[Senate Report 117-162]
[From the U.S. Government Publishing Office]


                                                        Calendar No. 504
117th Congress       }                           {            Report
                                 SENATE
 2d Session          }                           {            117-162
_______________________________________________________________________


            POST-DISASTER MENTAL HEALTH RESPONSE ACT OF 2022

                               __________

                              R E P O R T

                                 of the

                   COMMITTEE ON HOMELAND SECURITY AND

                          GOVERNMENTAL AFFAIRS

                          UNITED STATES SENATE

                              to accompany

                                S. 3677

          TO AMEND THE ROBERT T. STAFFORD DISASTER RELIEF AND
          EMERGENCY ASSISTANCE ACT TO AUTHORIZE THE PRESIDENT
         TO PROVIDE PROFESSIONAL COUNSELING SERVICES TO VICTIMS
     OF EMERGENCIES DECLARED UNDER SUCH ACT, AND FOR OTHER PURPOSES

		[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]


               September 27, 2022.--Ordered to be printed
               
               		       __________
               
               
               	    U.S. GOVERNMENT PUBLISHING OFFICE
               	    
29-010			  WASHINGTON : 2022               	    
               
               
               
        COMMITTEE ON HOMELAND SECURITY AND GOVERNMENTAL AFFAIRS

                   GARY C. PETERS, Michigan, Chairman
THOMAS R. CARPER, Delaware           ROB PORTMAN, Ohio
MAGGIE HASSAN, New Hampshire         RON JOHNSON, Wisconsin
KYRSTEN SINEMA, Arizona              RAND PAUL, Kentucky
JACKY ROSEN, Nevada                  JAMES LANKFORD, Oklahoma
ALEX PADILLA, California             MITT ROMNEY, Utah
JON OSSOFF, Georgia                  RICK SCOTT, Florida
                                     JOSH HAWLEY, Missouri

                   David M. Weinberg, Staff Director
                    Zachary I. Schram, Chief Counsel
         Christopher J. Mulkins, Director of Homeland Security
           Naveed Jazayeri, Senior Professional Staff Member
                Pamela Thiessen, Minority Staff Director
            Sam J. Mulopulos, Minority Deputy Staff Director
       Clyde E. Hicks Jr., Minority Director of Homeland Security
                     Laura W. Kilbride, Chief Clerk



                                                      Calendar No. 504
117th Congress       }                           {           Report
                                 SENATE
 2d Session          }                           {           117-162

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

 
                 POST-DISASTER MENTAL HEALTH RESPONSE 
                              ACT OF 2022

                                _______
                                

               September 27, 2022.--Ordered to be printed

                                _______
                                

 Mr. Peters, from the Committee on Homeland Security and Governmental 
                    Affairs, submitted the following

                              R E P O R T

                         [To accompany S. 3677]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on Homeland Security and Governmental 
Affairs, to which was referred the bill (S. 3677) to amend the 
Robert T. Stafford Disaster Relief and Emergency Assistance Act 
to authorize the President to provide professional counseling 
services to victims of emergencies declared under such Act, and 
for other purposes, having considered the same, reports 
favorably thereon without amendment and recommends that the 
bill do pass.

                                CONTENTS

                                                                   Page
  I. Purpose and Summary..............................................1
 II. Background and Need for the Legislation..........................2
III. Legislative History..............................................2
 IV. Section-by-Section Analysis of the Bill, as Reported.............3
  V. Evaluation of Regulatory Impact..................................3
 VI. Congressional Budget Office Cost Estimate........................3
VII. Changes in Existing Law Made by the Bill, as Reported............5

                         I. Purpose and Summary

    S. 3677, the Post-Disaster Mental Health Response Act, 
would expand eligibility for the Federal Emergency Management 
Agency's (FEMA) Crisis Counseling Assistance and Training 
Program (CCP), which is part of the agency's Individual 
Assistance (IA) suite of programs. Currently, the CCP provides 
short-term mental health and trauma support resources for 
survivors in an area that has received a major disaster 
declaration. This legislation would expand the CCP by amending 
the Robert T. Stafford Disaster Relief and Emergency Assistance 
Act (Stafford Act) to provide states, tribes, or territories 
with the option to request the program for an area that 
receives an emergency declaration.

              II. Background and Need for the Legislation

    Over the last decade, there have been more than 4,000 
emergency declarations across the United States.\1\ 
Individuals, families, and communities often face lasting 
trauma from emergencies, which range from floods and 
earthquakes to violent attacks, such as the Boston marathon 
bombing. Natural disasters can leave lasting impacts on 
disaster survivors. One study found that after an earthquake, 
24 percent of survivors develop post-traumatic stress disorder 
(PTSD).\2\ The CCP can aid disaster survivors with PTSD by 
helping them understand their current situation, promoting the 
use of coping mechanisms, assisting survivors in reviewing 
their disaster recovery options, and connecting survivors with 
other people and agencies who can help them in the recovery 
process.\3\
---------------------------------------------------------------------------
    \1\Federal Emergency Management Agency, OpenFEMA Dataset: Disaster 
Declarations Summaries--v2 (accessed April 2022).
    \2\Wenjie Dai, Long Chen, et al., The incidence of post-traumatic 
stress disorder among survivors after earthquakes: a systematic review 
and meta-analysis, BMC Psychiatry (June 7, 2016).
    \3\Substance Abuse and Mental Health Services Administration, 
Department of Health and Human Services, Crisis Counseling Assistance 
and Training Program (CCP) (https://www.samhsa.gov/dtac/ccp) (accessed 
May 5, 2022).
---------------------------------------------------------------------------
    Currently, FEMA may provide state, territorial, and tribal 
mental health authorities with assistance and reimbursement 
(through the CCP) to address the mental health impacts of major 
disaster declarations but not emergency declarations.\4\ 
Emergency declarations are made to protect property and public 
health and safety and to lessen or avert the threat of a major 
disaster or catastrophe. In contrast, a major disaster 
declaration is made as a result of a disaster or catastrophic 
event and constitutes a broader authority that helps states and 
local communities, as well as families and individuals, recover 
from the damage caused by the event. States currently cannot 
obtain reimbursement for trauma or mental health services 
delivered after emergency declarations.\5\
---------------------------------------------------------------------------
    \4\Federal Emergency Management Agency, FACT SHEET: Crisis 
Counseling Assistance & Training Program (March 2020).
    \5\Id.
---------------------------------------------------------------------------
    Data indicates that this legislation will help to address 
the long-term mental health impacts of various declared 
emergencies. For example, following the Boston marathon 
bombing, 11 percent of marathon attending children showed signs 
of PTSD, but since the tragedy did not meet the criteria for a 
major disaster declaration, crisis counseling was not made 
available through FEMA.\6\ To expand the CCP, this bill amends 
U.S. code to ensure that mental health resources can be made 
available to survivors and responders of declared emergencies 
in addition to major disasters.
---------------------------------------------------------------------------
    \6\Jonathan Comer, Annie Dantowitz, et al., Adjustment among Area 
Youth after the Boston Marathon Bombing and Subsequent Manhunt, 
Pediatrics (July 2014).
---------------------------------------------------------------------------

                        III. Legislative History

    Senators Richard Durbin (D-IL) and Rob Portman (R-OH) 
introduced S. 3677, the Post-Disaster Mental Health Response 
Act, on February 17, 2022. The bill was referred to the 
Committee on Homeland Security and Governmental Affairs. 
Senator Gary Peters (D-MI) later joined as a cosponsor on April 
27, 2022. The Committee considered S. 3677 at a business 
meeting on March 30, 2022. The bill was ordered reported 
favorably by voice vote en bloc. Senators present for the vote 
on the bill were: Peters, Carper, Hassan, Sinema, Rosen, 
Padilla, Ossoff, Paul, Lankford, Romney, Scott, and Hawley.

        IV. Section-by-Section Analysis of the Bill, as Reported


Section 1. Short title

    This section designates the name of the bill as the ``Post-
Disaster Mental Health Response Act.''

Section 2. Crisis counseling assistance and training

    This section amends section 502(a)(6) of the Stafford Act 
to allow mental health resources of the CCP to be made 
available to survivors and responders of declared emergencies 
in addition to major disasters.

                   V. Evaluation of Regulatory Impact

    Pursuant to the requirements of paragraph 11(b) of rule 
XXVI of the Standing Rules of the Senate, the Committee has 
considered the regulatory impact of this bill and determined 
that the bill will have no regulatory impact within the meaning 
of the rules. The Committee agrees with the Congressional 
Budget Office's statement that the bill contains no 
intergovernmental or private-sector mandates as defined in the 
Unfunded Mandates Reform Act (UMRA) and would impose no costs 
on state, local, or tribal governments.

             VI. Congressional Budget Office Cost Estimate

                                     U.S. Congress,
                               Congressional Budget Office,
                                 Washington, DC, September 7, 2022.
Hon. Gary Peters,
Chairman, Committee on Homeland Security and Governmental Affairs, U.S. 
        Senate, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for S. 3677, the Post-
Disaster Mental Health Response Act.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Jon Sperl.
            Sincerely,
                                         Phillip L. Swagel,
                                                          Director.
    Enclosure.

    	     [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
    

    S. 3677 would authorize the Federal Emergency Management 
Agency (FEMA) to cover the costs of crisis counseling for 
people affected by emergencies declared under the Robert T. 
Stafford Disaster Relief and Emergency Assistance Act when 
those services are paid for by local governments. Under current 
law, such federal assistance is only available in areas where 
the President has declared a major disaster under that act.
    Emergencies are typically declared for events that are less 
severe than major disasters; accordingly, FEMA approves fewer 
types of assistance and usually awards smaller amounts for 
emergencies than for major disasters. Over the 2019-2021 
period, the President declared 174 emergencies but in only one 
of those events did FEMA provide aid (about $1 million) to 
individuals and households under the Individual Assistance (IA) 
Program. Over that same period, the President declared 227 
major disasters, and for about half of those events, the agency 
provided a total of $6.1 billion to individuals and households 
under the IA Program. As part of that assistance for major 
disasters, FEMA provided funding to state and local governments 
for counseling services, including about $30 million in 2021.
    For this estimate, CBO expects that FEMA would award 
counseling assistance for emergencies at roughly the same 
proportion, relative to the total amounts provided under the IA 
program, as it has for major disasters. On that basis, CBO 
estimates that, under S. 3677, FEMA would provide an additional 
$3 million in crisis counseling assistance over the 2022-2032 
period, or about 1 percent of the $300 million of such 
assistance that CBO projects the agency will provide for major 
disasters over the next decade.
    Disaster assistance for programs authorized under the 
Stafford Act is paid from the agency's Disaster Relief Fund 
(DRF). Because S. 3677 would expand the use of previously 
appropriated balances from the DRF, some of which CBO estimates 
would not otherwise spend over the 2022-2032 period, the bill 
would increase direct spending. That increased spending would 
be offset by lower spending of the same amount in years after 
2032.
    In addition, CBO estimates that the agency would incur 
administrative costs to provide more counseling assistance to 
state and local governments. CBO estimates that those costs 
would total less than $500,000; any spending would be subject 
to the availability of appropriated funds.
    The CBO staff contact for this estimate is Jon Sperl. The 
estimate was reviewed by H. Samuel Papenfuss, Deputy Director 
of Budget Analysis.

       VII. Changes in Existing Law Made by the Bill, as Reported

    In compliance with paragraph 12 of rule XXVI of the 
Standing Rules of the Senate, changes in existing law made by 
the bill, as reported, are shown as follows: (existing law 
proposed to be omitted is enclosed in brackets, new matter is 
printed in italic, and existing law in which no change is 
proposed is shown in roman):

ROBERT T. STAFFORD DISASTER RELIEF AND EMERGENCY ASSISTANCE ACT

           *       *       *       *       *       *       *


TITLE V--EMERGENCY ASSISTANCE PROGRAMS

           *       *       *       *       *       *       *


SEC. 502. FEDERAL EMERGENCY ASSISTANCE.

    (a) Specified.--In any emergency, the President may--
          (1) * * *

           *       *       *       *       *       *       *

          (6) provide assistance in accordance with section 408 
        and section 416 of this title;

           *       *       *       *       *       *       *


                                  
                                  
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