I

104TH CONGRESS

1ST SESSION H. R. 1284

To establish a program to provide grants to improve the quality and availability of comprehensive education, health and social services for at-risk

youth and their families, and for other purposes.

IN THE HOUSE OF REPRESENTATIVES

MARCH 21, 1995

Ms. WATERS introduced the following bill; which was referred to the Committee on Economic and Educational Opportunities, and in addition to the

Committee on Commerce, for a period to be subsequently determined by

the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the commtitee concerned

A BILL

To establish a program to provide grants to improve the

quality and availability of comprehensive education,

health and social services for at-risk youth and their

families, and for other purposes.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘School-Based Clinic

5 Health Service Act of 1995’’.
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1 TITLE I—SCHOOL-BASED OR SCHOOL2 LINKED HEALTH AND SOCIAL SERV3 ICES CENTER GRANTS

4 SEC. 101. GRANT PROGRAM.

5 (a) IN GENERAL.—The Secretary of Health and

6 Human Services, acting through the Administrator of the

7 Health Resources and Services Administration, may

8 award grants to eligible local community partnerships to

9 coordinate and deliver comprehensive education, health,

10 and social services to children or youth in school-based,

11 school-linked or community-based locations.

12 (b) ELIGIBLE ENTITIES.—

13 (1) IN GENERAL.—To be eligible to receive a

14 grant under subsection (a), an entity shall—

15 (A) be a new or existing local community

16 partnership which, at a minimum, shall in17 clude—

18 (i) a local health care provider with

19 experience in delivering services to adoles20 cents;

21 (ii) one or more local public schools;

22 and

23 (iii) at least one community-based or24 ganization located in the community to be
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1 served that has a history of providing serv2 ices to at-risk youth in that community;

3 (B) prepare and submit to the Secretary

4 an application in accordance with subsection

5 (e), that has been developed and agreed to by

6 all members of the partnership;

7 (C) ensure the provision of core services in

8 accordance with subsection (c); and

9 (D) meet any other requirements deter10 mined appropriate by the Secretary.

11 (2) PARTICIPATION.—A partnership described

12 in paragraph (1)(A) shall, to the maximum extent

13 feasible, involve broad based community participa14 tion from parents and youth to be served, health and

15 social service providers, teachers and other public

16 school and school board personnel, community-based

17 organizations (particularly those serving minority

18 youth), youth development and service organizations

19 and interested business leaders. Such participation

20 may be through an expanded partnership, or an ad21 visory board to such a partnership.

22 (3) TARGETING.—A partnership described in

23 paragraph (1)(A) shall be located in and created to

24 serve a community in which youth are exposed to a

25 high-risk environment as documented by factors in-
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1 cluding high rates of children in poverty or who lack

2 access to health care, school dropouts and those re3 tained in grade, alcohol or other drug use, sexually

4 transmitted diseases including HIV, teen pregnancy,

5 early parenthood, suicide, community or gang vio6 lence, youth unemployment, and juvenile justice

7 involvement.

8 (c) USE OF AMOUNTS.—

9 (1) CORE SERVICES.—

10 (A) IN GENERAL.—A local partnership

11 awarded a grant under subsection (a) shall use

12 amounts received under such grant to coordi13 nate and deliver core services described in sub14 paragraphs (B) and (C) at a school-based,

15 school-linked, or community-based location or

16 locations accessible to, and utilized by, at-risk

17 children, youth, and their families.

18 (B) COMPREHENSIVE HEALTH, MENTAL

19 HEALTH, AND SOCIAL SERVICES.—With respect

20 to the delivery of comprehensive health, mental

21 health, and social services, a partnership shall

22 ensure that—

23 (i) at a minimum, health screening

24 and health care services, counseling and
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1 crisis intervention and referrals are pro2 vided in a single site; and

3 (ii) health, mental health and social

4 services which cannot be provided directly

5 on-site will be secured through contracted

6 arrangements with community-based pro7 viders and a case management system that

8 ensures that populations to be served re9 ceive needed services and appropriate fol10 low-up services, including supportive serv11 ices such as the provision of transpor12 tation.

13 (C) YOUTH DEVELOPMENT AND LIFE

14 PLANNING.—With respect to youth development

15 and life planning services, a partnership shall—

16 (i) provide age appropriate programs

17 and services that promote the development

18 of life skills and social competencies which

19 assist youth in completing school or em20 ployment training, establishing life and ca21 reer goals, and avoiding high risk behav22 iors; and

23 (ii) provide programs and services

24 that are designed to prevent HIV and

25 other sexually transmitted diseases, unin-
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1 tended pregnancies, early parenthood, alco2 hol and other drug use, suicide, community

3 or gang violence, and other risk-taking be4 haviors that reflect the needs of the popu5 lations identified by the community in the

6 comprehensive plan of the partnership.

7 (2) COORDINATION OF CORE SERVICES.—A

8 partnership awarded a grant under subsection (a)

9 shall, in meeting the requirements of paragraph (1),

10 use amounts received under such grant to coordinate

11 the delivery of existing services of the types de12 scribed in such paragraph to more effectively utilize

13 available resources prior to adding new resources or

14 developing new services.

15 (3) COORDINATION OF CORE SERVICES WITH

16 ADDITIONAL SERVICES.—A partnership awarded a

17 grant under subsection (a) may use amounts re18 ceived under such grant to coordinate or co-locate

19 core services with additional services identified in the

20 comprehensive plan to enhance the support available

21 through the partnership service delivery network.

22 (d) PRIORITY AND TERM OF GRANTS.—

23 (1) PRIORITY.—In awarding grants under this

24 subsection the Secretary shall give priority to those
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1 applicants that, through their comprehensive services

2 plan, demonstrate that—

3 (A) continuity of access to required core

4 services for youth will be made available on a

5 year round basis or beyond traditional school or

6 service hours, either on site or through a

7 backup referral system of community-based pro8 viders; and

9 (B) services to be offered by the partner10 ship will extend beyond the in-school population

11 and will include the provision of core services to

12 out-of-school youth, to the extent practicable.

13 (2) TERM OF GRANTS.—Grants awarded under

14 subsection (a) shall be for a term of not less than

15 3, or more than 5, years based on the ability of the

16 grantee partnership to achieve the goals and objec17 tives identified in the entity’s application. The Sec18 retary may provide 2 year extension awards to those

19 grantee partnerships that, following the initial 3

20 year grant period, demonstrate substantial progress

21 in the integration of comprehensive services, includ22 ing broad based institutional support for collabora23 tion from all members of the partnership, and im24 provement in the health and education outcomes of
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1 the populations served relative to baseline commu2 nity indices.

3 (e) APPLICATION.—

4 (1) IN GENERAL.—An entity that desires to re5 ceive a grant under subsection (a) shall prepare and

6 submit an application to the Secretary at such time,

7 in such manner, and accompanied by such informa8 tion as the Secretary may reasonably require. Such

9 application shall include a comprehensive services

10 plan that meets the requirements of paragraph (3)

11 and the assurances required under paragraph (4). A

12 copy of such application shall be provided to the

13 State agencies primarily responsible for health and

14 education for the particular State involved.

15 (2) FORMULATION.—In formulating a com16 prehensive services plan under this subsection, an

17 entity shall document the efforts undertaken by the

18 entity to obtain broad based community input from

19 teachers and school personnel, health providers in20 cluding organized medicine, social service providers

21 including community-based organizations, and par22 ents and at-risk youth to be served in order to—

23 (A) maximize participation in the needs as24 sessment conducted by the entity;
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1 (B) formulate a service plan that is com2 prehensive and reflective of the needs delineated

3 by youth and families to be served;

4 (C) build institutional support for the serv5 ices to be provided under the plan from the

6 staff and administration of all members of the

7 partnership and the larger community;

8 (D) encourage increased collaboration

9 among a broader range of public and private

10 providers to improve the quality, availability

11 and variety of services offered within the part12 nership; and

13 (E) heighten awareness of the linkage be14 tween access to comprehensive health and social

15 services and school performance.

16 (3) CONTENTS OF THE PLAN.—Each plan sub17 mitted under paragraph (1) shall include—

18 (A) a description of the children or youth

19 populations to which services will be provided

20 under the grant and an assessment of their

21 health, social services, and education needs;

22 (B) an inventory of existing core services

23 described in subsection (c) that are being pro24 vided to such populations within the commu-
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1 nity, including subpopulations of youth with

2 special needs;

3 (C) an identification of the unmet needs of

4 such populations, gaps in the system of core

5 services available, barriers to the utilization of

6 services, and barriers to the integration of serv7 ices including conflicting regulatory require8 ments and eligibility standards;

9 (D) a description of the program goals and

10 objectives and intended outcomes, which may

11 include increased integration and utilization of

12 services by the intended populations, and im13 proved health and education indicators for serv14 ice recipients relative to the baseline community

15 assessments described in subparagraph (A);

16 (E) a plan for the manner in which data

17 systems used by members of the partnership

18 will be coordinated in order to guide local plan19 ning and evaluate the progress made toward

20 achieving program goals and objectives de21 scribed in subparagraph (D);

22 (F) a description of the means by which

23 the entity will coordinate or co-locate services

24 currently provided by members of the partner-
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1 ship in order to maximize the effectiveness of

2 existing resources;

3 (G) a description of the services that will

4 be directly provided to children or youth popu5 lations with funds provided under this Act as

6 needed to address identified unmet core service

7 needs;

8 (H) a description of how the services will

9 be coordinated with the on-going educational

10 activities of the school or schools participating

11 in the partnership and the role the school nurse

12 and other student support personnel will play in

13 the expanded health care services;

14 (I) a description of the process by which

15 program decisions will be made within the part16 nership;

17 (J) an identification of the partnership’s

18 fiscal agent and the manner in which program

19 funds received under this section will be dis20 bursed and monitored; and

21 (K) a description of the strategy for secur22 ing the long term financing necessary to ensure

23 a continuity of services made available through

24 the partnership after the termination of the

25 grant period.
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1 (4) ASSURANCES.—An application submitted

2 under this section shall contain assurances that—

3 (A) core services will be provided in a co4 ordinated manner at a single site providing

5 ready access to the populations to be served,

6 and if such single site is to be school-based,

7 that an affirmative school board vote for the

8 project will be provided;

9 (B) core services will be targeted to popu10 lations and subpopulations identified in the

11 comprehensive plan and will be delivered in a

12 culturally sensitive and linguistically appro13 priate manner;

14 (C) amounts provided to the applicant

15 under this section will be used to coordinate ex16 isting services provided by the individual mem17 bers of the partnership before such amounts are

18 used to provide new services; and

19 (D) amounts provided to the applicant

20 under this section and used to deliver services

21 will be utilized in conformity with the unmet

22 core service needs as identified in the com23 prehensive plan of the entity.
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1 (f) GEOGRAPHIC DISTRIBUTION.—In awarding

2 grants to qualified applicants under this title, the Sec3 retary shall ensure—

4 (1) an equitable geographic distribution; and

5 (2) a distribution to both urban and rural com6 munities in which youth are exposed to a high risk

7 environment in accordance with section 101(b)(3).

8 (g) AMOUNT OF GRANT.—The annual amount of a

9 grant awarded under this title shall not be less than

10 $100,000 nor more than $300,000, except as provided in

11 section 102.

12 (h) FEDERAL SHARE.—

13 (1) IN GENERAL.—Subject to paragraph (3), a

14 grant for services awarded under this section may

15 not exceed—

16 (A) 90 percent of the total cost of the ac17 tivities to be funded under the program for the

18 first 2 fiscal years for which the program re19 ceives assistance under this section; and

20 (B) 75 percent of the total cost of such ac21 tivities for subsequent years for which the pro22 gram receives assistance under this section.

23 The remainder of such costs shall be made available

24 as provided in paragraph (2).
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1 (2) FORM OF NON-FEDERAL SHARE.—The non2 Federal share required by paragraph (1) may be in

3 cash or in-kind, fairly evaluated, including facilities,

4 equipment, personnel, or services, but may not in5 clude amounts provided by the Federal Government.

6 In-kind contributions may include space within a

7 school facility, school personnel, program use of

8 school transportation systems, outposted health and

9 social services personnel, and extension of health

10 provider medical liability insurance.

11 (3) WAIVER.—The Secretary may waive the re12 quirements of paragraph (1) for any year in accord13 ance with criteria established by regulation. Such

14 criteria shall include a documented need for the

15 services provided under this section and an inability

16 of the grantee to meet the requirements of para17 graph (1) despite a good faith effort.

18 (i) TRAINING AND TECHNICAL ASSISTANCE.—Enti19 ties that receive assistance under this section shall use 10

20 percent of the amount of such assistance to provide staff

21 training and to secure necessary technical assistance. To

22 the maximum extent feasible, technical assistance should

23 be sought through local community-based entities. Staff

24 training should include the training of teachers and other

25 school personnel necessary to ensure appropriate referral
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1 and utilization of services and school reinforced linkages

2 between classroom activities and services offered.

3 SEC. 102. PLANNING GRANTS.

4 (a) IN GENERAL.—The Secretary, acting through the

5 Administrator of the Health Resources and Services Ad6 ministration, may award 1-year nonrenewable planning

7 grants to entities described in section 101(b)(1)(A) that

8 agree to establish a local community partnership for the

9 purpose of delivering comprehensive services as described

10 in section 101.

11 (b) APPLICATION.—To be eligible to receive a grant

12 under subsection (a), a local community partnership shall

13 prepare and submit to the Secretary an application, at

14 such time, in such manner, and containing such informa15 tion as the Secretary may reasonably require. A copy of

16 such application shall be provided to the State agencies

17 primarily responsible for health and education in the par18 ticular State involved.

19 (c) USE OF AMOUNTS.—Amounts provided under a

20 grant awarded under subsection (a) shall be used to—

21 (1) assess the education, health, mental health,

22 and social service needs of children or youth in the

23 community proposed to be served by the local com24 munity partnership, and the current service delivery
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1 system, to identify unmet needs and barriers to serv2 ices;

3 (2) develop a plan for the delivery and coordi4 nating of comprehensive education, health and social

5 services for youth populations to be served in a

6 school-based, school-linked, or community-based lo7 cation; and

8 (3) develop program goals and objectives and

9 intended outcomes and the means by which progress

10 will be measured.

11 (d) LIMITATIONS.—

12 (1) AMOUNT AVAILABLE FOR GRANTS.—Not

13 more than 10 percent of the amounts appropriated

14 under section 308(l) shall be used to award planning

15 grants under subsection (a).

16 (2) AMOUNT AVAILABLE FOR INDIVIDUAL

17 GRANTS.—The Secretary shall not award a grant of

18 more than $50,000 under subsection (a).

19 TITLE II—STATE AND LOCAL

20 COORDINATED YOUTH SERVICES GRANTS

21 SEC. 201. PURPOSE.

22 It is the purpose of this title to award grants to city23 wide or countywide consortia, or to a State entity, with

24 a demonstrated commitment to the coordination and deliv25 ery of comprehensive education, health and social services
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1 to in-school and out-of-school youth on a citywide, county2 wide or statewide basis through a system of school-based,

3 school-linked, and community-based comprehensive youth

4 services centers.

5 Subtitle A—Local Consortia Grants

6 SEC. 211. COORDINATION AND SERVICE DELIVERY GRANTS.

7 (a) IN GENERAL.—The Secretary, acting through the

8 Administrator of the Health Resources and Services Ad9 ministration, may award grants to eligible consortia to en10 able such consortia to provide comprehensive core services

11 as described in section 231(a).

12 (b) ELIGIBLE CONSORTIA.—

13 (1) IN GENERAL.—To be eligible to receive a

14 grant under subsection (a), a consortia—

15 (A) shall be a new or existing collaborating

16 group of entities whose membership includes

17 representatives from the local health depart18 ment, the local educational agency, health and

19 social services providers and community-based

20 organizations located in the service delivery

21 area that have a history of providing service to

22 at-risk youth (including minority youth, school

23 dropouts, adolescent parents, and runaway or

24 homeless youth), youth development organiza-
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1 tions, juvenile justice personnel, and parents

2 and the at-risk youth to be served;

3 (B) shall consist of members who have

4 demonstrated a financial or organizational com5 mitment to providing comprehensive education,

6 health, and social services to at-risk youth

7 through an integrated service delivery network

8 directed by the consortia; and

9 (C) shall prepare and submit to the Sec10 retary an application in accordance with section

11 231(b).

12 (2) DEFINITION.—For purposes of paragraph

13 (1):

14 (A) The term ‘‘financial commitment’’

15 means an identification of locally controlled fi16 nancial resources, including those obtained

17 through individual or joint application with

18 other public and private funding sources, to be

19 dedicated to the planning, coordination and de20 livery of comprehensive services to at-risk youth

21 by the consortia.

22 (B) The term ‘‘organizational commit23 ment’’ means—

24 (i) an identification of existing institu25 tional and in-kind resources that each
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1 member of the consortia will dedicate to

2 the goals and objectives of the consortia;

3 (ii) an assurance that the training

4 and technical assistance necessary for

5 teachers and other frontline service provid6 ers to increase their knowledge, expertise,

7 and willingness to work collaboratively will

8 be provided;

9 (iii) a commitment to participate in

10 providing the data necessary to guide the

11 joint planning, implementation, and ongo12 ing monitoring consortia activities; and

13 (iv) with respect to the local edu14 cational agency, an affirmative vote by the

15 local school board on participation in the

16 consortia.

17 Subtitle B—Statewide Youth Services Center

18 Grants

19 SEC. 221. STATEWIDE COORDINATION AND SERVICE DELIV20 ERY GRANTS.

21 (a) IN GENERAL.—The Secretary, acting through the

22 Administrator of the Health Resources and Services Ad23 ministration, may award grants to eligible States to enable

24 such State to provide the core services described in sub-
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1 section 231(a) through the awarding of grants to local

2 community partnerships or consortia.

3 (b) ELIGIBLE STATES.—

4 (1) IN GENERAL.—To be eligible to receive a

5 grant under subsection (a), a State shall—

6 (A) provide assurances that a memoran7 dum of understanding or written cooperative

8 agreement has been entered into by the State

9 agencies responsible for education, health and

10 social services concerning the planned delivery

11 of comprehensive youth services;

12 (B) have a demonstrated financial and or13 ganizational commitment to providing com14 prehensive and co-located health, education, and

15 social services to at-risk youth through the

16 awarding of grants to local communities;

17 (C) currently support the coordinated de18 livery of such services through a system of

19 school-based, school-linked, or community-based

20 comprehensive youth services centers;

21 (D) provide documentation that services

22 are prioritized among communities that have

23 health and social indices that indicate a high

24 risk environment for youth, including high rates

25 of children in poverty or who lack access to
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1 health care, teen pregnancy and early parent2 hood, sexually transmitted diseases including

3 HIV, school dropouts, community or gang vio4 lence, alcohol or other drug use, youth unem5 ployment and juvenile justice involvement; and

6 (E) prepare and submit to the Secretary

7 an application in accordance with section

8 231(b).

9 (2) DEFINITIONS.—For the purposes of para10 graph (1):

11 (A) The term ‘‘demonstrated financial

12 commitment’’ means the investment of State13 controlled financial and other resources avail14 able to States for the purposes of planning, co15 ordinating, and delivering comprehensive serv16 ices to youth in the most recent fiscal year.

17 (B) The term ‘‘demonstrated organiza18 tional commitment’’ means—

19 (i) an administrative mechanism in

20 place under which a statewide system of

21 local partnerships is implemented among

22 education and public and private health

23 and social service providers for collabora24 tion in the joint planning, coordination,
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1 and delivery of comprehensive services to

2 youth populations; and

3 (ii) a defined strategic plan for the

4 manner in which the State provides tech5 nical assistance and training to localities

6 for the development of the collaborative

7 partnerships as described in clause (i).

8 Subtitle C—Provisions Relating to Both Local

9 and Statewide Grant Programs

10 SEC. 231. USE OF AMOUNTS AND APPLICATION.

11 (a) USE OF AMOUNTS.—

12 (1) CORE SERVICES.—

13 (A) IN GENERAL.—A consortia or State

14 entity awarded a grant under section 211 or

15 221 shall use amounts received under such

16 grant to coordinate and deliver core services de17 scribed in subparagraphs (B) and (C) through

18 a system of school-based, school-linked, or com19 munity-based youth centers, to serve in-school

20 and out-of-school youth and their families;

21 (B) COMPREHENSIVE HEALTH, MENTAL

22 HEALTH, AND SOCIAL SERVICES.—With respect

23 to the delivery of comprehensive health, mental

24 health, and social services, a consortia or entity

25 shall ensure that—
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1 (i) at a minimum, health screening

2 and health care services, counseling and

3 crisis intervention and referrals are pro4 vided on-site; and

5 (ii) health, mental health and social

6 services which cannot be provided directly

7 on-site will be secured through referrals to

8 community-based providers under contrac9 tual arrangements and a case management

10 system that ensures that youth receive

11 needed services and appropriate followup

12 services, including supportive services such

13 as the provision of transportation.

14 (C) YOUTH DEVELOPMENT AND LIFE

15 PLANNING.—With respect to youth development

16 and life planning services, a consortia or entity

17 shall—

18 (i) provide programs and services that

19 promote the development of life skills and

20 social competencies which assist youth in

21 completing school or employment training

22 by helping them to establish life and career

23 goals and avoid high risk behaviors; and

24 (ii) provide programs and services

25 that are designed to prevent HIV and
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1 other sexually transmitted diseases, unin2 tended pregnancy, early parenthood, alco3 hol and other drug use, suicide, community

4 or gang violence, and other adolescent risk

5 taking behaviors that reflect the needs of

6 the youth populations identified by the

7 community in the comprehensive plan of

8 the partnership.

9 (2) COORDINATION AND DELIVERY OF CORE

10 SERVICES.—An entity awarded a grant under this

11 title shall, in meeting the requirements of paragraph

12 (1), use amounts received under such grant to co13 ordinate and co-locate the delivery of existing core

14 services of the types described in such paragraph

15 into a broader system of health and social services

16 centers accessible to in-school or out-of-school youth

17 to more effectively utilize available resources prior to

18 adding new resources or developing new services.

19 (3) COORDINATION OF CORE SERVICES WITH

20 EDUCATION AND TRAINING SERVICES FOR OUT-OF21 SCHOOL YOUTH.—An entity awarded a grant under

22 this title shall use amounts received under such

23 grant to provide outreach services to out-of-school

24 youth (including adolescent parents and runaway

25 and homeless youth) and to coordinate core services
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1 with alternative education and job training and

2 placement opportunities for such youth.

3 (4) COORDINATION OF CORE SERVICES WITH

4 ADDITIONAL SERVICES.—An entity awarded a grant

5 under this title may use amounts received under

6 such grant to coordinate and co-locate core services

7 with additional services in order to enhance the sup8 port available to at-risk youth and their families

9 through the service delivery network.

10 (5) EXPANSION OF CORE SERVICES TO FEEDER

11 SCHOOLS.—An entity awarded a grant under this

12 title may use amounts received under such grant to

13 expand the coordination and delivery of core services

14 to those elementary schools whose students will at15 tend secondary schools currently providing core serv16 ices.

17 (b) APPLICATION.—

18 (1) IN GENERAL.—A consortia or State entity

19 that desires to receive a grant under this title shall

20 prepare and submit an application to the Secretary

21 at such time, in such manner, and accompanied by

22 such information as the Secretary may reasonably

23 require. Such application shall include a comprehen24 sive services plan that meets the requirements of
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1 paragraph (3) and the assurances required under

2 paragraph (4).

3 (2) FORMULATION.—In formulating a com4 prehensive services plan under this subsection, a

5 consortia or State entity shall document the efforts

6 undertaken to obtain broadbased community input

7 from teachers and other school personnel, health

8 providers including organized medicine, social serv9 ices providers including community-based organiza10 tions, and parents and at-risk youth in order to—

11 (A) maximize participation in the needs as12 sessment conducted by the entity;

13 (B) formulate a service plan that is com14 prehensive and reflective of the needs delineated

15 by the youth, families, and neighborhoods to be

16 served under the plan;

17 (C) build institutional support for the serv18 ices to be provided under the plan from the

19 staff and administration of all members of the

20 consortia and the support of parents and the

21 larger community; and

22 (D) encourage increased collaboration

23 among members of the consortia as well as a

24 broader range of providers to enhance the qual-
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1 ity, availability and a variety of services avail2 able within the consortia.

3 (3) CONTENTS OF THE PLAN.—Each plan sub4 mitted under paragraph (1) shall include, with re5 spect to local consortia or those localities to be

6 served under a statewide network—

7 (A) a description of the in-school and out8 of-school youth populations to which services

9 will be provided under the grant and an assess10 ment of their health and social services needs;

11 (B) an inventory of existing core services

12 described in subsection (a) that are being pro13 vided to such youth populations, including sub14 populations of youth with special needs;

15 (C) an identification of the unmet needs of

16 such youth populations, gaps in the system of

17 core services available, barriers to the utiliza18 tion of services by such youth, and barriers to

19 the integration of services including conflicting

20 regulatory requirements and eligibility stand21 ards;

22 (D) a description of the program goals and

23 objectives and intended outcomes, which may

24 include increased integration and utilization of

25 services by the intended youth populations, and
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1 improved health and education, indicators for

2 service recipients relative to baseline community

3 assessment;

4 (E) a description of the manner in which

5 such data systems will be utilized to guide plan6 ning and to evaluate progress toward achieving

7 the program goals and objectives described in

8 subparagraph (D);

9 (F) a description of the means by which an

10 entity awarded a grant under this title will—

11 (i) utilize existing Federal, State, local

12 and other funding sources and reimburse13 ment mechanisms (including Medicaid and

14 other third party payors), received by the

15 entity or its members for the coordinated

16 delivery of core services; and

17 (ii) co-locate currently operating serv18 ices provided by the entity or its members

19 into a system of comprehensive health and

20 social services centers in order to maximize

21 the effectiveness of existing resources in

22 serving in-school and out-of-school youth;

23 (G) a description of the services that will

24 be directly provided to such youth populations

25 with funds provided under this Act as needed to
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1 address unmet core service needs identified in

2 the comprehensive plan;

3 (H) a plan for the phased-in development

4 of comprehensive school-based and community5 based health and social services centers with

6 amounts received under this Act to achieve a

7 citywide, countywide, or Statewide service deliv8 ery network of both in-school and out-of-school

9 youth;

10 (I) a plan for the phased-in expansion of

11 services available through the entity by identify12 ing additional opportunities for collaboration

13 with providers offering services in addition to

14 the core services required under subsection (a)

15 which have been identified as needs of such

16 youth populations;

17 (J) a description of the process by which

18 program development, implementation, and

19 evaluation (including the criteria and decision20 making process that will be used in allocating

21 funds within the youth services center system)

22 will be carried out within the entity;

23 (K) an identification of the fiscal agent or

24 State agency administering the program and

25 the manner in which program funds received
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1 under this section will be disbursed and mon2 itored; and

3 (L) a description of the strategy for secur4 ing the long-term financing necessary to con5 tinue to provide the services made available

6 through the entity after the termination of the

7 grant period.

8 (4) ASSURANCES.—An application submitted

9 under this subsection shall contain assurances

10 that—

11 (A) core services will be provided in a co12 ordinated manner to in-school and out-of-school

13 youth through a system of comprehensive serv14 ices centers providing ready access to the youth

15 and their families to be served;

16 (B) core services will be targeted to youth

17 populations and subpopulations identified in the

18 comprehensive plan and will be delivered in a

19 culturally sensitive and linguistically appro20 priate manner;

21 (C) amounts provided to the applicant

22 under this section will be used to coordinate ex23 isting services before such amounts are used to

24 provide directly the services;
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1 (D) amounts provided to the applicant

2 under this section and used to deliver services

3 will be utilized in conformity with the unmet

4 needs as identified in the comprehensive plan of

5 the entity; and

6 (E) entities awarded grants under this title

7 will provide comprehensive services that extend

8 beyond traditional school or service hours, in9 cluding access to year-round programs and pro10 grams that provide services in the evenings or

11 on weekends.

12 (c) TERM OF GRANTS AND ADMINISTRATIVE

13 COSTS.—

14 (1) TERM OF GRANTS.—Grants awarded under

15 this title shall be for a term of not less than 3, or

16 more than 5, years based on the ability of the grant17 ee to achieve the goals and objectives identified in

18 the entities application. The Secretary may provide

19 2-year extension awards to those grantees that, fol20 lowing the initial 3-year grant period, demonstrate

21 substantial progress in the integration of comprehen22 sive services for at-risk youth, including broadbased

23 institutional support for collaboration from all mem24 bers of the consortia, and an improvement in the
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1 health and education outcomes of the youth served

2 relative to the baseline community indices.

3 (2) CAP ON ADMINISTRATIVE COSTS.—A grant4 ee may not use in excess of 5 percent of any

5 amounts received under a grant awarded under this

6 title for planning, data collection, administration, ac7 counting, reporting, and program oversight activi8 ties.

9 (3) INTEGRATION INCENTIVE.—The Secretary,

10 in making a grant under this title, may make avail11 able to an approved consortia or State, an amount

12 equal to—

13 (A) $1 under such a grant for every $5 of

14 Federal funds otherwise available to the individ15 ual members of the consortia or State through

16 other Federal discretionary grant programs

17 that will be integrated into the comprehensive

18 service delivery network established by the con19 sortia or State; and

20 (B) $1 under such a grant for every $1 of

21 local, State or other non-Federal funds made

22 available to carry out the purposes of this Act

23 (such non-Federal contributions may be cash,

24 from public or private entities, or in-kind, fairly
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1 evaluated, including facilities, equipment, and

2 personnel).

3 Amounts provided by the Federal Government and

4 applied under subparagraph (A), may not be in5 cluded in determining the local share for purposes of

6 this paragraph.

7 SEC. 232. CONSORTIA OR STATE PLANNING GRANTS.

8 (a) IN GENERAL.—The Secretary, acting through the

9 Administrator of the Health Resources and Services Ad10 ministration, may award 1-year nonrenewable planning

11 grants to consortia described in section 211(b)(1)(A) or

12 to States for the purpose of planning for the delivery of

13 comprehensive services as described in section 231.

14 (b) APPLICATION.—To be eligible to receive a grant

15 under subsection (a), consortia or State shall prepare and

16 submit to the Secretary an application, at such time, in

17 such manner, and containing such information as the Sec18 retary may reasonably require.

19 (c) USE OF AMOUNTS.—Amounts provided under a

20 grant awarded under subsection (a) shall be used to—

21 (1) establish an administrative mechanism for

22 the development and implementation of a citywide,

23 countywide, or statewide system of school-based,

24 school-linked, or community-based comprehensive

25 youth services centers;
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1 (2) assess the education, health, mental health,

2 and social service needs of youth proposed to be

3 served, and the current service delivery system, to

4 identify unmet needs and barriers to services for

5 youth;

6 (3) develop program goals and objectives and

7 intended outcomes and the means by which progress

8 will be measured; and

9 (4) develop a strategic plan for the coordinating

10 and delivery of comprehensive education, health and

11 social services for youth populations to be served in

12 a school-based, school-linked, or community-based

13 location.

14 (d) LIMITATIONS.—

15 (1) AMOUNT AVAILABLE FOR GRANTS.—Not

16 more than 10 percent of the amounts appropriated

17 under section 308(2) shall be used to award plan18 ning grants under subsection (a).

19 (2) AMOUNT AVAILABLE FOR INDIVIDUAL

20 GRANTS.—The Secretary shall not award a matching

21 grant of more than $150,000 under subsection (a).

22 TITLE III—IMPLEMENTATION PROVISIONS

23 SEC. 301. INTERRELATIONSHIP BETWEEN TITLES.

24 (a) LIMITATION.—
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1 (1) IN GENERAL.—A community that is cur2 rently receiving State funds for the delivery of co-lo3 cated education, health and social services, or a com4 munity that will receive funding from the State if

5 such State is funded under subtitle B of title II,

6 shall not be eligible to receive funds under title I.

7 (2) CONSTRUCTION.—Nothing in paragraph (1)

8 shall be construed to prevent a community partner9 ship that currently receives State funding for the de10 livery of co-located education, health, and social

11 services from forming a consortia in order to seek

12 funding for an expanded citywide or countywide

13 youth services network under subtitle A of title II.

14 (b) PARTICIPATION.—A local consortia operating in

15 a locality that is receiving State funding for the delivery

16 of co-located education, health, and social services, shall

17 include participation from the entities receiving such State

18 funding.

19 (c) CONTINUED FUNDING.—At the completion of the

20 5-year grant period under title I, a partnership receiving

21 funds under such title shall be eligible for continued fund22 ing if such partnership has expanded into a citywide or

23 countywide consortia as described under subtitle A of title

24 II, or has become part of statewide network as described

25 under subtitle B of title II.
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1 SEC. 302. CONSULTATION WITH OTHER DEPARTMENTS.

2 The Secretary shall consult with the Secretary of

3 Education in the development of program regulations to

4 implement this Act.

5 SEC. 303. TECHNICAL ASSISTANCE.

6 (a) IN GENERAL.—The Secretary shall—

7 (1) widely disseminate information regarding

8 the programs authorized under this Act to appro9 priate State and local health, education, and human

10 service agencies and community-based organizations;

11 (2) provide technical assistance to support enti12 ties in complying with the requirements of this Act;

13 and

14 (3) widely disseminate information with respect

15 to successful and model programs supported with

16 funds provided under this Act to current grantees

17 and to entities described in paragraph (1).

18 (b) ADMINISTRATION.—The assistance and informa19 tion under subsection (a) shall be provided directly

20 through the Health Resources and Services Administra21 tion as the administering agency, other agencies within the

22 Department of Health and Human Services with appro23 priate expertise, or through grants, or contracts with, non24 profit organizations with appropriate expertise. In carry25 ing out this section, the Secretary shall collaborate with
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1 the Department of Education, Department of Labor, and

2 the Commission on National and Community Service.

3 SEC. 304. REPORT TO SECRETARY.

4 (a) IN GENERAL.—Entities receiving funds under

5 this Act shall prepare and submit to the Secretary an an6 nual report that shall contain information concerning—

7 (1) service utilization, including the number of

8 client visits funded through this Act, the types of

9 services provided, demographic data on the age, sex

10 and race of participants, and the third party reim11 bursement source for such services provided;

12 (2) the most recent data for youth residing in

13 the service delivery area including—

14 (A) school dropout rates, absenteeism, and

15 school reentry rates;

16 (B) teen pregnancy, early parenthood, and

17 sexually transmitted disease rates, including

18 HIV disease rates; and

19 (C) available data on substance abuse

20 rates, juvenile crime indices, and youth unem21 ployment; and

22 (3) the number and types of entities participat23 ing in the delivery of services through the com24 prehensive services plan, and the actions taken to
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1 coordinate and collaborate with other entities in

2 service delivery.

3 (b) THIRD YEAR SUBMISSIONS.—At the end of the

4 third fiscal year for which a grant is awarded to an entity

5 under this Act, the entity shall submit, as part of the re6 port required under subsection (a), an analysis of the

7 progress that has been made in—

8 (1) achieving the program goals, objectives and

9 intended outcomes as outlined in the comprehensive

10 services plan; and

11 (2) improving the health and education out12 comes of the youth served relative to baseline com13 munity indices.

14 SEC. 305. MAINTENANCE OF EFFORT.

15 The Secretary may not make a grant to an applicant

16 under this Act unless such applicant agrees to maintain

17 the expenditures of the applicant for the purposes for

18 which the grant is awarded at a level equal to not less

19 than the level of such expenditures maintained by the ap20 plicant for the year preceding the fiscal year for which

21 the applicant is applying to receive the grant.

22 SEC. 306. DEFINITIONS.

23 As used in this Act:

24 (1) SECRETARY.—The term ‘‘Secretary’’ means

25 the Secretary of Health and Human Services.
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1 (2) CHILD.—The term ‘‘child’’ means an indi2 vidual between the ages of 5 and 10.

3 (3) YOUTH.—The term ‘‘youth’’ means individ4 uals between the ages 10 and 21.

5 (4) AT-RISK YOUTH.—The term ‘‘at-risk

6 youth’’ shall have the meaning given such term in

7 guidelines utilized by the Centers for Disease Con8 trol.

9 SEC. 307. AUTHORIZATION OF APPROPRIATIONS.

10 There are authorized to be appropriated to carry out

11 this Act, $2,000,000,000 for fiscal year 1996 and such

12 sums as may be necessary for each of the fiscal years 1997

13 through 2000. Of the amounts appropriated for each fiscal

14 year—

15 (1) 45 percent of such amount shall be made

16 available to carry out title I;

17 (2) 45 percent of such amount shall be made

18 available to carry out title II; and

19 (3) 10 percent of such amount shall be made

20 available to carry out section 401.
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1 TITLE IV—FEDERAL COORDINATED

2 YOUTH SERVICES INITIATIVES

3 SEC. 401. SPECIAL PROJECTS OF A NATIONAL SIGNIFI4 CANCE.

5 (a) IN GENERAL.—The Secretary, acting through the

6 Administrator of the Health Resources and Services Ad7 ministration, shall establish and administer a special

8 projects of national significance program to award direct

9 grants to public and nonprofit private entities to enable

10 such entities to fund model programs designed to integrate

11 health and social services, including HIV prevention, pro12 vided to special populations at risk as defined in sub13 section (c).

14 (b) GRANTS.—The Secretary shall award grants

15 under subsection (a) based on the—

16 (1) need to provide health and social services,

17 including HIV prevention services, to meet the spe18 cial needs of subpopulations of youth living in high

19 risk environments who may otherwise not be pro20 vided with assistance under this Act;

21 (2) need to assess the effectiveness of a particu22 lar prevention or service model or collaboration

23 strategy; and

24 (3) potential replicability of the proposed activ25 ity in other localities.
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1 (c) SPECIAL PROJECTS.—Special projects of a na2 tional significance to be funded under subsection (a) may

3 include those projects that are designed to target—

4 (1) runaway, homeless, or street youth;

5 (2) immigrant or migrant youth;

6 (3) youth involved in the juvenile justice sys7 tem;

8 (4) youth involved in the foster care system;

9 (5) youth involved in gangs;

10 (6) youth with a history of substance abuse;

11 (7) youth with HIV disease;

12 (8) adolescent parents; and

13 (9) Native American youth.

14 SEC. 402. FEDERAL COUNCIL ON CHILDREN, YOUTH, AND

15 FAMILIES.

16 Section 918(k) of the Claude Pepper Young Ameri17 cans Act of 1990 (42 U.S.C. 12314(k)) is amended—

18 (1) in paragraph (6), by striking ‘‘and’’ at the

19 end thereof;

20 (2) in paragraph (7), by striking the period and

21 inserting ‘‘; and’’ and

22 (3) by adding at the end the following new

23 paragraph:

24 ‘‘(8) make recommendations to the Congress

25 concerning legislative action needed to facilitate the
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1 coordination of education, health, and social services

2 for in school and out of school youth.’’.

3 SEC. 403. EVALUATION AND REPORT TO CONGRESS.

4 (a) REPORT TO CONGRESS.—The Secretary shall pre5 pare and submit to the appropriate committees of Con6 gress a biannual report concerning the implementation of

7 this Act. Such report shall include a summary of the data

8 provided in the annual reports submitted to the Secretary

9 under section 304, and an assessment of the progress

10 achieved by grantees under this Act in stabilizing and im11 proving participant outcomes and reducing adverse con12 sequences of adolescent risk taking behaviors and the ab13 sence of necessary services in the communities served

14 under this Act.

15 (b) EVALUATION.—

16 (1) IN GENERAL.—Not later than 54 months

17 after the date of enactment of this Act, the Sec18 retary shall, through the awarding of grants and

19 contracts to independent entities with expertise in

20 adolescent health and youth development, provide an

21 evaluation of the programs funded under this Act to

22 the appropriate committees of Congress. A rep23 resentative subset of grantees under each title shall

24 be selected with an equitable geographic distribution,

25 and urban and rural representation. The evaluation
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1 process shall commence not later than 12 months

2 after the date of enactment of this Act, with data

3 to be collected under subparagraphs (B), (C), (D),

4 and (E), at yearly intervals. The evaluation report

5 shall be conducted by individuals who are not di6 rectly involved in the administration of the programs

7 funded under this Act. The final evaluation report

8 shall include—

9 (A) the program goals and objectives iden10 tified in the comprehensive services plans of

11 grantees, and the degree to which they reflect

12 the unmet needs and service gaps of the appli13 cant area as delineated in the grant application;

14 (B) what services were provided by grant15 ees under this Act, who the recipients of the

16 services were, and an assessment of whether

17 high risk youth actually received services pro18 vided by grantees, including youth who are out

19 of school, runaway or homeless, and adolescent

20 parents;

21 (C) the impact of a comprehensive and co22 ordinated service delivery system on the base23 line health and education indices identified in

24 the comprehensive services plan of the grantee,

25 and an identification of other relevant factors
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1 affecting the health and education outcomes

2 among target youth in the service delivery area

3 during the grant period;

4 (D) the expansion of services achieved in

5 the service delivery area, both through en6 hanced planning and coordination of services

7 and the provision of new service capacity;

8 (E) the degree to which increased utiliza9 tion of services has paralleled service expansion;

10 (F) the process by which broad based

11 input was achieved in the formulation of com12 prehensive services plans on an ongoing basis;

13 (G) the methods by which coordination of

14 services was undertaken administratively among

15 agencies and providers, the degree to which

16 service coordination was achieved, and the bar17 riers that impeded the coordination of services;

18 and

19 (H) the sustainability of local partnerships,

20 consortia, and State comprehensive service de21 livery networks at the completion of the Federal

22 grant period.

23 (2) APPROPRIATIONS.—The Secretary shall use

24 amounts made available under section 2711 of the
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1 Public Health Service Act to conduct the evaluation

2 under this section.

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