I 

108TH CONGRESS 

1ST SESSION H. R. 811

To authorize the Secretary of Health and Human Services to make demonstration grants to promote the well-being and educational achievement 

of children through school-based health programs. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 13, 2003

Ms. EDDIE BERNICE JOHNSON of Texas (for herself, Mr. CUMMINGS, Ms. 

DELAURO, Mr. DAVIS of Illinois, Mr. SESSIONS, and Mr. CRANE) introduced the following bill; which was referred to the Committee on Energy 

and Commerce, and in addition to the Committee on Education and the 

Workforce, for a period to be subsequently determined by the Speaker, 

in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 

A BILL

To authorize the Secretary of Health and Human Services 

to make demonstration grants to promote the well-being 

and educational achievement of children through schoolbased health programs.

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 ‘‘Student Medical Ac5 cess Raising Test Scores Health Act’’, or the ‘‘SMARTS 

6 Health Act’’. 
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1 SEC. 2. FINDINGS. 

2 The Congress finds as follows: 

3 (1) The Journal of the American Medical Asso4 ciation reports that protecting children’s health re5 quires two key elements, which are (A) that a caring 

6 adult is engaged in the life of the child, and (B) that 

7 there is a connection between the child and his or 

8 her school. 

9 (2) Schools offer the most natural community 

10 setting in which individuals live, work, and play. 

11 Schools are a respected element of community infra12 structure and are recognized as the most valuable 

13 element in creating connection and support for chil14 dren, families, and communities. 

15 (3) Primary care and behavioral health services 

16 are among the most important elements of a com17 prehensive approach to promoting health and edu18 cation and preventing illness in children and youth. 

19 (4) School safety and violence prevention are 

20 critical to the well-being of each student, and early 

21 intervention and mental health care significantly re22 duce school discipline problems. 

23 (5) Good health is a prerequisite for optimal 

24 learning, and schools can help students achieve aca25 demic success by participating in efforts that pro-
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1 mote good health, including access to regular med2 ical and mental health care. 

3 (6) Children are experiencing increasing rates 

4 of behavioral and physical illness, such as attention 

5 deficit hyperactivity disorder (ADHD) and asthma 

6 and diabetes, and are experiencing increasing rates 

7 of obesity that portend increasing rates of diabetes, 

8 heart disease, and cancer later in life. 

9 (7) In order to be effective, new strategies for 

10 prevention must be built on community-based, com11 munity-designed, and community-implemented strat12 egies. 

13 (8) Effective behavioral and physical health 

14 services can be provided in a school-based setting in 

15 such a way as to prevent later disease. 

16 (9) Schools are ideal settings in which to pro17 vide care for children, especially those who would 

18 otherwise have inadequate access to health services. 

19 Limited access contributes directly to the growing 

20 rates of disease among children. Prevention strate21 gies should be joined with treatment to develop an 

22 understanding of what types of prevention can re23 duce rates of illness, and therefore the need for 

24 treatment. Higher rates of disease, even with ade-
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1 quate access to health services, portend loss of vital2 ity and higher complications from disease. 

3 (10) School-based health programs should focus 

4 on improving behavioral and physical health, includ5 ing with respect to obesity. 

6 (11) By reducing the incidence of disease, effec7 tive community-based prevention programs (whether 

8 through school-based approaches or otherwise) result 

9 in significant savings to the Federal Government 

10 and to the States by reducing expenditures in Fed11 eral and State health services programs. Such sav12 ings should be dedicated to further prevention ef13 forts, which in turn will result in further savings. 

14 Savings that result from prevention programs should 

15 not be redirected to unrelated purposes, and preven16 tion programs that achieve savings should not be pe17 nalized by having their funding levels reduced. 

18 SEC. 3. DEMONSTRATION GRANTS FOR EXPANSION OF 

19 SCHOOL-BASED HEALTH PROGRAMS. 

20 (a) IN GENERAL.—

21 (1) PROGRAM OF GRANTS.—The Secretary of 

22 Health and Human Services may make demonstra23 tion grants to eligible entities for the purpose of ex24 panding school-based health programs that are oper25 ated by such entities. 
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1 (2) CONSULTATION.—The Secretary shall co2 ordinate the program under this section with the 

3 program under title XIX of the Social Security Act 

4 (relating to Medicaid); the program under title XXI 

5 of such Act (relating to the State children’s health 

6 insurance program); programs of the Substance 

7 Abuse and Mental Health Services Administration; 

8 programs of the Health Resources and Services Ad9 ministration; programs of the Centers for Disease 

10 Control and Prevention; programs of the Agency for 

11 Healthcare Research and Quality; programs of the 

12 National Institutes of Health; and the National Cen13 ter on Minority Health and Health Disparities. 

14 (b) ELIGIBLE ENTITIES.—An entity is an eligible en15 tity for purposes of this Act if—

16 (1) the entity is a public or nonprofit private in17 stitution of higher education or a local educational 

18 agency; 

19 (2) the entity operates a school-based health 

20 program; 

21 (3) the health services provided by such pro22 gram include preventive health services and behav23 ioral health services, including with respect to nutri24 tion, physical activity, and otherwise preventing or 

25 treating obesity; and 
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1 (4) such program is carried out in coordination 

2 with public and nonprofit private entities in the com3 munity involved that provide health, education, or 

4 social services to children. 

5 (c) CERTAIN PROGRAMS.—Grants under subsection 

6 (a) shall be made only to the following entities (subject 

7 to the submission of an application in accordance with 

8 subsection (d) demonstrating status as an eligible entity), 

9 and for the following purposes: 

10 (1) To the University of Maryland for expand11 ing the school-based health program operated by 

12 such University in the vicinity of Baltimore, in the 

13 State of Maryland. 

14 (2) To the local educational agency that oper15 ates a school-based health program in an inde16 pendent school district in the vicinity of Dallas, in 

17 the State of Texas, for expanding such program. 

18 (3) To the University of New Mexico for ex19 panding the school-based health program operated 

20 by such University in the State of New Mexico. 

21 (4) To the University of California, Los Ange22 les, for expanding the school-based health program 

23 operated by such University in the vicinity of Los 

24 Angeles, in the State of California. 
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1 (5) To the Child Study Center Outpatient Clin2 ic, Yale University, for expanding the school-based 

3 health program operated by such Center in the vicin4 ity of New Haven, in the State of Connecticut. 

5 (6) To the University of Illinois at Chicago, for 

6 expanding the school-based health program operated 

7 by such University in the vicinity of Chicago, in the 

8 State of Illinois. 

9 (d) APPLICATION FOR GRANT.—A grant may be 

10 made under subsection (a) only if an application for the 

11 grant is submitted to the Secretary and the application 

12 is in such form, is made in such manner, and contains 

13 such agreements, assurances, and information as the sec14 retary determines to be necessary to carry out this section. 

15 (e) OUTCOME GOALS.—In making a grant under sub16 section (a) for a school-based health program, the Sec17 retary shall establish goals for the program in terms of 

18 health outcomes for the children served by the program. 

19 Such goals shall be based on the objectives established by 

20 the Secretary as part of the initiative known as Healthy 

21 People 2010, or on other measures determined by the Sec22 retary to be appropriate. 

23 (f) EVALUATIONS; REPORT.—

24 (1) EVALUATIONS.—The Secretary, directly or 

25 through grants or contracts, shall provide for evalua-
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1 tions of the school-based programs for which grants 

2 under subsection (a) are made. Such evaluations 

3 shall determine whether the programs have met the 

4 applicable goals under subsection (e), and shall de5 termine the extent to which the programs have in6 creased the access of the children involved to health 

7 services, have enhanced the overall health status of 

8 the children, and have reduced disease rates. 

9 (2) REPORT.—Not later than December 31, 

10 2004, the Secretary shall submit to the Congress a 

11 report that describes the findings made through 

12 evaluations under paragraph (1) and that provides 

13 the recommendations of the Secretary for a com14 prehensive national program to provide grants for 

15 the establishment and operation of school-based 

16 health programs, including a recommendation on the 

17 amount of funds that should be made available for 

18 the comprehensive national program, taking into ac19 count the savings that can be achieved in Federal 

20 and State health services programs by reducing the 

21 incidence of disease in the populations served by the 

22 program. 

23 (g) DEFINITIONS.—
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1 (1) The term ‘‘institution of higher education’’ 

2 has the meaning given such term in section 101(a) 

3 of the Higher Education Act of 1965. 

4 (2) The term ‘‘local educational agency’’ has 

5 the meaning given such term in section 9101(26) of 

6 the Elementary and Secondary Education Act of 

7 1965. 

8 (3) The term ‘‘Secretary’’ means the Secretary 

9 of Health and Human Services. 

10 (h) AUTHORIZATION OF APPROPRIATIONS.—For the 

11 purpose of carrying out this section, there are authorized 

12 to be appropriated such sums as may be necessary for 

13 each of the fiscal years 2003 through 2008.

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