```

[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2531 Introduced in House (IH)]

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.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Mental Health in Schools Act of 
2009''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) Approximately 1 in 5 children have a diagnosable mental 
        disorder.
            (2) Approximately 1 in 10 children have a serious emotional 
        or behavioral disorder that is severe enough to cause 
        substantial impairment in functioning at home, at school, or in 
        the community. It is estimated that about 75 percent of 
        children with emotional and behavioral disorders do not receive 
        specialty mental health services.
            (3) Only half of schools across the United States report 
        having formal partnerships with community mental health 
        providers to deliver mental health services.
            (4) If a school is going to respond to the mental health 
        needs of its students, it must have access to resources that 
        provide family-centered, culturally and linguistically 
        appropriate supports and services.
            (5) Effective school mental health programs reflect the 
        collaboration and commitment of families, students, educators, 
        and other community partners.
            (6) Many schools have school-employed mental health 
        providers supporting student's social, emotional, and 
        behavioral health needs in schools. The most common types of 
        staff providing mental health services in schools were school 
        counselors, followed by school nurses, school psychologists and 
        school social workers. Three-quarters of schools had at least 
        one school counselor on staff, over two-thirds had a school 
        psychologist or school nurse, and 44 percent had a school 
        social worker.
            (7) Although it is well recognized that mental health 
        directly affects children's learning and development, in a 
        recent study one-third of school districts reported decreased 
        funding for school mental health services, and at the same time 
        two-thirds of school districts reported increased need for such 
        services.

SEC. 3. PURPOSES.

    It is the purpose of this Act to--
            (1) revise, increase funding for, and expand the scope of 
        the Safe Schools-Healthy Students program in order to provide 
        access to more comprehensive school-based mental health 
        services and supports;
            (2) provide for comprehensive staff development for school 
        and community service personnel working in the school; and
            (3) provide for comprehensive training for children with 
        mental health disorders, for parents, siblings, and other 
        family members of such children, and for concerned members of 
        the community.

SEC. 4. AMENDMENTS TO THE PUBLIC HEALTH SERVICE ACT.

    (a) Technical Amendments.--The second part G (relating to services 
provided through religious organizations) of title V of the Public 
Health Service Act (42 U.S.C. 290kk et seq.) is amended--
            (1) by redesignating such part as part J; and
            (2) by redesignating sections 581 through 584 as sections 
        596 through 596C, respectively.
    (b) School-Based Mental Health and Children and Violence.--Section 
581 of the Public Health Service Act (42 U.S.C. 290hh) is amended to 
read as follows:

``SEC. 581. SCHOOL-BASED MENTAL HEALTH AND CHILDREN AND VIOLENCE.

    ``(a) In General.--The Secretary, in collaboration with the 
Secretary of Education and in consultation with the Attorney General, 
shall, directly or through grants, contracts, or cooperative agreements 
awarded to public entities and local education agencies, assist local 
communities and schools in applying a public health approach to mental 
health services both in schools and in the community. Such approach 
should provide comprehensive age appropriate services and supports, be 
linguistically and culturally appropriate, and incorporate age 
appropriate strategies of positive behavioral interventions and 
supports. A comprehensive school mental health program funded under 
this section shall assist children in dealing with violence.
    ``(b) Activities.--Under the program under subsection (a), the 
Secretary may--
            ``(1) provide financial support to enable local communities 
        to implement a comprehensive culturally and linguistically 
        appropriate, and age-appropriate, school mental health program 
        that incorporates positive behavioral interventions and 
        supports to foster the health and development of children;
            ``(2) provide technical assistance to local communities 
        with respect to the development of programs described in 
        paragraph (1);
            ``(3) provide assistance to local communities in the 
        development of policies to address child and adolescent mental 
        health issues and violence when and if it occurs;
            ``(4) facilitate community partnerships among families, 
        students, law enforcement agencies, education systems, mental 
        health and substance use disorder service systems, family-based 
        mental health service systems, welfare agencies, health care 
        service systems, and other community-based systems; and
            ``(5) establish mechanisms for children and adolescents to 
        report incidents of violence or plans by other children or 
        adolescents to commit violence.
    ``(c) Requirements.--
            ``(1) In general.--To be eligible for a grant, contract, or 
        cooperative agreement under subsection (a), an entity shall--
                    ``(A) be a partnership between a local education 
                agency and at least one community program or agency 
                that is involved in mental health; and
                    ``(B) submit an application, that is endorsed by 
                all members of the partnership, that contains the 
                assurances described in paragraph (2).
            ``(2) Required assurances.--An application under paragraph 
        (1) shall contain assurances as follows:
                    ``(A) That the applicant will ensure that, in 
                carrying out activities under this section, the local 
                educational agency involved will enter into a 
                memorandum of understanding--
                            ``(i) with, at a minimum, public or private 
                        mental health entities, health care entities, 
                        law enforcement or juvenile justice entities, 
                        child welfare agencies, family-based mental 
                        health entities, families and family 
                        organizations, and other community-based 
                        entities; and
                            ``(ii) that clearly states--
                                    ``(I) the responsibilities of each 
                                partner with respect to the activities 
                                to be carried out;
                                    ``(II) how each such partner will 
                                be accountable for carrying out such 
                                responsibilities; and
                                    ``(III) the amount of non-Federal 
                                funding or in-kind contributions that 
                                each such partner will contribute in 
                                order to sustain the program.
                    ``(B) That the comprehensive school-based mental 
                health program carried out under this section supports 
                the flexible use of funds to address--
                            ``(i) the promotion of the social, 
                        emotional, and behavioral health of all 
                        students in an environment that is conducive to 
                        learning;
                            ``(ii) the reduction in the likelihood of 
                        at risk students developing social, emotional, 
                        behavioral health problems, or substance use 
                        disorders;
                            ``(iii) the early identification of social, 
                        emotional, behavioral problems, or substance 
                        use disorders and the provision of early 
                        intervention services;
                            ``(iv) the treatment or referral for 
                        treatment of students with existing social, 
                        emotional, behavioral health problems, or 
                        substance use disorders; and
                            ``(v) the development and implementation of 
                        programs to assist children in dealing with 
                        violence.
                    ``(C) That the comprehensive school-based mental 
                health program carried out under this section will 
                provide for in-service training of all school 
                personnel, including ancillary staff and volunteers, 
                in--
                            ``(i) the techniques and supports needed to 
                        identify early children with, or at risk of, 
                        mental illness;
                            ``(ii) the use of referral mechanisms that 
                        effectively link such children to treatment and 
                        intervention services in the school and in the 
                        community;
                            ``(iii) strategies that promote a school-
                        wide positive environment;
                            ``(iv) strategies for promoting the social, 
                        emotional, mental, and behavioral health of all 
                        students; and
                            ``(v) strategies to increase the knowledge 
                        and skills of school and community leaders on 
                        the application of a public health approach to 
                        comprehensive school-based mental health 
                        programs.
                    ``(D) That the comprehensive school-based mental 
                health program carried out under this section will 
                include comprehensive training for parents, siblings, 
                and other family members of children with mental health 
                disorders, and for concerned members of the community 
                in--
                            ``(i) the techniques and supports needed to 
                        identify early children with, or at risk of, 
                        mental illness;
                            ``(ii) the use of referral mechanisms that 
                        effectively link such children to treatment and 
                        intervention services in the school and in the 
                        community; and
                            ``(iii) strategies that promote a school-
                        wide positive environment.
                    ``(E) That the comprehensive school-based mental 
                health program carried out under this section will 
                demonstrate the measures to be taken to sustain the 
                program after funding under this section terminates.
                    ``(F) That the local education agency partnership 
                involved is supported by the State educational and 
                mental health system to ensure that the sustainability 
                of the programs is established after funding under this 
                section terminates.
                    ``(G) That the comprehensive school-based mental 
                health program carried out under this section will be 
                based on evidence-based practices.
                    ``(H) That the comprehensive school-based mental 
                health program carried out under this section will be 
                coordinated with early intervening activities carried 
                out under the Individuals with Disabilities Education 
                Act.
                    ``(I) That the comprehensive school-based mental 
                health program carried out under this section will be 
                culturally and linguistically appropriate.
                    ``(J) That the comprehensive school-based mental 
                health program carried out under this section will 
                include a broad needs assessment of youth who drop out 
                of school due to policies of `zero tolerance' with 
                respect to drugs, alcohol, or weapons.
                    ``(K) That the mental health services provided 
                through the comprehensive school-based mental health 
                program carried out under this section will be provided 
                by qualified mental and behavioral health professionals 
                who are certified or licensed by the State involved and 
                practicing within their area of expertise.
    ``(d) Geographical Distribution.--The Secretary shall ensure that 
grants, contracts, or cooperative agreements under subsection (a) will 
be distributed equitably among the regions of the country and among 
urban and rural areas.
    ``(e) Duration of Awards.--With respect to a grant, contract, or 
cooperative agreement under subsection (a), the period during which 
payments under such an award will be made to the recipient shall be 5 
years. An entity may receive only one award under this section, except 
that an entity that is providing services and supports on a regional 
basis may receive additional funding after the expiration of the 
preceding grant period.
    ``(f) Evaluation and Measures of Outcomes.--
            ``(1) Development of process.--The Administrator shall 
        develop a process for evaluating activities carried out under 
        this section. Such process shall include--
                    ``(A) the development of guidelines for the 
                submission of program data by grant, contract, or 
                cooperative agreement recipients;
                    ``(B) the development of measures of outcomes (in 
                accordance with paragraph (2)) to be applied by such 
                recipients in evaluating programs carried out under 
                this section; and
                    ``(C) the submission of annual reports by such 
                recipients concerning the effectiveness of programs 
                carried out under this section.
            ``(2) Measures of outcomes.--
                    ``(A) In general.--The Administrator shall develop 
                measures of outcomes to be applied by recipients of 
                assistance under this section, and the Administrator, 
                in evaluating the effectiveness of programs carried out 
                under this section. Such measures shall include student 
                and family measures as provided for in subparagraph (B) 
                and local educational measures as provided for under 
                subparagraph (C).
                    ``(B) Student and family measures of outcomes.--The 
                measures of outcomes developed under paragraph (1)(B) 
                relating to students and families shall, with respect 
                to activities carried out under a program under this 
                section, at a minimum include provisions to evaluate--
                            ``(i) whether the program resulted in an 
                        increase in social and emotional competency;
                            ``(ii) whether the program resulted in an 
                        increase in academic competency;
                            ``(iii) whether the program resulted in a 
                        reduction in disruptive and aggressive 
                        behaviors;
                            ``(iv) whether the program resulted in 
                        improved family functioning;
                            ``(v) whether the program resulted in a 
                        reduction in substance use disorders;
                            ``(vi) whether the program resulted in a 
                        reduction in suspensions, truancy, expulsions 
                        and violence;
                            ``(vii) whether the program resulted in 
                        increased graduation rates; and
                            ``(viii) whether the program resulted in 
                        improved access to care for mental health 
                        disorders.
                    ``(C) Local educational outcomes.--The outcome 
                measures developed under paragraph (1)(B) relating to 
                local educational systems shall, with respect to 
                activities carried out under a program under this 
                section, at a minimum include provisions to evaluate--
                            ``(i) the effectiveness of comprehensive 
                        school mental health programs established under 
                        this section;
                            ``(ii) the effectiveness of formal 
                        partnership linkages among child and family 
                        serving institutions, community support 
                        systems, and the educational system;
                            ``(iii) the progress made in sustaining the 
                        program once funding under the grant has 
                        expired;
                            ``(iv) the effectiveness of training and 
                        professional development programs for all 
                        school personnel that incorporate indicators 
                        that measure cultural and linguistic 
                        competencies under the program in a manner that 
                        incorporates appropriate cultural and 
                        linguistic training;
                            ``(v) the improvement in perception of a 
                        safe and supportive learning environment among 
                        school staff, students, and parents;
                            ``(vi) the improvement in case-finding of 
                        students in need of more intensive services and 
                        referral of identified students to early 
                        intervention and clinical services;
                            ``(vii) the improvement in the immediate 
                        availability of clinical assessment and 
                        treatment services to students posing a danger 
                        to themselves or others;
                            ``(viii) the increased successful 
                        matriculation to postsecondary school; and
                            ``(ix) reduced referrals to juvenile 
                        justice
            ``(3) Submission of annual data.--An entity that receives a 
        grant, contract, or cooperative agreement under this section 
        shall annually submit to the Administrator a report that 
        includes data to evaluate the success of the program carried 
        out by the entity based on whether such program is achieving 
        the purposes of the program. Such reports shall utilize the 
        measures of outcomes under paragraph (2) in a reasonable manner 
        to demonstrate the progress of the program in achieving such 
        purposes.
            ``(4) Evaluation by administrator.--Based on the data 
        submitted under paragraph (3), the Administrator shall annually 
        submit to Congress a report concerning the results and 
        effectiveness of the programs carried out with assistance 
        received under this section.
    ``(g) Information and Education.--The Secretary shall establish 
comprehensive information and education programs to disseminate the 
findings of the knowledge development and application under this 
section to the general public and to health care professionals.
    ``(h) Amount of Grants and Authorization of Appropriations.--
            ``(1) Amount of grants.--A grant under this section shall 
        be in an amount that is not more than $1,000,000 for each of 
        grant years 2010 through 2014. The Secretary shall determine 
        the amount of each such grant based on the population of 
        children up to age 21 of the area to be served under the grant.
            ``(2) Authorization of appropriations.--There is authorized 
        to be appropriated to carry out this section, $200,000,000 for 
        each of fiscal years 2010 through 2014.''.
    (c) Conforming Amendment.--Part G of title V of the Public Health 
Service Act (42 U.S.C. 290hh et seq.), as amended by this section, is 
further amended by striking the part heading and inserting the 
following:

               ``PART VII--SCHOOL-BASED MENTAL HEALTH''.

                                 <all>
```