IA 

★ 

108TH CONGRESS 

2D SESSION S. 2634 

IN THE HOUSE OF REPRESENTATIVES 

JULY 9, 2004 

Referred to the Committee on Energy and Commerce 

AN ACT 

To amend the Public Health Service Act to support the 

planning, implementation, and evaluation of organized 

activities involving statewide youth suicide early intervention and prevention strategies, to provide funds for campus mental and behavioral health service centers, and 

for other purposes. 

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 ‘‘Garrett Lee Smith Me5 morial Act’’. 
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1 SEC. 2. FINDINGS. 

2 Congress makes the following findings: 

3 (1) More children and young adults die from 

4 suicide each year than from cancer, heart disease, 

5 AIDS, birth defects, stroke, and chronic lung disease 

6 combined. 

7 (2) Over 4,000 children and young adults trag8 ically take their lives every year, making suicide the 

9 third overall cause of death between the ages of 10 

10 and 24. According to the Centers for Disease Con11 trol and Prevention suicide is the third overall cause 

12 of death among college-age students. 

13 (3) According to the National Center for Injury 

14 Prevention and Control of the Centers for Disease 

15 Control and Prevention, children and young adults 

16 accounted for 15 percent of all suicides completed in 

17 2000. 

18 (4) From 1952 to 1995, the rate of suicide in 

19 children and young adults has tripled. 

20 (5) From 1980 to 1997, the rate of suicide 

21 among young adults ages 15 to 19 increased 11 per22 cent. 

23 (6) From 1980 to 1997, the rate of suicide 

24 among children ages 10 to 14 increased 109 percent. 

25 (7) According to the National Center of Health 

26 Statistics, suicide rates among Native Americans 
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1 range from 1.5 to 3 times the national average for 

2 other groups, with young people ages 15 to 34 mak3 ing up 64 percent of all suicides. 

4 (8) Congress has recognized that youth suicide 

5 is a public health tragedy linked to underlying men6 tal health problems and that youth suicide early 

7 intervention and prevention activities are national 

8 priorities. 

9 (9) Youth suicide early intervention and preven10 tion have been listed as urgent public health prior11 ities by the President’s New Freedom Commission in 

12 Mental Health (2002), the Institute of Medicine’s 

13 Reducing Suicide: A National Imperative (2002), the 

14 National Strategy for Suicide Prevention: Goals and 

15 Objectives for Action (2001), and the Surgeon Gen16 eral’s Call to Action To Prevent Suicide (1999). 

17 (10) Many States have already developed com18 prehensive Statewide youth suicide early intervention 

19 and prevention strategies that seek to provide effec20 tive early intervention and prevention services. 

21 (11) In a recent report, a startling 85 percent 

22 of college counseling centers revealed an increase in 

23 the number of students they see with psychological 

24 problems. Furthermore, the American College 

25 Health Association found that 61 percent of college 
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1 students reported feeling hopeless, 45 percent said 

2 they felt so depressed they could barely function, 

3 and 9 percent felt suicidal. 

4 (12) There is clear evidence of an increased in5 cidence of depression among college students. Ac6 cording to a survey described in the Chronicle of 

7 Higher Education (February 1, 2002), depression 

8 among freshmen has nearly doubled (from 8.2 per9 cent to 16.3 percent). Without treatment, research10 ers recently noted that ‘‘depressed adolescents are at 

11 risk for school failure, social isolation, promiscuity, 

12 self medication with drugs and alcohol, and sui13 cide—now the third leading cause of death among 

14 10–24 year olds.’’. 

15 (13) Researchers who conducted the study 

16 ‘‘Changes in Counseling Center Client Problems 

17 Across 13 Years’’ (1989–2001) at Kansas State 

18 University stated that ‘‘students are experiencing 

19 more stress, more anxiety, more depression than 

20 they were a decade ago.’’ (The Chronicle of Higher 

21 Education, February 14, 2003). 

22 (14) According to the 2001 National Household 

23 Survey on Drug Abuse, 20 percent of full-time un24 dergraduate college students use illicit drugs. 
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1 (15) The 2001 National Household Survey on 

2 Drug Abuse also reported that 18.4 percent of 

3 adults aged 18 to 24 are dependent on or abusing 

4 illicit drugs or alcohol. In addition, the study found 

5 that ‘‘serious mental illness is highly correlated with 

6 substance dependence or abuse. Among adults with 

7 serious mental illness in 2001, 20.3 percent were de8 pendent on or abused alcohol or illicit drugs, while 

9 the rate among adults without serious mental illness 

10 was only 6.3 percent.’’. 

11 (16) A 2003 Gallagher’s Survey of Counseling 

12 Center Directors found that 81 percent were con13 cerned about the increasing number of students with 

14 more serious psychological problems, 67 percent re15 ported a need for more psychiatric services, and 63 

16 percent reported problems with growing demand for 

17 services without an appropriate increase in re18 sources. 

19 (17) The International Association of Coun20 seling Services accreditation standards recommend 1 

21 counselor per 1,000 to 1,500 students. According to 

22 the 2003 Gallagher’s Survey of Counseling Center 

23 Directors, the ratio of counselors to students is as 

24 high as 1 counselor per 2,400 students at institu-
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1 tions of higher education with more than 15,000 

2 students. 

3 SEC. 3. AMENDMENT TO THE PUBLIC HEALTH SERVICES 

4 ACT. 

5 Title V of the Public Health Service Act (42 U.S.C. 

6 290aa et seq) is amended— 

7 (1) in section 520E (42 U.S.C. 290bb–36)— 

8 (A) in the section heading by striking 

9 ‘‘CHILDREN AND ADOLESCENTS’’ and in10 serting ‘‘YOUTH’’; 

11 (B) by striking subsection (a) and insert12 ing the following: 

13 ‘‘(a) IN GENERAL.—The Secretary shall award 

14 grants or cooperative agreements to public organizations, 

15 private nonprofit organizations, political subdivisions, and 

16 Federally recognized Indian tribes or tribal organizations 

17 to implement the State-sponsored statewide or tribal youth 

18 suicide early intervention and prevention strategy as devel19 oped under section 596A.’’; 

20 (C) in subsection (b), by striking all after 

21 ‘‘coordinated’’ and inserting ‘‘with the Strategy 

22 for Suicide Prevention Federal Steering Group 

23 and the suicide prevention resource center pro24 vided for under section 596B.’’; 

25 (D) in subsection (c)— 
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1 (i) in the matter preceding paragraph 

2 (1), by striking ‘‘A State’’ and all that fol3 lows through ‘‘desiring’’ and inserting ‘‘A 

4 public organization, private nonprofit orga5 nization, political subdivision, and Feder6 ally recognized Indian tribes or tribal orga7 nization desiring’’; 

8 (ii) by redesignating paragraphs (1) 

9 through (9) as paragraphs (2) through 

10 (10), respectively; 

11 (iii) by inserting before paragraph (2) 

12 (as so redesignated), the following: 

13 ‘‘(1) comply with the State-sponsored statewide 

14 early intervention and prevention strategy as devel15 oped under section 596A;’’; 

16 (iv) in paragraph (2) (as so redesig17 nated), by striking ‘‘children and adoles18 cents’’ and inserting ‘‘youth’’; 

19 (v) in paragraph (3) (as so redesig20 nated), by striking ‘‘best evidence-based,’’; 

21 (vi) in paragraph (4) (as so redesig22 nated), by striking ‘‘primary’’ and all that 

23 follows and inserting ‘‘general, mental, and 

24 behavioral health services, and substance 

25 abuse services;’’; 
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1 (vii) in paragraph (5) (as so redesig2 nated), by striking ‘‘children and’’ and all 

3 that follows and inserting ‘‘youth including 

4 the school systems, educational institu5 tions, juvenile justice system, substance 

6 abuse programs, mental health programs, 

7 foster care systems, and community child 

8 and youth support organizations;’’; 

9 (viii) by striking paragraph (8) (as so 

10 redesignated), and inserting the following: 

11 ‘‘(8) offer access to services and care to youth 

12 with diverse linguistic and cultural backgrounds;’’; 

13 and 

14 (ix) by striking paragraph (9) (as so 

15 redesignated), and inserting the following: 

16 ‘‘(9) conduct annual self-evaluations of out17 comes and activities, including consulting with inter18 ested families and advocacy organizations;’’; 

19 (E) by striking subsection (d) and insert20 ing the following: 

21 ‘‘(d) USE OF FUNDS.—Amounts provided under a 

22 grant or cooperative agreement under this section shall be 

23 used to supplement, and not supplant, Federal and non24 Federal funds available for carrying out the activities de-
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1 scribed in this section. Applicants shall provide financial 

2 information to demonstrate compliance with this section.’’; 

3 (F) in subsection (e)— 

4 (i) by striking ‘‘contract,’’; and 

5 (ii) by inserting after ‘‘Secretary that 

6 the’’ the following: ‘‘application complies 

7 with the State-sponsored statewide early 

8 intervention and prevention strategy as de9 veloped under section 596A and’’; 

10 (G) in subsection (f), by striking ‘‘con11 tracts,’’; 

12 (H) in subsection (g)— 

13 (i) by striking ‘‘A State’’ and all that 

14 follows through ‘‘organization receiving’’ 

15 and inserting ‘‘A public organization, pri16 vate nonprofit organization, political sub17 division, and Federally recognized Indian 

18 tribes or tribal organization receiving’’; 

19 and 

20 (ii) by striking ‘‘contract,’’ each place 

21 that such appears; 

22 (I) in subsection (h), by striking ‘‘con23 tracts,’’; 

24 (J) in subsection (i)— 
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1 (i) by striking ‘‘A State’’ and all that 

2 follows through ‘‘organization receiving’’ 

3 and inserting ‘‘A public organization, pri4 vate nonprofit organization, political sub5 division, and Federally recognized Indian 

6 tribes or tribal organization receiving’’; 

7 and 

8 (ii) by striking ‘‘contract,’’; 

9 (K) in subsection (k), by striking ‘‘5 

10 years’’ and inserting ‘‘3 years’’; 

11 (L) in subsection (l)(2), by striking ‘‘21’’ 

12 and inserting ‘‘24’’; and 

13 (M) in subsection (m)— 

14 (i) by striking ‘‘APPROPRIATION.—’’ 

15 and all that follows through ‘‘For’’ in 

16 paragraph (1) and inserting ‘‘APPROPRIA17 TION.—For’’; and 

18 (ii) by striking paragraph (2); 

19 (2) by inserting after part I (42 U.S.C. 290jj 

20 et seq), the following: 

21 ‘‘PART J—SUICIDE EARLY INTERVENTION AND 

22 PREVENTION’’; 

23 (3) by redesignating section 520E (42 U.S.C. 

24 290bb–36), as amended by paragraph (1), as section 
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1 596 and transferring such section to part J (as 

2 added by paragraph (2)); and 

3 (4) by adding at the end of part J (as added 

4 by paragraph (2) and amended by paragraph (3)), 

5 the following: 

6 ‘‘SEC. 596A. YOUTH SUICIDE EARLY INTERVENTION AND 

7 PREVENTION STRATEGIES, TRAINING, AND 

8 TECHNICAL ASSISTANCE. 

9 ‘‘(a) YOUTH SUICIDE EARLY INTERVENTION AND

10 PREVENTION STRATEGIES.— 

11 ‘‘(1) IN GENERAL.—The Secretary acting 

12 through the Administrator of the Substance Abuse 

13 and Mental Health Services Administration, shall 

14 award grants or cooperative agreements to eligible 

15 entities to— 

16 ‘‘(A) develop and implement State-spon17 sored statewide or tribal youth suicide early 

18 intervention and prevention strategies in 

19 schools, educational institutions, juvenile justice 

20 systems, substance abuse programs, mental 

21 health programs, foster care systems, and other 

22 child and youth support organizations; 

23 ‘‘(B) support public organizations and pri24 vate nonprofit organizations actively involved in 

25 State-sponsored statewide or tribal youth sui-
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1 cide early intervention and prevention strategies 

2 and in the development and continuation of 

3 State-sponsored statewide youth suicide early 

4 intervention and prevention strategies; 

5 ‘‘(C) collect and analyze data on State6 sponsored statewide or tribal youth suicide early 

7 intervention and prevention services that can be 

8 used to monitor the effectiveness of such serv9 ices and for research, technical assistance, and 

10 policy development; and 

11 ‘‘(D) assist eligible entities, through State12 sponsored statewide or tribal youth suicide early 

13 intervention and prevention strategies, in 

14 achieving targets for youth suicide reductions 

15 under title V of the Social Security Act (42 

16 U.S.C. 701 et seq.). 

17 ‘‘(2) ELIGIBLE ENTITY.— 

18 ‘‘(A) DEFINITION.—In this subsection, the 

19 term ‘eligible entity’ means— 

20 ‘‘(i) a State; 

21 ‘‘(ii) a public organization or private 

22 nonprofit organization designated by a 

23 State to develop or direct the State-spon24 sored statewide youth suicide early inter25 vention and prevention strategy; and 
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1 ‘‘(iii) a Federally-recognized Indian 

2 tribe or tribal organization (as defined in 

3 the Indian Self-Determination and Edu4 cation Assistance Act) or an urban Indian 

5 organization (as defined in the Indian 

6 Health Care Improvement Act) that is ac7 tively involved in the development and con8 tinuation of a tribal youth suicide early 

9 intervention and prevention strategy. 

10 ‘‘(B) PREFERENCE.—In awarding grants 

11 and cooperative agreements under this section, 

12 the Secretary shall give preference to States 

13 that have rates of youth suicide that signifi14 cantly exceed the national average as deter15 mined by the Centers for Disease Control and 

16 Prevention. 

17 ‘‘(C) LIMITATION.—In carrying out this 

18 section, the Secretary shall ensure that each 

19 State is awarded only one grant or cooperative 

20 agreement under this section. For purposes of 

21 the preceding sentence, a State shall be consid22 ered to have been awarded a grant or coopera23 tive agreement if the eligible entity involved is 

24 the State or an entity designated by the State 

25 under subparagraph (A)(ii). Nothing in this 
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1 subparagraph shall be construed to apply to en2 tities described in subparagraph (A)(iii). 

3 ‘‘(3) PREFERENCE.—In providing assistance 

4 under a grant or cooperative agreement under this 

5 subsection, an eligible entity shall give preference to 

6 public organizations, private nonprofit organizations, 

7 political subdivisions, and tribal organizations ac8 tively involved with the State-sponsored statewide or 

9 tribal youth suicide early intervention and prevention 

10 strategy that— 

11 ‘‘(A) provide early intervention and assess12 ment services, including screening programs, to 

13 youth who are at risk for mental or emotional 

14 disorders that may lead to a suicide attempt, 

15 and that are integrated with, school systems, 

16 educational institutions, juvenile justice sys17 tems, substance abuse programs, mental health 

18 programs, foster care systems, and other child 

19 and youth support organizations; 

20 ‘‘(B) demonstrate collaboration among 

21 early intervention and prevention services or 

22 certify that entities will engage in future col23 laboration; 

24 ‘‘(C) employ or include in their applica25 tions a commitment to evaluate youth suicide 
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1 early intervention and prevention practices and 

2 strategies adapted to the local community; 

3 ‘‘(D) provide timely referrals for appro4 priate community-based mental health care and 

5 treatment of youth who are at risk for suicide 

6 in child-serving settings and agencies; 

7 ‘‘(E) provide immediate support and infor8 mation resources to families of youth who are 

9 at risk for suicide; 

10 ‘‘(F) offer access to services and care to 

11 youth with diverse linguistic and cultural back12 grounds; 

13 ‘‘(G) offer appropriate post-suicide inter14 vention services, care, and information to fami15 lies, friends, schools, educational institutions, 

16 juvenile justice systems, substance abuse pro17 grams, mental health programs, foster care sys18 tems, and other child and youth support organi19 zations of youth who recently completed suicide; 

20 ‘‘(H) offer continuous and up-to-date in21 formation and awareness campaigns that target 

22 parents, family members, child care profes23 sionals, community care providers, and the gen24 eral public and highlight the risk factors associ25 ated with youth suicide and the life-saving help 
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1 and care available from early intervention and 

2 prevention services; 

3 ‘‘(I) ensure that information and aware4 ness campaigns on youth suicide risk factors, 

5 and early intervention and prevention services, 

6 use effective communication mechanisms that 

7 are targeted to and reach youth, families, 

8 schools, educational institutions, and youth or9 ganizations; 

10 ‘‘(J) provide a timely response system to 

11 ensure that child-serving professionals and pro12 viders are properly trained in youth suicide 

13 early intervention and prevention strategies and 

14 that child-serving professionals and providers 

15 involved in early intervention and prevention 

16 services are properly trained in effectively iden17 tifying youth who are at risk for suicide; 

18 ‘‘(K) provide continuous training activities 

19 for child care professionals and community care 

20 providers on the latest youth suicide early inter21 vention and prevention services practices and 

22 strategies; 

23 ‘‘(L) conduct annual self-evaluations of 

24 outcomes and activities, including consulting 
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1 with interested families and advocacy organiza2 tions; and 

3 ‘‘(M) provide services in areas or regions 

4 with rates of youth suicide that exceed the na5 tional average as determined by the Centers for 

6 Disease Control and Prevention. 

7 ‘‘(4) REQUIREMENT FOR DIRECT SERVICES.— 

8 Not less than 85 percent of grant funds received 

9 under this subsection shall be used to provide direct 

10 services. 

11 ‘‘(b) SUICIDE PREVENTION RESOURCE CENTER; 

12 TRAINING AND TECHNICAL ASSISTANCE.— 

13 ‘‘(1) OPERATION OF CENTER.—The Secretary, 

14 acting through the Administrator of the Substance 

15 Abuse and Mental Health Services Administration 

16 and in consultation with the National Strategy for 

17 Suicide Prevention Federal Steering Group, shall 

18 award a competitive grant or contract to a public or 

19 private nonprofit entity for the establishment of a 

20 Suicide Prevention Resource Center to carry out the 

21 activities described in paragraph (3). 

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

23 or contract under paragraph (1), an entity shall pre24 pare and submit to the Secretary an application at 
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1 such time, in such manner, and containing such in2 formation as the Secretary may require. 

3 ‘‘(3) AUTHORIZED ACTIVITIES.—The Suicide 

4 Prevention Resource Center shall provide appro5 priate information, training, and technical assistance 

6 to States, political subdivisions of a State, Federally 

7 recognized Indian tribes, tribal organizations, public 

8 organizations, or private nonprofit organizations 

9 for— 

10 ‘‘(A) the development or continuation of 

11 statewide or tribal youth suicide early interven12 tion and prevention strategies; 

13 ‘‘(B) ensuring the surveillance of youth 

14 suicide early intervention and prevention strate15 gies; 

16 ‘‘(C) studying the costs and effectiveness 

17 of statewide youth suicide early intervention 

18 and prevention strategies in order to provide in19 formation concerning relevant issues of impor20 tance to State, tribal, and national policy21 makers; 

22 ‘‘(D) further identifying and understanding 

23 causes and associated risk factors for youth sui24 cide; 
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1 ‘‘(E) analyzing the efficacy of new and ex2 isting youth suicide early intervention tech3 niques and technology; 

4 ‘‘(F) ensuring the surveillance of suicidal 

5 behaviors and nonfatal suicidal attempts; 

6 ‘‘(G) studying the effectiveness of State7 sponsored statewide and tribal youth suicide 

8 early intervention and prevention strategies on 

9 the overall wellness and health promotion strat10 egies related to suicide attempts; 

11 ‘‘(H) promoting the sharing of data re12 garding youth suicide with Federal agencies in13 volved with youth suicide early intervention and 

14 prevention, and State-sponsored statewide or 

15 tribal youth suicide early intervention and pre16 vention strategies for the purpose of identifying 

17 previously unknown mental health causes and 

18 associated risk-factors for suicide in youth; and 

19 ‘‘(I) other activities determined appropriate 

20 by the Secretary. 

21 ‘‘(5) AUTHORIZATION OF APPROPRIATIONS.— 

22 There is authorized to be appropriated to carry out 

23 this subsection, $3,000,000 for fiscal year 2005, 

24 $4,000,000 for fiscal year 2006, and $5,000,000 for 

25 fiscal year 2007. 
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1 ‘‘(c) COORDINATION AND COLLABORATION.— 

2 ‘‘(1) IN GENERAL.—In carrying out this sec3 tion, the Secretary shall collaborate with the Na4 tional Strategy for Suicide Prevention Federal Steer5 ing Group and other Federal agencies responsible 

6 for early intervention and prevention services relat7 ing to youth suicide. 

8 ‘‘(2) CONSULTATION.—In carrying out this sec9 tion, the Secretary shall consult with— 

10 ‘‘(A) State and local agencies, including 

11 agencies responsible for early intervention and 

12 prevention services under title XIX of the So13 cial Security Act (42 U.S.C. 1396 et seq.), the 

14 State Children’s Health Insurance Program 

15 under title XXI of the Social Security Act (42 

16 U.S.C. 1397aa et seq.), programs funded by 

17 grants under title V of the Social Security Act 

18 (42 U.S.C. 701 et seq.), and programs under 

19 part C of the Individuals with Disabilities Edu20 cation Act (20 U.S.C. 1431 et seq.); 

21 ‘‘(B) local and national organizations that 

22 serve youth at risk for suicide and their fami23 lies; 

24 ‘‘(C) relevant national medical and other 

25 health and education specialty organizations; 
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1 ‘‘(D) youth who are at risk for suicide, 

2 who have survived suicide attempts, or who are 

3 currently receiving care from early intervention 

4 services; 

5 ‘‘(E) families and friends of youth who are 

6 at risk for suicide, who have survived suicide at7 tempts, who are currently receiving care from 

8 early intervention and prevention services, or 

9 who have completed suicide; 

10 ‘‘(F) qualified professionals who possess 

11 the specialized knowledge, skills, experience, 

12 and relevant attributes needed to serve youth at 

13 risk for suicide and their families; and 

14 ‘‘(G) third-party payers, managed care or15 ganizations, and related commercial industries. 

16 ‘‘(3) POLICY DEVELOPMENT.—The Secretary 

17 shall— 

18 ‘‘(A) coordinate and collaborate on policy 

19 development at the Federal level with the Na20 tional Strategy for Suicide Prevention Federal 

21 Steering Group; and 

22 ‘‘(B) consult on policy development at the 

23 Federal level with the private sector, including 

24 consumer, medical, suicide prevention advocacy 

25 groups, and other health and education profes-
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1 sional-based organizations, with respect to 

2 State-sponsored statewide or tribal youth sui3 cide early intervention and prevention strate4 gies. 

5 ‘‘(d) RULE OF CONSTRUCTION; RELIGIOUS ACCOM6 MODATION.—Nothing in this section shall be construed to 

7 preempt any State law, including any State law that does 

8 not require the suicide early intervention for youth whose 

9 parents or legal guardians object to such early interven10 tion based on the parents’ or legal guardians’ religious be11 liefs. 

12 ‘‘(e) EVALUATIONS AND REPORT.— 

13 ‘‘(1) EVALUATIONS BY ELIGIBLE ENTITIES.— 

14 Not later than 18 months after receiving a grant or 

15 cooperative agreement under subsection (a), an eligi16 ble entity shall submit to the Secretary the results 

17 of an evaluation to be conducted by the entity con18 cerning the effectiveness of the activities carried out 

19 under the grant or agreement. 

20 ‘‘(2) REPORT.—Not later than 2 years after the 

21 date of enactment of this section, the Secretary shall 

22 submit to the appropriate committees of Congress a 

23 report concerning the results of— 

24 ‘‘(A) the evaluations conducted under 

25 paragraph (1); and 
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1 ‘‘(B) an evaluation conducted by the Sec2 retary to analyze the effectiveness and efficacy 

3 of the activities conducted with grants, collabo4 rations, and consultations under this section. 

5 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—For the 

6 purpose of carrying out subsection (a), there are author7 ized to be appropriated $7,000,000 for fiscal year 2005, 

8 $16,000,000 for fiscal year 2006, $25,000,000 for fiscal 

9 year 2007, and such sums as may be necessary for each 

10 of fiscal years 2008 and 2009. 

11 ‘‘SEC. 596B. MENTAL AND BEHAVIORAL HEALTH SERVICES 

12 ON CAMPUS. 

13 ‘‘(a) PURPOSE.—It is the purpose of this section to 

14 increase access to, and enhance the range of, services for 

15 students with mental and behavioral health problems that 

16 can lead to school failure, such as depression, substance 

17 abuse, and suicide attempts, so as to ensure that college 

18 students have the support necessary to successfully com19 plete their studies. 

20 ‘‘(b) PROGRAM AUTHORIZED.—From funds appro21 priated under subsection (j), the Secretary shall award 

22 competitive grants to institutions of higher education to 

23 create or expand mental and behavioral health services to 

24 students at such institutions, to provide such services, and 

25 to develop best practices for the delivery of such services. 
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1 Such grants shall, subject to the availability of such appro2 priations, be for a period of 3 years. 

3 ‘‘(c) ELIGIBLE GRANT RECIPIENTS.—Any institution 

4 of higher education that seeks to provide, or provides, 

5 mental and behavioral health services to students is eligi6 ble to apply for a grant under this section. Services may 

7 be provided at— 

8 ‘‘(1) college counseling centers; 

9 ‘‘(2) college and university psychological service 

10 centers; 

11 ‘‘(3) mental health centers; 

12 ‘‘(4) psychology training clinics; and 

13 ‘‘(5) institution of higher education supported, 

14 evidence-based, mental health and substance abuse 

15 screening programs. 

16 ‘‘(d) APPLICATIONS.—Each institution of higher edu17 cation seeking to obtain a grant under this section shall 

18 submit an application to the Secretary. Each such applica19 tion shall include— 

20 ‘‘(1) a description of identified mental and be21 havioral health needs of students at the institution 

22 of higher education; 

23 ‘‘(2) a description of currently available Fed24 eral, State, local, private, and institutional resources 
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1 to address the needs described in paragraph (1) at 

2 the institution of higher education; 

3 ‘‘(3) an outline of program objectives and an4 ticipated program outcomes, including an expla5 nation of how the treatment provider at the institu6 tion of higher education will coordinate activities 

7 under this section with existing programs and serv8 ices; 

9 ‘‘(4) the anticipated impact of funds provided 

10 under this section in improving the mental and be11 havioral health of students attending the institution 

12 of higher education; 

13 ‘‘(5) outreach strategies, including ways in 

14 which the treatment provider at the institution of 

15 higher education proposes to reach students, pro16 mote access to services, and address the range of 

17 needs of students; 

18 ‘‘(6) a proposed plan for reaching those stu19 dents most in need of services; 

20 ‘‘(7) a plan to evaluate program outcomes and 

21 assess the services provided with funds under this 

22 section; 

23 ‘‘(8) financial information concerning the appli24 cant to demonstrate compliance with subsection (h); 

25 and 
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1 ‘‘(9) such additional information as is required 

2 by the Secretary. 

3 ‘‘(e) PEER REVIEW OF APPLICATIONS.—The Sec4 retary, in consultation with the Secretary of Education, 

5 shall provide the applications submitted under this section 

6 to a peer review panel for evaluation. With respect to each 

7 application, the peer review panel shall recommend the ap8 plication for funding or for disapproval. 

9 ‘‘(f) USE OF FUNDS.—Funds provided by a grant 

10 under this section may be used for 1 or more of the fol11 lowing activities: 

12 ‘‘(1) Prevention, screening, early intervention, 

13 assessment, treatment, management, and education 

14 of mental and behavioral health problems that can 

15 lead to school failure, such as depression, substance 

16 abuse, and suicide attempts by students enrolled at 

17 the institution of higher education. 

18 ‘‘(2) Education of families to increase aware19 ness of potential mental and behavioral health issues 

20 of students enrolled at the institution of higher edu21 cation. 

22 ‘‘(3) Hiring staff trained to identify and treat 

23 mental and behavioral health problems, including 

24 residents and interns such as those in psychological 

25 doctoral and post doctoral programs. 
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1 ‘‘(4) Evaluating and disseminating outcomes 

2 and best practices of mental and behavioral health 

3 services. 

4 ‘‘(g) ADDITIONAL REQUIRED ELEMENTS.—Each in5 stitution of higher education that receives a grant under 

6 this section shall— 

7 ‘‘(1) provide annual reports to the Secretary de8 scribing the use of funds, the program’s objectives, 

9 and how the objectives were met, including a de10 scription of program outcomes; 

11 ‘‘(2) perform such additional evaluations as the 

12 Secretary may require, which may include— 

13 ‘‘(A) increases in range of services pro14 vided; 

15 ‘‘(B) increases in the quality of services 

16 provided; 

17 ‘‘(C) increases in access to services; 

18 ‘‘(D) college continuation rates; 

19 ‘‘(E) decreases in college dropout rates; 

20 ‘‘(F) increases in college graduation rates; 

21 and 

22 ‘‘(G) accepted and valid measurements and 

23 assessments of improved mental health 

24 functionality; and 
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1 ‘‘(3) coordinate such institution’s program 

2 under this section with other related efforts on cam3 pus by entities concerned with the general mental 

4 and behavioral health needs of students. 

5 ‘‘(h) SUPPLEMENT NOT SUPPLANT.—Grant funds 

6 provided under this section shall be used to supplement, 

7 and not supplant, Federal and non-Federal funds available 

8 for carrying out the activities described in this section. 

9 Grantees shall provide financial information to dem10 onstrate compliance with this subsection. 

11 ‘‘(i) REQUIREMENT FOR DIRECT SERVICES AND LIM12 ITATIONS.— 

13 ‘‘(1) DIRECT SERVICES.—Not less than 75 per14 cent of grant funds received under this section shall 

15 be used to provide direct services. 

16 ‘‘(2) ADMINISTRATIVE COSTS.—Not more than 

17 5 percent of grant funds received under this section 

18 shall be used for administrative costs. 

19 ‘‘(3) PROHIBITION ON USE FOR CONSTRUCTION

20 OR RENOVATION.—Grant funds received under this 

21 section shall not be used for construction or renova22 tion of facilities or buildings. 

23 ‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—There 

24 are authorized to be appropriated for grants under this 

25 section, $5,000,000 for fiscal year 2005, $7,000,000 for 
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1 fiscal year 2006, $10,000,000 for fiscal year 2007, and 

2 such sums as may be necessary for each fiscal years 2008 

3 and 2009. 

4 ‘‘SEC. 596C. DEFINITIONS. 

5 ‘‘In this part: 

6 ‘‘(1) EARLY INTERVENTION.—The term ‘early 

7 intervention’ means a strategy or approach that is 

8 intended to prevent an outcome or to alter the 

9 course of an existing condition. 

10 ‘‘(2) EDUCATIONAL INSTITUTION; INSTITUTION

11 OF HIGHER EDUCATION; SCHOOL.—The term— 

12 ‘‘(A) ‘educational institution’ means a 

13 school or institution of higher education; 

14 ‘‘(B) ‘institution of higher education’ has 

15 the meaning given such term in section 101 of 

16 the Higher Education Act of 1965; and 

17 ‘‘(C) ‘school’ means an elementary or sec18 ondary school (as such terms are defined in sec19 tion 901 of the Elementary and Secondary 

20 Education Act of 1965). 

21 ‘‘(3) PREVENTION.—The term ‘prevention’ 

22 means a strategy or approach that reduces the likeli23 hood or risk of onset, or delays the onset, of adverse 

24 health problems. 
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1 ‘‘(4) YOUTH.—The term ‘youth’ means individ2 uals who are between 6 and 24 years of age.’’. 

Passed the Senate July 8, 2004. 

Attest: EMILY J. REYNOLDS, 

Secretary.