II 

113TH CONGRESS 

1ST SESSION S. 689 

To reauthorize and improve programs related to mental health and substance 

use disorders. 

IN THE SENATE OF THE UNITED STATES 

APRIL 9, 2013 

Mr. HARKIN (for himself, Mr. ALEXANDER, Mr. FRANKEN, Mr. ENZI, Mr. 

BENNET, Ms. MURKOWSKI, Ms. BALDWIN, Mr. ROBERTS, Mrs. HAGAN, 

and Mr. ISAKSON) introduced the following bill; which was read twice and 

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

A BILL 

To reauthorize and improve programs related to mental 

health and substance use disorders. 

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 Aware5 ness and Improvement Act of 2013’’. 


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1 TITLE I—EDUCATION 

2 PROGRAMS 

3 SEC. 101. SHORT TITLE. 

4 This title may be cited as the ‘‘Achievement Through 

5 Prevention Act’’. 

6 SEC. 102. PURPOSE. 

7 The purpose of this title is to expand the use of posi8 tive behavioral interventions and supports and early inter9 vening services in schools in order to improve student aca10 demic achievement, reduce overidentification of individuals 

11 with disabilities, and reduce disciplinary problems in 

12 schools. 

13 SEC. 103. AMENDMENTS TO THE ELEMENTARY AND SEC14 ONDARY EDUCATION ACT OF 1965. 

15 (a) TITLE I STATE PLANS.—Section 1111(b) of the 

16 Elementary and Secondary Education Act of 1965 (20 

17 U.S.C. 6311(b)) is amended by adding at the end the fol18 lowing: 

19 ‘‘(11) POSITIVE BEHAVIORAL INTERVENTIONS

20 AND SUPPORTS.—In the case of a State that pro21 poses to use funds under this part to support posi22 tive behavioral interventions and supports, the State 

23 plan shall describe how the State educational agency 

24 will— 


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1 ‘‘(A) assist local educational agencies in 

2 implementing positive behavioral interventions 

3 and supports in schools served by the local edu4 cational agency on a whole-school basis; 

5 ‘‘(B) provide technical assistance and 

6 training to local educational agencies to im7 prove and support the development, implemen8 tation, and coordination of comprehensive posi9 tive behavioral interventions and supports car10 ried out under this Act with activities carried 

11 out under the Individuals with Disabilities Edu12 cation Act; and 

13 ‘‘(C) evaluate the effects of providing posi14 tive behavioral interventions and supports for 

15 all students, including improvement of the 

16 learning environment, academic achievement, 

17 disciplinary problems such as incidents of sus18 pensions, expulsions, referrals to law enforce19 ment, and other actions that remove students 

20 from instruction, and any other effects the 

21 State chooses to evaluate. 

22 ‘‘(12) EARLY INTERVENING SERVICES.—In the 

23 case of a State that proposes to use funds under this 

24 part to support early intervening services, the State 


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1 plan shall describe how the State educational agency 

2 will— 

3 ‘‘(A) assist local educational agencies in 

4 implementing early intervening services in 

5 schools served by the local educational agency 

6 to reduce the need to label children as children 

7 with disabilities in order to address the learning 

8 and behavioral needs of such children; 

9 ‘‘(B) provide technical assistance and 

10 training to local educational agencies to im11 prove coordination of early intervening services 

12 provided under this Act with early intervening 

13 services carried out under the Individuals with 

14 Disabilities Education Act; and 

15 ‘‘(C) evaluate the effects of providing early 

16 intervening services. 

17 ‘‘(13) CRISIS MANAGEMENT PLANS.—In the 

18 case of a State that proposes to use funds under this 

19 part to assist local educational agencies in the State 

20 in periodically updating the crisis management 

21 plans, as described in section 4114(d)(7)(D), of such 

22 local educational agencies, the State plan shall de23 scribe how the State educational agency will assist 

24 local educational agencies in updating such crisis 

25 management plans.’’. 


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1 (b) TITLE I STATE REPORTS.—Section 

2 1111(h)(1)(C) of the Elementary and Secondary Edu3 cation Act of 1965 (20 U.S.C. 6311(h)(1)(C)) is amend4 ed— 

5 (1) in clause (vii), by striking ‘‘and’’ after the 

6 semicolon; 

7 (2) in clause (viii), by striking the period and 

8 inserting a semicolon; and 

9 (3) by adding at the end the following: 

10 ‘‘(ix) the number of local educational 

11 agencies in the State that implement posi12 tive behavioral interventions and supports; 

13 ‘‘(x) the number of students— 

14 ‘‘(I) who are served through the 

15 use of early intervening services; and 

16 ‘‘(II) who, in the preceding 2- 

17 year period, received early intervening 

18 services and who, after receiving such 

19 services, have been identified as eligi20 ble for, and receive, special education 

21 and related services under part B of 

22 the Individuals with Disabilities Edu23 cation Act; and 


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1 ‘‘(xi) the number of local educational 

2 agencies in the State that implement 

3 school-based mental health programs.’’. 

4 (c) TITLE I LOCAL EDUCATIONAL AGENCY PLANS.— 

5 Section 1112(b)(1) of the Elementary and Secondary 

6 Education Act of 1965 (20 U.S.C. 6312(b)(1)) is amend7 ed— 

8 (1) in subparagraph (P), by striking ‘‘and’’ 

9 after the semicolon; 

10 (2) in subparagraph (Q), by striking the period 

11 and inserting a semicolon; and 

12 (3) by adding at the end the following: 

13 ‘‘(R) if the local educational agency pro14 poses to use subgrant funds under this part for 

15 positive behavioral interventions and supports, a 

16 description of the actions the local educational 

17 agency will take to provide positive behavioral 

18 interventions and supports and coordinate those 

19 activities with activities carried out under the 

20 Individuals with Disabilities Education Act; 

21 ‘‘(S) if the local educational agency pro22 poses to use subgrant funds under this part for 

23 early intervening services, a description of the 

24 actions the local educational agency will take to 

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1 nate those services with early intervening serv2 ices carried out under the Individuals with Dis3 abilities Education Act; 

4 ‘‘(T) if the local educational agency pro5 poses to use subgrant funds under this part for 

6 school-based mental health programs, a descrip7 tion of the actions the local educational agency 

8 will take to provide school-based mental health 

9 programs and coordinate those activities with 

10 activities carried out under the Individuals with 

11 Disabilities Education Act; and 

12 ‘‘(U) if the local educational agency pro13 poses to use subgrant funds under this part for 

14 periodically updating the crisis management 

15 plan of the local educational agency, as de16 scribed in section 4114(d)(7)(D), a description 

17 of the actions the local educational agency will 

18 take to develop and implement an updated cri19 sis management plan.’’. 

20 (d) TITLE I SCHOOLWIDE PROGRAMS.— 

21 (1) SCHOOLWIDE PROGRAMS.—Section 

22 1114(b)(1)(B)(iii)(I) of the Elementary and Sec23 ondary Education Act of 1965 (20 U.S.C. 

24 6314(b)(1)(B)(iii)(I)) is amended— 


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1 (A) in item (aa), by inserting ‘‘and school2 based mental health programs’’ after ‘‘serv3 ices’’; 

4 (B) by redesignating items (bb) and (cc) 

5 as items (dd) and (ee), respectively; and 

6 (C) by inserting after item (aa) the fol7 lowing: 

8 ‘‘(bb) implementation of 

9 schoolwide positive behavioral inter10 ventions and supports, including 

11 through coordination with activities 

12 carried out under the Individuals with 

13 Disabilities Education Act, in order to 

14 improve academic outcomes for stu15 dents and reduce the need for suspen16 sions, expulsions, and other actions 

17 that remove students from instruc18 tion; 

19 ‘‘(cc) implementation of early in20 tervening services, including through 

21 coordination with early intervening 

22 services carried out under the Individ23 uals with Disabilities Education Act;’’. 

24 (2) TECHNICAL ASSISTANCE.—Section 

25 1116(b)(4)(B) of the Elementary and Secondary 


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1 Education Act of 1965 (20 U.S.C. 6316(b)(4)(B)) is 

2 amended— 

3 (A) by redesignating clauses (iii) and (iv) 

4 as clauses (iv) and (v), respectively; and 

5 (B) by inserting after clause (ii) the fol6 lowing: 

7 ‘‘(iii) shall include assistance in the 

8 implementation of schoolwide positive be9 havior supports, school-based mental 

10 health programs, and other approaches 

11 with evidence of effectiveness for improving 

12 the learning environment in the school and 

13 reducing the need for suspensions, expul14 sions, and other actions that remove stu15 dents from instruction, including effective 

16 strategies for improving coordination of 

17 community resources;’’. 

18 (e) TITLE I ASSESSMENTS AND SCHOOL IMPROVE19 MENT.— 

20 (1) SCHOOL IMPROVEMENT PLAN.—Section 

21 1116(b)(3)(A) of the Elementary and Secondary 

22 Education Act of 1965 (20 U.S.C. 6316(b)(3)(A)) is 

23 amended— 

24 (A) in clause (ix), by striking ‘‘and’’ after 

25 the semicolon; 


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1 (B) in clause (x), by striking the period 

2 and inserting a semicolon; and 

3 (C) by adding at the end the following: 

4 ‘‘(xi) specify whether the local edu5 cational agency or the school will adopt 

6 and implement policies or practices to im7 plement or improve positive behavioral 

8 interventions and supports and enhance co9 ordination with activities carried out under 

10 the Individuals with Disabilities Education 

11 Act; 

12 ‘‘(xii) specify whether the local edu13 cational agency or the school will adopt 

14 and implement policies or practices to im15 plement or improve early intervening serv16 ices and coordinate with early intervening 

17 services carried out under such Act; and 

18 ‘‘(xiii) specify whether the local edu19 cational agency or school will adopt and 

20 implement school-based mental health pro21 grams and coordinate with programs car22 ried out under such Act.’’. 

23 (2) LOCAL EDUCATIONAL AGENCY IMPROVE24 MENT PLANS.—Section 1116(c)(10) of the ElemenVerDate Mar 15 2010 03:25 Apr 11, 2013 Jkt 029200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S689.IS S689

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1 tary and Secondary Education Act of 1965 (20 

2 U.S.C. 6316(c)(10)) is amended— 

3 (A) in subparagraph (B), by striking ‘‘sub4 paragraph (E)’’ and inserting ‘‘subparagraph 

5 (F)’’; 

6 (B) by redesignating subparagraphs (D) 

7 through (F) as subparagraphs (E) through (G), 

8 respectively; and 

9 (C) by inserting after subparagraph (C) 

10 the following: 

11 ‘‘(D) ADDITIONAL ACTIVITIES.—In addi12 tion to carrying out 1 or more of the corrective 

13 actions required under subparagraph (C) for a 

14 local educational agency, the State educational 

15 agency may also carry out 1 or more of the fol16 lowing activities: 

17 ‘‘(i) Improving or expanding positive 

18 behavioral interventions and supports and 

19 enhancing coordination with activities 

20 under the Individuals with Disabilities 

21 Education Act. 

22 ‘‘(ii) Improving or expanding early in23 tervening services and coordinating such 

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1 ried out under the Individuals with Dis2 abilities Education Act.’’. 

3 (f) TITLE I SCHOOL SUPPORT AND RECOGNITION.— 

4 (1) REGIONAL CENTERS.—Section 1117(a)(3) 

5 of the Elementary and Secondary Education Act of 

6 1965 (20 U.S.C. 6317(a)(3)) is amended— 

7 (A) by striking ‘‘of 2002 and comprehen8 sive’’ and inserting ‘‘of 2002, comprehensive’’; 

9 (B) by striking ‘‘and the comprehensive’’ 

10 and inserting ‘‘, the comprehensive’’; and 

11 (C) by inserting ‘‘and any technical assist12 ance center on schoolwide positive behavioral 

13 interventions and supports funded under section 

14 665(b) of the Individuals with Disabilities Edu15 cation Act,’’ after ‘‘2002),’’. 

16 (2) STATEWIDE SYSTEMS FOR SUPPORT.—Sec17 tion 1117(a)(5)(B) of the Elementary and Sec18 ondary Education Act of 1965 (20 U.S.C. 

19 6317(a)(5)(B)) is amended— 

20 (A) in clause (i), by striking the semicolon 

21 at the end and inserting the following: ‘‘, in22 cluding by improving or expanding the use of 

23 positive behavioral interventions and supports 

24 aligned with activities carried out under the In25 dividuals with Disabilities Education Act;’’; 


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1 (B) in clause (iii), by striking ‘‘and’’ after 

2 the semicolon; 

3 (C) in clause (iv), by striking the period 

4 and inserting a semicolon; and 

5 (D) by adding at the end the following: 

6 ‘‘(v) review and analyze the school’s 

7 efforts to identify and assist students with 

8 poor academic achievement and students 

9 who are children with disabilities, and as10 sist the school in developing or improving 

11 early intervening services that are coordi12 nated with activities carried out under the 

13 Individuals with Disabilities Education 

14 Act; 

15 ‘‘(vi) review and analyze the school’s 

16 efforts to address behavioral or disciplinary 

17 problems, and assist the school in devel18 oping or improving schoolwide positive be19 havioral interventions and supports that 

20 are coordinated with activities carried out 

21 under the Individuals with Disabilities 

22 Education Act; 

23 ‘‘(vii) review the number of discipline 

24 incidents in the school and use that infor25 mation to assist the school to implement 


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1 schoolwide positive behavioral interventions 

2 and supports or other early intervening 

3 services, or both; and 

4 ‘‘(viii) review and analyze the school’s 

5 efforts to address mental health needs 

6 among students and assist the school in 

7 developing or improving school-based men8 tal health programs that are coordinated 

9 with activities carried out under the Indi10 viduals with Disabilities Education Act.’’. 

11 (g) TITLE I PARENTAL INVOLVEMENT.—Section 

12 1118(e) of the Elementary and Secondary Education Act 

13 of 1965 (20 U.S.C. 6318(e)) is amended— 

14 (1) by redesignating paragraphs (6) through 

15 (14) as paragraphs (7) through (15), respectively; 

16 and 

17 (2) by inserting after paragraph (5) the fol18 lowing: 

19 ‘‘(6) shall provide information to school per20 sonnel, students, and parents about the school’s use 

21 of positive behavioral interventions and supports, 

22 school-based mental health programs, and the expec23 tations of school personnel, students, and parents in 

24 supporting a safe learning environment for all stu25 dents;’’. 


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1 (h) PREVENTION AND INTERVENTION PROGRAMS.— 

2 Section 1414(c)(8) of the Elementary and Secondary Edu3 cation Act of 1965 (20 U.S.C. 6434(c)(8)) is amended by 

4 inserting ‘‘, including coordinating the use of positive be5 havioral interventions and supports, early intervening 

6 services, and school-based mental health programs to im7 prove academic achievement and reduce disciplinary ac8 tions’’ before the semicolon at the end. 

9 (i) TECHNICAL ASSISTANCE.—Section 1419 of the 

10 Elementary and Secondary Education Act of 1965 (20 

11 U.S.C. 6439) is amended— 

12 (1) in paragraph (1), by striking ‘‘and’’ after 

13 the semicolon; 

14 (2) in paragraph (2), by striking the period and 

15 inserting ‘‘; and’’; and 

16 (3) by adding at the end the following: 

17 ‘‘(3) to provide technical assistance in imple18 menting positive behavior interventions and sup19 ports, early intervening services, and school-based 

20 mental health programs in order to improve aca21 demic achievement and reduce disciplinary actions.’’. 

22 (j) TITLE II MENTAL HEALTH PROFESSIONAL DE23 VELOPMENT.—Section 2123 of the Elementary and Sec24 ondary Education Act of 1965 (20 U.S.C. 6223) is amend25 ed— 


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1 (1) in subsection (a), by inserting after para2 graph (8) the following: 

3 ‘‘(9) Carrying out in-service training for school 

4 personnel in— 

5 ‘‘(A) the techniques and supports needed 

6 to identify children with trauma histories, and 

7 children with, or at risk of, mental illness, 

8 early; 

9 ‘‘(B) the use of referral mechanisms that 

10 effectively link such children to appropriate 

11 treatment and intervention services in the 

12 school and in the community where appropriate; 

13 and 

14 ‘‘(C) forming partnerships between school15 based mental health programs and public or 

16 private mental health organizations.’’; 

17 (2) by redesignating subsection (b) as sub18 section (c); and 

19 (3) by inserting after subsection (a) the fol20 lowing: 

21 ‘‘(b) LIABILITY PROTECTION FOR SCHOOL PER22 SONNEL.—Section 2366 shall apply to school personnel 

23 who received in-service training under subsection (a)(9), 

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1 ing, in the same manner as such section applies to teach2 ers.’’. 

3 (k) SCHOOL-BASED MENTAL HEALTH SERVICES

4 PARTNERSHIP PROGRAMS.—Section 4121 of the Elemen5 tary and Secondary Education Act of 1965 (20 U.S.C. 

6 7131) is amended— 

7 (1) in subsection (a)— 

8 (A) in the matter preceding paragraph (1), 

9 by inserting ‘‘, health (including mental 

10 health),’’ after ‘‘promote safety’’; 

11 (B) by redesignating paragraphs (3) 

12 through (8) and (9) as paragraphs (4) through 

13 (9) and (11), respectively; 

14 (C) by inserting after paragraph (2) the 

15 following: 

16 ‘‘(3) the development and implementation of 

17 school-based mental health services partnership pro18 grams under subsection (c);’’; 

19 (D) by striking paragraph (7), as redesig20 nated by subparagraph (B), and inserting the 

21 following: 

22 ‘‘(7)(A) assistance to school systems that have 

23 particularly severe drug and violence problems or as24 sistance to support appropriate response efforts to 

25 crisis situations, including— 


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1 ‘‘(i) hiring drug prevention and school 

2 safety coordinators; and 

3 ‘‘(ii) making available to students mental 

4 health services, conflict resolution programs, 

5 and other school-based violence prevention 

6 strategies;’’; 

7 (E) in paragraph (9), as redesignated by 

8 subparagraph (B), by striking ‘‘and’’ after the 

9 semicolon; and 

10 (F) by inserting after such paragraph (9) 

11 the following: 

12 ‘‘(10) assistance to States to help local edu13 cational agencies develop and implement comprehen14 sive emergency management plans; and’’; and 

15 (2) by adding at the end the following: 

16 ‘‘(c) SCHOOL-BASED MENTAL HEALTH SERVICES

17 PARTNERSHIP PROGRAMS.— 

18 ‘‘(1) IN GENERAL.—Each grant, contract, or 

19 cooperative agreement awarded or entered into 

20 under subsection (a)(3) shall meet the requirements 

21 of this subsection. 

22 ‘‘(2) ELIGIBILITY.— 

23 ‘‘(A) IN GENERAL.—To be eligible to re24 ceive a grant, contract, or cooperative agree25 ment under this subsection, a local educational 


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1 agency shall enter into a school-based mental 

2 health partnership that— 

3 ‘‘(i) shall include a public or private 

4 mental health entity or health care entity; 

5 and 

6 ‘‘(ii) may include a child welfare agen7 cy, family-based mental health entity, fam8 ily organization, trauma network, or other 

9 community-based entity. 

10 ‘‘(B) FLEXIBILITY FOR CERTAIN LOCAL

11 EDUCATIONAL AGENCIES.—Notwithstanding 

12 subparagraph (A), a local educational agency 

13 that is eligible for services under subpart 1 or 

14 2 of part B of title VI, as determined by the 

15 Secretary, and that is unable to partner with a 

16 public or private mental health entity or health 

17 care entity shall be eligible for a grant under 

18 this subsection if the local educational agency 

19 can demonstrate to the Secretary, in its appli20 cation for a grant under this subsection, that 

21 the local educational agency can otherwise build 

22 the capacity to carry out the requirements of 

23 this subsection. 

24 ‘‘(3) APPLICATION.—A local educational agency 

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1 ment under this subsection shall include, in the ap2 plication required by the Secretary, a description of 

3 how the local educational agency will— 

4 ‘‘(A) assist schools served by the local edu5 cational agency to provide, through the school6 based mental health services partnership pro7 gram, comprehensive school-based mental 

8 health services and supports and comprehensive 

9 staff development for school and community 

10 service personnel working in the school; 

11 ‘‘(B) provide technical assistance and 

12 training to improve and support the develop13 ment, implementation, and coordination of 

14 school-based mental health programs and en15 sure such programs are coordinated with activi16 ties carried out under the Individuals with Dis17 abilities Education Act; and 

18 ‘‘(C) evaluate the effects of providing 

19 school-based mental health programs. 

20 ‘‘(4) USE OF FUNDS.—A local educational 

21 agency receiving a grant, contract, or cooperative 

22 agreement under this subsection shall use funds pro23 vided under such grant, contract, or cooperative 

24 agreement to provide school-based mental health 

25 services and supports that— 


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1 ‘‘(A) may include— 

2 ‘‘(i) the early identification of social, 

3 emotional, or behavioral problems, or sub4 stance use disorders, and the provision of 

5 early intervening services; 

6 ‘‘(ii) not withstanding section 4154, 

7 the treatment or referral for treatment of 

8 students with social, emotional, or behav9 ioral health problems, or substance use dis10 orders; 

11 ‘‘(iii) the development and implemen12 tation of programs to assist children in 

13 dealing with trauma and violence; and 

14 ‘‘(iv) the development of mechanisms, 

15 based on best practices, for children to re16 port incidents of violence or plans by other 

17 children or adults to commit violence; 

18 ‘‘(B) are based on trauma-informed and 

19 evidence-based practices; 

20 ‘‘(C) are coordinated, where appropriate, 

21 with early intervening services carried out 

22 under the Individuals with Disabilities Edu23 cation Act; and 

24 ‘‘(D) are provided by qualified mental and 

25 behavioral health professionals who are certified 


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1 or licensed by the State involved and practicing 

2 within their area of expertise. 

3 ‘‘(5) GENERAL REQUIREMENTS.— 

4 ‘‘(A) PARENTAL CONSENT.— 

5 ‘‘(i) IN GENERAL.—Each local edu6 cational agency receiving a grant, contract, 

7 or cooperative agreement under this sub8 section shall obtain prior written, informed 

9 consent from the parent of each child who 

10 is under 18 years of age to participate in 

11 any assessment service, program, activity, 

12 or treatment that is— 

13 ‘‘(I) funded under this sub14 section; and 

15 ‘‘(II) conducted in connection 

16 with an elementary school or sec17 ondary school under the grant, con18 tract, or cooperative agreement. 

19 ‘‘(ii) EXCEPTION.—Notwithstanding 

20 clause (i), the written, informed consent 

21 described in such clause shall not be re22 quired in— 

23 ‘‘(I) an emergency, where it is 

24 necessary to protect the immediate 


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1 health and safety of the student, other 

2 students, or school personnel; or 

3 ‘‘(II) other instances where pa4 rental consent cannot reasonably be 

5 obtained, as defined by the Secretary. 

6 ‘‘(B) PROHIBITION ON MANDATORY MEDI7 CATION.—No child shall be required to obtain a 

8 prescription for a substance covered by the 

9 Controlled Substances Act (21 U.S.C. 801 et 

10 seq.) as a condition of receiving an evaluation 

11 under this subsection, receiving services under 

12 this subsection, or attending a school receiving 

13 assistance under this subsection. 

14 ‘‘(C) PRIVACY.—Each eligible entity receiv15 ing a grant under this subsection shall ensure 

16 that student mental health records are accorded 

17 the privacy protections provided under the regu18 lations promulgated under section 264(c) of the 

19 Health Insurance Portability and Accountability 

20 Act of 1996 (Public Law 104–191; 110 Stat. 

21 2033) and section 444 of the General Edu22 cation Provisions Act (20 U.S.C. 1232g) (com23 monly referred to as the ‘Federal Educational 

24 Rights and Privacy Act of 1974’). 


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1 ‘‘(6) LIABILITY PROTECTION FOR SCHOOL PER2 SONNEL.—Section 2366 shall apply to school per3 sonnel providing services under a grant, contract, or 

4 cooperative agreement under this subsection in the 

5 same manner as such section applies to teachers. 

6 ‘‘(7) PROHIBITION AGAINST FEDERAL MAN7 DATES, DIRECTION, OR CONTROL OR FEDERAL REG8 ULATION.—In addition to the prohibition of Federal 

9 Government control of a State, local educational 

10 agency, or school’s curriculum or program of in11 struction that is provided under section 9527(a), 

12 nothing in this subsection shall be construed to au13 thorize an officer or employee of the Federal Gov14 ernment to mandate, direct, or control a State, local 

15 educational agency, or school’s specific instructional 

16 content or academic achievement standards and as17 sessments.’’. 

18 (l) DEFINITION.—Section 9101 of the Elementary 

19 and Secondary Education Act of 1965 (20 U.S.C. 7801) 

20 is amended— 

21 (1) by redesignating paragraphs (17) through 

22 (43) as paragraphs (18) through (44), respectively; 

23 and 

24 (2) by inserting after paragraph (16) the fol25 lowing: 


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1 ‘‘(17) EARLY INTERVENING SERVICES.—The 

2 term ‘early intervening services’ means early inter3 vening services described in section 613(f)(1) of the 

4 Individuals with Disabilities Education Act.’’. 

5 SEC. 104. CONFORMING AMENDMENTS. 

6 (a) AMERICA COMPETES REAUTHORIZATION ACT

7 OF 2010.—Section 553(d)(6) of the America COMPETES 

8 Reauthorization Act of 2010 (20 U.S.C. 9903) is amended 

9 by striking ‘‘section 9101(23)’’ and inserting ‘‘section 

10 9101(24)’’. 

11 (b) HIGHER EDUCATION ACT OF 1965.—Section 

12 255(k) of the Higher Education Act of 1965 is amended— 

13 (1) in paragraph (1), by striking ‘‘section 

14 9101(23)(B)(ii)’’ and inserting ‘‘section 

15 9101(24)(B)(ii)’’; and 

16 (2) in paragraph (3), by striking ‘‘section 

17 9101(23)’’ and inserting ‘‘section 9101(24)’’. 

18 (c) INDIVIDUALS WITH DISABILITIES EDUCATION

19 ACT.—Section 602(10) of the Individuals with Disabilities 

20 Education Act (20 U.S.C. 1401(10)) is amended— 

21 (1) in subparagraph (C)(ii), by striking ‘‘section 

22 9101(23)’’ and inserting ‘‘section 9101(24)’’; and 

23 (2) in each of clauses (ii) and (iii) of subpara24 graph (D), by striking ‘‘section 9101(23)(C)(ii)’’ and 

25 inserting ‘‘section 9101(24)(C)(ii)’’. 


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1 TITLE II—HEALTH PROGRAMS 

2 SEC. 201. GARRETT LEE SMITH MEMORIAL ACT REAUTHOR3 IZATION. 

4 (a) SUICIDE PREVENTION TECHNICAL ASSISTANCE

5 CENTER.—Section 520C of the Public Health Service Act 

6 (42 U.S.C. 290bb–34) is amended— 

7 (1) in the section heading, by striking the sec8 tion heading and inserting ‘‘SUICIDE PREVENTION

9 TECHNICAL ASSISTANCE CENTER.’’; 

10 (2) in subsection (a), by striking ‘‘and in con11 sultation with’’ and all that follows through the pe12 riod at the end of paragraph (2) and inserting ‘‘shall 

13 establish a research, training, and technical assist14 ance resource center to provide appropriate informa15 tion, training, and technical assistance to States, po16 litical subdivisions of States, federally recognized In17 dian tribes, tribal organizations, institutions of high18 er education, public organizations, or private non19 profit organizations regarding the prevention of sui20 cide among all ages, particularly among groups that 

21 are at high risk for suicide.’’; 

22 (3) by striking subsections (b) and (c); 

23 (4) by redesignating subsection (d) as sub24 section (b); 

25 (5) in subsection (b), as so redesignated— 


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1 (A) by striking the subsection heading and 

2 inserting ‘‘RESPONSIBILITIES OF THE CEN3 TER.’’; 

4 (B) in the matter preceding paragraph (1), 

5 by striking ‘‘The additional research’’ and all 

6 that follows through ‘‘nonprofit organizations 

7 for’’ and inserting ‘‘The center established 

8 under subsection (a) shall conduct activities for 

9 the purpose of’’; 

10 (C) by striking ‘‘youth suicide’’ each place 

11 such term appears and inserting ‘‘suicide’’; 

12 (D) in paragraph (1)— 

13 (i) by striking ‘‘the development or 

14 continuation of’’ and inserting ‘‘developing 

15 and continuing’’; and 

16 (ii) by inserting ‘‘for all ages, particu17 larly among groups that are at high risk 

18 for suicide’’ before the semicolon at the 

19 end; 

20 (E) in paragraph (2), by inserting ‘‘for all 

21 ages, particularly among groups that are at 

22 high risk for suicide’’ before the semicolon at 

23 the end; 

24 (F) in paragraph (3), by inserting ‘‘and 

25 tribal’’ after ‘‘statewide’’; 


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1 (G) in paragraph (5), by inserting ‘‘and 

2 prevention’’ after ‘‘intervention’’; 

3 (H) in paragraph (8), by striking ‘‘in 

4 youth’’; 

5 (I) in paragraph (9), by striking ‘‘and be6 havioral health’’ and inserting ‘‘health and sub7 stance use disorder’’; and 

8 (J) in paragraph (10), by inserting ‘‘con9 ducting’’ before ‘‘other’’; and 

10 (6) by striking subsection (e) and inserting the 

11 following: 

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

13 purpose of carrying out this section, there are authorized 

14 to be appropriated $4,948,000 for each of fiscal years 

15 2014 through 2018.’’. 

16 (b) YOUTH SUICIDE EARLY INTERVENTION AND

17 PREVENTION STRATEGIES.—Section 520E of the Public 

18 Health Service Act (42 U.S.C. 290bb–36) is amended— 

19 (1) in paragraph (1) of subsection (a) and in 

20 subsection (c), by striking ‘‘substance abuse’’ each 

21 place such term appears and inserting ‘‘substance 

22 use disorder’’; 

23 (2) in subsection (b)(2)— 

24 (A) by striking ‘‘each State is awarded 

25 only 1 grant or cooperative agreement under 


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1 this section’’ and inserting ‘‘a State does not 

2 receive more than 1 grant or cooperative agree3 ment under this section at any 1 time’’; and 

4 (B) by striking ‘‘been awarded’’ and insert5 ing ‘‘received’’; and 

6 (3) by striking subsection (m) and inserting the 

7 following: 

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

9 the purpose of carrying out this section, there are author10 ized to be appropriated $29,682,000 for each of fiscal 

11 years 2014 through 2018.’’. 

12 (c) MENTAL HEALTH AND SUBSTANCE USE DIS13 ORDER SERVICES.—Section 520E–2 of the Public Health 

14 Service Act (42 U.S.C. 290bb–36b) is amended— 

15 (1) in the section heading, by striking ‘‘AND

16 BEHAVIORAL HEALTH’’ and inserting ‘‘HEALTH

17 AND SUBSTANCE USE DISORDER SERVICES’’; 

18 (2) in subsection (a)— 

19 (A) by striking ‘‘Services,’’ and inserting 

20 ‘‘Services and’’; 

21 (B) by striking ‘‘and behavioral health 

22 problems’’ and inserting ‘‘health or substance 

23 use disorders’’; and 

24 (C) by striking ‘‘substance abuse’’ and in25 serting ‘‘substance use disorders’’; 


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1 (3) in subsection (b)— 

2 (A) in the matter preceding paragraph (1), 

3 by striking ‘‘for—’’ and inserting ‘‘for one or 

4 more of the following:’’; and 

5 (B) by striking paragraphs (1) through (6) 

6 and inserting the following: 

7 ‘‘(1) Educating students, families, faculty, and 

8 staff to increase awareness of mental health and 

9 substance use disorders. 

10 ‘‘(2) The operation of hotlines. 

11 ‘‘(3) Preparing informational material. 

12 ‘‘(4) Providing outreach services to notify stu13 dents about available mental health and substance 

14 use disorder services. 

15 ‘‘(5) Administering voluntary mental health and 

16 substance use disorder screenings and assessments. 

17 ‘‘(6) Supporting the training of students, fac18 ulty, and staff to respond effectively to students with 

19 mental health and substance use disorders. 

20 ‘‘(7) Creating a network infrastructure to link 

21 colleges and universities with health care providers 

22 who treat mental health and substance use dis23 orders.’’; 

24 (4) in subsection (c)(5), by striking ‘‘substance 

25 abuse’’ and inserting ‘‘substance use disorder’’; 


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1 (5) in subsection (d)— 

2 (A) in the matter preceding paragraph (1), 

3 by striking ‘‘An institution of higher education 

4 desiring a grant under this section’’ and insert5 ing ‘‘To be eligible to receive a grant under this 

6 section, an institution of higher education’’; 

7 (B) in paragraph (1)— 

8 (i) by striking ‘‘and behavioral 

9 health’’ and inserting ‘‘health and sub10 stance use disorder’’; and 

11 (ii) by inserting ‘‘, including veterans 

12 whenever possible and appropriate,’’ after 

13 ‘‘students’’; and 

14 (C) in paragraph (2), by inserting ‘‘, which 

15 may include, as appropriate and in accordance 

16 with subsection (b)(7), a plan to seek input 

17 from relevant stakeholders in the community, 

18 including appropriate public and private enti19 ties, in order to carry out the program under 

20 the grant’’ before the period at the end; 

21 (6) in subsection (e)(1), by striking ‘‘and behav22 ioral health problems’’ and inserting ‘‘health and 

23 substance use disorders’’; 

24 (7) in subsection (f)(2)— 


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1 (A) by striking ‘‘and behavioral health’’ 

2 and inserting ‘‘health and substance use dis3 order’’; and 

4 (B) by striking ‘‘suicide and substance 

5 abuse’’ and inserting ‘‘suicide and substance 

6 use disorders’’; and 

7 (8) in subsection (h), by striking ‘‘$5,000,000 

8 for fiscal year 2005’’ and all that follows through 

9 the period at the end and inserting ‘‘$4,858,000 for 

10 each of fiscal years 2014 through 2018.’’. 

11 SEC. 202. MENTAL HEALTH AWARENESS TRAINING GRANTS. 

12 Section 520J of the Public Health Service Act (42 

13 U.S.C. 290bb–41) is amended— 

14 (1) in the section heading, by inserting ‘‘MEN15 TAL HEALTH AWARENESS’’ before ‘‘TRAINING’’; 

16 and 

17 (2) in subsection (b)— 

18 (A) in the subsection heading, by striking 

19 ‘‘ILLNESS’’ and inserting ‘‘HEALTH’’; 

20 (B) in paragraph (1), by inserting ‘‘and 

21 other categories of individuals, as determined 

22 by the Secretary,’’ after ‘‘emergency services 

23 personnel’’; 

24 (C) in paragraph (5)— 


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1 (i) in the matter preceding subpara2 graph (5), by striking ‘‘to’’ and inserting 

3 ‘‘for evidence-based programs for the pur4 pose of’’; and 

5 (ii) by striking subparagraphs (A) 

6 through (C) and inserting the following: 

7 ‘‘(A) recognizing the signs and symptoms 

8 of mental illness; and 

9 ‘‘(B)(i) providing education to personnel 

10 regarding resources available in the community 

11 for individuals with a mental illness and other 

12 relevant resources; or 

13 ‘‘(ii) the safe de-escalation of crisis situa14 tions involving individuals with a mental ill15 ness.’’; and 

16 (D) in paragraph (7), by striking ‘‘, 

17 $25,000,000’’ and all that follows through the 

18 period at the end and inserting ‘‘$20,000,000 

19 for each of fiscal years 2014 through 2018’’. 

20 SEC. 203. CHILDREN’S RECOVERY FROM TRAUMA. 

21 Section 582 of the Public Health Service Act (42 

22 U.S.C. 290hh–1) is amended— 

23 (1) in subsection (a), by striking ‘‘developing 

24 programs’’ and all that follows and inserting ‘‘devel25 oping and maintaining programs that provide for— 


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1 ‘‘(1) the continued operation of the National 

2 Child Traumatic Stress Initiative (referred to in this 

3 section as the ‘NCTSI’), which includes a coordi4 nating center, that focuses on the mental, behav5 ioral, and biological aspects of psychological trauma 

6 response; and 

7 ‘‘(2) the development of knowledge with regard 

8 to evidence-based practices for identifying and treat9 ing mental, behavioral, and biological disorders of 

10 children and youth resulting from witnessing or ex11 periencing a traumatic event.’’; 

12 (2) in subsection (b)— 

13 (A) by striking ‘‘subsection (a) related’’ 

14 and inserting ‘‘subsection (a)(2) (related’’; 

15 (B) by striking ‘‘treating disorders associ16 ated with psychological trauma’’ and inserting 

17 ‘‘treating mental, behavioral, and biological dis18 orders associated with psychological trauma)’’; 

19 and 

20 (C) by striking ‘‘mental health agencies 

21 and programs that have established clinical and 

22 basic research’’ and inserting ‘‘universities, hos23 pitals, mental health agencies, and other pro24 grams that have established clinical expertise 

25 and research’’; 


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1 (3) by redesignating subsections (c) through (g) 

2 as subsections (g) through (k), respectively; 

3 (4) by inserting after subsection (b), the fol4 lowing: 

5 ‘‘(c) CHILD OUTCOME DATA.—The NCTSI coordi6 nating center shall collect, analyze, and report NCTSI7 wide child treatment process and outcome data regarding 

8 the early identification and delivery of evidence-based 

9 treatment and services for children and families served by 

10 the NCTSI grantees. 

11 ‘‘(d) TRAINING.—The NCTSI coordinating center 

12 shall facilitate the coordination of training initiatives in 

13 evidence-based and trauma-informed treatments, interven14 tions, and practices offered to NCTSI grantees, providers, 

15 and partners. 

16 ‘‘(e) DISSEMINATION.—The NCTSI coordinating 

17 center shall, as appropriate, collaborate with the Secretary 

18 in the dissemination of evidence-based and trauma-in19 formed interventions, treatments, products and other re20 sources to appropriate stakeholders. 

21 ‘‘(f) REVIEW.—The Secretary shall, consistent with 

22 the peer review process, ensure that NCTSI applications 

23 are reviewed by appropriate experts in the field as part 

24 of a consensus review process. The Secretary shall include 


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1 review criteria related to expertise and experience in child 

2 trauma and evidence-based practices.’’; 

3 (5) in subsection (g) (as so redesignated), by 

4 striking ‘‘with respect to centers of excellence are 

5 distributed equitably among the regions of the coun6 try’’ and inserting ‘‘are distributed equitably among 

7 the regions of the United States’’; 

8 (6) in subsection (i) (as so redesignated), by 

9 striking ‘‘recipient may not exceed 5 years’’ and in10 serting ‘‘recipient shall not be less than 4 years, but 

11 shall not exceed 5 years’’; and 

12 (7) in subsection (j) (as so redesignated), by 

13 striking ‘‘$50,000,000’’ and all that follows through 

14 ‘‘2006’’ and inserting ‘‘$45,713,000 for each of fis15 cal years 2014 through 2018’’. 

16 SEC. 204. ASSESSING BARRIERS TO BEHAVIORAL HEALTH 

17 INTEGRATION. 

18 (a) IN GENERAL.—Not later than 2 years after the 

19 date of enactment of this Act, the Comptroller General 

20 of the United States shall submit a report to the Com21 mittee on Health, Education, Labor, and Pensions of the 

22 Senate and the Committee on Energy and Commerce of 

23 the House of Representatives concerning Federal require24 ments that impact access to treatment of mental health 

25 and substance use disorders related to integration with 


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1 primary care, administrative and regulatory issues, quality 

2 measurement and accountability, and data sharing. 

3 (b) CONTENTS.—The report submitted under sub4 section (a) shall include the following: 

5 (1) An evaluation of the administrative or regu6 latory burden on behavioral healthcare providers. 

7 (2) The identification of outcome and quality 

8 measures relevant to integrated health care, evalua9 tion of the data collection burden on behavioral 

10 healthcare providers, and any alternative methods 

11 for evaluation. 

12 (3) An analysis of the degree to which elec13 tronic data standards, including interoperability and 

14 meaningful use includes behavioral health measures, 

15 and an analysis of strategies to address barriers to 

16 health information exchange posed by part 2 of title 

17 42, Code of Federal Regulations. 

18 (4) An analysis of the degree to which Federal 

19 rules and regulations for behavioral and physical 

20 health care are aligned, including recommendations 

21 to address any identified barriers. 

22 SEC. 205. INCREASING EDUCATION AND AWARENESS OF 

23 TREATMENTS FOR OPIOID USE DISORDERS. 

24 (a) IN GENERAL.—In order to improve the quality 

25 of care delivery and treatment outcomes among patients 


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1 with opioid use disorders, the Secretary of Health and 

2 Human Services (referred to in this section as the ‘‘Sec3 retary’’), acting through the Administrator for the Sub4 stance Abuse and Mental Health Services Administration, 

5 may advance, through existing programs as appropriate, 

6 the education and awareness of providers, patients, and 

7 other appropriate stakeholders regarding all products ap8 proved by the Food and Drug Administration to treat 

9 opioid use disorders. 

10 (b) ACTIVITIES.—The activities described in sub11 section (a) may include— 

12 (1) disseminating evidence-based practices for 

13 the treatment of opioid use disorders; 

14 (2) facilitating continuing education programs 

15 for health professionals involved in treating opioid 

16 use disorders; 

17 (3) increasing awareness among relevant stake18 holders of the treatment of opioid use disorders; 

19 (4) assessing current barriers to the treatment 

20 of opioid use disorders for patients and providers 

21 and development and implementation of strategies to 

22 mitigate such barriers; and 

23 (5) continuing innovative approaches to the 

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1 ment settings, such as prisons, community mental 

2 health centers, primary care, and hospitals. 

3 (c) REPORT.—Not later than 1 year after the date 

4 of enactment of this Act, if the Secretary carries out the 

5 activities under this section, the Secretary shall submit to 

6 the Committee on Health, Education, Labor, and Pen7 sions of the Senate and the Committee on Energy and 

8 Commerce of the House of Representatives a report that 

9 examines— 

10 (1) the activities the Substance Abuse and Men11 tal Health Services Administration conducts under 

12 this section, including any potential impacts on 

13 health care costs associated with such activities; 

14 (2) the role of adherence in the treatment of 

15 opioid use disorders and methods to reduce opioid 

16 use disorders; and 

17 (3) recommendations on priorities and strate18 gies to address co-occurring substance use disorders 

19 and mental illnesses. 

20 SEC. 206. EXAMINING MENTAL HEALTH CARE FOR CHIL21 DREN. 

22 (a) IN GENERAL.—Not later than 1 year after the 

23 date of enactment of this Act, the Comptroller General 

24 of the United States shall conduct an independent evalua25 tion, and submit to the Committee on Health, Education, 


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1 Labor, and Pensions of the Senate and the Committee on 

2 Energy and Commerce of the House of Representatives, 

3 a report concerning the utilization of mental health serv4 ices for children, including the usage of psychotropic medi5 cations. 

6 (b) CONTENT.—The report submitted under sub7 section (a) shall review and assess— 

8 (1) the ways in which children access mental 

9 health care, including information on whether chil10 dren are treated by primary care or specialty pro11 viders, what types of referrals for additional care are 

12 recommended, and any barriers to accessing this 

13 care; 

14 (2) the extent to which children are prescribed 

15 psychotropic medications in the United States in16 cluding the frequency of concurrent medication 

17 usage; and 

18 (3) the tools, assessments, and medications that 

19 are available and used to diagnose and treat children 

20 with mental health disorders. 

21 SEC. 207. EVIDENCE BASED PRACTICES FOR OLDER 

22 ADULTS. 

23 (a) GERIATRIC SUBSTANCE USE DISORDERS TREAT24 MENT.—Section 509(e) of the Public Health Service Act 

25 (42 U.S.C. 290bb–2(e)) is amended— 


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1 (1) by striking ‘‘The Secretary shall establish’’ 

2 and inserting: 

3 ‘‘(1) IN GENERAL.—The Secretary shall estab4 lish’’; and 

5 (2) by adding at the end the following: 

6 ‘‘(2) GERIATRIC SUBSTANCE USE DISORDERS

7 TREATMENT.—The Secretary shall, as appropriate, 

8 provide technical assistance to grantees regarding 

9 evidence-based practices for the treatment of geri10 atric substance use disorders, as well as disseminate 

11 information about such evidence-based practices to 

12 States and nongrantees throughout the United 

13 States.’’. 

14 (b) GERIATRIC SUBSTANCE USE DISORDERS PRE15 VENTION.—Section 516(e) of the Public Health Service 

16 Act (42 U.S.C. 290bb–22(e)) is amended— 

17 (1) by striking ‘‘The Secretary shall establish’’ 

18 and inserting: 

19 ‘‘(1) IN GENERAL.—The Secretary shall estab20 lish’’; and 

21 (2) by adding at the end the following: 

22 ‘‘(2) GERIATRIC SUBSTANCE USE DISORDERS

23 PREVENTION.—The Secretary shall, as appropriate, 

24 provide technical assistance to grantees regarding 

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1 atric substance use disorders, as well as disseminate 

2 information about such evidence-based practices to 

3 States and nongrantees throughout the United 

4 States.’’. 

5 (c) GERIATRIC MENTAL HEALTH DISORDERS.—Sec6 tion 520A(e) of the Public Health Service Act (42 U.S.C. 

7 290bb–32(e)) is amended by adding at the end the fol8 lowing: 

9 ‘‘(3) GERIATRIC MENTAL HEALTH DIS10 ORDERS.—The Secretary shall, as appropriate, pro11 vide technical assistance to grantees regarding evi12 dence-based practices for the prevention and treat13 ment of geriatric mental health disorders, as well as 

14 disseminate information about such evidence-based 

15 practices to States and nongrantees throughout the 

16 United States.’’. 

17 SEC. 208. NATIONAL VIOLENT DEATH REPORTING SYSTEM. 

18 The Secretary of Health and Human Services, acting 

19 through the Director of the Centers for Disease Control 

20 and Prevention, is encouraged to improve, particularly 

21 through the inclusion of additional States, the National 

22 Violent Death Reporting System as authorized by title III 

23 of the Public Health Service Act. Participation in the sys24 tem by the States shall be voluntary. 


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1 SEC. 209. GAO STUDY ON VIRGINIA TECH RECOMMENDA2 TIONS. 

3 (a) IN GENERAL.—Not later than 1 year after the 

4 date of enactment of this Act, the Comptroller General 

5 of the United States shall conduct an independent evalua6 tion, and submit to the appropriate committees of Con7 gress a report concerning the status of implementation of 

8 recommendations made in the report to the President, On 

9 Issues Raised by the Virginia Tech Tragedy, by the Secre10 taries of Health and Human Services and Education and 

11 the Attorney General of the United States, submitted to 

12 the President on June 13, 2007. 

13 (b) CONTENT.—The report submitted to the commit14 tees of Congress under subsection (a) shall review and as15 sess— 

16 (1) the extent to which the recommendations in 

17 the report that include participation by the Depart18 ment of Health and Human Services were imple19 mented; 

20 (2) whether there are any barriers to implemen21 tation of such recommendations; and 

22 (3) identification of any additional actions the 

23 Federal government can take to support States and 

24 local communities and ensure that the Federal gov25 ernment and Federal law are not obstacles to ad26 dressing at the community level— 


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1 (A) school violence; and 

2 (B) mental illness. 

Æ 


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