II 

110TH CONGRESS 

2D SESSION S. 3195 

To provide assistance to adolescents and young adults with serious mental 

health disorders as they transition to adulthood. 

IN THE SENATE OF THE UNITED STATES 

JUNE 25, 2008 

Mr. SMITH (for himself and Mr. DODD) introduced the following bill; which 

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

Labor, and Pensions 

A BILL 

To provide assistance to adolescents and young adults with 

serious mental health disorders as they transition to 

adulthood. 

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 ‘‘Healthy Transition 

5 Act of 2008’’. 

6 SEC. 2. HEALTHY TRANSITIONING FOR YOUTH. 

7 Subpart 3 of part B of title V of the Public Health 

8 Service Act (42 U.S.C. 290bb–31 et seq.) is amended by 

9 adding at the end the following: 


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1 ‘‘SEC. 520K. HEALTHY TRANSITIONING FOR YOUTH. 

2 ‘‘(a) PLANNING GRANTS.— 

3 ‘‘(1) IN GENERAL.—The Secretary, in consulta4 tion with the agencies described in subsection (c)(3), 

5 shall award grants or cooperative agreements to 

6 States to develop plans for the statewide coordina7 tion of services to assist adolescents and young 

8 adults with a serious mental health disorder in ac9 quiring the skills, knowledge, and resources nec10 essary to ensure their healthy transition to success11 ful adult roles and responsibilities. 

12 ‘‘(2) APPLICATION.—To be eligible for a grant 

13 or cooperative agreement under this subsection, a 

14 State shall submit to the Secretary an application, 

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

16 information as the Secretary may require. 

17 ‘‘(3) PLAN.—Not later than 18 months after 

18 the receipt of a grant or cooperative agreement 

19 under this subsection, a State shall submit to the 

20 Secretary a State plan that shall include— 

21 ‘‘(A) reliable estimates on the number of 

22 adolescents and young adults with serious men23 tal health disorders in the State; 

24 ‘‘(B) information on the youth targeted 

25 under this Act, including— 


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1 ‘‘(i) the number of adolescents and 

2 young adults with serious mental health 

3 disorders in the State and the number of 

4 such individuals who are currently being 

5 served in the State; 

6 ‘‘(ii) the number of such individuals 

7 who are receiving mental health services 

8 provided by State agencies other than the 

9 agency responsible for mental health serv10 ices in the State; 

11 ‘‘(iii) the number of youth with seri12 ous mental health disorders who are in13 volved in the juvenile justice system in the 

14 State; 

15 ‘‘(iv) the number of youth with seri16 ous mental health disorders who are in17 volved in the child protection system in the 

18 State; 

19 ‘‘(v) the number of youth with serious 

20 mental health disorders who have plans in 

21 effect under the Individuals with Disabil22 ities Education Act in the State; 

23 ‘‘(vi) the number of youth with seri24 ous mental health disorders who are inVerDate Aug 31 2005 00:14 Jun 27, 2008 Jkt 069200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S3195.IS S3195

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1 volved in vocational rehabilitation in the 

2 State; 

3 ‘‘(vii) the range of ages served by the 

4 programs described in clauses (i) through 

5 (vi); and 

6 ‘‘(viii) a description of the overall 

7 transition coordination that is currently 

8 provided by the State or local authorities 

9 and programs in the State; 

10 ‘‘(C) an identification of the skills, knowl11 edge, and resources that adolescents and young 

12 adults with serious mental health disorders in 

13 the State will need to ensure their successful 

14 and healthy transition into adult roles and re15 sponsibilities; 

16 ‘‘(D) an identification of the obstacles that 

17 adolescents and young adults with serious men18 tal health disorders in the State encounter while 

19 transitioning into adult roles and responsibil20 ities, including breaks in service or programs 

21 caused by eligibility and program criteria dif22 ferences between the child and adult mental 

23 health systems and the lack of local access to 

24 mental health and transition services; 


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1 ‘‘(E) an identification of the current level, 

2 type, quality, effectiveness, and availability of 

3 services, including evidence-based practices, 

4 available in the State that are uniquely de5 signed for adolescents and young adults with a 

6 serious mental health disorder to ensure a 

7 healthy transition to successful adult roles and 

8 responsibilities; 

9 ‘‘(F) an identification of adolescents and 

10 young adults with a serious emotional disorder 

11 who have a low likelihood of a healthy and suc12 cessful transition due to the severity of their ill13 ness, and an identification of how the State will 

14 provide treatment and other support services to 

15 this population; 

16 ‘‘(G) an analyses of the strengths, weak17 nesses, and gaps of the current system in the 

18 State, including the availability of lack of men19 tal health professionals trained to treat adoles20 cents and young adults with a serious mental 

21 health disorder, as well as barriers, to address 

22 the needs of adolescents and young adults with 

23 a serious mental health disorder with an appro24 priate array of effective services and supports; 


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1 ‘‘(H) a description of how the State will 

2 improve the system of care to ensure successful 

3 and healthy transitions; 

4 ‘‘(I) a description of how the State will co5 ordinate the services of State and non-State 

6 agencies that serve adolescents and young 

7 adults with a serious mental health disorder; 

8 ‘‘(J) a description of how the State will 

9 provide a system of coordinated service delivery 

10 under the grant or cooperative agreement that 

11 will address the effective services, supports, and 

12 unique needs of adolescents and young adults 

13 with a serious mental disorder, including those 

14 who have been placed in out of home settings 

15 such as the juvenile justice system or those who 

16 are or were involved in the child protection sys17 tems; 

18 ‘‘(K) a description of how the State will co19 ordinate efforts under the grant or cooperative 

20 agreement with existing services and systems in 

21 the State that focus on life skills necessary for 

22 a healthy transition including health, employ23 ment and pre-employment training, transpor24 tation, housing, recreation, mental health serv25 ices, substance abuse, vocational rehabilitation 


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1 services for persons with disabilities, and train2 ing for adolescents, young adults and adults, 

3 consumers and their families; 

4 ‘‘(L) a description of how the State will 

5 work to build workforce capacity to serve the 

6 population described in subparagraph (J); 

7 ‘‘(M) a description of how the State will 

8 reach out to the target population pre-transi9 tion, during transition, and post-transition; 

10 ‘‘(N) a description of how the State is cur11 rently utilizing and leveraging (and how the 

12 State will use and leverage) Federal funding 

13 streams to care for the target population, in14 cluding funding through Medicaid, the Depart15 ment of Housing and Urban Development, the 

16 Department of Labor though supported employ17 ment, the Early and Periodic Screening, Diag18 nosis, and Treatment Program, and other pro19 grams, and including an outline of the barriers 

20 the State faces in making Federal funding flow 

21 to the targeted population in a coordinated 

22 manner; 

23 ‘‘(O) a description of how the State will in24 volve adolescents and young adults with serious 

25 mental health disorders and their families and 


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1 guardians in the service design, planning, and 

2 implementation of the plan under the grant or 

3 cooperative agreement; 

4 ‘‘(P) an implementation subplan that shall 

5 be designed to recognize the challenges of im6 plementing a program between communities at 

7 a statewide level and how the State will over8 come those challenges; 

9 ‘‘(Q) a description of how the State plans 

10 to evaluate outcomes under the program funded 

11 under the grant or cooperative agreement; 

12 ‘‘(R) a designation of the State office that 

13 will be the lead agency responsible for admin14 istering the program under the grant or cooper15 ative agreement; 

16 ‘‘(S) a description of how the State will en17 sure that the activities planned under the grant 

18 or cooperative agreement will remain sustain19 able at the end of the cycle of Federal funding 

20 under this section; and 

21 ‘‘(T) any other information determined ap22 propriate by the Secretary. 

23 ‘‘(4) DURATION OF SUPPORT.—The duration of 

24 a grant or cooperative agreement under this sub25 section shall not exceed 2 fiscal years. 


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1 ‘‘(5) TECHNICAL ASSISTANCE.—The Secretary 

2 shall provide technical assistance and training in the 

3 development of the plan under paragraph (3), in4 cluding convening a meeting of potential applicants 

5 for grants or cooperative agreement under this sub6 section. 

7 ‘‘(6) AUTHORIZATION OF APPROPRIATIONS.— 

8 ‘‘(A) IN GENERAL.—There is authorized to 

9 be appropriated to carry out this subsection, 

10 $6,000,000 for fiscal year 2009, and such sums 

11 as may be necessary for each of fiscal years 

12 2010 through 2013. 

13 ‘‘(B) TECHNICAL ASSISTANCE.—The Sec14 retary shall make available 15 percent of the 

15 amount appropriated under subparagraph (A) 

16 in each fiscal year for technical assistance 

17 under paragraph (5). 

18 ‘‘(b) IMPLEMENTATION GRANTS.— 

19 ‘‘(1) IN GENERAL.—The Secretary shall award 

20 grants or cooperative agreement to eligible States 

21 for the coordination of services to assist adolescents 

22 and young adults with serious mental health dis23 orders in acquiring the services, skills, and knowl24 edge necessary to ensure their healthy transition to 

25 successful adult roles and responsibilities. 


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1 ‘‘(2) ELIGIBILITY.—To be eligible for a grant 

2 or cooperative agreement under paragraph (1), a 

3 State shall— 

4 ‘‘(A) be a State that has received a grant 

5 or cooperative agreement under subsection (a) 

6 and submitted a plan that meets the require7 ments of paragraph (3) of such subsection; or 

8 ‘‘(B) be a State that has not received such 

9 a grant or cooperative agreement but that has 

10 a plan that is equivalent to the plan required 

11 under subsection (a)(3). 

12 ‘‘(3) APPLICATION.—To be eligible for a grant 

13 or cooperative agreement under this subsection, a 

14 State shall submit to the Secretary an application, 

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

16 information as the Secretary requires, including— 

17 ‘‘(A) a copy of the plan submitted under 

18 subsection (a)(3), or in the case of a State de19 scribed in paragraph (2)(B), a plan that is 

20 equivalent to the plan required under subsection 

21 (a)(3); 

22 ‘‘(B) a list of the State agencies that will 

23 participate in the program to be funded under 

24 the grant or cooperative agreement along with 


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1 written verification as to the commitment of 

2 such agencies to the program; 

3 ‘‘(C) an assurance that the State will de4 velop a coordinating committee composed of 

5 representatives of the participating State agen6 cies, as well as consumers and families of con7 sumers; 

8 ‘‘(D) a description of the role of such co9 ordinating committee; and 

10 ‘‘(E) the names of at least two local com11 munities that will implement the program at 

12 the local level and how those communities will 

13 implement the State plan. 

14 ‘‘(4) USE OF FUNDS.—Funds provided under a 

15 grant or cooperative agreement under this sub16 section shall be used to implement the State plan, 

17 including— 

18 ‘‘(A) facilitating a youth ombudsman or 

19 other advocacy program; 

20 ‘‘(B) facilitating peer support programs 

21 and networks within the State; 

22 ‘‘(C) facilitating access to independent liv23 ing and life skills supports; 


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1 ‘‘(D) developing infrastructure to support 

2 access to necessary health, mental health, em3 ployment, education, and housing supports; and 

4 ‘‘(E) facilitating the training of support 

5 providers and workforce capacity to serve the 

6 target population. 

7 ‘‘(5) DURATION OF SUPPORT.—The duration of 

8 a grant or cooperative agreement under this sub9 section shall not exceed 5 fiscal years. 

10 ‘‘(6) MATCHING REQUIREMENT.— 

11 ‘‘(A) IN GENERAL.—To be eligible for a 

12 grant or cooperative agreement under this sub13 section, the State shall agree that, with respect 

14 to the costs to be incurred by the State in car15 rying out activities under the grant or coopera16 tive agreement, the State will make available 

17 (directly or through donations from public or 

18 private entities) non-Federal contributions to19 ward such costs in an amount that— 

20 ‘‘(i) for the first fiscal year for which 

21 the State receives payments under the 

22 grant or cooperative agreement, is not less 

23 than $1 for each $3 of Federal funds pro24 vided under the grant or cooperative agree25 ment; 


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1 ‘‘(ii) for any second or third such fis2 cal year, is not less than $1 for each $2 of 

3 Federal funds provided under the grant or 

4 cooperative agreement; 

5 ‘‘(iii) for any fourth such fiscal year, 

6 is not less than $1 for each $1 of Federal 

7 funds provided under the grant or coopera8 tive agreement; and 

9 ‘‘(iv) for any fifth such fiscal year, is 

10 not less than $2 for each $1 of Federal 

11 funds provided under the grant or coopera12 tive agreement. 

13 ‘‘(B) DETERMINATION OF AMOUNT CON14 TRIBUTED.— 

15 ‘‘(i) IN GENERAL.—Non-Federal con16 tributions required under subparagraph 

17 (A) may be in cash or in kind, fairly evalu18 ated, including plant, equipment, or serv19 ices. Amounts provided by the Federal 

20 Government, or services assisted or sub21 sidized to any significant extent by the 

22 Federal Government, may not be included 

23 in determining the amount of such non24 Federal contributions. 


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1 ‘‘(ii) NON-FEDERAL CONTRIBU2 TIONS.—In making a determination of the 

3 amount of non-Federal contributions for 

4 purposes of clause (i), the Secretary may 

5 include only non-Federal contributions in 

6 excess of the average amount of non-Fed7 eral contributions made by the State in8 volved toward the purpose of the grant or 

9 cooperative agreement under this sub10 section for the 2-year period preceding the 

11 first fiscal year for which the State re12 ceives a grant or cooperative agreement 

13 under such subsection. 

14 ‘‘(7) TECHNICAL ASSISTANCE.—The Secretary 

15 shall provide technical assistance and training to re16 cipients of grants or cooperative agreements under 

17 this subsection, including convening meetings each 

18 year to identify ways of improving State programs. 

19 Such meetings shall include the members of the 

20 Federal Partners Committee under subsection (c). 

21 ‘‘(8) EVALUATION.—The Secretary shall carry 

22 out a cross-site evaluation that— 

23 ‘‘(A) reports on current State efforts to 

24 transition the population involved prior to the 


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1 implementation of the State plans under this 

2 section; and 

3 ‘‘(B) evaluates the program carried out by 

4 the State under this section to determine the ef5 fectiveness of such program in meeting its goals 

6 and objectives as compared with current ap7 proaches. 

8 ‘‘(9) AUTHORIZATION OF APPROPRIATIONS.— 

9 ‘‘(A) IN GENERAL.—There is authorized to 

10 be appropriated to carry out this subsection, 

11 $6,000,000 for each of fiscal years 2009 and 

12 2010, $15,000,000 for fiscal year 2011, 

13 $20,000,000 for fiscal year 2012, and 

14 $25,000,000 for fiscal year 2013. 

15 ‘‘(B) TECHNICAL ASSISTANCE AND EVAL16 UATION.—The Secretary shall make available 

17 15 percent of the amount appropriated under 

18 subparagraph (A), or $2,000,000 whichever is 

19 greater, in each fiscal year for technical assist20 ance under paragraph (7) and the evaluation 

21 under paragraph (8). 

22 ‘‘(c) FEDERAL PARTNERS.— 

23 ‘‘(1) IN GENERAL.—The Secretary shall des24 ignate an existing Federal entity, or establish a 

25 Committee of Federal Partners, to coordinate service 


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1 programs to assist adolescents and young adults 

2 with serious mental health disorders in acquiring the 

3 knowledge and skills necessary for them to transi4 tion into adult roles and responsibilities. 

5 ‘‘(2) EXISTING FEDERAL ENTITY.—If the Sec6 retary elects to utilize an existing Federal entity 

7 under paragraph (1), the Secretary shall ensure 

8 that— 

9 ‘‘(A) such entity is comprised of represent10 atives of at least the agencies described in para11 graph (3); and 

12 ‘‘(B) such entity shall give special atten13 tion to the knowledge and skills needed by ado14 lescents and young adults with mental health 

15 disorders in coordinating the programs funded 

16 under this section. 

17 ‘‘(3) MEMBERSHIP.—A Federal entity utilized 

18 under this subsection, or a committee established 

19 under paragraph (1), shall include representatives 

20 of— 

21 ‘‘(A) the Department of Education (or any 

22 subagency of the Department); 

23 ‘‘(B) the Department of Health and 

24 Human Services (or any subagency of the De25 partment); 


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1 ‘‘(C) the Department of Labor (or any 

2 subagency of the Department); 

3 ‘‘(D) the Department of Transportation 

4 (or any subagency of the Department); 

5 ‘‘(E) the Department of Housing and 

6 Urban Development (or any subagency of the 

7 Department); 

8 ‘‘(F) the Department of Interior (or any 

9 subagency of the Department); 

10 ‘‘(G) the Department of Justice (or any 

11 subagency of the Department); 

12 ‘‘(H) the Social Security Administration; 

13 ‘‘(I) an organization representing con14 sumers and families of consumers as designated 

15 by the Secretary; and 

16 ‘‘(J) an organization representing mental 

17 health and behavioral health professionals as 

18 designated by the Secretary. 

19 ‘‘(4) ROLE OF ENTITY OR COMMITTEE.—The 

20 Federal entity or committee designated or estab21 lished under paragraph (1) shall review how Federal 

22 programs and efforts that address issues related to 

23 the transition of adolescents and young adults with 

24 serious mental health disorders may be coordinated 

25 to ensure the maximum benefit for the individuals 


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1 being served and to provide technical assistance to 

2 the States who are planning or implementing pro3 grams under this section. 

4 ‘‘(5) REPORT.—Not later than 18 months after 

5 the date of enactment of this Act, the Federal entity 

6 or committee designated or established under para7 graph (1) shall submit to the appropriate commit8 tees of Congress, and make available to the general 

9 public, a report concerning the participation of Fed10 eral agencies and stakeholders in the planning and 

11 operations of the entity or committee. Such report 

12 shall also contain a description of the status of the 

13 efforts of such entity or committee in coordinating 

14 Federal efforts on behalf of the target population. 

15 ‘‘(6) AUTHORIZATION OF APPROPRIATIONS.— 

16 There are authorized to be appropriated to carry out 

17 this subsection, $1,000,000 for fiscal year 2009, and 

18 such sums as may be necessary for each of fiscal 

19 years 2010 through 2013. 

20 ‘‘(d) DEFINITION.—In this section, the term ‘serious 

21 mental health disorder’ has the meaning given the term 

22 ‘serious mental illness’ by the Administrator for purposes 

23 of this title.’’. 

Æ 


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