II 

113TH CONGRESS 

1ST SESSION S. 116 

To revise and extend provisions under the Garrett Lee Smith Memorial 

Act. 

IN THE SENATE OF THE UNITED STATES 

JANUARY 23 (legislative day, JANUARY 3), 2013 

Mr. REED (for himself, Ms. MURKOWSKI, Mr. DURBIN, Ms. COLLINS, Mr. 

UDALL of New Mexico, Mrs. MURRAY, Mr. LAUTENBERG, Mr. 

BLUMENTHAL, Mr. COONS, Ms. KLOBUCHAR, Ms. STABENOW, and Mr. 

BEGICH) introduced the following bill; which was read twice and referred 

to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To revise and extend provisions under the Garrett Lee Smith 

Memorial Act. 

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 ‘‘Garrett Lee Smith Me5 morial Act Reauthorization of 2013’’. 

6 SEC. 2. SUICIDE PREVENTION TECHNICAL ASSISTANCE 

7 CENTER. 

8 (a) REPEAL.—Section 520C of the Public Health 

9 Service Act (42 U.S.C. 290bb–34) is repealed. 


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1 (b) SUICIDE PREVENTION TECHNICAL ASSISTANCE

2 CENTER.—Title V of the Public Health Service Act (42 

3 U.S.C. 290aa et seq.) (as amended by subsection (a)) is 

4 amended by inserting after section 520B the following: 

5 ‘‘SEC. 520C. SUICIDE PREVENTION TECHNICAL ASSISTANCE 

6 CENTER. 

7 ‘‘(a) PROGRAM AUTHORIZED.—The Secretary, acting 

8 through the Administrator of the Substance Abuse and 

9 Mental Health Services Administration, shall establish a 

10 research, training, and technical assistance resource cen11 ter to provide appropriate information, training, and tech12 nical assistance to States, political subdivisions of States, 

13 federally recognized Indian tribes, tribal organizations, in14 stitutions of higher education, public organizations, or pri15 vate nonprofit organizations concerning the prevention of 

16 suicide among all ages, particularly among groups that are 

17 at high risk for suicide. 

18 ‘‘(b) RESPONSIBILITIES OF THE CENTER.—The cen19 ter established under subsection (a) shall— 

20 ‘‘(1) assist in the development or continuation 

21 of statewide and tribal suicide early intervention and 

22 prevention strategies for all ages, particularly among 

23 groups that are at high risk for suicide; 

24 ‘‘(2) ensure the surveillance of suicide early 

25 intervention and prevention strategies for all ages, 


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1 particularly among groups that are at high risk for 

2 suicide; 

3 ‘‘(3) study the costs and effectiveness of state4 wide and tribal suicide early intervention and pre5 vention strategies in order to provide information 

6 concerning relevant issues of importance to State, 

7 tribal, and national policymakers; 

8 ‘‘(4) further identify and understand causes 

9 and associated risk factors for suicide for all ages, 

10 particularly among groups that are at high risk for 

11 suicide; 

12 ‘‘(5) analyze the efficacy of new and existing 

13 suicide early intervention and prevention techniques 

14 and technology for all ages, particularly among 

15 groups that are at high risk for suicide; 

16 ‘‘(6) ensure the surveillance of suicidal behav17 iors and nonfatal suicidal attempts; 

18 ‘‘(7) study the effectiveness of State-sponsored 

19 statewide and tribal suicide early intervention and 

20 prevention strategies for all ages particularly among 

21 groups that are at high risk for suicide on the over22 all wellness and health promotion strategies related 

23 to suicide attempts; 

24 ‘‘(8) promote the sharing of data regarding sui25 cide with Federal agencies involved with suicide 


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1 early intervention and prevention, and State-spon2 sored statewide and tribal suicide early intervention 

3 and prevention strategies for the purpose of identi4 fying previously unknown mental health causes and 

5 associated risk factors for suicide among all ages 

6 particularly among groups that are at high risk for 

7 suicide; 

8 ‘‘(9) evaluate and disseminate outcomes and 

9 best practices of mental health and substance use 

10 disorder services at institutions of higher education; 

11 and 

12 ‘‘(10) conduct other activities determined ap13 propriate by the Secretary. 

14 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—For the 

15 purpose of carrying out this section, there are authorized 

16 to be appropriated $5,000,000 for each of the fiscal years 

17 2014 through 2018.’’. 

18 SEC. 3. YOUTH SUICIDE INTERVENTION AND PREVENTION 

19 STRATEGIES. 

20 Section 520E of the Public Health Service Act (42 

21 U.S.C. 290bb–36) is amended to read as follows: 

22 ‘‘SEC. 520E. YOUTH SUICIDE EARLY INTERVENTION AND 

23 PREVENTION STRATEGIES. 

24 ‘‘(a) IN GENERAL.—The Secretary, acting through 

25 the Administrator of the Substance Abuse and Mental 


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1 Health Services Administration, shall award grants or co2 operative agreements to eligible entities to— 

3 ‘‘(1) develop and implement State-sponsored 

4 statewide or tribal youth suicide early intervention 

5 and prevention strategies in schools, educational in6 stitutions, juvenile justice systems, substance use 

7 disorder programs, mental health programs, foster 

8 care systems, and other child and youth support or9 ganizations; 

10 ‘‘(2) support public organizations and private 

11 nonprofit organizations actively involved in State12 sponsored statewide or tribal youth suicide early 

13 intervention and prevention strategies and in the de14 velopment and continuation of State-sponsored 

15 statewide youth suicide early intervention and pre16 vention strategies; 

17 ‘‘(3) provide grants to institutions of higher 

18 education to coordinate the implementation of State19 sponsored statewide or tribal youth suicide early 

20 intervention and prevention strategies; 

21 ‘‘(4) collect and analyze data on State-spon22 sored statewide or tribal youth suicide early inter23 vention and prevention services that can be used to 

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1 search, technical assistance, and policy development; 

2 and 

3 ‘‘(5) assist eligible entities, through State-spon4 sored statewide or tribal youth suicide early inter5 vention and prevention strategies, in achieving tar6 gets for youth suicide reductions under title V of the 

7 Social Security Act. 

8 ‘‘(b) ELIGIBLE ENTITY.— 

9 ‘‘(1) DEFINITION.—In this section, the term 

10 ‘eligible entity’ means— 

11 ‘‘(A) a State; 

12 ‘‘(B) a public organization or private non13 profit organization designated by a State to de14 velop or direct the State-sponsored statewide 

15 youth suicide early intervention and prevention 

16 strategy; or 

17 ‘‘(C) a federally recognized Indian tribe or 

18 tribal organization (as defined in the Indian 

19 Self-Determination and Education Assistance 

20 Act) or an urban Indian organization (as de21 fined in the Indian Health Care Improvement 

22 Act) that is actively involved in the development 

23 and continuation of a tribal youth suicide early 

24 intervention and prevention strategy. 


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1 ‘‘(2) LIMITATION.—In carrying out this section, 

2 the Secretary shall ensure that a State does not re3 ceive more than one grant or cooperative agreement 

4 under this section at any one time. For purposes of 

5 the preceding sentence, a State shall be considered 

6 to have received a grant or cooperative agreement if 

7 the eligible entity involved is the State or an entity 

8 designated by the State under paragraph (1)(B). 

9 Nothing in this paragraph shall be constructed to 

10 apply to entities described in paragraph (1)(C). 

11 ‘‘(c) PREFERENCE.—In providing assistance under a 

12 grant or cooperative agreement under this section, an eli13 gible entity shall give preference to public organizations, 

14 private nonprofit organizations, political subdivisions, in15 stitutions of higher education, and tribal organizations ac16 tively involved with the State-sponsored statewide or tribal 

17 youth suicide early intervention and prevention strategy 

18 that— 

19 ‘‘(1) provide early intervention and assessment 

20 services, including screening programs, to youth who 

21 are at risk for mental or emotional disorders that 

22 may lead to a suicide attempt, and that are inte23 grated with school systems, educational institutions, 

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1 grams, mental health programs, foster care systems, 

2 and other child and youth support organizations; 

3 ‘‘(2) demonstrate collaboration among early 

4 intervention and prevention services or certify that 

5 entities will engage in future collaboration; 

6 ‘‘(3) employ or include in their applications a 

7 commitment to evaluate youth suicide early interven8 tion and prevention practices and strategies adapted 

9 to the local community; 

10 ‘‘(4) provide timely referrals for appropriate 

11 community-based mental health care and treatment 

12 of youth who are at risk for suicide in child-serving 

13 settings and agencies; 

14 ‘‘(5) provide immediate support and informa15 tion resources to families of youth who are at risk 

16 for suicide; 

17 ‘‘(6) offer access to services and care to youth 

18 with diverse linguistic and cultural backgrounds; 

19 ‘‘(7) offer appropriate postsuicide intervention 

20 services, care, and information to families, friends, 

21 schools, educational institutions, juvenile justice sys22 tems, substance use disorder programs, mental 

23 health programs, foster care systems, and other 

24 child and youth support organizations of youth who 

25 recently completed suicide; 


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1 ‘‘(8) offer continuous and up-to-date informa2 tion and awareness campaigns that target parents, 

3 family members, child care professionals, community 

4 care providers, and the general public and highlight 

5 the risk factors associated with youth suicide and 

6 the life-saving help and care available from early 

7 intervention and prevention services; 

8 ‘‘(9) ensure that information and awareness 

9 campaigns on youth suicide risk factors, and early 

10 intervention and prevention services, use effective 

11 communication mechanisms that are targeted to and 

12 reach youth, families, schools, educational institu13 tions, and youth organizations; 

14 ‘‘(10) provide a timely response system to en15 sure that child-serving professionals and providers 

16 are properly trained in youth suicide early interven17 tion and prevention strategies and that child-serving 

18 professionals and providers involved in early inter19 vention and prevention services are properly trained 

20 in effectively identifying youth who are at risk for 

21 suicide; 

22 ‘‘(11) provide continuous training activities for 

23 child care professionals and community care pro24 viders on the latest youth suicide early intervention 

25 and prevention services practices and strategies; 


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1 ‘‘(12) conduct annual self-evaluations of out2 comes and activities, including consulting with inter3 ested families and advocacy organizations; 

4 ‘‘(13) provide services in areas or regions with 

5 rates of youth suicide that exceed the national aver6 age as determined by the Centers for Disease Con7 trol and Prevention; and 

8 ‘‘(14) obtain informed written consent from a 

9 parent or legal guardian of an at-risk child before 

10 involving the child in a youth suicide early interven11 tion and prevention program. 

12 ‘‘(d) REQUIREMENT FOR DIRECT SERVICES.—Not 

13 less than 85 percent of grant funds received under this 

14 section shall be used to provide direct services, of which 

15 not less than 5 percent shall be used for activities author16 ized under subsection (a)(3). 

17 ‘‘(e) CONSULTATION AND POLICY DEVELOPMENT.— 

18 ‘‘(1) IN GENERAL.—In carrying out this sec19 tion, the Secretary shall collaborate with relevant 

20 Federal agencies and suicide working groups respon21 sible for early intervention and prevention services 

22 relating to youth suicide. 

23 ‘‘(2) CONSULTATION.—In carrying out this sec24 tion, the Secretary shall consult with— 


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1 ‘‘(A) State and local agencies, including 

2 agencies responsible for early intervention and 

3 prevention services under title XIX of the So4 cial Security Act, the State Children’s Health 

5 Insurance Program under title XXI of the So6 cial Security Act, and programs funded by 

7 grants under title V of the Social Security Act; 

8 ‘‘(B) local and national organizations that 

9 serve youth at risk for suicide and their fami10 lies; 

11 ‘‘(C) relevant national medical and other 

12 health and education specialty organizations; 

13 ‘‘(D) youth who are at risk for suicide, 

14 who have survived suicide attempts, or who are 

15 currently receiving care from early intervention 

16 services; 

17 ‘‘(E) families and friends of youth who are 

18 at risk for suicide, who have survived suicide at19 tempts, who are currently receiving care from 

20 early intervention and prevention services, or 

21 who have completed suicide; 

22 ‘‘(F) qualified professionals who possess 

23 the specialized knowledge, skills, experience, 

24 and relevant attributes needed to serve youth at 

25 risk for suicide and their families; and 


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1 ‘‘(G) third-party payers, managed care or2 ganizations, and related commercial industries. 

3 ‘‘(3) POLICY DEVELOPMENT.—In carrying out 

4 this section, the Secretary shall— 

5 ‘‘(A) coordinate and collaborate on policy 

6 development at the Federal level with the rel7 evant Department of Health and Human Serv8 ices agencies and suicide working groups; and 

9 ‘‘(B) consult on policy development at the 

10 Federal level with the private sector, including 

11 consumer, medical, suicide prevention advocacy 

12 groups, and other health and education profes13 sional-based organizations, with respect to 

14 State-sponsored statewide or tribal youth sui15 cide early intervention and prevention strate16 gies. 

17 ‘‘(f) RULE OF CONSTRUCTION; RELIGIOUS AND

18 MORAL ACCOMMODATION.—Nothing in this section shall 

19 be construed to require suicide assessment, early interven20 tion, or treatment services for youth whose parents or 

21 legal guardians object based on the parents’ or legal 

22 guardians’ religious beliefs or moral objections. 

23 ‘‘(g) EVALUATIONS AND REPORT.— 

24 ‘‘(1) EVALUATIONS BY ELIGIBLE ENTITIES.— 

25 Not later than 18 months after receiving a grant or 


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1 cooperative agreement under this section, an eligible 

2 entity shall submit to the Secretary the results of an 

3 evaluation to be conducted by the entity concerning 

4 the effectiveness of the activities carried out under 

5 the grant or agreement. 

6 ‘‘(2) REPORT.—Not later than 2 years after the 

7 date of enactment of this section, the Secretary shall 

8 submit to the appropriate committees of Congress a 

9 report concerning the results of— 

10 ‘‘(A) the evaluations conducted under 

11 paragraph (1); and 

12 ‘‘(B) an evaluation conducted by the Sec13 retary to analyze the effectiveness and efficacy 

14 of the activities conducted with grants, collabo15 rations, and consultations under this section. 

16 ‘‘(h) RULE OF CONSTRUCTION; STUDENT MEDICA17 TION.—Nothing in this section shall be construed to allow 

18 school personnel to require that a student obtain any 

19 medication as a condition of attending school or receiving 

20 services. 

21 ‘‘(i) PROHIBITION.—Funds appropriated to carry out 

22 this section, section 527, or section 529 shall not be used 

23 to pay for or refer for abortion. 

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1 ten, informed consent from the child’s parent or legal 

2 guardian for assessment services, school-sponsored pro3 grams, and treatment involving medication related to 

4 youth suicide conducted in elementary and secondary 

5 schools. The requirement of the preceding sentence does 

6 not apply in the following cases: 

7 ‘‘(1) In an emergency, where it is necessary to 

8 protect the immediate health and safety of the stu9 dent or other students. 

10 ‘‘(2) Other instances, as defined by the State, 

11 where parental consent cannot reasonably be ob12 tained. 

13 ‘‘(k) RELATION TO EDUCATION PROVISIONS.—Noth14 ing in this section shall be construed to supersede section 

15 444 of the General Education Provisions Act, including 

16 the requirement of prior parental consent for the disclo17 sure of any education records. Nothing in this section shall 

18 be construed to modify or affect parental notification re19 quirements for programs authorized under the Elementary 

20 and Secondary Education Act of 1965 (as amended by the 

21 No Child Left Behind Act of 2001; Public Law 107–110). 

22 ‘‘(l) DEFINITIONS.—In this section: 

23 ‘‘(1) EARLY INTERVENTION.—The term ‘early 

24 intervention’ means a strategy or approach that is 


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1 intended to prevent an outcome or to alter the 

2 course of an existing condition. 

3 ‘‘(2) EDUCATIONAL INSTITUTION; INSTITUTION

4 OF HIGHER EDUCATION; SCHOOL.—The term— 

5 ‘‘(A) ‘educational institution’ means a 

6 school or institution of higher education; 

7 ‘‘(B) ‘institution of higher education’ has 

8 the meaning given such term in section 101 of 

9 the Higher Education Act of 1965; and 

10 ‘‘(C) ‘school’ means an elementary or sec11 ondary school (as such terms are defined in sec12 tion 9101 of the Elementary and Secondary 

13 Education Act of 1965). 

14 ‘‘(3) PREVENTION.—The term ‘prevention’ 

15 means a strategy or approach that reduces the likeli16 hood or risk of onset, or delays the onset, of adverse 

17 health problems that have been known to lead to sui18 cide. 

19 ‘‘(4) YOUTH.—The term ‘youth’ means individ20 uals who are between 10 and 24 years of age. 

21 ‘‘(m) AUTHORIZATION OF APPROPRIATIONS.—For 

22 the purpose of carrying out this section, there are author23 ized to be appropriated $32,000,000 for each of the fiscal 

24 years 2014 through 2018.’’. 


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1 SEC. 4. MENTAL HEALTH AND SUBSTANCE USE DISORDERS 

2 SERVICES AND OUTREACH ON CAMPUS. 

3 Section 520E–2 of the Public Health Service Act (42 

4 U.S.C. 290bb–36b) is amended to read as follows: 

5 ‘‘SEC. 520E–2. MENTAL HEALTH AND SUBSTANCE USE DIS6 ORDERS SERVICES ON CAMPUS. 

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

8 the Director of the Center for Mental Health Services and 

9 in consultation with the Secretary of Education, shall 

10 award grants on a competitive basis to institutions of 

11 higher education to enhance services for students with 

12 mental health or substance use disorders and to develop 

13 best practices for the delivery of such services. 

14 ‘‘(b) USES OF FUNDS.—Amounts received under a 

15 grant under this section shall be used for 1 or more of 

16 the following activities: 

17 ‘‘(1) The provision of mental health and sub18 stance use disorder services to students, including 

19 prevention, promotion of mental health, voluntary 

20 screening, early intervention, voluntary assessment, 

21 treatment, and management of mental health and 

22 substance abuse disorder issues. 

23 ‘‘(2) The provision of outreach services to notify 

24 students about the existence of mental health and 

25 substance use disorder services. 


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1 ‘‘(3) Educating students, families, faculty, staff, 

2 and communities to increase awareness of mental 

3 health and substance use disorders. 

4 ‘‘(4) The employment of appropriately trained 

5 staff, including administrative staff. 

6 ‘‘(5) The provision of training to students, fac7 ulty, and staff to respond effectively to students with 

8 mental health and substance use disorders. 

9 ‘‘(6) The creation of a networking infrastruc10 ture to link colleges and universities with providers 

11 who can treat mental health and substance use dis12 orders. 

13 ‘‘(7) Developing, supporting, evaluating, and 

14 disseminating evidence-based and emerging best 

15 practices. 

16 ‘‘(c) IMPLEMENTATION OF ACTIVITIES USING GRANT

17 FUNDS.—An institution of higher education that receives 

18 a grant under this section may carry out activities under 

19 the grant through— 

20 ‘‘(1) college counseling centers; 

21 ‘‘(2) college and university psychological service 

22 centers; 

23 ‘‘(3) mental health centers; 

24 ‘‘(4) psychology training clinics; 


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1 ‘‘(5) institution of higher education supported, 

2 evidence-based, mental health and substance use dis3 order programs; or 

4 ‘‘(6) any other entity that provides mental 

5 health and substance use disorder services at an in6 stitution of higher education. 

7 ‘‘(d) APPLICATION.—To be eligible to receive a grant 

8 under this section, an institution of higher education shall 

9 prepare and submit to the Secretary an application at 

10 such time and in such manner as the Secretary may re11 quire. At a minimum, such application shall include the 

12 following: 

13 ‘‘(1) A description of identified mental health 

14 and substance use disorder needs of students at the 

15 institution of higher education. 

16 ‘‘(2) A description of Federal, State, local, pri17 vate, and institutional resources currently available 

18 to address the needs described in paragraph (1) at 

19 the institution of higher education. 

20 ‘‘(3) A description of the outreach strategies of 

21 the institution of higher education for promoting ac22 cess to services, including a proposed plan for reach23 ing those students most in need of mental health 

24 services. 


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1 ‘‘(4) A plan, when applicable, to meet the spe2 cific mental health and substance use disorder needs 

3 of veterans attending institutions of higher edu4 cation. 

5 ‘‘(5) A plan to seek input from community 

6 mental health providers, when available, community 

7 groups and other public and private entities in car8 rying out the program under the grant. 

9 ‘‘(6) A plan to evaluate program outcomes, in10 cluding a description of the proposed use of funds, 

11 the program objectives, and how the objectives will 

12 be met. 

13 ‘‘(7) An assurance that the institution will sub14 mit a report to the Secretary each fiscal year con15 cerning the activities carried out with the grant and 

16 the results achieved through those activities. 

17 ‘‘(e) SPECIAL CONSIDERATIONS.—In awarding 

18 grants under this section, the Secretary shall give special 

19 consideration to applications that describe programs to be 

20 carried out under the grant that— 

21 ‘‘(1) demonstrate the greatest need for new or 

22 additional mental and substance use disorder serv23 ices, in part by providing information on current ra24 tios of students to mental health and substance use 

25 disorder health professionals; and 


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1 ‘‘(2) demonstrate the greatest potential for rep2 lication. 

3 ‘‘(f) REQUIREMENT OF MATCHING FUNDS.— 

4 ‘‘(1) IN GENERAL.—The Secretary may make a 

5 grant under this section to an institution of higher 

6 education only if the institution agrees to make 

7 available (directly or through donations from public 

8 or private entities) non-Federal contributions in an 

9 amount that is not less than $1 for each $1 of Fed10 eral funds provided under the grant, toward the 

11 costs of activities carried out with the grant (as de12 scribed in subsection (b)) and other activities by the 

13 institution to reduce student mental health and sub14 stance use disorders. 

15 ‘‘(2) DETERMINATION OF AMOUNT CONTRIB16 UTED.—Non-Federal contributions required under 

17 paragraph (1) may be in cash or in kind. Amounts 

18 provided by the Federal Government, or services as19 sisted or subsidized to any significant extent by the 

20 Federal Government, may not be included in deter21 mining the amount of such non-Federal contribu22 tions. 

23 ‘‘(3) WAIVER.—The Secretary may waive the 

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1 mines that extraordinary need at the institution jus2 tifies the waiver. 

3 ‘‘(g) REPORTS.—For each fiscal year that grants are 

4 awarded under this section, the Secretary shall conduct 

5 a study on the results of the grants and submit to the 

6 Congress a report on such results that includes the fol7 lowing: 

8 ‘‘(1) An evaluation of the grant program out9 comes, including a summary of activities carried out 

10 with the grant and the results achieved through 

11 those activities. 

12 ‘‘(2) Recommendations on how to improve ac13 cess to mental health and substance use disorder 

14 services at institutions of higher education, including 

15 efforts to reduce the incidence of suicide and sub16 stance use disorders. 

17 ‘‘(h) DEFINITIONS.—In this section, the term ‘insti18 tution of higher education’ has the meaning given such 

19 term in section 101 of the Higher Education Act of 1965. 

20 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—For the 

21 purpose of carrying out this section, there are authorized 

22 to be appropriated $7,000,000 for each of the fiscal years 

23 2014 through 2018.’’. 

Æ 


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