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[108th Congress Public Law 355]
[From the U.S. Government Printing Office]

[DOCID: f:publ355.108]

[[Page 1403]]

                     GARRETT LEE SMITH MEMORIAL ACT

[[Page 118 STAT. 1404]]

Public Law 108-355
108th Congress

                                 An Act

 
    To amend the Public Health Service Act to support the planning, 
    implementation, and evaluation of organized activities involving 
statewide youth suicide early intervention and prevention strategies, to 
 authorize grants to institutions of higher education to reduce student 
          mental and behavioral health problems, and for other 
             purposes. <<NOTE: Oct. 21, 2004 -  [S. 2634]>> 

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled, <<NOTE: Garrett Lee 
Smith Memorial Act. 42 USC 201 note.>> 

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Garrett Lee Smith Memorial Act''.

SEC. 2. <<NOTE: 42 USC 290bb-36 note.>> FINDINGS.

    Congress makes the following findings:
            (1) More children and young adults die from suicide each 
        year than from cancer, heart disease, AIDS, birth defects, 
        stroke, and chronic lung disease combined.
            (2) Over 4,000 children and young adults tragically take 
        their lives every year, making suicide the third overall cause 
        of death between the ages of 10 and 24. According to the Centers 
        for Disease Control and Prevention, suicide is the third overall 
        cause of death among college-age students.
            (3) According to the National Center for Injury Prevention 
        and Control of the Centers for Disease Control and Prevention, 
        children and young adults accounted for 15 percent of all 
        suicides completed in 2000.
            (4) From 1952 to 1995, the rate of suicide in children and 
        young adults tripled.
            (5) From 1980 to 1997, the rate of suicide among young 
        adults ages 15 to 19 increased 11 percent.
            (6) From 1980 to 1997, the rate of suicide among children 
        ages 10 to 14 increased 109 percent.
            (7) According to the National Center of Health Statistics, 
        suicide rates among Native Americans range from 1.5 to 3 times 
        the national average for other groups, with young people ages 15 
        to 34 making up 64 percent of all suicides.
            (8) Congress has recognized that youth suicide is a public 
        health tragedy linked to underlying mental health problems and 
        that youth suicide early intervention and prevention activities 
        are national priorities.
            (9) Youth suicide early intervention and prevention have 
        been listed as urgent public health priorities by the 
        President's New Freedom Commission in Mental Health (2002), the 
        Institute of Medicine's Reducing Suicide: A National Imperative

[[Page 118 STAT. 1405]]

        (2002), the National Strategy for Suicide Prevention: Goals and 
        Objectives for Action (2001), and the Surgeon General's Call to 
        Action To Prevent Suicide (1999).
            (10) Many States have already developed comprehensive 
        statewide youth suicide early intervention and prevention 
        strategies that seek to provide effective early intervention and 
        prevention services.
            (11) In a recent report, a startling 85 percent of college 
        counseling centers revealed an increase in the number of 
        students they see with psychological problems. Furthermore, the 
        American College Health Association found that 61 percent of 
        college students reported feeling hopeless, 45 percent said they 
        felt so depressed they could barely function, and 9 percent felt 
        suicidal.
            (12) There is clear evidence of an increased incidence of 
        depression among college students. According to a survey 
        described in the Chronicle of Higher Education (February 1, 
        2002), depression among freshmen has nearly doubled (from 8.2 
        percent to 16.3 percent). Without treatment, researchers 
        recently noted that ``depressed adolescents are at risk for 
        school failure, social isolation, promiscuity, self-medication 
        with drugs and alcohol, and suicide--now the third leading cause 
        of death among 10-24 year olds.''.
            (13) Researchers who conducted the study ``Changes in 
        Counseling Center Client Problems Across 13 Years'' (1989-2001) 
        at Kansas State University stated that ``students are 
        experiencing more stress, more anxiety, more depression than 
        they were a decade ago.'' (The Chronicle of Higher Education, 
        February 14, 2003).
            (14) According to the 2001 National Household Survey on Drug 
        Abuse, 20 percent of full-time undergraduate college students 
        use illicit drugs.
            (15) The 2001 National Household Survey on Drug Abuse also 
        reported that 18.4 percent of adults aged 18 to 24 are dependent 
        on or abusing illicit drugs or alcohol. In addition, the study 
        found that ``serious mental illness is highly correlated with 
        substance dependence or abuse. Among adults with serious mental 
        illness in 2001, 20.3 percent were dependent on or abused 
        alcohol or illicit drugs, while the rate among adults without 
        serious mental illness was only 6.3 percent.''.
            (16) A 2003 Gallagher's Survey of Counseling Center 
        Directors found that 81 percent were concerned about the 
        increasing number of students with more serious psychological 
        problems, 67 percent reported a need for more psychiatric 
        services, and 63 percent reported problems with growing demand 
        for services without an appropriate increase in resources.
            (17) The International Association of Counseling Services 
        accreditation standards recommend 1 counselor per 1,000 to 1,500 
        students. According to the 2003 Gallagher's Survey of Counseling 
        Center Directors, the ratio of counselors to students is as high 
        as 1 counselor per 2,400 students at institutions of higher 
        education with more than 15,000 students.
SEC. 3. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT.

    (a) Youth Interagency Research, Training, and Technical Assistance 
Centers.--Section 520C of the Public Health Service Act (42 U.S.C. 
290bb-34) is amended--

[[Page 118 STAT. 1406]]

            (1) in subsection (a)--
                    (A) by striking ``Health, shall award grants'' and 
                inserting ``Health--
            ``(1) shall award grants'';
                    (B) by striking the period at the end and inserting 
                ``; and''; and
                    (C) by adding at the end the following:
            ``(2) shall award a competitive grant to 1 additional 
        research, training, and technical assistance center to carry out 
        the activities described in subsection (d).'';
            (2) in subsection (c), in the matter preceding paragraph 
        (1), by striking ``grant or contract under subsection (a)'' and 
        inserting ``grant or contract under subsection (a)(1)'';
            (3) in subsection (d)--
                    (A) by striking ``Appropriations.--For the purpose 
                of carrying out this section'' and inserting 
                ``Appropriations.--
            ``(1) For the purpose of awarding grants or contracts under 
        subsection (a)(1)''; and
                    (B) by adding at the end the following:
            ``(2) <<NOTE: Appropriation authorization.>> For the purpose 
        of awarding a grant under subsection (a)(2), there are 
        authorized to be appropriated $3,000,000 for fiscal year 2005, 
        $4,000,000 for fiscal year 2006, and $5,000,000 for fiscal year 
        2007.'';
            (4) by redesignating subsection (d) as subsection (e); and
            (5) by inserting after subsection (c) the following:

    ``(d) Additional Center.--The additional research, training, and 
technical assistance center established under subsection (a)(2) shall 
provide appropriate information, training, and technical assistance to 
States, political subdivisions of a State, Federally recognized Indian 
tribes, tribal organizations, institutions of higher education, public 
organizations, or private nonprofit organizations for--
            ``(1) the development or continuation of statewide or tribal 
        youth suicide early intervention and prevention strategies;
            ``(2) ensuring the surveillance of youth suicide early 
        intervention and prevention strategies;
            ``(3) studying the costs and effectiveness of statewide 
        youth suicide early intervention and prevention strategies in 
        order to provide information concerning relevant issues of 
        importance to State, tribal, and national policymakers;
            ``(4) further identifying and understanding causes and 
        associated risk factors for youth suicide;
            ``(5) analyzing the efficacy of new and existing youth 
        suicide early intervention techniques and technology;
            ``(6) ensuring the surveillance of suicidal behaviors and 
        nonfatal suicidal attempts;
            ``(7) studying the effectiveness of State-sponsored 
        statewide and tribal youth suicide early intervention and 
        prevention strategies on the overall wellness and health 
        promotion strategies related to suicide attempts;
            ``(8) promoting the sharing of data regarding youth suicide 
        with Federal agencies involved with youth suicide early 
        intervention and prevention, and State-sponsored statewide or 
        tribal youth suicide early intervention and prevention 
        strategies for the purpose of identifying previously unknown 
        mental health causes and associated risk factors for suicide in 
        youth;

[[Page 118 STAT. 1407]]

            ``(9) evaluating and disseminating outcomes and best 
        practices of mental and behavioral health services at 
        institutions of higher education; and
            ``(10) other activities determined appropriate by the 
        Secretary.''.

    (b) Suicide Prevention for Youth.--Title V of the Public Health 
Service Act (42 U.S.C. 290aa et seq.) is amended--
            (1) in section 520E (42 U.S.C. 290bb-36)--
                    (A) in the section heading by striking ``CHILDREN 
                AND ADOLESCENTS'' and inserting ``YOUTH'';
                    (B) by striking subsection (a) and inserting the 
                following:

    ``(a) <<NOTE: Contracts.>> In General.--The Secretary shall award 
grants or
cooperative agreements to public organizations, private nonprofit 
organizations, political subdivisions, consortia of political 
subdivisions, consortia of States, or Federally recognized Indian tribes 
or tribal organizations to design early intervention and prevention 
strategies that will complement the State-sponsored statewide or tribal 
youth suicide early intervention and prevention strategies developed 
pursuant to section 520E.'';
                    (C) in subsection (b), by striking all after 
                ``coordinated'' and inserting ``with the relevant 
                Department of Health and Human Services agencies and 
                suicide working groups.'';
                    (D) in subsection (c)--
                          (i) in the matter preceding paragraph (1), by 
                      striking ``A State'' and all that follows through 
                      ``desiring'' and inserting ``A public 
                      organization, private nonprofit organization, 
                      political subdivision, consortium of political 
                      subdivisions, consortium of States, or federally 
                      recognized Indian tribe or tribal organization 
                      desiring'';
                          (ii) by redesignating paragraphs (1) through 
                      (9) as paragraphs (2) through (10), respectively;
                          (iii) by inserting before paragraph (2) (as so 
                      redesignated) the following:
            ``(1)(A) comply with the State-sponsored statewide early 
        intervention and prevention strategy as developed under section 
        520E; and
            ``(B) in the case of a consortium of States, receive the 
        support of all States involved;'';
                          (iv) in paragraph (2) (as so redesignated), by 
                      striking ``children and adolescents'' and 
                      inserting ``youth'';
                          (v) in paragraph (3) (as so redesignated), by 
                      striking ``best evidence-based,'';
                          (vi) in paragraph (4) (as so redesignated), by 
                      striking ``primary'' and all that follows and 
                      inserting ``general, mental, and behavioral health 
                      services, and substance abuse services;'';
                          (vii) in paragraph (5) (as so redesignated), 
                      by striking ``children and'' and all that follows 
                      and inserting ``youth including the school 
                      systems, educational institutions, juvenile 
                      justice system, substance abuse programs, mental 
                      health programs, foster care systems, and 
                      community child and youth support 
                      organizations;'';

[[Page 118 STAT. 1408]]

                          (viii) by striking paragraph (8) (as so 
                      redesignated) and inserting the following:
            ``(8) offer access to services and care to youth with 
        diverse linguistic and cultural backgrounds;''; and
                          (ix) by striking paragraph (9) (as so 
                      redesignated) and inserting the following:
            ``(9) conduct annual self-evaluations of outcomes and 
        activities, including consulting with interested families and 
        advocacy organizations;'';
                    (E) by striking subsection (d) and inserting the 
                following:

    ``(d) Use of Funds.--Amounts provided under a grant or cooperative 
agreement under this section shall be used to supplement, and not 
supplant, Federal and non-Federal funds available for carrying out the 
activities described in this section. Applicants shall provide financial 
information to demonstrate compliance with this section.'';
                    (F) in subsection (e)--
                          (i) by striking ``, contract,''; and
                          (ii) by inserting after ``Secretary that the'' 
                      the following: ``application complies with the 
                      State-sponsored statewide early intervention and 
                      prevention strategy as developed under section 
                      520E and the'';
                    (G) in subsection (f), by striking ``, contracts,'';
                    (H) in subsection (g)--
                          (i) by striking ``A State'' and all that 
                      follows through ``organization receiving'' and 
                      inserting ``A public organization, private 
                      nonprofit organization, political subdivision, 
                      consortium of political subdivisions, consortium 
                      of States, or Federally recognized Indian tribe or 
                      tribal organization receiving''; and
                          (ii) by striking ``, contract,'' each place 
                      such term appears;
                    (I) in subsection (h), by striking ``, contracts,'';
                    (J) in subsection (i)--
                          (i) by striking ``A State'' and all that 
                      follows through ``organization receiving'' and 
                      inserting ``A public organization, private 
                      nonprofit organization, political subdivision, 
                      consortium of political subdivisions, consortium 
                      of States, or Federally recognized Indian tribe or 
                      tribal organization receiving''; and
                          (ii) by striking ``, contract,'';
                    (K) in subsection (k), by striking ``5 years'' and 
                inserting ``3 years'';
                    (L) in subsection (l)--
                          (i) in paragraph (2), by striking ``21'' and 
                      inserting ``24''; and
                          (ii) in paragraph (3), by striking ``which 
                      might have been'';
                    (M) in subsection (m)--
                          (i) by striking ``Appropriation.--'' and all 
                      that follows through ``For'' in paragraph (1) and 
                      inserting ``Appropriation.--For''; and
                          (ii) by striking paragraph (2);
                    (N) by redesignating subsection (m) as subsection 
                (n); and
                    (O) by inserting after subsection (l) the following:

[[Page 118 STAT. 1409]]

    ``(m) Definitions.--In this section, the terms `early intervention', 
`educational institution', `institution of higher education', 
`prevention', `school', and `youth' have the meanings given to those 
terms in section 520E.''; and
            (2) <<NOTE: 42 USC 290bb-36, 290bb-36a.>> by redesignating 
        section 520E as section 520E-1.

    (c) Youth Suicide and Early Intervention and Prevention 
Strategies.--Title V of the Public Health Service Act (42 U.S.C. 290aa 
et seq.) is amended by inserting before section 520E-1 (as redesignated 
by subsection (b)) the following:
``SEC. 520E. YOUTH <<NOTE: 42 USC 290bb-36.>> SUICIDE EARLY 
                              INTERVENTION AND PREVENTION 
                              STRATEGIES.

    ``(a) <<NOTE: Contracts.>> In General.--The Secretary, acting 
through the Administrator of the Substance Abuse and Mental Health 
Services
Administration, shall award grants or cooperative agreements to eligible 
entities to--
            ``(1) develop and implement State-sponsored statewide or 
        tribal youth suicide early intervention and prevention 
        strategies in schools, educational institutions, juvenile 
        justice systems, substance abuse programs, mental health 
        programs, foster care systems, and other child and youth support 
        organizations;
            ``(2) support public organizations and private nonprofit 
        organizations actively involved in State-sponsored statewide or 
        tribal youth suicide early intervention and prevention 
        strategies and in the development and continuation of State-
        sponsored statewide youth suicide early intervention and 
        prevention strategies;
            ``(3) provide grants to institutions of higher education to 
        coordinate the implementation of State-sponsored statewide or 
        tribal youth suicide early intervention and prevention 
        strategies;
            ``(4) collect and analyze data on State-sponsored statewide 
        or tribal youth suicide early intervention and prevention 
        services that can be used to monitor the effectiveness of such 
        services and for research, technical assistance, and policy 
        development; and
            ``(5) assist eligible entities, through State-sponsored 
        statewide or tribal youth suicide early intervention and 
        prevention strategies, in achieving targets for youth suicide 
        reductions under title V of the Social Security Act.

    ``(b) Eligible Entity.--
            ``(1) Definition.--In this section, the term `eligible 
        entity' means--
                    ``(A) a State;
                    ``(B) a public organization or private nonprofit 
                organization designated by a State to develop or direct 
                the State-sponsored statewide youth suicide early 
                intervention and prevention strategy; or
                    ``(C) a Federally recognized Indian tribe or tribal 
                organization (as defined in the Indian Self-
                Determination and Education Assistance Act) or an urban 
                Indian organization (as defined in the Indian Health 
                Care Improvement Act) that is actively involved in the 
                development and continuation of a tribal youth suicide 
                early intervention and prevention strategy.

[[Page 118 STAT. 1410]]

            ``(2) Limitation.--In carrying out this section, the 
        Secretary shall ensure that each State is awarded only 1 grant 
        or cooperative agreement under this section. For purposes of the 
        preceding sentence, a State shall be considered to have been 
        awarded a grant or cooperative agreement if the eligible entity 
        involved is the State or an entity designated by the State under 
        paragraph (1)(B). Nothing in this paragraph shall be construed 
        to apply to entities described in paragraph (1)(C).

    ``(c) Preference.--In providing assistance under a grant or 
cooperative agreement under this section, an eligible entity shall give 
preference to public organizations, private nonprofit organizations, 
political subdivisions, institutions of higher education, and tribal 
organizations actively involved with the State-sponsored statewide or 
tribal youth suicide early intervention and prevention strategy that--
            ``(1) provide early intervention and assessment services, 
        including screening programs, to youth who are at risk for 
        mental or emotional disorders that may lead to a suicide 
        attempt, and that are integrated with school systems, 
        educational institutions, juvenile justice systems, substance 
        abuse programs, mental health programs, foster care systems, and 
        other child and youth support organizations;
            ``(2) demonstrate collaboration among early intervention and 
        prevention services or certify that entities will engage in 
        future collaboration;
            ``(3) employ or include in their applications a commitment 
        to evaluate youth suicide early intervention and prevention 
        practices and strategies adapted to the local community;
            ``(4) provide timely referrals for appropriate community-
        based mental health care and treatment of youth who are at risk 
        for suicide in child-serving settings and agencies;
            ``(5) provide immediate support and information resources to 
        families of youth who are at risk for suicide;
            ``(6) offer access to services and care to youth with 
        diverse linguistic and cultural backgrounds;
            ``(7) offer appropriate postsuicide intervention services, 
        care, and information to families, friends, schools, educational 
        institutions, juvenile justice systems, substance abuse 
        programs, mental health programs, foster care systems, and other 
        child and youth support organizations of youth who recently 
        completed suicide;
            ``(8) offer continuous and up-to-date information and 
        awareness campaigns that target parents, family members, child 
        care professionals, community care providers, and the general 
        public and highlight the risk factors associated with youth 
        suicide and the life-saving help and care available from early 
        intervention and prevention services;
            ``(9) ensure that information and awareness campaigns on 
        youth suicide risk factors, and early intervention and 
        prevention services, use effective communication mechanisms that 
        are targeted to and reach youth, families, schools, educational 
        institutions, and youth organizations;
            ``(10) provide a timely response system to ensure that 
        child-serving professionals and providers are properly trained 
        in youth suicide early intervention and prevention strategies 
        and that child-serving professionals and providers involved in 
        early

[[Page 118 STAT. 1411]]

        intervention and prevention services are properly trained in 
        effectively identifying youth who are at risk for suicide;
            ``(11) provide continuous training activities for child care 
        professionals and community care providers on the latest youth 
        suicide early intervention and prevention services practices and 
        strategies;
            ``(12) conduct annual self-evaluations of outcomes and 
        activities, including consulting with interested families and 
        advocacy organizations;
            ``(13) provide services in areas or regions with rates of 
        youth suicide that exceed the national average as determined by 
        the Centers for Disease Control and Prevention; and
            ``(14) obtain informed written consent from a parent or 
        legal guardian of an at-risk child before involving the child in 
        a youth suicide early intervention and prevention program.

    ``(d) Requirement for Direct Services.--Not less than 85 percent of 
grant funds received under this section shall be used to provide direct 
services, of which not less than 5 percent shall be used for activities 
authorized under subsection (a)(3).
    ``(e) Coordination and Collaboration.--
            ``(1) In general.--In carrying out this section, the 
        Secretary shall collaborate with relevant Federal agencies and 
        suicide working groups responsible for early intervention and 
        prevention services relating to youth suicide.
            ``(2) Consultation.--In carrying out this section, the 
        Secretary shall consult with--
                    ``(A) State and local agencies, including agencies 
                responsible for early intervention and prevention 
                services under title XIX of the Social Security Act, the 
                State Children's Health Insurance Program under title 
                XXI of the Social Security Act, and programs funded by 
                grants under title V of the Social Security Act;
                    ``(B) local and national organizations that serve 
                youth at risk for suicide and their families;
                    ``(C) relevant national medical and other health and 
                education specialty organizations;
                    ``(D) youth who are at risk for suicide, who have 
                survived suicide attempts, or who are currently 
                receiving care from early intervention services;
                    ``(E) families and friends of youth who are at risk 
                for suicide, who have survived suicide attempts, who are 
                currently receiving care from early intervention and 
                prevention services, or who have completed suicide;
                    ``(F) qualified professionals who possess the 
                specialized knowledge, skills, experience, and relevant 
                attributes needed to serve youth at risk for suicide and 
                their families; and
                    ``(G) third-party payers, managed care 
                organizations, and related commercial industries.
            ``(3) Policy development.--In carrying out this section, the 
        Secretary shall--
                    ``(A) coordinate and collaborate on policy 
                development at the Federal level with the relevant 
                Department of Health and Human Services agencies and 
                suicide working groups; and

[[Page 118 STAT. 1412]]

                    ``(B) consult on policy development at the Federal 
                level with the private sector, including consumer, 
                medical, suicide prevention advocacy groups, and other 
                health and education professional-based organizations, 
                with respect to State-sponsored statewide or tribal 
                youth suicide early intervention and prevention 
                strategies.

    ``(f) Rule of Construction; Religious and Moral Accommodation.--
Nothing in this section shall be construed to require suicide 
assessment, early intervention, or treatment services for youth whose 
parents or legal guardians object based on the parents' or legal 
guardians' religious beliefs or moral objections.
    ``(g) Evaluations and Report.--
            ``(1) Evaluations by eligible entities.--Not later than 18 
        months after receiving a grant or cooperative agreement under 
        this section, an eligible entity shall submit to the Secretary 
        the results of an evaluation to be conducted by the entity 
        concerning the effectiveness of the activities carried out under 
        the grant or agreement.
            ``(2) Report.--Not later than 2 years after the date of 
        enactment of this section, the Secretary shall submit to the 
        appropriate committees of Congress a report concerning the 
        results of--
                    ``(A) the evaluations conducted under paragraph (1); 
                and
                    ``(B) an evaluation conducted by the Secretary to 
                analyze the effectiveness and efficacy of the activities 
                conducted with grants, collaborations, and consultations 
                under this section.

    ``(h) Rule of Construction; Student Medication.--Nothing in this 
section or section 520E-1 shall be construed to allow school personnel 
to require that a student obtain any medication as a condition of 
attending school or receiving services.
    ``(i) Prohibition.--Funds appropriated to carry out this section, 
section 520C, section 520E-1, or section 520E-2 shall not be used to pay 
for or refer for abortion.
    ``(j) Parental consent.--States and entities receiving funding under 
this section and section 520E-1 shall obtain prior written, informed 
consent from the child's parent or legal guardian for assessment 
services, school-sponsored programs, and treatment involving medication 
related to youth suicide conducted in elementary and secondary schools. 
The requirement of the preceding sentence does not apply in the 
following cases:
            ``(1) In an emergency, where it is necessary to protect the 
        immediate health and safety of the student or other students.
            ``(2) Other instances, as defined by the State, where 
        parental consent cannot reasonably be obtained.

    ``(k) Relation to Education Provisions.--Nothing in this section or 
section 520E-1 shall be construed to supersede section 444 of the 
General Education Provisions Act, including the requirement of prior 
parental consent for the disclosure of any education records. Nothing in 
this section or section 520E-1 shall be construed to modify or affect 
parental notification requirements for programs authorized under the 
Elementary and Secondary Education Act of 1965 (as amended by the No 
Child Left Behind Act of 2001; Public Law 107-110).
    ``(l) Definitions.--In this section:

[[Page 118 STAT. 1413]]

            ``(1) Early intervention.--The term `early intervention' 
        means a strategy or approach that is intended to prevent an 
        outcome or to alter the course of an existing condition.
            ``(2) Educational institution; institution of higher 
        education; school.--The term--
                    ``(A) `educational institution' means a school or 
                institution of higher education;
                    ``(B) `institution of higher education' has the 
                meaning given such term in section 101 of the Higher 
                Education Act of 1965; and
                    ``(C) `school' means an elementary or secondary 
                school (as such terms are defined in section 9101 of the 
                Elementary and Secondary Education Act of 1965).
            ``(3) Prevention.--The term `prevention' means a strategy or 
        approach that reduces the likelihood or risk of onset, or delays 
        the onset, of adverse health problems that have been known to 
        lead to suicide.
            ``(4) Youth.--The term `youth' means individuals who are 
        between 10 and 24 years of age.

    ``(m) Authorization of Appropriations.--
            ``(1) In general.--For the purpose of carrying out this 
        section, there are authorized to be appropriated $7,000,000 for 
        fiscal year 2005, $18,000,000 for fiscal year 2006, and 
        $30,000,000 for fiscal year 2007.
            ``(2) Preference.--If less than $3,500,000 is appropriated 
        for any fiscal year to carry out this section, in awarding 
        grants and cooperative agreements under this section during the 
        fiscal year, the Secretary shall give preference to States that 
        have rates of suicide that significantly exceed the national 
        average as determined by the Centers for Disease Control and 
        Prevention.''.

    (d) Mental and Behavioral Health Services on Campus.--Title V of the 
Public Health Service Act (42 U.S.C. 290aa et seq.) is amended by 
inserting after section 520E-1 (as redesignated by subsection (b)) the 
following:
``SEC. 520E-2. MENTAL <<NOTE: 42 USC 290bb-36b.>> AND BEHAVIORAL 
                              HEALTH SERVICES ON
                              CAMPUS.

    ``(a) In General.--The Secretary, acting through the Director of the 
Center for Mental Health Services, in consultation with the Secretary of 
Education, may award grants on a competitive basis to institutions of 
higher education to enhance services for students with mental and 
behavioral health problems that can lead to school failure, such as 
depression, substance abuse, and suicide attempts, so that students will 
successfully complete their studies.
    ``(b) Use of Funds.--The Secretary may not make a grant to an 
institution of higher education under this section unless the 
institution agrees to use the grant only for--
            ``(1) educational seminars;
            ``(2) the operation of hot lines;
            ``(3) preparation of informational material;
            ``(4) preparation of educational materials for families of 
        students to increase awareness of potential mental and 
        behavioral health issues of students enrolled at the institution 
        of higher education;

[[Page 118 STAT. 1414]]

            ``(5) training programs for students and campus personnel to 
        respond effectively to students with mental and behavioral 
        health problems that can lead to school failure, such as 
        depression, substance abuse, and suicide attempts; or
            ``(6) the creation of a networking infrastructure to link 
        colleges and universities that do not have mental health 
        services with health care providers who can treat mental and 
        behavioral health problems.

    ``(c) Eligible grant recipients.--Any institution of higher 
education receiving a grant under this section may carry out activities 
under the grant through--
            ``(1) college counseling centers;
            ``(2) college and university psychological service centers;
            ``(3) mental health centers;
            ``(4) psychology training clinics; or
            ``(5) institution of higher education supported, evidence-
        based, mental health and substance abuse programs.

    ``(d) Application.--An institution of higher education desiring a 
grant under this section shall prepare and submit an application to the 
Secretary at such time and in such manner as the Secretary may require. 
At a minimum, the application shall include the following:
            ``(1) A description of identified mental and behavioral 
        health needs of students at the institution of higher education.
            ``(2) A description of Federal, State, local, private, and 
        institutional resources currently available to address the needs 
        described in paragraph (1) at the institution of higher 
        education.
            ``(3) A description of the outreach strategies of the 
        institution of higher education for promoting access to 
        services, including a proposed plan for reaching those students 
        most in need of mental health services.
            ``(4) A plan to evaluate program outcomes, including a 
        description of the proposed use of funds, the program 
        objectives, and how the objectives will be met.
            ``(5) <<NOTE: Reports.>> An assurance that the institution 
        will submit a report to the Secretary each fiscal year on the 
        activities carried out with the grant and the results achieved 
        through those activities.

    ``(e) Requirement of Matching Funds.--
            ``(1) In general.--The Secretary may make a grant under this 
        section to an institution of higher education only if the 
        institution agrees to make available (directly or through 
        donations from public or private entities) non-Federal 
        contributions in an amount that is not less than $1 for each $1 
        of Federal funds provided in the grant, toward the costs of 
        activities carried out with the grant (as described in 
        subsection (b)) and other activities by the institution to 
        reduce student mental and behavioral health problems.
            ``(2) Determination of amount contributed.--Non-Federal 
        contributions required under paragraph (1) may be in cash or in 
        kind. Amounts provided by the Federal Government, or services 
        assisted or subsidized to any significant extent by the Federal 
        Government, may not be included in determining the amount of 
        such non-Federal contributions.
            ``(3) Waiver.--The Secretary may waive the requirement 
        established in paragraph (1) with respect to an institution

[[Page 118 STAT. 1415]]

        of higher education if the Secretary determines that 
        extraordinary need at the institution justifies the waiver.

    ``(f) Reports.--For each fiscal year that grants are awarded under 
this section, the Secretary shall conduct a study on the results of the 
grants and submit to the Congress a report on such results that includes 
the following:
            ``(1) An evaluation of the grant program outcomes, including 
        a summary of activities carried out with the grant and the 
        results achieved through those activities.
            ``(2) Recommendations on how to improve access to mental and 
        behavioral health services at institutions of higher education, 
        including efforts to reduce the incidence of suicide and 
        substance abuse.

    ``(g) Definition.--In this section, the term `institution of higher 
education' has the meaning given such term in section 101 of the Higher 
Education Act of 1965.
    ``(h) Authorization of Appropriations.--For the purpose of carrying 
out this section, there are authorized to be appropriated $5,000,000 for 
fiscal year 2005, $5,000,000 for fiscal year 2006, and $5,000,000 for 
fiscal year 2007.''.

    Approved October 21, 2004.

LEGISLATIVE HISTORY--S. 2634:
---------------------------------------------------------------------------

CONGRESSIONAL RECORD, Vol. 150 (2004):
            July 8, considered and passed Senate.
            Sept. 8, considered in House.
            Sept. 9, considered and passed House, amended. Senate 
                concurred in House amendment.

                                  <all>
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