```

[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[S. 195 Introduced in Senate (IS)]

113th CONGRESS
  1st Session
                                 S. 195

 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 SENATE OF THE UNITED STATES

                            January 31, 2013

   Mr. Franken (for himself, Mr. Durbin, Mr. Baucus, Mr. Cardin, Ms. 
 Hirono, Mr. Brown, Ms. Landrieu, Mr. Blumenthal, Mr. Tester, and Mr. 
   Sanders) introduced the following bill; which was read twice and 
  referred to the Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 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 
2013''.

SEC. 2. 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. 3. 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, be trauma-informed, 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 
trauma and 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, trauma-informed, and age-appropriate, school 
        mental health program that incorporates positive behavioral 
        interventions, client treatment, 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 trauma 
        and 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 (including physicians), faith-based programs, 
        trauma networks, and other community-based systems; and
            ``(5) establish mechanisms for children and adolescents to 
        report incidents of violence or plans by other children, 
        adolescents, or adults 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 least one, public or private 
                        mental health entity, health care entity, law 
                        enforcement or juvenile justice entity, child 
                        welfare agency, family-based mental health 
                        entity, family or family organization, trauma 
                        network, or other community-based entity; 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 
                        trauma and 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 trauma histories 
                        and children with, or at risk of, mental 
                        illness;
                            ``(ii) the use of referral mechanisms that 
                        effectively link such children to appropriate 
                        treatment and intervention services in the 
                        school and in the community and to follow-up 
                        when services are not available;
                            ``(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 
                        about the impact of trauma and violence and 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 trauma histories, 
                        and children with, or at risk of, mental 
                        illness;
                            ``(ii) the use of referral mechanisms that 
                        effectively link such children to appropriate 
                        treatment and intervention services in the 
                        school and in the community and follow-up when 
                        such services are not available; 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 trauma-informed and 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 
                trauma-informed and 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 and an inability 
                to obtain appropriate services.
                    ``(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.
            ``(3) Coordinator.--Any entity that is a member of a 
        partnership described in paragraph (1)(A) may serve as the 
        coordinator of funding and activities under the grant if all 
        members of the partnership agree.
            ``(4) Compliance with hipaa.--A grantee under this section 
        shall be deemed to be a covered entity for purposes of 
        compliance with the regulations promulgated under section 
        264(c) of the Health Insurance Portability and Accountability 
        Act of 1996 with respect to any patient records developed 
        through activities under the grant.
    ``(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 6 
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 fiscally appropriate 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 
                whether the program is effective in--
                            ``(i) increasing social and emotional 
                        competency;
                            ``(ii) increasing academic competency (as 
                        defined by Secretary);
                            ``(iii) reducing disruptive and aggressive 
                        behaviors;
                            ``(iv) improving child functioning;
                            ``(v) reducing substance use disorders;
                            ``(vi) reducing suspensions, truancy, 
                        expulsions and violence;
                            ``(vii) increasing graduation rates (as 
                        defined in section 1111(b)(2)(C)(vi) of the 
                        Elementary and Secondary Education Act of 
                        1965); and
                            ``(viii) improving 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 within the context of the 
                        local community 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.
            ``(5) Limitation.--A grantee shall use not to exceed 10 
        percent of amounts received under a grant under this section to 
        carry out evaluation activities under this subsection.
    ``(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 2013 through 2017. 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 2013 through 2017.''.
    (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 G--SCHOOL-BASED MENTAL HEALTH''.

                                 <all>
```