108TH CONGRESS

2D SESSION S. 2634

AMENDMENTS

In the House of Representatives, U. S.,

September 9, 2004.

Resolved, That the bill from the Senate (S. 2634) entitled ‘‘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’’, do pass with the following

AMENDMENTS:

Strike out all after the enacting clause and insert:

1 SECTION 1. SHORT TITLE.

2 This Act may be cited as the ‘‘Garrett Lee Smith Me3 morial Act’’.

4 SEC. 2. FINDINGS.

5 Congress makes the following findings:

6 (1) More children and young adults die from

7 suicide each year than from cancer, heart disease,

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

9 combined.

10 (2) Over 4,000 children and young adults trag11 ically take their lives every year, making suicide the
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1 third overall cause of death between the ages of 10

2 and 24. According to the Centers for Disease Control

3 and Prevention, suicide is the third overall cause of

4 death among college-age students.

5 (3) According to the National Center for Injury

6 Prevention and Control of the Centers for Disease

7 Control and Prevention, children and young adults

8 accounted for 15 percent of all suicides completed in

9 2000.

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

11 children and young adults tripled.

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

13 among young adults ages 15 to 19 increased 11 per14 cent.

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

16 among children ages 10 to 14 increased 109 percent.

17 (7) According to the National Center of Health

18 Statistics, suicide rates among Native Americans

19 range from 1.5 to 3 times the national average for

20 other groups, with young people ages 15 to 34 making

21 up 64 percent of all suicides.

22 (8) Congress has recognized that youth suicide is

23 a public health tragedy linked to underlying mental

24 health problems and that youth suicide early inter-
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1 vention and prevention activities are national prior2 ities.

3 (9) Youth suicide early intervention and preven4 tion have been listed as urgent public health priorities

5 by the President’s New Freedom Commission in Men6 tal Health (2002), the Institute of Medicine’s Reduc7 ing Suicide: A National Imperative (2002), the Na8 tional Strategy for Suicide Prevention: Goals and Ob9 jectives for Action (2001), and the Surgeon General’s

10 Call to Action To Prevent Suicide (1999).

11 (10) Many States have already developed com12 prehensive statewide youth suicide early intervention

13 and prevention strategies that seek to provide effective

14 early intervention and prevention services.

15 (11) In a recent report, a startling 85 percent of

16 college counseling centers revealed an increase in the

17 number of students they see with psychological prob18 lems. Furthermore, the American College Health Asso19 ciation found that 61 percent of college students re20 ported feeling hopeless, 45 percent said they felt so de21 pressed they could barely function, and 9 percent felt

22 suicidal.

23 (12) There is clear evidence of an increased inci24 dence of depression among college students. According

25 to a survey described in the Chronicle of Higher Edu-
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1 cation (February 1, 2002), depression among fresh2 men has nearly doubled (from 8.2 percent to 16.3 per3 cent). Without treatment, researchers recently noted

4 that ‘‘depressed adolescents are at risk for school fail5 ure, social isolation, promiscuity, self-medication

6 with drugs and alcohol, and suicide—now the third

7 leading cause of death among 10–24 year olds.’’.

8 (13) Researchers who conducted the study

9 ‘‘Changes in Counseling Center Client Problems

10 Across 13 Years’’ (1989–2001) at Kansas State Uni11 versity stated that ‘‘students are experiencing more

12 stress, more anxiety, more depression than they were

13 a decade ago.’’ (The Chronicle of Higher Education,

14 February 14, 2003).

15 (14) According to the 2001 National Household

16 Survey on Drug Abuse, 20 percent of full-time under17 graduate college students use illicit drugs.

18 (15) The 2001 National Household Survey on

19 Drug Abuse also reported that 18.4 percent of adults

20 aged 18 to 24 are dependent on or abusing illicit

21 drugs or alcohol. In addition, the study found that

22 ‘‘serious mental illness is highly correlated with sub23 stance dependence or abuse. Among adults with seri24 ous mental illness in 2001, 20.3 percent were depend25 ent on or abused alcohol or illicit drugs, while the
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1 rate among adults without serious mental illness was

2 only 6.3 percent.’’.

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

4 Center Directors found that 81 percent were concerned

5 about the increasing number of students with more se6 rious psychological problems, 67 percent reported a

7 need for more psychiatric services, and 63 percent re8 ported problems with growing demand for services

9 without an appropriate increase in resources.

10 (17) The International Association of Counseling

11 Services accreditation standards recommend 1 coun12 selor per 1,000 to 1,500 students. According to the

13 2003 Gallagher’s Survey of Counseling Center Direc14 tors, the ratio of counselors to students is as high as

15 1 counselor per 2,400 students at institutions of high16 er education with more than 15,000 students.

17 SEC. 3. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT.

18 (a) YOUTH INTERAGENCY RESEARCH, TRAINING, AND

19 TECHNICAL ASSISTANCE CENTERS.—Section 520C of the

20 Public Health Service Act (42 U.S.C. 290bb–34) is

21 amended—

22 (1) in subsection (a)—

23 (A) by striking ‘‘Health, shall award

24 grants’’ and inserting ‘‘Health—

25 ‘‘(1) shall award grants’’;
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1 (B) by striking the period at the end and

2 inserting ‘‘; and’’; and

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

4 ‘‘(2) shall award a competitive grant to 1 addi5 tional research, training, and technical assistance

6 center to carry out the activities described in sub7 section (d).’’;

8 (2) in subsection (c), in the matter preceding

9 paragraph (1), by striking ‘‘grant or contract under

10 subsection (a)’’ and inserting ‘‘grant or contract

11 under subsection (a)(1)’’;

12 (3) in subsection (d)—

13 (A) by striking ‘‘APPROPRIATIONS.—For the

14 purpose of carrying out this section’’ and insert15 ing ‘‘APPROPRIATIONS.—

16 ‘‘(1) For the purpose of awarding grants or con17 tracts under subsection (a)(1)’’; and

18 (B) by adding at the end the following:

19 ‘‘(2) For the purpose of awarding a grant under

20 subsection (a)(2), there are authorized to be appro21 priated $3,000,000 for fiscal year 2005, $4,000,000

22 for fiscal year 2006, and $5,000,000 for fiscal year

23 2007.’’;

24 (4) by redesignating subsection (d) as subsection

25 (e); and
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1 (5) by inserting after subsection (c) the fol2 lowing:

3 ‘‘(d) ADDITIONAL CENTER.—The additional research,

4 training, and technical assistance center established under

5 subsection (a)(2) shall provide appropriate information,

6 training, and technical assistance to States, political sub7 divisions of a State, Federally recognized Indian tribes,

8 tribal organizations, institutions of higher education, public

9 organizations, or private nonprofit organizations for—

10 ‘‘(1) the development or continuation of state11 wide or tribal youth suicide early intervention and

12 prevention strategies;

13 ‘‘(2) ensuring the surveillance of youth suicide

14 early intervention and prevention strategies;

15 ‘‘(3) studying the costs and effectiveness of state16 wide youth suicide early intervention and prevention

17 strategies in order to provide information concerning

18 relevant issues of importance to State, tribal, and na19 tional policymakers;

20 ‘‘(4) further identifying and understanding

21 causes and associated risk factors for youth suicide;

22 ‘‘(5) analyzing the efficacy of new and existing

23 youth suicide early intervention techniques and tech24 nology;
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1 ‘‘(6) ensuring the surveillance of suicidal behav2 iors and nonfatal suicidal attempts;

3 ‘‘(7) studying the effectiveness of State-sponsored

4 statewide and tribal youth suicide early intervention

5 and prevention strategies on the overall wellness and

6 health promotion strategies related to suicide at7 tempts;

8 ‘‘(8) promoting the sharing of data regarding

9 youth suicide with Federal agencies involved with

10 youth suicide early intervention and prevention, and

11 State-sponsored statewide or tribal youth suicide

12 early intervention and prevention strategies for the

13 purpose of identifying previously unknown mental

14 health causes and associated risk factors for suicide in

15 youth;

16 ‘‘(9) evaluating and disseminating outcomes and

17 best practices of mental and behavioral health services

18 at institutions of higher education; and

19 ‘‘(10) other activities determined appropriate by

20 the Secretary.’’.

21 (b) SUICIDE PREVENTION FOR YOUTH.—Title V of the

22 Public Health Service Act (42 U.S.C. 290aa et seq.) is

23 amended—

24 (1) in section 520E (42 U.S.C. 290bb–36)—
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1 (A) in the section heading by striking

2 ‘‘CHILDREN AND ADOLESCENTS’’ and in3 serting ‘‘YOUTH’’;

4 (B) by striking subsection (a) and inserting

5 the following:

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

7 or cooperative agreements to public organizations, private

8 nonprofit organizations, political subdivisions, consortia of

9 political subdivisions, consortia of States, or Federally rec10 ognized Indian tribes or tribal organizations to design early

11 intervention and prevention strategies that will complement

12 the State-sponsored statewide or tribal youth suicide early

13 intervention and prevention strategies developed pursuant

14 to section 520E.’’;

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

16 ‘‘coordinated’’ and inserting ‘‘with the relevant

17 Department of Health and Human Services

18 agencies and suicide working groups.’’;

19 (D) in subsection (c)—

20 (i) in the matter preceding paragraph

21 (1), by striking ‘‘A State’’ and all that fol22 lows through ‘‘desiring’’ and inserting ‘‘A

23 public organization, private nonprofit orga24 nization, political subdivision, consortium

25 of political subdivisions, consortium of
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1 States, or federally recognized Indian tribe

2 or tribal organization desiring’’;

3 (ii) by redesignating paragraphs (1)

4 through (9) as paragraphs (2) through (10),

5 respectively;

6 (iii) by inserting before paragraph (2)

7 (as so redesignated) the following:

8 ‘‘(1)(A) comply with the State-sponsored state9 wide early intervention and prevention strategy as

10 developed under section 520E; and

11 ‘‘(B) in the case of a consortium of States, re12 ceive the support of all States involved;’’;

13 (iv) in paragraph (2) (as so redesig14 nated), by striking ‘‘children and adoles15 cents’’ and inserting ‘‘youth’’;

16 (v) in paragraph (3) (as so redesig17 nated), by striking ‘‘best evidence-based,’’;

18 (vi) in paragraph (4) (as so redesig19 nated), by striking ‘‘primary’’ and all that

20 follows and inserting ‘‘general, mental, and

21 behavioral health services, and substance

22 abuse services;’’;

23 (vii) in paragraph (5) (as so redesig24 nated), by striking ‘‘children and’’ and all

25 that follows and inserting ‘‘youth including
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1 the school systems, educational institutions,

2 juvenile justice system, substance abuse pro3 grams, mental health programs, foster care

4 systems, and community child and youth

5 support organizations;’’;

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

7 redesignated) and inserting the following:

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

9 with diverse linguistic and cultural backgrounds;’’;

10 and

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

12 redesignated) and inserting the following:

13 ‘‘(9) conduct annual self-evaluations of outcomes

14 and activities, including consulting with interested

15 families and advocacy organizations;’’;

16 (E) by striking subsection (d) and inserting

17 the following:

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

19 grant or cooperative agreement under this section shall be

20 used to supplement, and not supplant, Federal and non21 Federal funds available for carrying out the activities de22 scribed in this section. Applicants shall provide financial

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

24 (F) in subsection (e)—

25 (i) by striking ‘‘, contract,’’; and
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1 (ii) by inserting after ‘‘Secretary that

2 the’’ the following: ‘‘application complies

3 with the State-sponsored statewide early

4 intervention and prevention strategy as de5 veloped under section 520E and the’’;

6 (G) in subsection (f), by striking ‘‘, con7 tracts,’’;

8 (H) in subsection (g)—

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

10 follows through ‘‘organization receiving’’

11 and inserting ‘‘A public organization, pri12 vate nonprofit organization, political sub13 division, consortium of political subdivi14 sions, consortium of States, or Federally

15 recognized Indian tribe or tribal organiza16 tion receiving’’; and

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

18 such term appears;

19 (I) in subsection (h), by striking ‘‘, con20 tracts,’’;

21 (J) in subsection (i)—

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

23 follows through ‘‘organization receiving’’

24 and inserting ‘‘A public organization, pri25 vate nonprofit organization, political sub-
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1 division, consortium of political subdivi2 sions, consortium of States, or Federally

3 recognized Indian tribe or tribal organiza4 tion receiving’’; and

5 (ii) by striking ‘‘, contract,’’;

6 (K) in subsection (k), by striking ‘‘5 years’’

7 and inserting ‘‘3 years’’;

8 (L) in subsection (l)—

9 (i) in paragraph (2), by striking ‘‘21’’

10 and inserting ‘‘24’’; and

11 (ii) in paragraph (3), by striking

12 ‘‘which might have been’’;

13 (M) in subsection (m)—

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

15 and all that follows through ‘‘For’’ in para16 graph (1) and inserting ‘‘APPROPRIA17 TION.—For’’; and

18 (ii) by striking paragraph (2);

19 (N) by redesignating subsection (m) as sub20 section (n); and

21 (O) by inserting after subsection (l) the fol22 lowing:

23 ‘‘(m) DEFINITIONS.—In this section, the terms ‘early

24 intervention’, ‘educational institution’, ‘institution of high-
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1 er education’, ‘prevention’, ‘school’, and ‘youth’ have the

2 meanings given to those terms in section 520E.’’; and

3 (2) by redesignating section 520E as section

4 520E–1.

5 (c) YOUTH SUICIDE AND EARLY INTERVENTION AND

6 PREVENTION STRATEGIES.—Title V of the Public Health

7 Service Act (42 U.S.C. 290aa et seq.) is amended by insert8 ing before section 520E–1 (as redesignated by subsection

9 (b)) the following:

10 ‘‘SEC. 520E. YOUTH SUICIDE EARLY INTERVENTION AND

11 PREVENTION STRATEGIES.

12 ‘‘(a) IN GENERAL.—The Secretary, acting through the

13 Administrator of the Substance Abuse and Mental Health

14 Services Administration, shall award grants or cooperative

15 agreements to eligible entities to—

16 ‘‘(1) develop and implement State-sponsored

17 statewide or tribal youth suicide early intervention

18 and prevention strategies in schools, educational in19 stitutions, juvenile justice systems, substance abuse

20 programs, mental health programs, foster care sys21 tems, and other child and youth support organiza22 tions;

23 ‘‘(2) support public organizations and private

24 nonprofit organizations actively involved in State25 sponsored statewide or tribal youth suicide early
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1 intervention and prevention strategies and in the de2 velopment and continuation of State-sponsored state3 wide youth suicide early intervention and prevention

4 strategies;

5 ‘‘(3) provide grants to institutions of higher edu6 cation to coordinate the implementation of State7 sponsored statewide or tribal youth suicide early

8 intervention and prevention strategies;

9 ‘‘(4) collect and analyze data on State-sponsored

10 statewide or tribal youth suicide early intervention

11 and prevention services that can be used to monitor

12 the effectiveness of such services and for research, tech13 nical assistance, and policy development; and

14 ‘‘(5) assist eligible entities, through State-spon15 sored statewide or tribal youth suicide early interven16 tion and prevention strategies, in achieving targets

17 for youth suicide reductions under title V of the So18 cial Security Act.

19 ‘‘(b) ELIGIBLE ENTITY.—

20 ‘‘(1) DEFINITION.—In this section, the term ‘eli21 gible entity’ means—

22 ‘‘(A) a State;

23 ‘‘(B) a public organization or private non24 profit organization designated by a State to de25 velop or direct the State-sponsored statewide
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1 youth suicide early intervention and prevention

2 strategy; or

3 ‘‘(C) a Federally recognized Indian tribe or

4 tribal organization (as defined in the Indian

5 Self-Determination and Education Assistance

6 Act) or an urban Indian organization (as de7 fined in the Indian Health Care Improvement

8 Act) that is actively involved in the development

9 and continuation of a tribal youth suicide early

10 intervention and prevention strategy.

11 ‘‘(2) LIMITATION.—In carrying out this section,

12 the Secretary shall ensure that each State is awarded

13 only 1 grant or cooperative agreement under this sec14 tion. For purposes of the preceding sentence, a State

15 shall be considered to have been awarded a grant or

16 cooperative agreement if the eligible entity involved is

17 the State or an entity designated by the State under

18 paragraph (1)(B). Nothing in this paragraph shall be

19 construed to apply to entities described in paragraph

20 (1)(C).

21 ‘‘(c) PREFERENCE.—In providing assistance under a

22 grant or cooperative agreement under this section, an eligi23 ble entity shall give preference to public organizations, pri24 vate nonprofit organizations, political subdivisions, institu25 tions of higher education, and tribal organizations actively
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1 involved with the State-sponsored statewide or tribal youth

2 suicide early intervention and prevention strategy that—

3 ‘‘(1) provide early intervention and assessment

4 services, including screening programs, to youth who

5 are at risk for mental or emotional disorders that

6 may lead to a suicide attempt, and that are inte7 grated with school systems, educational institutions,

8 juvenile justice systems, substance abuse programs,

9 mental health programs, foster care systems, and

10 other child and youth support organizations;

11 ‘‘(2) demonstrate collaboration among early

12 intervention and prevention services or certify that

13 entities will engage in future collaboration;

14 ‘‘(3) employ or include in their applications a

15 commitment to evaluate youth suicide early interven16 tion and prevention practices and strategies adapted

17 to the local community;

18 ‘‘(4) provide timely referrals for appropriate

19 community-based mental health care and treatment of

20 youth who are at risk for suicide in child-serving set21 tings and agencies;

22 ‘‘(5) provide immediate support and information

23 resources to families of youth who are at risk for sui24 cide;
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1 ‘‘(6) offer access to services and care to youth

2 with diverse linguistic and cultural backgrounds;

3 ‘‘(7) offer appropriate postsuicide intervention

4 services, care, and information to families, friends,

5 schools, educational institutions, juvenile justice sys6 tems, substance abuse programs, mental health pro7 grams, foster care systems, and other child and youth

8 support organizations of youth who recently com9 pleted suicide;

10 ‘‘(8) offer continuous and up-to-date information

11 and awareness campaigns that target parents, family

12 members, child care professionals, community care

13 providers, and the general public and highlight the

14 risk factors associated with youth suicide and the life15 saving help and care available from early interven16 tion and prevention services;

17 ‘‘(9) ensure that information and awareness

18 campaigns on youth suicide risk factors, and early

19 intervention and prevention services, use effective

20 communication mechanisms that are targeted to and

21 reach youth, families, schools, educational institu22 tions, and youth organizations;

23 ‘‘(10) provide a timely response system to ensure

24 that child-serving professionals and providers are

25 properly trained in youth suicide early intervention
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1 and prevention strategies and that child-serving pro2 fessionals and providers involved in early interven3 tion and prevention services are properly trained in

4 effectively identifying youth who are at risk for sui5 cide;

6 ‘‘(11) provide continuous training activities for

7 child care professionals and community care pro8 viders on the latest youth suicide early intervention

9 and prevention services practices and strategies;

10 ‘‘(12) conduct annual self-evaluations of out11 comes and activities, including consulting with inter12 ested families and advocacy organizations;

13 ‘‘(13) provide services in areas or regions with

14 rates of youth suicide that exceed the national average

15 as determined by the Centers for Disease Control and

16 Prevention; and

17 ‘‘(14) obtain informed written consent from a

18 parent or legal guardian of an at-risk child before in19 volving the child in a youth suicide early intervention

20 and prevention program.

21 ‘‘(d) REQUIREMENT FOR DIRECT SERVICES.—Not less

22 than 85 percent of grant funds received under this section

23 shall be used to provide direct services, of which not less

24 than 5 percent shall be used for activities authorized under

25 subsection (a)(3).
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1 ‘‘(e) COORDINATION AND COLLABORATION.—

2 ‘‘(1) IN GENERAL.—In carrying out this section,

3 the Secretary shall collaborate with relevant Federal

4 agencies and suicide working groups responsible for

5 early intervention and prevention services relating to

6 youth suicide.

7 ‘‘(2) CONSULTATION.—In carrying out this sec8 tion, the Secretary shall consult with—

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

10 agencies responsible for early intervention and

11 prevention services under title XIX of the Social

12 Security Act, the State Children’s Health Insur13 ance Program under title XXI of the Social Se14 curity Act, and programs funded by grants

15 under title V of the Social Security Act;

16 ‘‘(B) local and national organizations that

17 serve youth at risk for suicide and their families;

18 ‘‘(C) relevant national medical and other

19 health and education specialty organizations;

20 ‘‘(D) youth who are at risk for suicide, who

21 have survived suicide attempts, or who are cur22 rently receiving care from early intervention

23 services;

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

25 at risk for suicide, who have survived suicide at-
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1 tempts, who are currently receiving care from

2 early intervention and prevention services, or

3 who have completed suicide;

4 ‘‘(F) qualified professionals who possess the

5 specialized knowledge, skills, experience, and rel6 evant attributes needed to serve youth at risk for

7 suicide and their families; and

8 ‘‘(G) third-party payers, managed care or9 ganizations, and related commercial industries.

10 ‘‘(3) POLICY DEVELOPMENT.—In carrying out

11 this section, the Secretary shall—

12 ‘‘(A) coordinate and collaborate on policy

13 development at the Federal level with the rel14 evant Department of Health and Human Serv15 ices agencies and suicide working groups; and

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

17 Federal level with the private sector, including

18 consumer, medical, suicide prevention advocacy

19 groups, and other health and education profes20 sional-based organizations, with respect to State21 sponsored statewide or tribal youth suicide early

22 intervention and prevention strategies.

23 ‘‘(f) RULE OF CONSTRUCTION; RELIGIOUS AND MORAL

24 ACCOMMODATION.—Nothing in this section shall be con25 strued to require suicide assessment, early intervention, or
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1 treatment services for youth whose parents or legal guard2 ians object based on the parents’ or legal guardians’ reli3 gious beliefs or moral objections.

4 ‘‘(g) EVALUATIONS AND REPORT.—

5 ‘‘(1) EVALUATIONS BY ELIGIBLE ENTITIES.—Not

6 later than 18 months after receiving a grant or coop7 erative agreement under this section, an eligible enti8 ty shall submit to the Secretary the results of an eval9 uation to be conducted by the entity concerning the

10 effectiveness of the activities carried out under the

11 grant or agreement.

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

13 date of enactment of this section, the Secretary shall

14 submit to the appropriate committees of Congress a

15 report concerning the results of—

16 ‘‘(A) the evaluations conducted under para17 graph (1); and

18 ‘‘(B) an evaluation conducted by the Sec19 retary to analyze the effectiveness and efficacy of

20 the activities conducted with grants, collabora21 tions, and consultations under this section.

22 ‘‘(h) RULE OF CONSTRUCTION; STUDENT MEDICA23 TION.—Nothing in this section or section 520E–1 shall be

24 construed to allow school personnel to require that a student
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1 obtain any medication as a condition of attending school

2 or receiving services.

3 ‘‘(i) PROHIBITION.—Funds appropriated to carry out

4 this section, section 520C, section 520E–1, or section 520E–

5 2 shall not be used to pay for or refer for abortion.

6 ‘‘(j) PARENTAL CONSENT.—States and entities receiv7 ing funding under this section and section 520E–1 shall

8 obtain prior written, informed consent from the child’s par9 ent or legal guardian for assessment services, school-spon10 sored programs, and treatment involving medication re11 lated to youth suicide conducted in elementary and sec12 ondary schools. The requirement of the preceding sentence

13 does not apply in the following cases:

14 ‘‘(1) In an emergency, where it is necessary to

15 protect the immediate health and safety of the student

16 or other students.

17 ‘‘(2) Other instances, as defined by the State,

18 where parental consent cannot reasonably be obtained.

19 ‘‘(k) RELATION TO EDUCATION PROVISIONS.—Nothing

20 in this section or section 520E–1 shall be construed to su21 persede section 444 of the General Education Provisions

22 Act, including the requirement of prior parental consent for

23 the disclosure of any education records. Nothing in this sec24 tion or section 520E-1 shall be construed to modify or affect

25 parental notification requirements for programs authorized
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1 under the Elementary and Secondary Education Act of

2 1965 (as amended by the No Child Left Behind Act of 2001;

3 Public Law 107–110).

4 ‘‘(l) DEFINITIONS.—In this section:

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

6 intervention’ means a strategy or approach that is in7 tended to prevent an outcome or to alter the course of

8 an existing condition.

9 ‘‘(2) EDUCATIONAL INSTITUTION; INSTITUTION

10 OF HIGHER EDUCATION; SCHOOL.—The term—

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

12 school or institution of higher education;

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

14 the meaning given such term in section 101 of

15 the Higher Education Act of 1965; and

16 ‘‘(C) ‘school’ means an elementary or sec17 ondary school (as such terms are defined in sec18 tion 9101 of the Elementary and Secondary

19 Education Act of 1965).

20 ‘‘(3) PREVENTION.—The term ‘prevention’ means

21 a strategy or approach that reduces the likelihood or

22 risk of onset, or delays the onset, of adverse health

23 problems that have been known to lead to suicide.

24 ‘‘(4) YOUTH.—The term ‘youth’ means individ25 uals who are between 10 and 24 years of age.
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1 ‘‘(m) AUTHORIZATION OF APPROPRIATIONS.—

2 ‘‘(1) IN GENERAL.—For the purpose of carrying

3 out this section, there are authorized to be appro4 priated $7,000,000 for fiscal year 2005, $18,000,000

5 for fiscal year 2006, and $30,000,000 for fiscal year

6 2007.

7 ‘‘(2) PREFERENCE.—If less than $3,500,000 is

8 appropriated for any fiscal year to carry out this sec9 tion, in awarding grants and cooperative agreements

10 under this section during the fiscal year, the Sec11 retary shall give preference to States that have rates

12 of suicide that significantly exceed the national aver13 age as determined by the Centers for Disease Control

14 and Prevention.’’.

15 (d) MENTAL AND BEHAVIORAL HEALTH SERVICES ON

16 CAMPUS.—Title V of the Public Health Service Act (42

17 U.S.C. 290aa et seq.) is amended by inserting after section

18 520E–1 (as redesignated by subsection (b)) the following:

19 ‘‘SEC. 520E–2. MENTAL AND BEHAVIORAL HEALTH SERVICES

20 ON CAMPUS.

21 ‘‘(a) IN GENERAL.—The Secretary, acting through the

22 Director of the Center for Mental Health Services, in con23 sultation with the Secretary of Education, may award

24 grants on a competitive basis to institutions of higher edu25 cation to enhance services for students with mental and be-
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1 havioral health problems that can lead to school failure,

2 such as depression, substance abuse, and suicide attempts,

3 so that students will successfully complete their studies.

4 ‘‘(b) USE OF FUNDS.—The Secretary may not make

5 a grant to an institution of higher education under this

6 section unless the institution agrees to use the grant only

7 for—

8 ‘‘(1) educational seminars;

9 ‘‘(2) the operation of hot lines;

10 ‘‘(3) preparation of informational material;

11 ‘‘(4) preparation of educational materials for

12 families of students to increase awareness of potential

13 mental and behavioral health issues of students en14 rolled at the institution of higher education;

15 ‘‘(5) training programs for students and campus

16 personnel to respond effectively to students with men17 tal and behavioral health problems that can lead to

18 school failure, such as depression, substance abuse,

19 and suicide attempts; or

20 ‘‘(6) the creation of a networking infrastructure

21 to link colleges and universities that do not have men22 tal health services with health care providers who can

23 treat mental and behavioral health problems.
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1 ‘‘(c) ELIGIBLE GRANT RECIPIENTS.—Any institution

2 of higher education receiving a grant under this section

3 may carry out activities under the grant through—

4 ‘‘(1) college counseling centers;

5 ‘‘(2) college and university psychological service

6 centers;

7 ‘‘(3) mental health centers;

8 ‘‘(4) psychology training clinics; or

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

10 evidence-based, mental health and substance abuse

11 programs.

12 ‘‘(d) APPLICATION.—An institution of higher edu13 cation desiring a grant under this section shall prepare and

14 submit an application to the Secretary at such time and

15 in such manner as the Secretary may require. At a min16 imum, the application shall include the following:

17 ‘‘(1) A description of identified mental and be18 havioral health needs of students at the institution of

19 higher education.

20 ‘‘(2) A description of Federal, State, local, pri21 vate, and institutional resources currently available

22 to address the needs described in paragraph (1) at the

23 institution of higher education.

24 ‘‘(3) A description of the outreach strategies of

25 the institution of higher education for promoting ac-
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1 cess to services, including a proposed plan for reach2 ing those students most in need of mental health serv3 ices.

4 ‘‘(4) A plan to evaluate program outcomes, in5 cluding a description of the proposed use of funds, the

6 program objectives, and how the objectives will be met.

7 ‘‘(5) An assurance that the institution will sub8 mit a report to the Secretary each fiscal year on the

9 activities carried out with the grant and the results

10 achieved through those activities.

11 ‘‘(e) REQUIREMENT OF MATCHING FUNDS.—

12 ‘‘(1) IN GENERAL.—The Secretary may make a

13 grant under this section to an institution of higher

14 education only if the institution agrees to make avail15 able (directly or through donations from public or

16 private entities) non-Federal contributions in an

17 amount that is not less than $1 for each $1 of Federal

18 funds provided in the grant, toward the costs of ac19 tivities carried out with the grant (as described in

20 subsection (b)) and other activities by the institution

21 to reduce student mental and behavioral health prob22 lems.

23 ‘‘(2) DETERMINATION OF AMOUNT CONTRIB24 UTED.—Non-Federal contributions required under

25 paragraph (1) may be in cash or in kind. Amounts
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1 provided by the Federal Government, or services as2 sisted or subsidized to any significant extent by the

3 Federal Government, may not be included in deter4 mining the amount of such non-Federal contributions.

5 ‘‘(3) WAIVER.—The Secretary may waive the re6 quirement established in paragraph (1) with respect

7 to an institution of higher education if the Secretary

8 determines that extraordinary need at the institution

9 justifies the waiver.

10 ‘‘(f) REPORTS.—For each fiscal year that grants are

11 awarded under this section, the Secretary shall conduct a

12 study on the results of the grants and submit to the Congress

13 a report on such results that includes the following:

14 ‘‘(1) An evaluation of the grant program out15 comes, including a summary of activities carried out

16 with the grant and the results achieved through those

17 activities.

18 ‘‘(2) Recommendations on how to improve access

19 to mental and behavioral health services at institu20 tions of higher education, including efforts to reduce

21 the incidence of suicide and substance abuse.

22 ‘‘(g) DEFINITION.—In this section, the term ‘institu23 tion of higher education’ has the meaning given such term

24 in section 101 of the Higher Education Act of 1965.
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1 ‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—For the

2 purpose of carrying out this section, there are authorized

3 to be appropriated $5,000,000 for fiscal year 2005,

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

5 year 2007.’’.
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Amend the title so as to read: ‘‘A bill 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 authorize grants to institutions of higher education to reduce student mental and behavioral

health problems, and for other purposes.’’.

Attest:

Clerk.