I 

116TH CONGRESS 

1ST SESSION H. R. 4381 

To effectively staff the public elementary schools and secondary schools of 

the United States with school-based mental health services providers. 

IN THE HOUSE OF REPRESENTATIVES 

SEPTEMBER 18, 2019 

Ms. CLARK of Massachusetts introduced the following bill; which was referred 

to the Committee on Education and Labor 

A BILL 

To effectively staff the public elementary schools and secondary schools of the United States with school-based 

mental health services 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 ‘‘Elementary and Sec5 ondary School Counseling Act’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 

8 (1) One in 5 children ages 13 through 18 have, 

9 or will have, a serious mental illness. 


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1 (2) Eleven percent of youth have a mood dis2 order, 10 percent of youth have a behavior or con3 duct disorder, and 8 percent of youth have an anx4 iety disorder. 

5 (3) Fifty percent of all lifetime cases of mental 

6 illness begin by age 14. Thirty-seven percent of stu7 dents with a mental health condition age 14 and 

8 older drop out of school, which is the highest school 

9 dropout rate of any disability group. 

10 (4) Seventy percent of youth in State and local 

11 juvenile systems have a mental illness. 

12 (5) Youth with access to mental health services 

13 in school-based health centers are 10 times more 

14 likely to seek care for mental health or substance 

15 abuse than youth without access. 

16 (6) The leading counseling, guidance, and men17 tal health organizations, including the American 

18 School Counselor Association, the National Associa19 tion of School Psychologists, the National Associa20 tion of Social Workers, and the School Social Work 

21 Association of America, recommend that schools 

22 maintain— 

23 (A) a maximum student to school coun24 selor ratio of 250 to 1; 


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1 (B) a maximum student to school psychol2 ogist ratio of 500–700 to 1; and 

3 (C) a maximum student to school social 

4 worker ratio of 250 to 1. 

5 SEC. 3. DEFINITIONS. 

6 In this Act: 

7 (1) ESEA DEFINITIONS.—The terms ‘‘elemen8 tary school’’, ‘‘local educational agency’’, ‘‘secondary 

9 school’’, ‘‘State’’, and ‘‘State educational agency’’ 

10 have the meanings given the terms in section 8101 

11 of the Elementary and Secondary Education Act of 

12 1965 (20 U.S.C. 7801). 

13 (2) SCHOOL-BASED MENTAL HEALTH SERVICES

14 PROVIDER.—The term ‘‘school-based mental health 

15 services provider’’ has the meaning given the term in 

16 section 4102 of the Elementary and Secondary Edu17 cation Act of 1965 (20 U.S.C. 7112). 

18 (3) SECRETARY.—The term ‘‘Secretary’’ means 

19 the Secretary of Education. 

20 SEC. 4. GRANTS. 

21 (a) PROGRAM AUTHORIZED.— 

22 (1) IN GENERAL.—From the amounts made 

23 available under section 5 for a fiscal year, the Sec24 retary shall award grants, in amounts determined 

25 under subsection (b), to State educational agencies 


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1 to enable the State educational agencies to award 

2 subgrants to local educational agencies in order to 

3 provide school-based mental health services providers 

4 at public elementary schools and secondary schools 

5 served by the local educational agencies. 

6 (2) DURATION.—A grant awarded under this 

7 section shall be for a 5-year period and may be re8 newed for additional 5-year periods upon a showing 

9 of adequate progress, as determined by the Sec10 retary. 

11 (b) AMOUNTS OF GRANTS.— 

12 (1) BASE AMOUNT ALLOTMENT.— 

13 (A) BASE AMOUNT.—The Secretary shall 

14 use $2,000,000,000 of the amounts made avail15 able under section 5 for a fiscal year to provide 

16 a base grant for such fiscal year to each State 

17 educational agency that submits a complete ap18 plication, on a proportional basis based on the 

19 number of elementary school and secondary 

20 school students in each State, subject to sub21 paragraph (C). 

22 (B) RATABLE REDUCTION.—If the 

23 amounts made available under section 5 are less 

24 than $2,000,000,000, the Secretary shall rat25 ably reduce the amount provided under subVerDate Sep 11 2014 20:54 Sep 20, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H4381.IH H4381

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1 paragraph (A) to each State, subject to sub2 paragraph (C). 

3 (C) MANDATORY MINIMUM.—No State 

4 shall receive less than $1,000,000 under sub5 paragraph (A) for a fiscal year. 

6 (2) NEED-BASED ADDITIONAL FUNDING.— 

7 (A) IN GENERAL.—In any fiscal year for 

8 which the funds made available under section 5 

9 are greater than $2,000,000,000, the Secretary 

10 shall use such additional funds to provide, on a 

11 competitive basis, additional amounts for the 

12 grants provided under this section to State edu13 cational agencies that agree to meet the match14 ing requirement under subparagraph (B). 

15 (B) MATCHING REQUIREMENTS.—In order 

16 to receive additional funding under this para17 graph, a State educational agency shall agree to 

18 provide matching funds, in an amount equal to 

19 not less than one-half of the additional amount 

20 provided under subparagraph (A), toward the 

21 costs of the activities carried out under this 

22 grant. 

23 (C) AWARD BASIS.—The Secretary shall 

24 award the additional amounts under subpara25 graph (A) based on the need for school-based 


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1 mental health services providers in the public 

2 elementary schools and secondary schools in the 

3 State and the Secretary’s assessment of the ra4 tios included in each application under sub5 section (c)(3). 

6 (3) AMOUNT LIMITATION.—In no case shall the 

7 total amount awarded under this subsection exceed 

8 the amount needed to meet the recommended max9 imum student-to-provider ratios described in sub10 section (d)(1)(B) in all public elementary schools 

11 and secondary schools in the State. 

12 (c) APPLICATION.—A State educational agency desir13 ing a grant under this section shall submit an application 

14 at such time, in such manner, and containing such infor15 mation as the Secretary may require. Each application 

16 shall include— 

17 (1) a description of how the State educational 

18 agency will award subgrants to local educational 

19 agencies under subsection (d) consistent with the 

20 consideration described in subsection (b)(2)(C); 

21 (2) a description of how the State educational 

22 agency will disseminate, in a timely manner, infor23 mation regarding the subgrants and the application 

24 process for such subgrants to eligible local edu25 cational agencies; and 


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1 (3) the ratios, as of the date of application, of 

2 students to school-based mental health services pro3 viders in each public elementary school and sec4 ondary school in the State, in the aggregate and 

5 disaggregated to include— 

6 (A) the ratios of students to school coun7 selors, school psychologists, and school social 

8 workers; and 

9 (B) as applicable, the ratios of students to 

10 other school-based mental health services pro11 viders not described in subparagraph (A), in the 

12 aggregate and disaggregated by type of pro13 vider. 

14 (d) SUBGRANTS.— 

15 (1) IN GENERAL.—A State educational agency 

16 receiving a grant under this section shall use grant 

17 funds to award subgrants, on a competitive basis, to 

18 local educational agencies in the State, to enable the 

19 local educational agencies to— 

20 (A) employ a school-based mental health 

21 services provider at each public elementary 

22 school and secondary school served by the local 

23 educational agency; and 

24 (B) work toward effectively staffing the 

25 public elementary schools and secondary schools 


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1 of the State with school-based mental health 

2 services providers, including by meeting the rec3 ommended maximum ratios of— 

4 (i) 250 students per school counselor; 

5 (ii) 500 to 700 students per school 

6 psychologist; and 

7 (iii) 250 students per school social 

8 worker. 

9 (2) APPLICATION.—A local educational agency 

10 desiring a subgrant under this subsection shall sub11 mit an application to the State educational agency 

12 at such time, in such manner, and containing such 

13 information as the State educational agency may re14 quire. 

15 (e) GRANT AND SUBGRANT REQUIREMENTS.— 

16 (1) SUPPLEMENT, NOT SUPPLANT.—Amounts 

17 provided under a grant or subgrant under this sec18 tion shall supplement, and not supplant, any other 

19 funds available to a State educational agency or 

20 local educational agency for school-based mental 

21 health services. 

22 (2) COMBINING FUNDS ALLOWED.—A State 

23 educational agency receiving a grant under this sec24 tion may combine funds made available under this 


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1 section with State or local funds to carry out the ac2 tivities described in subsection (d)(1). 

3 (f) REPORT.— 

4 (1) IN GENERAL.—A State educational agency 

5 receiving a grant under this section shall annually 

6 prepare and submit a report to the Secretary that— 

7 (A) evaluates the progress made in achiev8 ing the purposes of the grant; 

9 (B) includes the most recent student to 

10 provider ratios, in the aggregate and 

11 disaggregated as provided in subsection (c)(3), 

12 for public elementary schools and secondary 

13 schools in the State that were assisted under 

14 the grant under this section; and 

15 (C) describes any other resources needed 

16 to meet the required recommended maximum 

17 student to school-based mental health services 

18 provider ratios. 

19 (2) PUBLIC AVAILABILITY.—The Secretary 

20 shall make all reports submitted under paragraph 

21 (1) available to the public, including through the 

22 website of the Department. 

23 SEC. 5. AUTHORIZATION OF APPROPRIATIONS. 

24 In order to provide school-based mental health serv25 ices providers in public elementary schools and secondary 


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1 schools in the States, there are authorized to be appro2 priated to carry out this section— 

3 (1) $5,000,000,000 for fiscal year 2020; and 

4 (2) such sums as may be necessary for each 

5 succeeding fiscal year. 

Æ 


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