I 

111TH CONGRESS 

1ST SESSION H. R. 2531 

To amend the Public Health Service Act to revise and extend projects relating 

to children and violence to provide access to school-based comprehensive 

mental health programs. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 20, 2009 

Mrs. NAPOLITANO (for herself, Ms. DEGETTE, Mr. TIM MURPHY of Pennsylvania, Mr. FRANK of Massachusetts, Ms. BORDALLO, Ms. ROYBAL-ALLARD, Mr. COSTELLO, Mrs. BONO MACK, Mr. BISHOP of Georgia, Mr. 

KENNEDY, Mr. SERRANO, Ms. EDDIE BERNICE JOHNSON of Texas, Ms. 

BALDWIN, Mr. OLVER, Mr. BACA, Mr. MCGOVERN, Mrs. CHRISTENSEN, 

Mr. RODRIGUEZ, Mr. GENE GREEN of Texas, Mr. SESTAK, and Mrs. 

CAPPS) introduced the following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To amend the Public Health Service Act to revise and extend 

projects relating to children and violence to provide access to school-based comprehensive mental health programs. 

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 ‘‘Mental Health in 

5 Schools Act of 2009’’. 


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1 SEC. 2. FINDINGS. 

2 Congress makes the following findings: 

3 (1) Approximately 1 in 5 children have a 

4 diagnosable mental disorder. 

5 (2) Approximately 1 in 10 children have a seri6 ous emotional or behavioral disorder that is severe 

7 enough to cause substantial impairment in func8 tioning at home, at school, or in the community. It 

9 is estimated that about 75 percent of children with 

10 emotional and behavioral disorders do not receive 

11 specialty mental health services. 

12 (3) Only half of schools across the United 

13 States report having formal partnerships with com14 munity mental health providers to deliver mental 

15 health services. 

16 (4) If a school is going to respond to the mental 

17 health needs of its students, it must have access to 

18 resources that provide family-centered, culturally 

19 and linguistically appropriate supports and services. 

20 (5) Effective school mental health programs re21 flect the collaboration and commitment of families, 

22 students, educators, and other community partners. 

23 (6) Many schools have school-employed mental 

24 health providers supporting student’s social, emo25 tional, and behavioral health needs in schools. The 

26 most common types of staff providing mental health 


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1 services in schools were school counselors, followed 

2 by school nurses, school psychologists and school so3 cial workers. Three-quarters of schools had at least 

4 one school counselor on staff, over two-thirds had a 

5 school psychologist or school nurse, and 44 percent 

6 had a school social worker. 

7 (7) Although it is well recognized that mental 

8 health directly affects children’s learning and devel9 opment, in a recent study one-third of school dis10 tricts reported decreased funding for school mental 

11 health services, and at the same time two-thirds of 

12 school districts reported increased need for such 

13 services. 

14 SEC. 3. PURPOSES. 

15 It is the purpose of this Act to— 

16 (1) revise, increase funding for, and expand the 

17 scope of the Safe Schools-Healthy Students program 

18 in order to provide access to more comprehensive 

19 school-based mental health services and supports; 

20 (2) provide for comprehensive staff development 

21 for school and community service personnel working 

22 in the school; and 

23 (3) provide for comprehensive training for chil24 dren with mental health disorders, for parents, sibVerDate Nov 24 2008 01:18 May 23, 2009 Jkt 079200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2531.IH H2531

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1 lings, and other family members of such children, 

2 and for concerned members of the community. 

3 SEC. 4. AMENDMENTS TO THE PUBLIC HEALTH SERVICE 

4 ACT. 

5 (a) TECHNICAL AMENDMENTS.—The second part G 

6 (relating to services provided through religious organiza7 tions) of title V of the Public Health Service Act (42 

8 U.S.C. 290kk et seq.) is amended— 

9 (1) by redesignating such part as part J; and 

10 (2) by redesignating sections 581 through 584 

11 as sections 596 through 596C, respectively. 

12 (b) SCHOOL-BASED MENTAL HEALTH AND CHIL13 DREN AND VIOLENCE.—Section 581 of the Public Health 

14 Service Act (42 U.S.C. 290hh) is amended to read as fol15 lows: 

16 ‘‘SEC. 581. SCHOOL-BASED MENTAL HEALTH AND CHIL17 DREN AND VIOLENCE. 

18 ‘‘(a) IN GENERAL.—The Secretary, in collaboration 

19 with the Secretary of Education and in consultation with 

20 the Attorney General, shall, directly or through grants, 

21 contracts, or cooperative agreements awarded to public en22 tities and local education agencies, assist local commu23 nities and schools in applying a public health approach 

24 to mental health services both in schools and in the com25 munity. Such approach should provide comprehensive age 


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1 appropriate services and supports, be linguistically and 

2 culturally appropriate, and incorporate age appropriate 

3 strategies of positive behavioral interventions and sup4 ports. A comprehensive school mental health program 

5 funded under this section shall assist children in dealing 

6 with violence. 

7 ‘‘(b) ACTIVITIES.—Under the program under sub8 section (a), the Secretary may— 

9 ‘‘(1) provide financial support to enable local 

10 communities to implement a comprehensive cul11 turally and linguistically appropriate, and age-appro12 priate, school mental health program that incor13 porates positive behavioral interventions and sup14 ports to foster the health and development of chil15 dren; 

16 ‘‘(2) provide technical assistance to local com17 munities with respect to the development of pro18 grams described in paragraph (1); 

19 ‘‘(3) provide assistance to local communities in 

20 the development of policies to address child and ado21 lescent mental health issues and violence when and 

22 if it occurs; 

23 ‘‘(4) facilitate community partnerships among 

24 families, students, law enforcement agencies, edu25 cation systems, mental health and substance use disVerDate Nov 24 2008 01:18 May 23, 2009 Jkt 079200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H2531.IH H2531

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1 order service systems, family-based mental health 

2 service systems, welfare agencies, health care service 

3 systems, and other community-based systems; and 

4 ‘‘(5) establish mechanisms for children and ado5 lescents to report incidents of violence or plans by 

6 other children or adolescents to commit violence. 

7 ‘‘(c) REQUIREMENTS.— 

8 ‘‘(1) IN GENERAL.—To be eligible for a grant, 

9 contract, or cooperative agreement under subsection 

10 (a), an entity shall— 

11 ‘‘(A) be a partnership between a local edu12 cation agency and at least one community pro13 gram or agency that is involved in mental 

14 health; and 

15 ‘‘(B) submit an application, that is en16 dorsed by all members of the partnership, that 

17 contains the assurances described in paragraph 

18 (2). 

19 ‘‘(2) REQUIRED ASSURANCES.—An application 

20 under paragraph (1) shall contain assurances as fol21 lows: 

22 ‘‘(A) That the applicant will ensure that, 

23 in carrying out activities under this section, the 

24 local educational agency involved will enter into 

25 a memorandum of understanding— 


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1 ‘‘(i) with, at a minimum, public or 

2 private mental health entities, health care 

3 entities, law enforcement or juvenile justice 

4 entities, child welfare agencies, family5 based mental health entities, families and 

6 family organizations, and other commu7 nity-based entities; and 

8 ‘‘(ii) that clearly states— 

9 ‘‘(I) the responsibilities of each 

10 partner with respect to the activities 

11 to be carried out; 

12 ‘‘(II) how each such partner will 

13 be accountable for carrying out such 

14 responsibilities; and 

15 ‘‘(III) the amount of non-Federal 

16 funding or in-kind contributions that 

17 each such partner will contribute in 

18 order to sustain the program. 

19 ‘‘(B) That the comprehensive school-based 

20 mental health program carried out under this 

21 section supports the flexible use of funds to ad22 dress— 

23 ‘‘(i) the promotion of the social, emo24 tional, and behavioral health of all students 


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1 in an environment that is conducive to 

2 learning; 

3 ‘‘(ii) the reduction in the likelihood of 

4 at risk students developing social, emo5 tional, behavioral health problems, or sub6 stance use disorders; 

7 ‘‘(iii) the early identification of social, 

8 emotional, behavioral problems, or sub9 stance use disorders and the provision of 

10 early intervention services; 

11 ‘‘(iv) the treatment or referral for 

12 treatment of students with existing social, 

13 emotional, behavioral health problems, or 

14 substance use disorders; and 

15 ‘‘(v) the development and implementa16 tion of programs to assist children in deal17 ing with violence. 

18 ‘‘(C) That the comprehensive school-based 

19 mental health program carried out under this 

20 section will provide for in-service training of all 

21 school personnel, including ancillary staff and 

22 volunteers, in— 

23 ‘‘(i) the techniques and supports need24 ed to identify early children with, or at risk 

25 of, mental illness; 


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1 ‘‘(ii) the use of referral mechanisms 

2 that effectively link such children to treat3 ment and intervention services in the 

4 school and in the community; 

5 ‘‘(iii) strategies that promote a school6 wide positive environment; 

7 ‘‘(iv) strategies for promoting the so8 cial, emotional, mental, and behavioral 

9 health of all students; and 

10 ‘‘(v) strategies to increase the knowl11 edge and skills of school and community 

12 leaders on the application of a public 

13 health approach to comprehensive school14 based mental health programs. 

15 ‘‘(D) That the comprehensive school-based 

16 mental health program carried out under this 

17 section will include comprehensive training for 

18 parents, siblings, and other family members of 

19 children with mental health disorders, and for 

20 concerned members of the community in— 

21 ‘‘(i) the techniques and supports need22 ed to identify early children with, or at risk 

23 of, mental illness; 

24 ‘‘(ii) the use of referral mechanisms 

25 that effectively link such children to treatVerDate Nov 24 2008 01:18 May 23, 2009 Jkt 079200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H2531.IH H2531

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1 ment and intervention services in the 

2 school and in the community; and 

3 ‘‘(iii) strategies that promote a school4 wide positive environment. 

5 ‘‘(E) That the comprehensive school-based 

6 mental health program carried out under this 

7 section will demonstrate the measures to be 

8 taken to sustain the program after funding 

9 under this section terminates. 

10 ‘‘(F) That the local education agency part11 nership involved is supported by the State edu12 cational and mental health system to ensure 

13 that the sustainability of the programs is estab14 lished after funding under this section termi15 nates. 

16 ‘‘(G) That the comprehensive school-based 

17 mental health program carried out under this 

18 section will be based on evidence-based prac19 tices. 

20 ‘‘(H) That the comprehensive school-based 

21 mental health program carried out under this 

22 section will be coordinated with early inter23 vening activities carried out under the Individ24 uals with Disabilities Education Act. 


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1 ‘‘(I) That the comprehensive school-based 

2 mental health program carried out under this 

3 section will be culturally and linguistically ap4 propriate. 

5 ‘‘(J) That the comprehensive school-based 

6 mental health program carried out under this 

7 section will include a broad needs assessment of 

8 youth who drop out of school due to policies of 

9 ‘zero tolerance’ with respect to drugs, alcohol, 

10 or weapons. 

11 ‘‘(K) That the mental health services pro12 vided through the comprehensive school-based 

13 mental health program carried out under this 

14 section will be provided by qualified mental and 

15 behavioral health professionals who are certified 

16 or licensed by the State involved and practicing 

17 within their area of expertise. 

18 ‘‘(d) GEOGRAPHICAL DISTRIBUTION.—The Secretary 

19 shall ensure that grants, contracts, or cooperative agree20 ments under subsection (a) will be distributed equitably 

21 among the regions of the country and among urban and 

22 rural areas. 

23 ‘‘(e) DURATION OF AWARDS.—With respect to a 

24 grant, contract, or cooperative agreement under sub25 section (a), the period during which payments under such 


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1 an award will be made to the recipient shall be 5 years. 

2 An entity may receive only one award under this section, 

3 except that an entity that is providing services and sup4 ports on a regional basis may receive additional funding 

5 after the expiration of the preceding grant period. 

6 ‘‘(f) EVALUATION AND MEASURES OF OUTCOMES.— 

7 ‘‘(1) DEVELOPMENT OF PROCESS.—The Ad8 ministrator shall develop a process for evaluating ac9 tivities carried out under this section. Such process 

10 shall include— 

11 ‘‘(A) the development of guidelines for the 

12 submission of program data by grant, contract, 

13 or cooperative agreement recipients; 

14 ‘‘(B) the development of measures of out15 comes (in accordance with paragraph (2)) to be 

16 applied by such recipients in evaluating pro17 grams carried out under this section; and 

18 ‘‘(C) the submission of annual reports by 

19 such recipients concerning the effectiveness of 

20 programs carried out under this section. 

21 ‘‘(2) MEASURES OF OUTCOMES.— 

22 ‘‘(A) IN GENERAL.—The Administrator 

23 shall develop measures of outcomes to be ap24 plied by recipients of assistance under this sec25 tion, and the Administrator, in evaluating the 


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1 effectiveness of programs carried out under this 

2 section. Such measures shall include student 

3 and family measures as provided for in sub4 paragraph (B) and local educational measures 

5 as provided for under subparagraph (C). 

6 ‘‘(B) STUDENT AND FAMILY MEASURES OF

7 OUTCOMES.—The measures of outcomes devel8 oped under paragraph (1)(B) relating to stu9 dents and families shall, with respect to activi10 ties carried out under a program under this 

11 section, at a minimum include provisions to 

12 evaluate— 

13 ‘‘(i) whether the program resulted in 

14 an increase in social and emotional com15 petency; 

16 ‘‘(ii) whether the program resulted in 

17 an increase in academic competency; 

18 ‘‘(iii) whether the program resulted in 

19 a reduction in disruptive and aggressive 

20 behaviors; 

21 ‘‘(iv) whether the program resulted in 

22 improved family functioning; 

23 ‘‘(v) whether the program resulted in 

24 a reduction in substance use disorders; 


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1 ‘‘(vi) whether the program resulted in 

2 a reduction in suspensions, truancy, expul3 sions and violence; 

4 ‘‘(vii) whether the program resulted in 

5 increased graduation rates; and 

6 ‘‘(viii) whether the program resulted 

7 in improved access to care for mental 

8 health disorders. 

9 ‘‘(C) LOCAL EDUCATIONAL OUTCOMES.— 

10 The outcome measures developed under para11 graph (1)(B) relating to local educational sys12 tems shall, with respect to activities carried out 

13 under a program under this section, at a min14 imum include provisions to evaluate— 

15 ‘‘(i) the effectiveness of comprehensive 

16 school mental health programs established 

17 under this section; 

18 ‘‘(ii) the effectiveness of formal part19 nership linkages among child and family 

20 serving institutions, community support 

21 systems, and the educational system; 

22 ‘‘(iii) the progress made in sustaining 

23 the program once funding under the grant 

24 has expired; 


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1 ‘‘(iv) the effectiveness of training and 

2 professional development programs for all 

3 school personnel that incorporate indica4 tors that measure cultural and linguistic 

5 competencies under the program in a man6 ner that incorporates appropriate cultural 

7 and linguistic training; 

8 ‘‘(v) the improvement in perception of 

9 a safe and supportive learning environment 

10 among school staff, students, and parents; 

11 ‘‘(vi) the improvement in case-finding 

12 of students in need of more intensive serv13 ices and referral of identified students to 

14 early intervention and clinical services; 

15 ‘‘(vii) the improvement in the imme16 diate availability of clinical assessment and 

17 treatment services to students posing a 

18 danger to themselves or others; 

19 ‘‘(viii) the increased successful matric20 ulation to postsecondary school; and 

21 ‘‘(ix) reduced referrals to juvenile jus22 tice 

23 ‘‘(3) SUBMISSION OF ANNUAL DATA.—An entity 

24 that receives a grant, contract, or cooperative agree25 ment under this section shall annually submit to the 


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1 Administrator a report that includes data to evalu2 ate the success of the program carried out by the en3 tity based on whether such program is achieving the 

4 purposes of the program. Such reports shall utilize 

5 the measures of outcomes under paragraph (2) in a 

6 reasonable manner to demonstrate the progress of 

7 the program in achieving such purposes. 

8 ‘‘(4) EVALUATION BY ADMINISTRATOR.—Based 

9 on the data submitted under paragraph (3), the Ad10 ministrator shall annually submit to Congress a re11 port concerning the results and effectiveness of the 

12 programs carried out with assistance received under 

13 this section. 

14 ‘‘(g) INFORMATION AND EDUCATION.—The Sec15 retary shall establish comprehensive information and edu16 cation programs to disseminate the findings of the knowl17 edge development and application under this section to the 

18 general public and to health care professionals. 

19 ‘‘(h) AMOUNT OF GRANTS AND AUTHORIZATION OF

20 APPROPRIATIONS.— 

21 ‘‘(1) AMOUNT OF GRANTS.—A grant under this 

22 section shall be in an amount that is not more than 

23 $1,000,000 for each of grant years 2010 through 

24 2014. The Secretary shall determine the amount of 

25 each such grant based on the population of children 


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1 up to age 21 of the area to be served under the 

2 grant. 

3 ‘‘(2) AUTHORIZATION OF APPROPRIATIONS.— 

4 There is authorized to be appropriated to carry out 

5 this section, $200,000,000 for each of fiscal years 

6 2010 through 2014.’’. 

7 (c) CONFORMING AMENDMENT.—Part G of title V of 

8 the Public Health Service Act (42 U.S.C. 290hh et seq.), 

9 as amended by this section, is further amended by striking 

10 the part heading and inserting the following: 

11 ‘‘PART VII—SCHOOL-BASED MENTAL HEALTH’’. 

Æ 


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