I 

108TH CONGRESS 

1ST SESSION H. R. 3063

To authorize the Secretary of Health and Human Services, the Secretary 

of Education, and the Attorney General to make 10 grants to demonstration facilities to implement evidence-based preventive-screening tools to 

detect mental illness and suicidal tendencies in school-age youth at selected facilities. 

IN THE HOUSE OF REPRESENTATIVES 

SEPTEMBER 10, 2003

Ms. DELAURO (for herself, Mr. WAXMAN, Mr. SERRANO, Mr. TOWNS, Mr. 

GRIJALVA, Mrs. CHRISTENSEN, and Mr. ACEVEDO-VILA ́) introduced the 

following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Education and the Workforce, 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 committee concerned 

A BILL

To authorize the Secretary of Health and Human Services, 

the Secretary of Education, and the Attorney General 

to make 10 grants to demonstration facilities to implement evidence-based preventive-screening tools to detect 

mental illness and suicidal tendencies in school-age youth 

at selected facilities.

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

2 This Act may be cited as the ‘‘Children’s Mental 

3 Health Screening and Prevention Act of 2003’’. 

4 SEC. 2. FINDINGS. 

5 The Congress finds as follows: 

6 (1) Over the past 20 years, advances in sci7 entific research have changed the way of thinking 

8 about children’s mental health and proven that the 

9 same mental disorders that afflict adults can also 

10 occur in children and adolescents. 

11 (2) In January 2001, the Report of the Sur12 geon General’s Conference on Children’s Mental 

13 Health noted that 74 percent of individuals age 21 

14 with mental disorders had prior problems, indicating 

15 that children’s mental disorders often persist into 

16 adulthood. 

17 (3) Scientific research has demonstrated that 

18 early identification and treatment of mental dis19 orders in youth greatly improves a child or adoles20 cent’s prognosis throughout his or her lifetime. 

21 (4) In January 2001, the Surgeon General 

22 noted that, while 1 in 10 children and adolescents in 

23 the United States suffers from mental illness severe 

24 enough to cause some level of impairment, only 1 in 

25 5 of such children and adolescents receives needed 

26 mental health treatment. 
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1 (5) According to an interim report by the Presi2 dent’s New Freedom Commission on Mental Health, 

3 about 7 to 9 percent of all children who are 9 to 17 

4 years of age (about 1 or 2 in every classroom) have 

5 a serious emotional disturbance. 

6 (6) In September 2002, the National Council 

7 on Disability noted that between 60 and 70 percent 

8 of youth in the juvenile justice system have an emo9 tional disturbance and almost 50 percent have co-oc10 curring disabilities. 

11 (7) The World Health Organization has re12 ported that youth neuropsychiatric disorders will rise 

13 by over 50 percent by 2020, making such disorders 

14 1 of the top 5 causes of disability, morbidity, and 

15 mortality among children and adolescents. 

16 (8) Psychological autopsy studies have found 

17 that 90 percent of youths who end their own lives 

18 have depression or another diagnosable mental or 

19 substance abuse disorder at the time of their deaths, 

20 verifying a link between mental illness and suicide. 

21 (9) According to an interim report by the Presi22 dent’s New Freedom Commission on Mental Health, 

23 more than 30,000 lives are lost every year to suicide, 

24 which is a largely preventable public health problem. 
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1 (10) In 1999, the Surgeon General recognized 

2 that mental illness and substance abuse disorders 

3 are, in fact, the greatest risk factors for suicidal be4 havior, and that properly identifying and treating 

5 mental illness and substance abuse disorders are an 

6 important part of suicide prevention activities. 

7 (11) The National Council on Disability has 

8 also stated that ‘‘the failure to identify and treat 

9 mental disabilities between children and youth has 

10 serious consequences, including school failure, in11 volvement with the justice system and other tragic 

12 outcomes,’’ including ‘‘the growing problem of teen 

13 suicides and/or suicide attempts’’. 

14 (12) The Centers for Disease Control and Pre15 vention reported that in 2000 suicide was the 3rd 

16 leading cause of death among youth 15 to 24 years 

17 of age. 

18 (13) The Substance Abuse and Mental Health 

19 Services Administration reported that in 1999 al20 most 3,000,000 youth were at risk for suicide, but 

21 only 36 percent received mental health treatment. 

22 (14) According to the Youth Risk Behavior 

23 Surveillance System of the Centers for Disease Con24 trol and Prevention, among high school students 

25 surveyed in 2001, 19 percent had seriously consid-
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1 ered attempting suicide, almost 15 percent had 

2 made a specific plan to attempt suicide, almost 9 

3 percent had attempted suicide, and almost 3 percent 

4 had made an attempt at suicide that required med5 ical attention. 

6 (15) The Centers for Disease Control and Pre7 vention reported that each year in the United States, 

8 almost as many adolescents and young adults com9 mit suicide as die from all natural causes combined, 

10 including leukemia, birth defects, pneumonia, influ11 enza, and AIDS. 

12 (16) In January 2001, the Surgeon General 

13 issued a goal to ‘‘improve the assessment of and rec14 ognition of mental health needs in children’’ in part 

15 by encouraging ‘‘early identification of mental health 

16 needs in existing preschool, child care, education, 

17 health, welfare, juvenile justice, and substance abuse 

18 treatment systems’’. 

19 (17) In May 2003, the National Council on 

20 Disability noted that ‘‘despite calls for significant 

21 prevention and early intervention efforts in schools 

22 and the juvenile justice system, there is little evi23 dence that such efforts are widespread’’. The Coun24 cil also found that ‘‘the absence is notable because 

25 research suggests that such programming may be 
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1 the only effective method for reducing the involve2 ment of youth with disabilities in the juvenile justice 

3 system’’. 

4 (18) The April 2003 Outline of the Final Re5 port for the President’s New Freedom Commission 

6 on Mental Health states that ‘‘evidence-based prac7 tice interventions should be tested in demonstration 

8 projects with oversight by a public-private consor9 tium of stakeholders’’. 

10 (19) An interim report by the President’s New 

11 Freedom Commission on Mental Health concludes 

12 that there is a range of effective treatments, serv13 ices, and supports to facilitate recovery from mental 

14 illness, but the current system can not efficiently de15 liver them. 

16 (20) The efforts, initiatives, and activities of 

17 the Federal Government should be used to support 

18 evidence-based preventive-screening tools to detect 

19 mental illness and suicidal tendencies in school-age 

20 youth. 

21 SEC. 3. MENTAL HEALTH SCREENING DEMONSTRATION 

22 PROJECT. 

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

24 Human Services, the Secretary of Education, and the At25 torney General, acting jointly and in consultation with the 
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1 Directors (as that term is defined in subsection (k)), shall 

2 make 10 grants to demonstration facilities to implement 

3 evidence-based preventive-screening tools to detect mental 

4 illness and suicidal tendencies in school-age youth and to 

5 refer those youth in need of assessment or treatment. 

6 (b) EQUITABLE GEOGRAPHIC DISTRIBUTION.—To 

7 the extent practicable, the Secretaries shall ensure an eq8 uitable distribution of grants under this section among the 

9 geographic regions of the United States. 

10 (c) PERIOD OF GRANTS.—Each grant made under 

11 subsection (a) shall be for a period of 3 years. 

12 (d) APPLICATION REQUIREMENTS.—

13 (1) IN GENERAL.—To seek a grant under this 

14 section, a demonstration facility shall submit an ap15 plication at such time and in such manner as the 

16 Secretaries reasonably require. 

17 (2) CONTENTS.—An application submitted by a 

18 demonstration facility for a grant under subsection 

19 (a) shall—

20 (A) demonstrate that the facility has 

21 formed a multidisciplinary project implementa22 tion committee; 

23 (B) specify an evidence-based preventive24 screening tool to be implemented with the 

25 grant; 
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1 (C) demonstrate that the facility has the 

2 means to obtain the necessary resources and 

3 tools, other than personnel, to implement the 

4 specified evidence-based preventive-screening 

5 tool; 

6 (D) demonstrate that the facility has exist7 ing staff, will hire new staff, or will partner 

8 with staff from a local, licensed mental health 

9 or medical organization, and has the ability to 

10 train staff—

11 (i) to implement the specified evi12 dence-based screening tool; 

13 (ii) to case manage youth with symp14 toms or indicators for mental illness, suici15 dal ideation, or suicide attempts; and 

16 (iii) to work with the parents or 

17 guardians of youth with symptoms or indi18 cators for mental illness, suicidal ideation, 

19 or suicide attempts to help them under20 stand the youth’s outcome and treatment 

21 options; 

22 (E) identify the location (which need not 

23 be at the facility) where the specified evidence24 based preventive-screening tool will be imple25 mented; 
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1 (F) demonstrate that the facility has ob2 tained full approval to screen at such location; 

3 (G) identify the sample of school-age youth 

4 to be screened; 

5 (H) identify a method for obtaining writ6 ten consent from the parent or legal guardian 

7 of any minor participating in the demonstration 

8 project; 

9 (I) identify licensed mental health pro10 viders (including mental health professionals, 

11 hospitals, residential treatment centers, or out12 patient clinics) in the community where the fa13 cility is located that will partner with the facil14 ity to provide further mental health assess15 ments and treatment for participating youth 

16 with symptoms or indicators of mental illness, 

17 and demonstrate the ability of those providers 

18 to accept referrals; and 

19 (J) contain such other information as the 

20 Secretaries reasonably require. 

21 (e) MULTIDISCIPLINARY PROJECT IMPLEMENTATION

22 COMMITTEE.—The Secretaries may not make a grant to 

23 a demonstration facility under subsection (a) for a dem24 onstration project unless the facility agrees to the fol25 lowing: 
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1 (1) The multidisciplinary project implementa2 tion committee formed under subsection (d)(2)(A) 

3 will consist of the following: 

4 (A) Representatives of the facility. 

5 (B) Representatives of the location where 

6 the specified evidence-based preventive screen7 ing tool will be implemented (if that location is 

8 other than the demonstration facility). 

9 (C) A facility case manager (as that posi10 tion is described in subsection (d)(2)(D)(ii)). 

11 (D) Mental health providers in the commu12 nity. 

13 (E) Mental health consumers or family 

14 members of mental health consumers. 

15 (F) Parents or guardians of any school16 aged youth to be screened. 

17 (2) When possible, the multidisciplinary project 

18 implementation committee will follow the guidance of 

19 any suicide prevention plan endorsed by State or 

20 local government officials or local public health offi21 cials. 

22 (3) The multidisciplinary project implementa23 tion committee will be responsible for ensuring com24 pliance with the representations made by the facility 

25 in its grant application. 
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1 (4) The multidisciplinary project implementa2 tion committee will coordinate and collaborate with 

3 mental health providers in the community, including 

4 those identified in subsection (d)(2)(I), to guarantee 

5 that all youth with symptoms or indicators for men6 tal illness, suicidal ideation, or suicide attempts re7 ceive appropriate and affordable treatment regard8 less of the financial or insurance status of the 

9 youth’s parent or guardian. 

10 (f) INFORMATION COLLECTION.—The Secretaries 

11 may not make a grant to an applicant under subsection 

12 (a) for a demonstration project unless the applicant agrees 

13 to collect the following: 

14 (1) Information on the demographics of youth 

15 participating in the project, including—

16 (A) the number of youth invited to partici17 pate in the project, including the number of 

18 such youth disaggregated by age, gender, and 

19 ethnicity; and 

20 (B) the number of youth with symptoms or 

21 indicators for mental illness requiring clinical 

22 consultation or assessment, including such 

23 number disaggregated by disorder. 

24 (2) Information on the outcomes of evidence25 based preventive-screening tools, including—
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1 (A) the number of screening refusals, due 

2 to lack of consent by a parent or legal guardian 

3 or refusal of the youth; 

4 (B) the number of youth with symptoms or 

5 indicators for all mental illnesses, including 

6 such number disaggregated by disorder; and 

7 (C) post assessment, the number of youth 

8 with positive outcomes for suicidal ideation or 

9 suicide attempts. 

10 (3) Information on referrals based on outcomes, 

11 including—

12 (A) the number of youth referred for clin13 ical interviews to determine the need for further 

14 evaluation or treatment; 

15 (B) the number of youth referred for fur16 ther evaluation or treatment, including such 

17 number disaggregated by type and location of 

18 treatment; 

19 (C) the number of youth and their parents 

20 or legal guardians who accept referrals for fur21 ther evaluation or treatment; and 

22 (D) the number of youth and their parents 

23 or legal guardians who refuse referrals for fur24 ther evaluation or treatment. 
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1 (4) To the extent practicable, information on 

2 treatment based on referrals, including the number 

3 of appointments kept by referred youth. 

4 (5) To the extent practicable, information on 

5 suicide attempts, suicide rates, and access to evi6 dence-based mental health screening and suicide pre7 vention programs among school-age youth in the 

8 designated jurisdiction in which the grantee is lo9 cated for the 3 years preceding the commencement 

10 of the project. 

11 (6) To the extent practicable, data on barriers 

12 to care encountered by referred youth, including but 

13 not limited to linguistic barriers, transportation dif14 ficulties, lack of providers in the community, or lack 

15 of insurance. 

16 (7) Such additional information as the Secre17 taries reasonably require. 

18 (g) INFORMATION REPORTING.—The Secretaries 

19 may not make a grant to an applicant under subsection 

20 (a) for a demonstration project unless the applicant agrees 

21 to report information collected under subsection (f) to the 

22 Secretaries as follows: 

23 (1) Information collected under paragraphs (1), 

24 (2), (3), (4), (6), (7), and (8) of subsection (f) shall 

25 be reported—
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1 (A) not later than the date that is 2 

2 months after completion of the 1st year of the 

3 project; 

4 (B) not later than the date that is 2 

5 months after completion of the 2nd year of the 

6 project; and 

7 (C) not later than the date that is 2 

8 months after completion of the 3rd year of the 

9 project. 

10 (2) Any information collected under paragraph 

11 (5) of subsection (f) shall be reported not later than 

12 the date that is 6 months after commencement of 

13 the demonstration project. 

14 (h) FEASIBILITY OF COLLECTING INFORMATION ON

15 PRECEDING YEARS.—In making grants under subsection 

16 (a), the Secretaries may not discriminate against an appli17 cant because it will not be practicable, owing to insuffi18 cient funds or otherwise, for the applicant to collect infor19 mation under subsection (f)(5). 

20 (i) ADVISORY PANEL.—

21 (1) ESTABLISHMENT.—Not later than 14 

22 months after making the first grant under sub23 section (a), the Secretaries shall convene an advisory 

24 panel. 

25 (2) DUTIES.—The advisory panel shall—
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1 (A) assist in the review and evaluation of 

2 the information collected and reported pursuant 

3 to subsections (f) and (g), respectively; and 

4 (B) submit recommendations to each of 

5 the Secretaries on the use or improvement of 

6 evidence-based preventive-screening tools to de7 tect mental illness and suicidal tendencies in 

8 school-age youth. 

9 (3) MEMBERSHIP.—The advisory panel shall 

10 consist of not more than 20 members, and the mem11 bers shall represent the following: 

12 (A) National or local organizations rep13 resenting for-profit and nonprofit mental health 

14 care treatment facilities. 

15 (B) National or local organizations rep16 resenting mental health care professionals. 

17 (C) National or local organizations rep18 resenting mental health care consumers. 

19 (D) National or local organizations rep20 resenting school-based mental health care pro21 fessionals. 

22 (E) National or local organizations dedi23 cated to school-based health care. 

24 (F) National or local organizations rep25 resenting school administrators. 
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1 (G) National or local organizations rep2 resenting school boards and school board mem3 bers. 

4 (H) National or local organizations rep5 resenting juvenile justice professionals. 

6 (I) National or local organizations dedi7 cated to juvenile justice. 

8 (J) National or local organizations rep9 resenting foster care professionals. 

10 (K) National or local organizations dedi11 cated to foster care. 

12 (L) National or local organizations dedi13 cated to child welfare. 

14 (M) Accredited child and adolescent psy15 chiatric programs at national medical colleges 

16 and universities. 

17 (N) Any other entities or individuals that 

18 the Secretaries deem appropriate. 

19 (j) REPORT.—Not later than 6 months after the end 

20 of the 3-year grant period for the last grant made under 

21 subsection (a), the Secretaries, in consultation with the 

22 Directors and the advisory panel, shall submit to the Con23 gress a report on the grants made under this section. Such 

24 report shall be based on the information collected and re25 ported under subsections (f) and (g), respectively, and 
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1 shall include the evaluation and recommendations of the 

2 advisory panel. 

3 (k) DEFINITIONS.—In this section: 

4 (1) ADVISORY PANEL.—The term ‘‘advisory 

5 panel’’ means the advisory panel convened under 

6 subsection (i). 

7 (2) DEMONSTRATION FACILITY.—The term 

8 ‘‘demonstration facility’’ means a facility that serves 

9 at-risk youth or performs outreach to school-age 

10 youth, including any elementary school, secondary 

11 school, school-based health center, juvenile justice 

12 facility, foster care setting, homeless shelter, youth 

13 drop-in center, youth outreach organization, youth 

14 residential treatment center, or State or local mental 

15 health organization. 

16 (3) DIRECTORS.—The term ‘‘Directors’’ means 

17 the Administrator of the Health Resources and Serv18 ices Administration, the Administrator of the Sub19 stance Abuse and Mental Health Services Adminis20 tration, the Director of the Centers for Disease Con21 trol and Prevention, the Director of the Indian 

22 Health Service, and the Director of the National In23 stitute of Mental Health. 

24 (4) ELEMENTARY SCHOOL; SECONDARY

25 SCHOOL.—The terms ‘‘elementary school’’ and ‘‘sec-
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1 ondary school’’ have the meanings given those terms 

2 in section 9101 of the Elementary and Secondary 

3 Education Act (20 U.S.C. 7801). 

4 (5) EVIDENCE-BASED PREVENTIVE-SCREENING

5 TOOL.—The term ‘‘evidence-based preventive-screen6 ing tool’’ means a preventive-screening tool that has 

7 been shown to be valid and effective through re8 search that is conducted by independent scientific 

9 teams, is determined by well-regarded scientists to 

10 be of high quality, and meets the quality standards 

11 for publication in scientific peer-reviewed journals. 

12 (6) SCHOOL-AGE YOUTH.—The term ‘‘school13 age youth’’ means an individual who is 6 to 18 years 

14 of age, or who is enrolled in any elementary school 

15 or secondary school. 

16 (7) SECRETARIES.—The term ‘‘Secretaries’’ 

17 means the Secretary of Health and Human Services, 

18 the Secretary of Education, and the Attorney Gen19 eral, acting jointly. 

20 (l) AUTHORIZATION OF APPROPRIATIONS.—There 

21 are authorized to be appropriated to the Secretaries to 

22 carry out this section $7,500,000 for each of fiscal years 

23 2004 through 2006, and such sums as may be necessary 

24 thereafter, to remain available until expended.

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