II 

Calendar No. 37 

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, 

Mr. ISAKSON, Mr. MURPHY, and Mr. KIRK) introduced the following bill; 

which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

APRIL 11, 2013 

Reported by Mr. HARKIN, with an amendment 

[Strike out all after the enacting clause and insert the part printed in italic] 

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 Elemenmstockstill on DSK4VPTVN1PROD with BILLS

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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. 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Mental Health Aware5 ness and Improvement Act of 2013’’. 

6 TITLE I—EDUCATION PROGRAMS 

7 SEC. 101. SHORT TITLE. 

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

9 Prevention Act’’. 

10 SEC. 102. PURPOSE. 

11 The purpose of this title is to expand the use of positive 

12 behavioral interventions and supports and early inter13 vening services in schools in order to improve student aca14 demic achievement, reduce overidentification of individuals 

15 with disabilities, and reduce disciplinary problems in 

16 schools. 

17 SEC. 103. AMENDMENTS TO THE ELEMENTARY AND SEC18 ONDARY EDUCATION ACT OF 1965. 

19 (a) TITLE I STATE PLANS.—Section 1111(b) of the El20 ementary and Secondary Education Act of 1965 (20 U.S.C. 

21 6311(b)) is amended by adding at the end the following: 

22 ‘‘(11) POSITIVE BEHAVIORAL INTERVENTIONS

23 AND SUPPORTS.—In the case of a State that proposes 

24 to use funds under this part to support positive be25 havioral interventions and supports, the State plan 

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1 shall describe how the State educational agency 

2 will— 

3 ‘‘(A) assist local educational agencies in im4 plementing positive behavioral interventions and 

5 supports in schools served by the local edu6 cational agency on a whole-school basis; 

7 ‘‘(B) provide technical assistance and train8 ing to local educational agencies to improve and 

9 support the development, implementation, and 

10 coordination of comprehensive positive behav11 ioral interventions and supports carried out 

12 under this Act with activities carried out under 

13 the Individuals with Disabilities Education Act; 

14 and 

15 ‘‘(C) evaluate the effects of providing posi16 tive behavioral interventions and supports for all 

17 students, including improvement of the learning 

18 environment, academic achievement, disciplinary 

19 problems such as incidents of suspensions, expul20 sions, referrals to law enforcement, and other ac21 tions that remove students from instruction, and 

22 any other effects the State chooses to evaluate. 

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

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

25 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 im4 plementing early intervening services in schools 

5 served by the local educational agency to reduce 

6 the need to label children as children with dis7 abilities in order to address the learning and be8 havioral needs of such children; 

9 ‘‘(B) provide technical assistance and train10 ing to local educational agencies to improve co11 ordination of early intervening services provided 

12 under this Act with early intervening services 

13 carried out under the Individuals with Disabil14 ities Education Act; and 

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

16 intervening services. 

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

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

19 to assist local educational agencies in the State in pe20 riodically updating the crisis management plans, as 

21 described in section 4114(d)(7)(D), of such local edu22 cational agencies, the State plan shall describe how 

23 the State educational agency will assist local edu24 cational agencies in updating such crisis management 

25 plans.’’. 

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1 (b) TITLE I STATE REPORTS.—Section 1111(h)(1)(C) 

2 of the Elementary and Secondary Education Act of 1965 

3 (20 U.S.C. 6311(h)(1)(C)) is amended— 

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

5 semicolon; 

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

7 inserting a semicolon; and 

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

9 ‘‘(ix) the number of local educational 

10 agencies in the State that implement posi11 tive behavioral interventions and supports; 

12 ‘‘(x) the number of students— 

13 ‘‘(I) who are served through the 

14 use of early intervening services; and 

15 ‘‘(II) who, in the preceding 2-year 

16 period, received early intervening serv17 ices and who, after receiving such serv18 ices, have been identified as eligible for, 

19 and receive, special education and re20 lated services under part B of the Indi21 viduals with Disabilities Education 

22 Act; and 

23 ‘‘(xi) the number of local educational 

24 agencies in the State that implement school25 based mental health programs.’’. 

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

2 Section 1112(b)(1) of the Elementary and Secondary Edu3 cation Act of 1965 (20 U.S.C. 6312(b)(1)) is amended— 

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

5 the semicolon; 

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

7 and inserting a semicolon; and 

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

9 ‘‘(R) if the local educational agency pro10 poses to use subgrant funds under this part for 

11 positive behavioral interventions and supports, a 

12 description of the actions the local educational 

13 agency will take to provide positive behavioral 

14 interventions and supports and coordinate those 

15 activities with activities carried out under the 

16 Individuals with Disabilities Education Act; 

17 ‘‘(S) if the local educational agency pro18 poses to use subgrant funds under this part for 

19 early intervening services, a description of the 

20 actions the local educational agency will take to 

21 provide early intervening services and coordinate 

22 those services with early intervening services car23 ried out under the Individuals with Disabilities 

24 Education Act; 

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1 ‘‘(T) if the local educational agency pro2 poses to use subgrant funds under this part for 

3 school-based mental health programs, a descrip4 tion of the actions the local educational agency 

5 will take to provide school-based mental health 

6 programs and coordinate those activities with 

7 activities carried out under the Individuals with 

8 Disabilities Education Act; and 

9 ‘‘(U) if the local educational agency pro10 poses to use subgrant funds under this part for 

11 periodically updating the crisis management 

12 plan of the local educational agency, as described 

13 in section 4114(d)(7)(D), a description of the ac14 tions the local educational agency will take to 

15 develop and implement an updated crisis man16 agement plan.’’. 

17 (d) TITLE I SCHOOLWIDE PROGRAMS.— 

18 (1) SCHOOLWIDE PROGRAMS.—Section 

19 1114(b)(1)(B)(iii)(I) of the Elementary and Sec20 ondary Education Act of 1965 (20 U.S.C. 

21 6314(b)(1)(B)(iii)(I)) is amended— 

22 (A) in item (aa), by striking ‘‘and men23 toring services’’ and inserting ‘‘mentoring serv24 ices, and school-based mental health programs’’; 

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1 (B) by redesignating items (bb) and (cc) as 

2 items (dd) and (ee), respectively; and 

3 (C) by inserting after item (aa) the fol4 lowing: 

5 ‘‘(bb) implementation of 

6 schoolwide positive behavioral interven7 tions and supports, including through 

8 coordination with activities carried out 

9 under the Individuals with Disabilities 

10 Education Act, in order to improve 

11 academic outcomes for students and re12 duce the need for suspensions, expul13 sions, and other actions that remove 

14 students from instruction; 

15 ‘‘(cc) implementation of early in16 tervening services, including through 

17 coordination with early intervening 

18 services carried out under the Individ19 uals with Disabilities Education Act;’’. 

20 (2) TECHNICAL ASSISTANCE.—Section 

21 1116(b)(4)(B) of the Elementary and Secondary Edu22 cation Act of 1965 (20 U.S.C. 6316(b)(4)(B)) is 

23 amended— 

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

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

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1 (B) by inserting after clause (ii) the fol2 lowing: 

3 ‘‘(iii) shall include assistance in the 

4 implementation of schoolwide positive be5 havioral interventions and supports, school6 based mental health programs, and other 

7 approaches with evidence of effectiveness for 

8 improving the learning environment in the 

9 school and reducing the need for suspen10 sions, expulsions, and other actions that re11 move students from instruction, including 

12 effective strategies for improving coordina13 tion of community resources;’’. 

14 (e) TITLE I ASSESSMENTS AND SCHOOL IMPROVE15 MENT.— 

16 (1) SCHOOL IMPROVEMENT PLAN.—Section 

17 1116(b)(3)(A) of the Elementary and Secondary Edu18 cation Act of 1965 (20 U.S.C. 6316(b)(3)(A)) is 

19 amended— 

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

21 the semicolon; 

22 (B) in clause (x), by striking the period and 

23 inserting a semicolon; and 

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

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1 ‘‘(xi) specify whether the local edu2 cational agency or the school will adopt and 

3 implement policies or practices to imple4 ment or improve positive behavioral inter5 ventions and supports and enhance coordi6 nation with activities carried out under the 

7 Individuals with Disabilities Education 

8 Act; 

9 ‘‘(xii) specify whether the local edu10 cational agency or the school will adopt and 

11 implement policies or practices to imple12 ment or improve early intervening services 

13 and coordinate with early intervening serv14 ices carried out under such Act; and 

15 ‘‘(xiii) specify whether the local edu16 cational agency or school will adopt and 

17 implement school-based mental health pro18 grams and coordinate with programs car19 ried out under such Act.’’. 

20 (2) LOCAL EDUCATIONAL AGENCY IMPROVEMENT

21 PLANS.—Section 1116(c)(10) of the Elementary and 

22 Secondary Education Act of 1965 (20 U.S.C. 

23 6316(c)(10)) is amended— 

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1 (A) in subparagraph (B), by striking ‘‘sub2 paragraph (E)’’ and inserting ‘‘subparagraph 

3 (F)’’; 

4 (B) by redesignating subparagraphs (D) 

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

6 respectively; and 

7 (C) by inserting after subparagraph (C) the 

8 following: 

9 ‘‘(D) ADDITIONAL ACTIVITIES.—In addition 

10 to carrying out 1 or more of the corrective ac11 tions required under subparagraph (C) for a 

12 local educational agency, the State educational 

13 agency may also carry out 1 or more of the fol14 lowing activities: 

15 ‘‘(i) Improving or expanding positive 

16 behavioral interventions and supports and 

17 enhancing coordination with activities 

18 under the Individuals with Disabilities 

19 Education Act. 

20 ‘‘(ii) Improving or expanding early in21 tervening services and coordinating such 

22 services with early intervening services car23 ried out under the Individuals with Disabil24 ities Education Act.’’. 

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

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

2 the Elementary and Secondary Education Act of 

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

4 (A) by striking ‘‘of 2002 and comprehen5 sive’’ and inserting ‘‘of 2002, comprehensive’’; 

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

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

8 (C) by inserting ‘‘and any technical assist9 ance center on schoolwide positive behavioral 

10 interventions and supports funded under section 

11 665(b) of the Individuals with Disabilities Edu12 cation Act,’’ after ‘‘2002),’’. 

13 (2) STATEWIDE SYSTEMS FOR SUPPORT.—Sec14 tion 1117(a)(5)(B) of the Elementary and Secondary 

15 Education Act of 1965 (20 U.S.C. 6317(a)(5)(B)) is 

16 amended— 

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

18 at the end and inserting the following: ‘‘, includ19 ing by improving or expanding the use of posi20 tive behavioral interventions and supports 

21 aligned with activities carried out under the In22 dividuals with Disabilities Education Act;’’; 

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

24 the semicolon; 

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

2 and inserting a semicolon; and 

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

4 ‘‘(v) review and analyze the school’s ef5 forts to identify and assist students with 

6 poor academic achievement and students 

7 who are children with disabilities, and as8 sist the school in developing or improving 

9 early intervening services that are coordi10 nated with activities carried out under the 

11 Individuals with Disabilities Education 

12 Act; 

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

14 efforts to address behavioral or disciplinary 

15 problems, and assist the school in devel16 oping or improving schoolwide positive be17 havioral interventions and supports that 

18 are coordinated with activities carried out 

19 under the Individuals with Disabilities 

20 Education Act; 

21 ‘‘(vii) review the number of discipline 

22 incidents in the school and use that infor23 mation to assist the school to implement 

24 schoolwide positive behavioral interventions 

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1 and supports or other early intervening 

2 services, or both; and 

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

4 efforts to address mental health needs 

5 among students and assist the school in de6 veloping or improving school-based mental 

7 health programs that are coordinated with 

8 activities carried out under the Individuals 

9 with Disabilities Education Act.’’. 

10 (g) TITLE I PARENTAL INVOLVEMENT.—Section 

11 1118(e) of the Elementary and Secondary Education Act 

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

13 (1) by redesignating paragraphs (6) through (14) 

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

15 (2) by inserting after paragraph (5) the fol16 lowing: 

17 ‘‘(6) shall provide information to school per18 sonnel, students, and parents about the school’s use of 

19 positive behavioral interventions and supports, school20 based mental health programs, and the expectations of 

21 school personnel, students, and parents in supporting 

22 a safe learning environment for all students;’’. 

23 (h) PREVENTION AND INTERVENTION PROGRAMS.— 

24 Section 1414(c)(8) of the Elementary and Secondary Edu25 cation Act of 1965 (20 U.S.C. 6434(c)(8)) is amended by 

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1 inserting ‘‘, including coordinating the use of positive be2 havioral interventions and supports, early intervening serv3 ices, and school-based mental health programs to improve 

4 academic achievement and reduce disciplinary actions’’ be5 fore the semicolon at the end. 

6 (i) TECHNICAL ASSISTANCE.—Section 1419 of the Ele7 mentary and Secondary Education Act of 1965 (20 U.S.C. 

8 6439) is amended— 

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

10 semicolon; 

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

12 inserting ‘‘; and’’; and 

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

14 ‘‘(3) to provide technical assistance in imple15 menting positive behavioral interventions and sup16 ports, early intervening services, and school-based 

17 mental health programs in order to improve academic 

18 achievement and reduce disciplinary actions.’’. 

19 (j) TITLE II MENTAL HEALTH PROFESSIONAL DEVEL20 OPMENT.—Section 2123 of the Elementary and Secondary 

21 Education Act of 1965 (20 U.S.C. 6623) is amended— 

22 (1) in subsection (a), by inserting after para23 graph (8) the following: 

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

25 personnel in— 

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1 ‘‘(A) the techniques and supports needed to 

2 identify children with trauma histories, and 

3 children with, or at risk of, mental illness, early; 

4 ‘‘(B) the use of referral mechanisms that ef5 fectively link such children to appropriate treat6 ment and intervention services in the school and 

7 in the community where appropriate; and 

8 ‘‘(C) forming partnerships between school9 based mental health programs and public or pri10 vate mental health organizations.’’; 

11 (2) by redesignating subsection (b) as subsection 

12 (c); and 

13 (3) by inserting after subsection (a) the fol14 lowing: 

15 ‘‘(b) LIABILITY PROTECTION FOR SCHOOL PER16 SONNEL.—Section 2366 shall apply to school personnel who 

17 received in-service training under subsection (a)(9), and 

18 who are carrying out activities related to such training, in 

19 the same manner as such section applies to teachers.’’. 

20 (k) SCHOOL-BASED MENTAL HEALTH SERVICES

21 PARTNERSHIP PROGRAMS.—Section 4121 of the Elemen22 tary and Secondary Education Act of 1965 (20 U.S.C. 

23 7131) is amended— 

24 (1) in subsection (a)— 

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

2 by inserting ‘‘, health (including mental 

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

4 (B) by redesignating paragraphs (3) 

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

6 (9) and (11), respectively; 

7 (C) by inserting after paragraph (2) the fol8 lowing: 

9 ‘‘(3) the development and implementation of 

10 school-based mental health services partnership pro11 grams under subsection (c);’’; 

12 (D) by striking paragraph (7), as redesig13 nated by subparagraph (B), and inserting the 

14 following: 

15 ‘‘(7) assistance to school systems that have par16 ticularly severe drug and violence problems or assist17 ance to support appropriate response efforts to crisis 

18 situations, including— 

19 ‘‘(A) hiring drug prevention and school 

20 safety coordinators; and 

21 ‘‘(B) making available to students mental 

22 health services, conflict resolution programs, and 

23 other school-based violence prevention strate24 gies;’’; 

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

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

3 semicolon; and 

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

5 the following: 

6 ‘‘(10) assistance to States to help local edu7 cational agencies develop and implement comprehen8 sive emergency management plans; and’’; and 

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

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

11 PARTNERSHIP PROGRAMS.— 

12 ‘‘(1) IN GENERAL.—Each grant, contract, or co13 operative agreement awarded or entered into under 

14 subsection (a)(3) shall meet the requirements of this 

15 subsection. 

16 ‘‘(2) ELIGIBILITY.— 

17 ‘‘(A) IN GENERAL.—To be eligible to receive 

18 a grant, contract, or cooperative agreement 

19 under this subsection, a local educational agency 

20 shall enter into a school-based mental health 

21 partnership that— 

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

23 mental health entity or health care entity; 

24 and 

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1 ‘‘(ii) may include a child welfare agen2 cy, family-based mental health entity, fam3 ily organization, trauma network, or other 

4 community-based entity. 

5 ‘‘(B) FLEXIBILITY FOR CERTAIN LOCAL

6 EDUCATIONAL AGENCIES.—Notwithstanding sub7 paragraph (A), a local educational agency that 

8 is eligible for services under subpart 1 or 2 of 

9 part B of title VI, as determined by the Sec10 retary, and that is unable to partner with a pub11 lic or private mental health entity or health care 

12 entity shall be eligible for a grant under this 

13 subsection if the local educational agency can 

14 demonstrate to the Secretary, in its application 

15 for a grant under this subsection, that the local 

16 educational agency can otherwise build the ca17 pacity to carry out the requirements of this sub18 section. 

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

20 that desires a grant, contract, or cooperative agree21 ment under this subsection shall include, in the appli22 cation required by the Secretary, a description of how 

23 the local educational agency will— 

24 ‘‘(A) assist schools served by the local edu25 cational agency to provide, through the schoolmstockstill on DSK4VPTVN1PROD with BILLS

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1 based mental health services partnership pro2 gram, comprehensive school-based mental health 

3 services and supports and comprehensive staff 

4 development for school and community service 

5 personnel working in the school; 

6 ‘‘(B) provide technical assistance and train7 ing to improve and support the development, im8 plementation, and coordination of school-based 

9 mental health programs and ensure such pro10 grams are coordinated with activities carried out 

11 under the Individuals with Disabilities Edu12 cation Act; and 

13 ‘‘(C) evaluate the effects of providing school14 based mental health programs. 

15 ‘‘(4) USE OF FUNDS.—A local educational agen16 cy receiving a grant, contract, or cooperative agree17 ment under this subsection shall use funds provided 

18 under such grant, contract, or cooperative agreement 

19 to provide school-based mental health services and 

20 supports that— 

21 ‘‘(A) may include— 

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

23 emotional, or behavioral problems, or sub24 stance use disorders, and the provision of 

25 early intervening services; 

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1 ‘‘(ii) not withstanding section 4154, 

2 the treatment or referral for treatment of 

3 students with social, emotional, or behav4 ioral health problems, or substance use dis5 orders; 

6 ‘‘(iii) the development and implemen7 tation of programs to assist children in 

8 dealing with trauma and violence; and 

9 ‘‘(iv) the development of mechanisms, 

10 based on best practices, for children to re11 port incidents of violence or plans by other 

12 children or adults to commit violence; 

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

14 evidence-based practices; 

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

16 with early intervening services carried out under 

17 the Individuals with Disabilities Education Act; 

18 and 

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

20 behavioral health professionals who are certified 

21 or licensed by the State involved and practicing 

22 within their area of expertise. 

23 ‘‘(5) GENERAL REQUIREMENTS.— 

24 ‘‘(A) PARENTAL CONSENT.— 

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1 ‘‘(i) IN GENERAL.—Each local edu2 cational agency receiving a grant, contract, 

3 or cooperative agreement under this sub4 section shall obtain prior written, informed 

5 consent from the parent of each child who is 

6 under 18 years of age to participate in any 

7 assessment service, program, activity, or 

8 treatment that is— 

9 ‘‘(I) funded under this subsection; 

10 and 

11 ‘‘(II) conducted in connection 

12 with an elementary school or secondary 

13 school under the grant, contract, or co14 operative agreement. 

15 ‘‘(ii) EXCEPTION.—Notwithstanding 

16 clause (i), the written, informed consent de17 scribed in such clause shall not be required 

18 in— 

19 ‘‘(I) an emergency, where it is 

20 necessary to protect the immediate 

21 health and safety of the student, other 

22 students, or school personnel; or 

23 ‘‘(II) other instances where paren24 tal consent cannot reasonably be ob25 tained, as defined by the Secretary. 

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1 ‘‘(B) PROHIBITION ON MANDATORY MEDICA2 TION.—No child shall be required to obtain a 

3 prescription for a substance covered by the Con4 trolled Substances Act (21 U.S.C. 801 et seq.) as 

5 a condition of receiving an evaluation under this 

6 subsection, receiving services under this sub7 section, or attending a school receiving assistance 

8 under this subsection. 

9 ‘‘(C) PRIVACY.—Each local educational 

10 agency receiving a grant, contract, or cooperative 

11 agreement under this subsection shall ensure that 

12 student mental health records are accorded the 

13 privacy protections provided under the regula14 tions promulgated under section 264(c) of the 

15 Health Insurance Portability and Accountability 

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

17 2033) and section 444 of the General Education 

18 Provisions Act (20 U.S.C. 1232g) (commonly re19 ferred to as the ‘Family Educational Rights and 

20 Privacy Act of 1974’). 

21 ‘‘(6) LIABILITY PROTECTION FOR SCHOOL PER22 SONNEL.—Section 2366 shall apply to school per23 sonnel providing services under a grant, contract, or 

24 cooperative agreement under this subsection in the 

25 same manner as such section applies to teachers. 

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1 ‘‘(7) PROHIBITION AGAINST FEDERAL MANDATES, 

2 DIRECTION, OR CONTROL OR FEDERAL REGULA3 TION.—In addition to the prohibition of Federal Gov4 ernment control of a State, local educational agency, 

5 or school’s curriculum or program of instruction that 

6 is provided under section 9527(a), nothing in this 

7 subsection shall be construed to authorize an officer or 

8 employee of the Federal Government to mandate, di9 rect, or control a State, local educational agency, or 

10 school’s specific instructional content or academic 

11 achievement standards and assessments.’’. 

12 (l) DEFINITION.—Section 9101 of the Elementary and 

13 Secondary Education Act of 1965 (20 U.S.C. 7801) is 

14 amended— 

15 (1) by redesignating paragraphs (17) through 

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

17 and 

18 (2) by inserting after paragraph (16) the fol19 lowing: 

20 ‘‘(17) EARLY INTERVENING SERVICES.—The term 

21 ‘early intervening services’ means early intervening 

22 services described in section 613(f)(1) of the Individ23 uals with Disabilities Education Act.’’. 

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1 SEC. 104. CONFORMING AMENDMENTS. 

2 (a) AMERICA COMPETES REAUTHORIZATION ACT OF

3 2010.—Section 553(d)(6) of the America COMPETES Re4 authorization Act of 2010 (20 U.S.C. 9903(d)(6)) is amend5 ed by striking ‘‘section 9101(23)’’ and inserting ‘‘section 

6 9101(24)’’. 

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

8 255(k) of the Higher Education Act of 1965 is amended— 

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

10 9101(23)(B)(ii)’’ and inserting ‘‘section 

11 9101(24)(B)(ii)’’; and 

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

13 9101(23)’’ and inserting ‘‘section 9101(24)’’. 

14 (c) INDIVIDUALS WITH DISABILITIES EDUCATION

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

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

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

18 9101(23)’’ and inserting ‘‘section 9101(24)’’; and 

19 (2) in each of clauses (ii) and (iii) of subpara20 graph (D), by striking ‘‘section 9101(23)(C)(ii)’’ and 

21 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 section 

8 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 subsection 

24 (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 CENTER.’’; 

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

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

5 that follows through ‘‘nonprofit organizations 

6 for’’ and inserting ‘‘The center established under 

7 subsection (a) shall conduct activities for the 

8 purpose of’’; 

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

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

11 (D) in paragraph (1)— 

12 (i) by striking ‘‘the development or 

13 continuation of’’ and inserting ‘‘developing 

14 and continuing’’; and 

15 (ii) by inserting ‘‘for all ages, particu16 larly among groups that are at high risk for 

17 suicide’’ before the semicolon at the end; 

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

19 ages, particularly among groups that are at high 

20 risk for suicide’’ before the semicolon at the end; 

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

22 tribal’’ after ‘‘statewide’’; 

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

24 prevention’’ after ‘‘intervention’’; 

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

2 youth’’; 

3 (I) in paragraph (9), by striking ‘‘and be4 havioral health’’ and inserting ‘‘health and sub5 stance use disorder’’; and 

6 (J) in paragraph (10), by inserting ‘‘con7 ducting’’ before ‘‘other’’; and 

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

9 following: 

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

11 purpose of carrying out this section, there are authorized 

12 to be appropriated $4,948,000 for each of fiscal years 2014 

13 through 2018.’’. 

14 (b) YOUTH SUICIDE EARLY INTERVENTION AND PRE15 VENTION STRATEGIES.—Section 520E of the Public Health 

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

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

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

19 place such term appears and inserting ‘‘substance use 

20 disorder’’; 

21 (2) in subsection (b)(2)— 

22 (A) by striking ‘‘each State is awarded only 

23 1 grant or cooperative agreement under this sec24 tion’’ and inserting ‘‘a State does not receive 

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1 more than 1 grant or cooperative agreement 

2 under this section at any 1 time’’; and 

3 (B) by striking ‘‘been awarded’’ and insert4 ing ‘‘received’’; and 

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

6 following: 

7 ‘‘(m) AUTHORIZATION OF APPROPRIATIONS.—For the 

8 purpose of carrying out this section, there are authorized 

9 to be appropriated $29,682,000 for each of fiscal years 2014 

10 through 2018.’’. 

11 (c) MENTAL HEALTH AND SUBSTANCE USE DISORDER

12 SERVICES.—Section 520E–2 of the Public Health Service 

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

14 (1) in the section heading, by striking ‘‘AND BE15 HAVIORAL HEALTH’’ and inserting ‘‘HEALTH AND

16 SUBSTANCE USE DISORDER SERVICES’’; 

17 (2) in subsection (a)— 

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

19 ‘‘Services and’’; 

20 (B) by striking ‘‘and behavioral health 

21 problems’’ and inserting ‘‘health or substance use 

22 disorders’’; and 

23 (C) by striking ‘‘substance abuse’’ and in24 serting ‘‘substance use disorders’’; 

25 (3) in subsection (b)— 

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

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

3 more of the following:’’; and 

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

5 and inserting the following: 

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

7 staff to increase awareness of mental health and sub8 stance use disorders. 

9 ‘‘(2) The operation of hotlines. 

10 ‘‘(3) Preparing informational material. 

11 ‘‘(4) Providing outreach services to notify stu12 dents about available mental health and substance use 

13 disorder services. 

14 ‘‘(5) Administering voluntary mental health and 

15 substance use disorder screenings and assessments. 

16 ‘‘(6) Supporting the training of students, faculty, 

17 and staff to respond effectively to students with men18 tal health and substance use disorders. 

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

20 colleges and universities with health care providers 

21 who treat mental health and substance use dis22 orders.’’; 

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

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

25 (5) in subsection (d)— 

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

2 by striking ‘‘An institution of higher education 

3 desiring a grant under this section’’ and insert4 ing ‘‘To be eligible to receive a grant under this 

5 section, an institution of higher education’’; 

6 (B) in paragraph (1)— 

7 (i) by striking ‘‘and behavioral health’’ 

8 and inserting ‘‘health and substance use 

9 disorder’’; and 

10 (ii) by inserting ‘‘, including veterans 

11 whenever possible and appropriate,’’ after 

12 ‘‘students’’; and 

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

14 may include, as appropriate and in accordance 

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

16 relevant stakeholders in the community, includ17 ing appropriate public and private entities, in 

18 order to carry out the program under the grant’’ 

19 before the period at the end; 

20 (6) in subsection (e)(1), by striking ‘‘and behav21 ioral health problems’’ and inserting ‘‘health and sub22 stance use disorders’’; 

23 (7) in subsection (f)(2)— 

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

2 inserting ‘‘health and substance use disorder’’; 

3 and 

4 (B) by striking ‘‘suicide and substance 

5 abuse’’ and inserting ‘‘suicide and substance use 

6 disorders’’; and 

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

8 fiscal year 2005’’ and all that follows through the pe9 riod at the end and inserting ‘‘$4,858,000 for each of 

10 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 by 

22 the Secretary,’’ after ‘‘emergency services per23 sonnel’’; 

24 (C) in paragraph (5)— 

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1 (i) in the matter preceding subpara2 graph (A), 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 of 

8 mental illness; and 

9 ‘‘(B)(i) providing education to personnel re10 garding resources available in the community for 

11 individuals with a mental illness and other rel12 evant 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 pe18 riod at the end and inserting ‘‘$20,000,000 for 

19 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, behavioral, 

5 and biological aspects of psychological trauma re6 sponse; and 

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

8 evidence-based practices for identifying and treating 

9 mental, behavioral, and biological disorders of chil10 dren and youth resulting from witnessing or experi11 encing a traumatic event.’’; 

12 (2) in subsection (b)— 

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

14 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 and 

21 programs that have established clinical and basic 

22 research’’ and inserting ‘‘universities, hospitals, 

23 mental health agencies, and other programs that 

24 have established clinical expertise 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 NCTSI-wide 

7 child treatment process and outcome data regarding the 

8 early identification and delivery of evidence-based treat9 ment and services for children and families served by the 

10 NCTSI grantees. 

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

12 facilitate the coordination of training initiatives in evi13 dence-based and trauma-informed treatments, interven14 tions, and practices offered to NCTSI grantees, providers, 

15 and partners. 

16 ‘‘(e) DISSEMINATION.—The NCTSI coordinating cen17 ter shall, as appropriate, collaborate with the Secretary in 

18 the dissemination of evidence-based and trauma-informed 

19 interventions, treatments, products and other resources to 

20 appropriate stakeholders. 

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

22 peer review process, ensure that NCTSI applications are re23 viewed by appropriate experts in the field as part of a con24 sensus review process. The Secretary shall include review 

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1 criteria related to expertise and experience in child trauma 

2 and evidence-based practices.’’; 

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

4 striking ‘‘with respect to centers of excellence are dis5 tributed equitably among the regions of the country’’ 

6 and inserting ‘‘are distributed equitably among the 

7 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 fiscal 

15 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 of 

20 the United States shall submit a report to the Committee 

21 on Health, Education, Labor, and Pensions of the Senate 

22 and the Committee on Energy and Commerce of the House 

23 of Representatives concerning Federal requirements that 

24 impact access to treatment of mental health and substance 

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1 ministrative and regulatory issues, quality measurement 

2 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 for 

11 evaluation. 

12 (3) An analysis of the degree to which electronic 

13 data standards, including interoperability and mean14 ingful use includes behavioral health measures, and 

15 an analysis of strategies to address barriers to health 

16 information exchange posed by part 2 of title 42, 

17 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 to 

21 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 of 

25 care delivery and treatment outcomes among patients with 

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1 opioid use disorders, the Secretary of Health and Human 

2 Services (referred to in this section as the ‘‘Secretary’’), act3 ing through the Administrator for the Substance Abuse and 

4 Mental Health Services Administration, may advance, 

5 through existing programs as appropriate, the education 

6 and awareness of providers, patients, and other appropriate 

7 stakeholders regarding all products approved by the Food 

8 and Drug Administration to treat opioid use disorders. 

9 (b) ACTIVITIES.—The activities described in subsection 

10 (a) may include— 

11 (1) disseminating evidence-based practices for 

12 the treatment of opioid use disorders; 

13 (2) facilitating continuing education programs 

14 for health professionals involved in treating opioid 

15 use disorders; 

16 (3) increasing awareness among relevant stake17 holders of the treatment of opioid use disorders; 

18 (4) assessing current barriers to the treatment of 

19 opioid use disorders for patients and providers and 

20 development and implementation of strategies to miti21 gate such barriers; and 

22 (5) continuing innovative approaches to the 

23 treatment of opioid use disorders in various treatment 

24 settings, such as prisons, community mental health 

25 centers, primary care, and hospitals. 

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

2 enactment of this Act, if the Secretary carries out the activi3 ties under this section, the Secretary shall submit to the 

4 Committee on Health, Education, Labor, and Pensions of 

5 the Senate and the Committee on Energy and Commerce 

6 of the House of Representatives a report that examines— 

7 (1) the activities the Substance Abuse and Men8 tal Health Services Administration conducts under 

9 this section, including any potential impacts on 

10 health care costs associated with such activities; 

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

12 opioid use disorders and methods to reduce opioid use 

13 disorders; and 

14 (3) recommendations on priorities and strategies 

15 to address co-occurring substance use disorders and 

16 mental illnesses. 

17 SEC. 206. EXAMINING MENTAL HEALTH CARE FOR CHIL18 DREN. 

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

20 of enactment of this Act, the Comptroller General of the 

21 United States shall conduct an independent evaluation, and 

22 submit to the Committee on Health, Education, Labor, and 

23 Pensions of the Senate and the Committee on Energy and 

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1 cerning the utilization of mental health services for chil2 dren, including the usage of psychotropic medications. 

3 (b) CONTENT.—The report submitted under subsection 

4 (a) shall review and assess— 

5 (1) the ways in which children access mental 

6 health care, including information on whether chil7 dren are treated by primary care or specialty pro8 viders, what types of referrals for additional care are 

9 recommended, and any barriers to accessing this care; 

10 (2) the extent to which children are prescribed 

11 psychotropic medications in the United States includ12 ing the frequency of concurrent medication usage; and 

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

14 are available and used to diagnose and treat children 

15 with mental health disorders. 

16 SEC. 207. EVIDENCE BASED PRACTICES FOR OLDER 

17 ADULTS. 

18 Section 520A(e) of the Public Health Service Act (42 

19 U.S.C. 290bb-32(e)) is amended by adding at the end the 

20 following: 

21 ‘‘(3) GERIATRIC MENTAL HEALTH DISORDERS.— 

22 The Secretary shall, as appropriate, provide technical 

23 assistance to grantees regarding evidence-based prac24 tices for the prevention and treatment of geriatric 

25 mental health disorders and co-occurring mental 

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1 health and substance use disorders among geriatric 

2 populations, as well as disseminate information about 

3 such evidence-based practices to States and non4 grantees throughout the United States.’’. 

5 SEC. 208. NATIONAL VIOLENT DEATH REPORTING SYSTEM. 

6 The Secretary of Health and Human Services, acting 

7 through the Director of the Centers for Disease Control and 

8 Prevention, is encouraged to improve, particularly through 

9 the inclusion of additional States, the National Violent 

10 Death Reporting System as authorized by title III of the 

11 Public Health Service Act. Participation in the system by 

12 the States shall be voluntary. 

13 SEC. 209. GAO STUDY ON VIRGINIA TECH RECOMMENDA14 TIONS. 

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

16 of enactment of this Act, the Comptroller General of the 

17 United States shall conduct an independent evaluation, and 

18 submit to the appropriate committees of Congress a report 

19 concerning the status of implementation of recommenda20 tions made in the report to the President, On Issues Raised 

21 by the Virginia Tech Tragedy, by the Secretaries of Health 

22 and Human Services and Education and the Attorney Gen23 eral of the United States, submitted to the President on 

24 June 13, 2007. 

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1 (b) CONTENT.—The report submitted to the committees 

2 of Congress under subsection (a) shall review and assess— 

3 (1) the extent to which the recommendations in 

4 the report that include participation by the Depart5 ment of Health and Human Services were imple6 mented; 

7 (2) whether there are any barriers to implemen8 tation of such recommendations; and 

9 (3) identification of any additional actions the 

10 Federal government can take to support States and 

11 local communities and ensure that the Federal gov12 ernment and Federal law are not obstacles to address13 ing at the community level— 

14 (A) school violence; and 

15 (B) mental illness. 

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Calendar No. 37 

113TH CONGRESS 

1ST SESSION S. 689 

A BILL 

To reauthorize and improve programs related to 

mental health and substance use disorders. 

APRIL 11, 2013 

Reported with an amendment 

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