I 

118TH CONGRESS 

1ST SESSION H. R. 6091 

To amend the Elementary and Secondary Education Act of 1965 to direct 

the Secretary of Education to make grants to States for assistance 

in hiring additional school-based mental health and student service providers. 

IN THE HOUSE OF REPRESENTATIVES 

OCTOBER 26, 2023 

Ms. LEE of California (for herself, Ms. TOKUDA, Mr. THANEDAR, Ms. CROCKETT, Ms. SALINAS, Mrs. WATSON COLEMAN, and Mrs. CHERFILUSMCCORMICK) introduced the following bill; which was referred to the 

Committee on Education and the Workforce 

A BILL 

To amend the Elementary and Secondary Education Act 

of 1965 to direct the Secretary of Education to make 

grants to States for assistance in hiring additional 

school-based mental health and student service providers. 

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 ‘‘Student Support Act’’. 


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1 SEC. 2. SCHOOL-BASED MENTAL HEALTH AND STUDENT 

2 SERVICE PROVIDERS. 

3 (a) IN GENERAL.—Part A of title IV of the Elemen4 tary and Secondary Education Act of 1965 (20 U.S.C. 

5 7101 et seq.) is amended by adding at the end the fol6 lowing: 

7 ‘‘SUBPART 3—SCHOOL-BASED MENTAL HEALTH AND

8 STUDENT SERVICE PROVIDERS

9 ‘‘SEC. 4131. FINDINGS. 

10 ‘‘Congress finds the following: 

11 ‘‘(1) The Surgeon General of the Public Health 

12 Service has found that 1 in 6 children (ages 2 to 8) 

13 has a diagnosable mental disorder and 1 in 10 chil14 dren and adolescents suffer from mental illness se15 vere enough to cause some level of impairment. 

16 However, 75 to 80 percent of children in need of 

17 mental health services do not receive needed treat18 ment. The short- and long-term consequences of un19 treated childhood mental disorders are costly, in 

20 both human and fiscal terms. 

21 ‘‘(2) Thirty-seven percent of students with a 

22 mental health condition age 14 and older drop out 

23 of school—the highest dropout rate of any disability 

24 group. 


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1 ‘‘(3) Fifty percent of all lifetimes cases of men2 tal illness begin by the age of 14 and 75 percent by 

3 age 24. 

4 ‘‘(4) In June 2010, the American Academy of 

5 Pediatrics called for all pediatricians to screen chil6 dren and adolescents for mental illness and sub7 stance use. 

8 ‘‘(5) Just over half (50.6 percent) of children 

9 with a mental health condition aged 8–15 received 

10 mental health services in the previous year. 

11 ‘‘(6) African Americans and Hispanic Ameri12 cans each use mental health services at about one13 half the rate of Caucasian Americans and Asian 

14 Americans at about one-third the rate. 

15 ‘‘(7) School counselors, school social workers, 

16 school psychologists, other qualified psychologists, 

17 and child and adolescent psychiatrists are critically 

18 needed to help these children and to provide a vari19 ety of crucial support services as 70–80 percent of 

20 children and adolescents who receive mental health 

21 services access these services in school settings. 

22 ‘‘(8) Across the United States, there are insuffi23 cient resources for school-based counseling profes24 sionals, and often students do not get the help they 

25 need. The 2017 national average ratio of students to 


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1 school counselors in elementary and secondary 

2 schools was 482 to 1. 

3 ‘‘(9) United States public schools need more 

4 mental health professionals because participation in 

5 the use of school-based mental health centers 

6 (SBHC) was positively associated with increases in 

7 grade point average (GPA) and attendance. 

8 ‘‘(10) According to the leading counseling, guid9 ance, and mental health organizations, including the 

10 American School Counselor Association, the Na11 tional Association of Social Psychologists, the Na12 tional Association of Social Workers, and the School 

13 Social Work Association of America, the maximum 

14 recommended ratio of— 

15 ‘‘(A) students to school counselors is 250 

16 to 1; 

17 ‘‘(B) students to school psychologists is 

18 500 to 1; and 

19 ‘‘(C) students to school social workers is 

20 250 to 1. 

21 ‘‘(11) A recent study revealed a national aver22 age ratio of 1,653 students per school psychologist, 

23 despite the 1:500–700 recommendation from the 

24 National Association of Social Psychologists. This 

25 deficit is further compounded by studies predicting 


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1 a 2–4 percent shortage of school psychologists over 

2 the next 10 years due to retirement. In some 

3 schools, there are no school-based mental health and 

4 student service providers available to assist students 

5 in times of crisis, or at any other time. 

6 ‘‘(12) Counselor-to-student ratios in 35 States 

7 exceed 1:400 despite recommendations from the 

8 American School Counselor Association for a 1:250 

9 ratio. Only three States—Vermont, Wyoming & New 

10 Hampshire—meet the recommended ratio. This 

11 shortage occurs during a time when the National 

12 Center on Education Statistics forecasts that the 

13 Nation’s number of public school students (Pre-K to 

14 12th) will grow by 7 percent between 2011 and 

15 2022, particularly in States that already spend the 

16 least money per student. 

17 ‘‘(13) Model programs using school-based men18 tal health and student service providers have positive 

19 effects on emotional, behavioral and academic out20 comes, such as reductions in aggressive and disrup21 tive behavior, referrals to the principal’s office, the 

22 use of weapons, force, or threats, and increased stu23 dents’ feelings of safety. Studies also find that men24 tal health programs can have a range of positive out25 comes across all grade levels, including gains in 


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1 achievement test scores, grade point averages, course 

2 credit completion, as well as decreases in absences 

3 and substance use. 

4 ‘‘SEC. 4132. PURPOSES. 

5 ‘‘The purposes of this subpart are to assist States 

6 and local educational agencies in hiring additional school7 based mental health providers, including additional school 

8 counselors, school psychologists, other qualified psycholo9 gists, child and adolescent psychiatrists, and school social 

10 workers to achieve each of the following: 

11 ‘‘(1) To reduce the ratios of school-based men12 tal health and student service providers to students 

13 in elementary and secondary schools in the United 

14 States to the following minimum ratios rec15 ommended by the leading counseling, guidance, and 

16 mental health organizations, including the American 

17 School Counselor Association, the National Associa18 tion of Social Psychologists, the National Associa19 tion of Social Workers, and the School Social Work 

20 Association of America: 

21 ‘‘(A) One school counselor for every 250 

22 students. 

23 ‘‘(B) One school psychologist for every 500 

24 to 700 students. 


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1 ‘‘(C) One school social worker for every 

2 250 students. 

3 ‘‘(2) To provide evidence-based school mental 

4 health and student services through a whole school 

5 and interdisciplinary approach. 

6 ‘‘(3) To remove emotional, behavioral, and psy7 chosocial barriers to learning so as to enhance stu8 dents’ classroom preparedness, overall school per9 formance, decrease rates of absenteeism, and ability 

10 to problem solve and set goals. 

11 ‘‘(4) To support school staff and teachers in 

12 improving classroom management, conducting be13 havioral interventions to improve school discipline, 

14 and developing the awareness and skills to identify 

15 the need for mental health services. 

16 ‘‘(5) To support parental involvement in im17 proving the school behavior and academic success of 

18 their children. 

19 ‘‘(6) To improve the overall mental, behavioral, 

20 social, and psychology assessment and trajectory of 

21 each student who seeks mental health services. 

22 ‘‘(7) To ensure each student feels comfortable 

23 and has all the resources they need to continue short 

24 and/or long-term mental health treatment. 


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1 ‘‘SEC. 4133. DEFINITIONS. 

2 ‘‘In this subpart, the following definitions apply: 

3 ‘‘(1) CHILD.—The term ‘child’ means an indi4 vidual who is not less than 5 years old and not more 

5 than 17 years old. 

6 ‘‘(2) CHILD AND ADOLESCENT PSYCHIA7 TRIST.—The term ‘child and adolescent psychiatrist’ 

8 has the meaning given such term in section 5421(e). 

9 ‘‘(3) CHILD IN POVERTY.—The term ‘child in 

10 poverty’ means a child from a family with an income 

11 below the poverty line. 

12 ‘‘(4) MENTAL HEALTH AND STUDENT SERVICE

13 PROVIDER.—The term ‘mental health and student 

14 service provider’ means a qualified individual who 

15 provides mental health and student services, includ16 ing any individual who is a qualified school coun17 selor, a qualified school psychologist or any other 

18 qualified psychologist, a child or adolescent psychia19 trist, or a qualified school social worker. 

20 ‘‘(5) MENTAL HEALTH AND STUDENT SERV21 ICES.—The term ‘mental health and student serv22 ices’ includes direct, individual, and group services 

23 provided to students, parents, and school personnel 

24 by mental health and student service providers, and 

25 the coordination of prevention strategies in schools 

26 or community-based programs. 


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1 ‘‘(6) OTHER QUALIFIED PSYCHOLOGIST.—The 

2 term ‘other qualified psychologist’ has the meaning 

3 given such term in section 5421(e). 

4 ‘‘(7) POVERTY LINE.—The term ‘poverty line’ 

5 means the poverty line (as defined by the Office of 

6 Management and Budget, and revised annually in 

7 accordance with section 673(2) of the Community 

8 Services Block Grant Act (42 U.S.C. 9902(2))) ap9 plicable to a family of the size involved. 

10 ‘‘(8) SCHOOL COUNSELOR.—The term ‘school 

11 counselor’ means an individual who has documented 

12 competence in counseling children and adolescents in 

13 a school setting and who— 

14 ‘‘(A) possesses State licensure or certifi15 cation granted by an independent professional 

16 regulatory authority; 

17 ‘‘(B) possesses national certification in 

18 school counseling or a specialty of counseling 

19 granted by an independent professional organi20 zation; or 

21 ‘‘(C) holds a minimum of a master’s de22 gree in school counseling from a program ac23 credited by the Council for Accreditation of 

24 Counseling and Related Educational Programs 

25 or the equivalent. 


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1 ‘‘(9) SCHOOL PSYCHOLOGIST.—The term 

2 ‘school psychologist’ means an individual who— 

3 ‘‘(A) possesses a minimum of 60 graduate 

4 semester hours in school psychology from an in5 stitution of higher education and has completed 

6 1,200 clock hours in a supervised school psy7 chology internship, of which 600 hours shall be 

8 in a school setting; 

9 ‘‘(B) possesses State licensure or certifi10 cation in school psychology in the State in 

11 which the individual works; or 

12 ‘‘(C) possesses national certification by the 

13 National School Psychology Certification Board. 

14 ‘‘(10) SCHOOL SOCIAL WORKER.—The term 

15 ‘school social worker’ means an individual who— 

16 ‘‘(A) holds a master’s degree in social work 

17 from a program accredited by the Council on 

18 Social Work Education; 

19 ‘‘(B) is licensed or certified by the State in 

20 which services are provided; or 

21 ‘‘(C) possesses a national credential or na22 tional certification as a school social work spe23 cialist granted by an independent professional 

24 organization. 


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1 ‘‘(11) STATE.—The term ‘State’ means each of 

2 the several States, the District of Columbia, and the 

3 Commonwealth of Puerto Rico. 

4 ‘‘SEC. 4134. SCHOOL-BASED MENTAL HEALTH AND STU5 DENT SERVICE PROVIDER GRANT PROGRAM. 

6 ‘‘(a) IN GENERAL.—In accordance with this subpart, 

7 the Secretary shall make grants to eligible States to assist 

8 local educational agencies in those States in hiring addi9 tional school-based mental health and student service pro10 viders. 

11 ‘‘(b) ALLOCATION OF FUNDS.—From the total 

12 amount appropriated for a fiscal year to carry out this 

13 subpart, the Secretary shall— 

14 ‘‘(1) make available 1 percent of such amount 

15 to the Secretary of the Interior (on behalf of the Bu16 reau of Indian Affairs) and the outlying areas for 

17 activities that carry out the purposes of this subpart; 

18 and 

19 ‘‘(2) make available in the form of grants to 

20 each eligible State an amount equal to the sum of— 

21 ‘‘(A) an amount that bears the same rela22 tionship to 50 percent of such total amount as 

23 the number of children in poverty who reside in 

24 the State bears to the number of such children 

25 in all States; and 


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1 ‘‘(B) an amount that bears the same rela2 tionship to 50 percent of such total amount as 

3 the number of children enrolled in public and 

4 private nonprofit elementary schools and sec5 ondary schools in the State bears to the number 

6 of children enrolled in all such schools in all 

7 States. 

8 ‘‘(c) MINIMUM GRANT.—Notwithstanding subsection 

9 (b), no grant under this section shall be for an amount 

10 less than $1,000,000. 

11 ‘‘(d) REALLOCATION.—The Secretary shall reallocate 

12 to States that have received approval under subsection 

13 (e)(2) any funds allocated under subsection (b) to a State 

14 that fails to submit an application that is approved by the 

15 Secretary. 

16 ‘‘(e) APPLICATION BY STATE.— 

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

18 grant under this subpart, a State shall submit an 

19 application to the Secretary at such time, in such 

20 manner, and containing such information as the Sec21 retary may require. 

22 ‘‘(2) APPROVAL.—The Secretary may not ap23 prove an application under this subsection unless the 

24 State submitting the application— 


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1 ‘‘(A) presents a plan, which the Secretary 

2 considers to be reasonable, under which the 

3 State will make grants, in accordance with the 

4 purposes of this subpart, to local educational 

5 agencies to fund the hiring of additional school 

6 counselors, school psychologists, other qualified 

7 psychologists, child and adolescent psychia8 trists, and school social workers; and 

9 ‘‘(B) provides an assurance that the State 

10 will provide the matching amount required 

11 under subsection (g). 

12 ‘‘(f) USE OF FUNDS BY STATE.— 

13 ‘‘(1) IN GENERAL.—In accordance with this 

14 subsection, the total of the amounts made available 

15 to a State under this section and the amounts of the 

16 non-Federal match required under subsection (g) 

17 may only be used by a State to make grants to local 

18 educational agencies to assist such agencies in hiring 

19 additional school-based mental health and student 

20 service providers. 

21 ‘‘(2) ADMINISTRATIVE COSTS.—In each fiscal 

22 year, a State may use not more than 5 percent of 

23 the assistance made available to it under this sub24 part for the administrative costs of the State in carVerDate Sep 11 2014 17:31 Oct 28, 2023 Jkt 049200 PO 00000 Frm 00013 Fmt 6652 Sfmt 6201 E:\BILLS\H6091.IH H6091

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1 rying out the State’s responsibilities under this sub2 part. 

3 ‘‘(3) ALLOCATION OF FUNDS.—In making 

4 grants in accordance with this subsection, the State 

5 shall allocate from the total described in paragraph 

6 (1) to each local educational agency an amount 

7 equal to the sum of— 

8 ‘‘(A) an amount that bears the same rela9 tionship to 50 percent of such total as the num10 ber of children in poverty who reside in the 

11 school district served by the local educational 

12 agency bears to the number of such children 

13 who reside in all the school districts in the 

14 State; and 

15 ‘‘(B) an amount that bears the same rela16 tionship to 50 percent of such total as the num17 ber of children enrolled in public and private 

18 nonprofit elementary schools and secondary 

19 schools in the school district served by the local 

20 educational agency bears to the number of chil21 dren enrolled in all such schools in the State. 

22 ‘‘(4) MINIMUM GRANT.—Notwithstanding para23 graph (3), no grant made by a State in accordance 

24 with this subsection shall be for an amount less than 

25 $50,000. 


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1 ‘‘(5) SOURCE OF DATA.—For purposes of para2 graph (3), the State shall use data from the most 

3 recent fiscal year for which satisfactory data are 

4 available, except that the State may adjust such 

5 data, or use alternative child poverty data, if the 

6 State demonstrates to the Secretary’s satisfaction 

7 that such adjusted or alternative data more accu8 rately reflect the relative incidence of children who 

9 are living in poverty and who reside in the school 

10 districts in the State. 

11 ‘‘(6) APPLICATION BY LOCAL EDUCATIONAL

12 AGENCIES.—A State may require that, in order to 

13 be eligible for a grant made by the State in accord14 ance with this subsection, a local educational agency 

15 shall submit an application to the State at such 

16 time, in such manner, and containing such informa17 tion as the State may require. 

18 ‘‘(g) MATCHING FUNDS.— 

19 ‘‘(1) IN GENERAL.—As a condition of receiving 

20 a grant under this section, the Secretary shall re21 quire that a State provide from non-Federal sources 

22 an amount equal to the amount of the grant. 

23 ‘‘(2) LOCAL CONTRIBUTION.—In making grants 

24 to local educational agencies in accordance with this 

25 subsection, a State may require that a local eduVerDate Sep 11 2014 17:31 Oct 28, 2023 Jkt 049200 PO 00000 Frm 00015 Fmt 6652 Sfmt 6201 E:\BILLS\H6091.IH H6091

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1 cational agency match a portion of the amount of 

2 the grant made to the agency. 

3 ‘‘(3) FORM.—The non-Federal share required 

4 by this subsection may be provided in cash or in 

5 kind, fairly evaluated, and may include facilities, 

6 equipment, or services. 

7 ‘‘(h) FUNDS TO BE SUPPLEMENTARY.—Assistance 

8 made available under this subpart shall be used to supple9 ment, and may not supplant, Federal, State, or local funds 

10 used for employing school-based mental health and stu11 dent service providers. 

12 ‘‘(i) DATA COLLECTION AND REPORT.— 

13 ‘‘(1) IN GENERAL.—For each fiscal year for 

14 which it receives assistance under this subpart, a 

15 State shall collect data describing how the assistance 

16 is used. 

17 ‘‘(2) REPORT.—Not later than 1 year after as18 sistance is made available to a State under this sub19 part, the State shall transmit to the Secretary a re20 port on the data described in paragraph (1), includ21 ing information with respect to each local edu22 cational agency to which the State made a grant 

23 with assistance made available under this subpart— 

24 ‘‘(A) the number of school counselors, 

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1 gists, child and adolescent psychiatrists, and 

2 school social workers employed by local edu3 cational agency; and 

4 ‘‘(B) the ratio of students to school coun5 selors, the ratio of students to school psycholo6 gists or other qualified psychologists, the ratio 

7 of students to child and adolescent psychia8 trists, and the ratio of students to school social 

9 workers. 

10 ‘‘(3) SOURCE OF FUNDS.—A State may use a 

11 portion of the assistance permitted to be used for 

12 administrative costs to carry out its responsibilities 

13 under this subsection. 

14 ‘‘(4) PUBLICATION.—The Secretary shall make 

15 data received under this subsection publicly available 

16 on an annual basis. 

17 ‘‘SEC. 4135. AUTHORIZATION OF APPROPRIATIONS. 

18 ‘‘There are authorized to be appropriated to carry out 

19 this subpart $100,000,000 for each of fiscal years 2024 

20 through 2028.’’. 

21 (b) CLERICAL AMENDMENT.—The table of contents 

22 for the Elementary and Secondary Education Act of 1965 

23 (20 U.S.C. 6301 et seq.) is amended by inserting after 

24 the item relating to section 4121 the following: 

‘‘SUBPART 3—SCHOOL-BASED MENTAL HEALTH AND STUDENT SERVICE

PROVIDERS


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‘‘Sec. 4131. Findings. 

‘‘Sec. 4132. Purposes. 

‘‘Sec. 4133. Definitions. 

‘‘Sec. 4134. School-based mental health and student service provider grant program. 

‘‘Sec. 4135. Authorization of appropriations.’’. 

Æ 


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