I 

108TH CONGRESS 

1ST SESSION H. R. 81

To amend the Public Health Service Act with respect to mental health 

services for children, adolescents and their families. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 7, 2003

Ms. JACKSON-LEE of Texas introduced the following bill; which was referred 

to the Committee on Energy and Commerce 

A BILL

To amend the Public Health Service Act with respect to 

mental health services for children, adolescents and their 

families.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,
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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Give a Kid a Chance 

3 Omnibus Mental Health Services Act of 2003’’. 

4 SEC. 2. FINDINGS. 

5 The Congress finds as follows: 

6 (1) At least one in five children and adolescents 

7 has a diagnosable mental, emotional, or behavioral 

8 problem that can lead to school failure, alcohol or 

9 other drug use, violence, or suicide. Mental disorders 

10 that begin early in life have a strong effect on future 

11 educational success. Adolescent emotional problems 

12 may increase the likelihood of risk-taking behaviors, 

13 including gun violence, drug abuse, reckless driving, 

14 and early sexual activity. 

15 (2) From a public health promotion/disease pre16 vention perspective, it is noteworthy that children 

17 and adolescents with mental illnesses often don’t be18 come substance abusers until 5 to 10 years after the 

19 mental illness becomes apparent. This creates a win20 dow of opportunity during which time it may be pos21 sible to prevent substance abuse from occurring in 

22 these children. 

23 (3) The interaction of multiple factors has in24 creased the overall number of children suffering 

25 from psychological, emotional and behavioral dis26 orders. Children as a group suffer from poverty at 
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1 a higher rate than all other age groups. More than 

2 one in three children are raised in single-parent 

3 households. Children over the age of 10 years are 

4 frequently caring for themselves after school and 

5 sometimes into the evening before their parents or 

6 other caregivers arrive. These factors create greater 

7 problems with children’s emotional development. 

8 (4) The combination of witnessing and experi9 encing traumatic events, poverty, alienation, and 

10 multiple environmental and family factors including 

11 abuse and neglect, creates greater psychological ne12 glect and social isolation, further contributing to 

13 various mental health problems. The combination of 

14 these factors in an emotionally unhealthy climate 

15 combined with the availability of firearms can 

16 produce deadly results. 

17 (5) In many urban, poor and predominantly mi18 nority communities, young children are chronically 

19 exposed to serious violent crime during their forma20 tive years. It is the recent school violence in subur21 ban and rural communities that has increased 

22 awareness about the prevalence of violence in the 

23 lives of America’s children. Increasingly, in the 

24 home, community and at school, children are af-
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1 fected by or involved in theft, vandalism, bullying, 

2 intimidation, intolerance, and disruption. 

3 (6) While the above behaviors are symptomatic 

4 of mental health problems requiring service interven5 tions, most children with mental health problems are 

6 not violent to others. They are more likely than their 

7 peers to be the recipients of intimidation and vio8 lence, and are the largest, most neglected group of 

9 children suffering from serious illness or disability. 

10 (7) Only one in five children with a serious 

11 emotional disturbance receive mental health specialty 

12 services, although twice as many such children re13 ceive some form of mental health intervention. Thus, 

14 about 75 to 80 percent fail to receive specialty serv15 ices, and the majority of these children fail to re16 ceive any services at all. 

17 (8) Mental health is indispensable to personal 

18 well-being, family and interpersonal relationships, 

19 and contribution to community or society. From 

20 early childhood until death, mental health is the 

21 basis for thinking and communication skills, learn22 ing, emotional growth, resilience, and self-esteem. 

23 (9) Mental, emotional, and behavioral disorders 

24 lead to irregular school attendance, difficulty with
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1 concentration, focus, and motivation to learn basic 

2 academic fundamentals. 

3 (10) Prevention programs, early intervention, 

4 help from the faith-based community, and mental 

5 health services in the family, school, and community 

6 setting have proven successful and cost-effective 

7 using both school and community resources for re8 ducing the neglected tragedy of mental, emotional 

9 and behavioral problems among youth. 

10 (11) Mental health services personnel can pro11 vide consultation with teachers to improve classroom 

12 environment and provide guidance around specific 

13 children. Consulting with parents, they enable teach14 ers and families to work together, increasing the 

15 family’s involvement in their child’s academic per16 formance and psychosocial development. 

17 (12) The lack of mental health services in 

18 schools and communities where the greatest need ex19 ists has resulted in a disproportionate increase in 

20 children dropping out of school, becoming involved in 

21 delinquent activity, and becoming part of the juve22 nile and adult criminal justice systems. In fact, be23 cause of the lack of intervention and mental health 

24 services, more children are being certified to be tried 

25 as adults and are being subjected to incarceration in 
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1 the juvenile or adult criminal justice systems. These 

2 issues impact especially minority populations and 

3 those living in poverty. 

4 (13) Little effort has previously been directed 

5 toward promoting the development of mental health, 

6 recognizing signs of early problems and providing 

7 early intervention to ameliorate these problems. 

8 SEC. 3. MENTAL HEALTH SERVICES FOR CHILDREN, ADO9 LESCENTS AND THEIR FAMILIES. 

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

11 290aa et seq.) is amended by inserting after section 520A 

12 the following section: 

13 ‘‘SEC. 520B. MENTAL HEALTH SERVICES FOR CHILDREN, 

14 ADOLESCENTS AND THEIR FAMILIES. 

15 ‘‘(a) IN GENERAL.—In cooperation with the Sec16 retary of Education, the Secretary of Health and Human 

17 Services shall support either directly or through grants, 

18 contracts or cooperative agreements with public entities 

19 programs to promote mental health among all children, 

20 from birth through adolescence, and their families and to 

21 provide early intervention services to ameliorate identified 

22 mental health problems in children and adolescents. 

23 ‘‘(b) EQUITABLE DISTRIBUTION OF GRANTS.—The 

24 Secretary shall provide for an equitable distribution of 
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1 grants by region, to include urban, suburban and rural 

2 regions, including Native American communities. 

3 ‘‘(c) PRIORITY.—The Secretary shall give priority to 

4 those applicants who—

5 ‘‘(1) provide a comprehensive, community6 based, culturally competent and developmentally ap7 propriate prevention and early intervention program 

8 that provides for the identification of early mental 

9 health problems and promotes the mental health and 

10 enhances the resiliency of children from birth 

11 through adolescence and their families; 

12 ‘‘(2) incorporate families, schools and commu13 nities in an integral role in the program; 

14 ‘‘(3) coordinate behavioral health care services, 

15 interventions, and supports in traditional and non16 traditional settings and provides a continuum of care 

17 for children from birth through adolescence and 

18 their families; 

19 ‘‘(4) provide public health education to improve 

20 the public’s understanding of healthy emotional de21 velopment; 

22 ‘‘(5) provide training, technical assistance, con23 sultation, and support for community service pro24 viders, school personnel, families and children to
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1 promote healthy emotional development and enhance 

2 resiliency in children from birth through adolescence; 

3 ‘‘(6) increase the resources available to such 

4 programs and provide for their sustainability by re5 quiring a commitment on the part of local commu6 nities in which the programs provide services; 

7 ‘‘(7) provide for the evaluation of programs op8 erating under this section to ensure that they are 

9 providing intended services in an efficient and effec10 tive manner; and 

11 ‘‘(8) provide school-based mental health assess12 ment and treatment services conducted by a mental 

13 health professional (who may be a school counselor, 

14 school nurse, school psychologist, clinical psycholo15 gist, or school social worker) in public elementary or 

16 secondary schools. 

17 ‘‘(d) MATCHING REQUIREMENT.—A condition for an 

18 award under subsection (a) is that the entity involved 

19 agree that the entity will, with respect to the costs to be 

20 incurred by the entity in carrying out the purpose de21 scribed in such subsection, make available (directly or 

22 through donations from public or private entities) non23 Federal contributions toward such costs in an amount that 

24 is not less than $2 for each $3 of Federal funds provided 

25 in the award. 
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1 ‘‘(e) DURATIONS OF GRANTS.—With respect to an 

2 award under subsection (a), the period during which pay3 ments under such award are made to the recipient may 

4 not exceed 5 years. 

5 ‘‘(f) EVALUATION.—The Secretary shall ensure that 

6 entities receiving awards under subsection (a) carry out 

7 an evaluation of the project which will include the effec8 tiveness of program strategies, and short, intermediate, 

9 and long-term outcomes including the program’s overall 

10 impact on strengthening families with young children and 

11 creating environments in home, school, and community 

12 settings that promote healthy emotional development and 

13 reduce incipient mental health and substance abuse prob14 lems. Local educational agencies receiving such grants 

15 shall ensure that the schools receiving these funds main16 tain an average ratio of one certified or licensed—

17 ‘‘(1) school counselor for every 250 students; 

18 ‘‘(2) school nurse for every 700 students; 

19 ‘‘(3) school psychologist for every 1000 stu20 dents; and 

21 ‘‘(4) school social worker for every 800 stu22 dents. 

23 ‘‘(g) DEFINITIONS.—For purposes of this section: 

24 ‘‘(1) The term ‘mental health’ means a state of 

25 successful performance of mental function, resulting 
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1 in productive activities, fulfilling relationships with 

2 other people, and the ability to adapt to change and 

3 cope with adversity. 

4 ‘‘(2) The term ‘mental illness’ refers to all 

5 diagnosable mental disorders (health conditions 

6 characterized by alterations in thinking, mood, or 

7 behavior or some combination thereof) associated 

8 with distress or impaired functioning or both. 

9 ‘‘(3) The term ‘mental health problems’ refers 

10 to symptoms of insufficient intensity or duration to 

11 meet the criteria for any mental disorder. 

12 ‘‘(4)(A) The term ‘mental health professionals’ 

13 refers to qualified counselors, nurses, psychologists, 

14 and social workers. 

15 ‘‘(B) The terms ‘school counselor’, ‘school 

16 nurse’, ‘school psychologist’, and ‘school social work17 er’ mean an individual who possesses licensure or 

18 certification in the State involved, and who meets 

19 professional standards for practice in schools and re20 lated settings, as a school counselor, school nurse, 

21 school psychologist, or school social worker, respec22 tively. 

23 ‘‘(5) The term ‘public entity’ means any State, 

24 any political subdivision of a State, including any 

25 local educational agency, and any Indian tribe or 
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1 tribal organization (as defined in section 4(b) and 

2 section 4(c) of the Indian Self-Determination and 

3 Education Assistance Act). 

4 ‘‘(h) AUTHORIZATION OF APPROPRIATION.—There 

5 are authorized to be appropriated to carry out this section 

6 $100,000,000 for fiscal year 2004 and such sums as are 

7 necessary for fiscal years 2005 and 2006. These funds are 

8 authorized to be used to carry out the provision of this 

9 section and cannot be utilized to supplement or supplant 

10 funding provided for other mental health services pro11 grams.’’.

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