 (1989).
---------------------------------------------------------------------------
    By prohibiting discretionary clauses in ERISA plans under 
Title VII of H.R. 7780, any benefit determinations made by the 
plan would be far more likely to be challenged in court. Every 
time an issue arises where the plan terms are not 100 percent 
clear, the plan administrator would be powerless to interpret 
the plan, leaving litigation as the only means of resolving the 
issue. This outcome will substantially increase the costs and 
liability of offering mental health and retirement benefits to 
workers and their families. The American Retirement Association 
agree with this assessment, stating as follows:

          This change will simply result in more retirement 
        plan administrative costs and litigation that will 
        benefit the plaintiffs' bar but not everyday working 
        Americans who are saving for a secure retirement. This 
        legislation only offers more deterrent to maintaining 
        retirement plans and should be opposed.\13\
---------------------------------------------------------------------------
    \13\Letter from Brian H. Graff, Exec. Dir./CEO, Am. Ret. Ass'n., to 
Reps. Bobby Scott and Virginia Foxx (May 17, 2022).

    The U.S. Chamber of Commerce shared similar concerns with 
---------------------------------------------------------------------------
the Committee:

          Contrary to its name, by effectively prohibiting 
        arbitration in ERISA claims and prohibiting 
        discretionary clauses, this provision would limit 
        recovery amounts, increase the costs of claims for 
        benefits, and increase the time for courts to resolve 
        claims for benefits, including time sensitive claims 
        such as disability and severance.\14\
---------------------------------------------------------------------------
    \14\Letter from Neil L. Bradley, Exec. Dir., Chief Pol'y Off., & 
Head of Strategic Advocacy, U.S. Chamber of Com., to Reps. Bobby Scott 
and Virginia Foxx (May 18, 2022).

    At best, employers sponsoring mental health and retirement 
plans will divert cash to pay plaintiffs' attorneys that could 
be better spent providing benefits to employees. At worst, plan 
sponsors will reduce or eliminate benefits altogether. Either 
way, there will be downward pressure on mental health benefits 
and retirement savings--at a time when soaring inflation is 
eating away both wages and savings.

Arbitration Clauses

    Title VII of H.R. 7780 further delays ERISA's benefits 
claims process at the expense of plan participants by 
prohibiting pre-dispute arbitration and curtailing post-dispute 
arbitration. Arbitration clauses are important tools for 
protecting participants and benefit plans from the costs of 
litigation and the fees paid to plaintiffs' attorneys. Unlike 
litigation, which takes years to realize results, arbitration 
can facilitate the timely receipt of benefits owed to 
participants. The national average time between filing a civil 
case and a trial in U.S. district courts is more than two 
years; if the court is overworked, the average is often three 
or four years.\15\ In comparison, a recent study found that 
consumer- and employee-arbitration claimants are more likely to 
win, receive higher monetary awards, and spend less time in 
arbitration than in litigation.\16\ Given the advantages of 
arbitration to plan participants, Title VII of H.R. 7780's 
curtailment of arbitration only benefits trial lawyers who reap 
attorneys' fees in litigation.
---------------------------------------------------------------------------
    \15\The Judicial Conference's Recommendation for More Judgeships: 
Hearing Before the S. Comm. on the Judiciary, 116th Cong. (June 30, 
2020) (statement of Judge Brian Stacy Miller, D.C. Ark., at 10).
    \16\Nam D. Pham & Mary Donavan, NDP Analytics, Fairer, Faster, 
Better III: An Empirical Assessment of Consumer and Employment 
Arbitration (Mar. 2022), https://instituteforlegalreform.com/wp-
content/uploads/2022/03/FINAL-ndp-Consumer-and-Employment-Arbitration-
Paper-2022.pdf.
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              H.R. 7780 NEEDLESSLY SPENDS TAXPAYER DOLLARS

    H.R. 7780 needlessly appropriates an additional $275 
million in new mandatory funding over 10 years to EBSA for 
mental health parity enforcement. To put this into perspective, 
EBSA's Fiscal Year 2022 budget is $181 million. In addition to 
annual appropriations, EBSA received $8.6 million in FY 2021 
and $23.8 million in FY 2020 to implement the mental health 
parity requirements of the Consolidated Appropriations Act, 
2020.\17\
---------------------------------------------------------------------------
    \17\Title VI's large increase in spending reflects the Department 
of Labor's FY 2023 budget request for mental health parity enforcement. 
The budget request proposes doubling EBSA's full-time employees 
auditing plans. FY 2023 Congressional Budget Justification, Emp. 
Benefits Security Admin., https://www.dol.gov/sites/dolgov/files/
general/budget/2023/CBJ-2023-V2-01.pdf.
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                         REPUBLICAN AMENDMENTS

    Rep. Rick Allen (R-GA) offered an amendment at the 
Committee markup to ensure that DOL assists employers and 
health plans to meet mental health parity requirements and to 
protect taxpayers from yet more needless government spending. 
The amendment makes implementation of Title VI of H.R. 7780 
conditional on DOL fulfilling its statutory duty by issuing a 
rule that provides clear guidance and compliance assistance to 
employers and plans on how to meet its mental health parity 
requirements. The amendment also strikes Title VI's $275 
million in new mandatory funding for mental health parity 
enforcement. Congress should not provide DOL with additional 
enforcement authority and taxpayer dollars to create mental 
health parity rules through litigation and legal claims. DOL 
could more effectively advance mental health if it focused its 
efforts on establishing clear guidance and compliance 
assistance instead of harassing plans and employers. Democrats 
voted against this commonsense amendment.
    Rep. Diana Harshbarger (R-TN) offered an amendment 
highlighting Democrats' preferential treatment for union-run 
benefit plans. The amendment strikes Title VII's exemption of 
multiemployer benefit plans from the bill`s prohibition on 
discretionary clauses. Prohibiting discretionary clauses is a 
drastic and ill-conceived departure from current law that will 
only benefit trial lawyers at the expense of workers and 
retirees who rely on employee benefit plans. If Democrats 
insist on disrupting the administration of employee benefits, 
then they should not exempt their friends in Big Labor who run 
multiemployer benefit plans. While alarming, this blatant 
display of favoritism is not surprising. Last year, Democrats 
enacted an irresponsible and uncapped taxpayer-funded bailout 
of mismanaged multiemployer pension plans under the guise of 
COVID 19 relief in the so-called American Rescue Plan Act.\18\ 
Rather than apply the law equally to single employer and 
multiemployer plans, Democrats rejected this amendment in a 
party-line vote.
---------------------------------------------------------------------------
    \18\Pub. L. No. 117-2 (2021), 29 U.S.C. Sec. 1432.
---------------------------------------------------------------------------
    Rep. Mary Miller (R-IL) offered an amendment to strike the 
requirement to provide graduates specific education regarding 
how to meet the needs of lesbian, gay, bisexual, transgender, 
queer, or questioning, non-binary, or Two-Spirit. This grant is 
supposed to be for increasing the number of school-based mental 
health professionals serving in high-need school districts and 
federal grants should be structured to help local areas address 
the various needs they face.

                               Conclusion

    Mental health is a grave issue that impacts families and 
children alike. Washington should stop pretending there is one 
solution that works for every community. If America is going to 
solve this crisis, it will take clearer goals, stronger 
support, and more flexibility given to local leaders on how 
best to solve the problems faced on the ground. The Republican 
alternative does all this in a fiscally responsible manner. 
Republicans are ready to work with Democrats once they are drop 
their bloated proposals that fail to focus on local needs.
                                   Virginia Foxx,
                                           Ranking Member.
                                   Glenn ``GT'' Thompson.
                                   Tim Walberg.
                                   Glenn Grothman.
                                   Elise M. Stefanik.
                                   Rick W. Allen.
                                   James Comer.
                                   Russ Fulcher.
                                   Fred Keller.
                                   Burgess Owens.
                                   Lisa C. McClain.
                                   Mary E. Miller.
                                   Scott Fitzgerald.
                                   Chris Jacobs.
                                   Brad Finstad.

                                  [all]