I 
111TH CONGRESS 
1ST SESSION H. R. 2531 
To amend the Public Health Service Act to revise and extend projects relating 
to children and violence to provide access to school-based comprehensive 
mental health programs. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 20, 2009 
Mrs. NAPOLITANO (for herself, Ms. DEGETTE, Mr. TIM MURPHY of Pennsyl-
vania, Mr. FRANK of Massachusetts, Ms. BORDALLO, Ms. ROYBAL-AL-
LARD, Mr. COSTELLO, Mrs. BONO MACK, Mr. BISHOP of Georgia, Mr. 
KENNEDY, Mr. SERRANO, Ms. EDDIE BERNICE JOHNSON of Texas, Ms. 
BALDWIN, Mr. OLVER, Mr. BACA, Mr. MCGOVERN, Mrs. CHRISTENSEN, 
Mr. RODRIGUEZ, Mr. GENE GREEN of Texas, Mr. SESTAK, and Mrs. 
CAPPS) introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce 
A BILL 
To amend the Public Health Service Act to revise and extend 
projects relating to children and violence to provide ac-
cess to school-based comprehensive mental health pro-
grams. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Mental Health in 
Schools Act of 2009’’. 
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SEC. 2. FINDINGS. 
Congress makes the following findings: 
(1) Approximately 1 in 5 children have a 
diagnosable mental disorder. 
(2) Approximately 1 in 10 children have a seri-
ous emotional or behavioral disorder that is severe 
enough to cause substantial impairment in func-
tioning at home, at school, or in the community. It 
is estimated that about 75 percent of children with 
emotional and behavioral disorders do not receive 
specialty mental health services. 
(3) Only half of schools across the United 
States report having formal partnerships with com-
munity mental health providers to deliver mental 
health services. 
(4) If a school is going to respond to the mental 
health needs of its students, it must have access to 
resources that provide family-centered, culturally 
and linguistically appropriate supports and services. 
(5) Effective school mental health programs re-
flect the collaboration and commitment of families, 
students, educators, and other community partners. 
(6) Many schools have school-employed mental 
health providers supporting student’s social, emo-
tional, and behavioral health needs in schools. The 
most common types of staff providing mental health 
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services in schools were school counselors, followed 
by school nurses, school psychologists and school so-
cial workers. Three-quarters of schools had at least 
one school counselor on staff, over two-thirds had a 
school psychologist or school nurse, and 44 percent 
had a school social worker. 
(7) Although it is well recognized that mental 
health directly affects children’s learning and devel-
opment, in a recent study one-third of school dis-
tricts reported decreased funding for school mental 
health services, and at the same time two-thirds of 
school districts reported increased need for such 
services. 
SEC. 3. PURPOSES. 
It is the purpose of this Act to— 
(1) revise, increase funding for, and expand the 
scope of the Safe Schools-Healthy Students program 
in order to provide access to more comprehensive 
school-based mental health services and supports; 
(2) provide for comprehensive staff development 
for school and community service personnel working 
in the school; and 
(3) provide for comprehensive training for chil-
dren with mental health disorders, for parents, sib-
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lings, and other family members of such children, 
and for concerned members of the community. 
SEC. 4. AMENDMENTS TO THE PUBLIC HEALTH SERVICE 
ACT. 
(a) TECHNICAL AMENDMENTS.—The second part G 
(relating to services provided through religious organiza-
tions) of title V of the Public Health Service Act (42 
U.S.C. 290kk et seq.) is amended— 
(1) by redesignating such part as part J; and 
(2) by redesignating sections 581 through 584 
as sections 596 through 596C, respectively. 
(b) SCHOOL-BASED MENTAL HEALTH AND CHIL-
DREN AND VIOLENCE.—Section 581 of the Public Health 
Service Act (42 U.S.C. 290hh) is amended to read as fol-
lows: 
‘‘SEC. 581. SCHOOL-BASED MENTAL HEALTH AND CHIL-
DREN AND VIOLENCE. 
‘‘(a) IN GENERAL.—The Secretary, in collaboration 
with the Secretary of Education and in consultation with 
the Attorney General, shall, directly or through grants, 
contracts, or cooperative agreements awarded to public en-
tities and local education agencies, assist local commu-
nities and schools in applying a public health approach 
to mental health services both in schools and in the com-
munity. Such approach should provide comprehensive age 
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appropriate services and supports, be linguistically and 
culturally appropriate, and incorporate age appropriate 
strategies of positive behavioral interventions and sup-
ports. A comprehensive school mental health program 
funded under this section shall assist children in dealing 
with violence. 
‘‘(b) ACTIVITIES.—Under the program under sub-
section (a), the Secretary may— 
‘‘(1) provide financial support to enable local 
communities to implement a comprehensive cul-
turally and linguistically appropriate, and age-appro-
priate, school mental health program that incor-
porates positive behavioral interventions and sup-
ports to foster the health and development of chil-
dren; 
‘‘(2) provide technical assistance to local com-
munities with respect to the development of pro-
grams described in paragraph (1); 
‘‘(3) provide assistance to local communities in 
the development of policies to address child and ado-
lescent mental health issues and violence when and 
if it occurs; 
‘‘(4) facilitate community partnerships among 
families, students, law enforcement agencies, edu-
cation systems, mental health and substance use dis-
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order service systems, family-based mental health 
service systems, welfare agencies, health care service 
systems, and other community-based systems; and 
‘‘(5) establish mechanisms for children and ado-
lescents to report incidents of violence or plans by 
other children or adolescents to commit violence. 
‘‘(c) REQUIREMENTS.— 
‘‘(1) IN GENERAL.—To be eligible for a grant, 
contract, or cooperative agreement under subsection 
(a), an entity shall— 
‘‘(A) be a partnership between a local edu-
cation agency and at least one community pro-
gram or agency that is involved in mental 
health; and 
‘‘(B) submit an application, that is en-
dorsed by all members of the partnership, that 
contains the assurances described in paragraph 
(2). 
‘‘(2) REQUIRED ASSURANCES.—An application 
under paragraph (1) shall contain assurances as fol-
lows: 
‘‘(A) That the applicant will ensure that, 
in carrying out activities under this section, the 
local educational agency involved will enter into 
a memorandum of understanding— 
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‘‘(i) with, at a minimum, public or 
private mental health entities, health care 
entities, law enforcement or juvenile justice 
entities, child welfare agencies, family- 
based mental health entities, families and 
family organizations, and other commu-
nity-based entities; and 
‘‘(ii) that clearly states— 
‘‘(I) the responsibilities of each 
partner with respect to the activities 
to be carried out; 
‘‘(II) how each such partner will 
be accountable for carrying out such 
responsibilities; and 
‘‘(III) the amount of non-Federal 
funding or in-kind contributions that 
each such partner will contribute in 
order to sustain the program. 
‘‘(B) That the comprehensive school-based 
mental health program carried out under this 
section supports the flexible use of funds to ad-
dress— 
‘‘(i) the promotion of the social, emo-
tional, and behavioral health of all students 
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in an environment that is conducive to 
learning; 
‘‘(ii) the reduction in the likelihood of 
at risk students developing social, emo-
tional, behavioral health problems, or sub-
stance use disorders; 
‘‘(iii) the early identification of social, 
emotional, behavioral problems, or sub-
stance use disorders and the provision of 
early intervention services; 
‘‘(iv) the treatment or referral for 
treatment of students with existing social, 
emotional, behavioral health problems, or 
substance use disorders; and 
‘‘(v) the development and implementa-
tion of programs to assist children in deal-
ing with violence. 
‘‘(C) That the comprehensive school-based 
mental health program carried out under this 
section will provide for in-service training of all 
school personnel, including ancillary staff and 
volunteers, in— 
‘‘(i) the techniques and supports need-
ed to identify early children with, or at risk 
of, mental illness; 
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‘‘(ii) the use of referral mechanisms 
that effectively link such children to treat-
ment and intervention services in the 
school and in the community; 
‘‘(iii) strategies that promote a school- 
wide positive environment; 
‘‘(iv) strategies for promoting the so-
cial, emotional, mental, and behavioral 
health of all students; and 
‘‘(v) strategies to increase the knowl-
edge and skills of school and community 
leaders on the application of a public 
health approach to comprehensive school- 
based mental health programs. 
‘‘(D) That the comprehensive school-based 
mental health program carried out under this 
section will include comprehensive training for 
parents, siblings, and other family members of 
children with mental health disorders, and for 
concerned members of the community in— 
‘‘(i) the techniques and supports need-
ed to identify early children with, or at risk 
of, mental illness; 
‘‘(ii) the use of referral mechanisms 
that effectively link such children to treat-
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ment and intervention services in the 
school and in the community; and 
‘‘(iii) strategies that promote a school- 
wide positive environment. 
‘‘(E) That the comprehensive school-based 
mental health program carried out under this 
section will demonstrate the measures to be 
taken to sustain the program after funding 
under this section terminates. 
‘‘(F) That the local education agency part-
nership involved is supported by the State edu-
cational and mental health system to ensure 
that the sustainability of the programs is estab-
lished after funding under this section termi-
nates. 
‘‘(G) That the comprehensive school-based 
mental health program carried out under this 
section will be based on evidence-based prac-
tices. 
‘‘(H) That the comprehensive school-based 
mental health program carried out under this 
section will be coordinated with early inter-
vening activities carried out under the Individ-
uals with Disabilities Education Act. 
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‘‘(I) That the comprehensive school-based 
mental health program carried out under this 
section will be culturally and linguistically ap-
propriate. 
‘‘(J) That the comprehensive school-based 
mental health program carried out under this 
section will include a broad needs assessment of 
youth who drop out of school due to policies of 
‘zero tolerance’ with respect to drugs, alcohol, 
or weapons. 
‘‘(K) That the mental health services pro-
vided through the comprehensive school-based 
mental health program carried out under this 
section will be provided by qualified mental and 
behavioral health professionals who are certified 
or licensed by the State involved and practicing 
within their area of expertise. 
‘‘(d) GEOGRAPHICAL DISTRIBUTION.—The Secretary 
shall ensure that grants, contracts, or cooperative agree-
ments under subsection (a) will be distributed equitably 
among the regions of the country and among urban and 
rural areas. 
‘‘(e) DURATION
OF AWARDS.—With respect to a 
grant, contract, or cooperative agreement under sub-
section (a), the period during which payments under such 
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an award will be made to the recipient shall be 5 years. 
An entity may receive only one award under this section, 
except that an entity that is providing services and sup-
ports on a regional basis may receive additional funding 
after the expiration of the preceding grant period. 
‘‘(f) EVALUATION AND MEASURES OF OUTCOMES.— 
‘‘(1) DEVELOPMENT
OF
PROCESS.—The Ad-
ministrator shall develop a process for evaluating ac-
tivities carried out under this section. Such process 
shall include— 
‘‘(A) the development of guidelines for the 
submission of program data by grant, contract, 
or cooperative agreement recipients; 
‘‘(B) the development of measures of out-
comes (in accordance with paragraph (2)) to be 
applied by such recipients in evaluating pro-
grams carried out under this section; and 
‘‘(C) the submission of annual reports by 
such recipients concerning the effectiveness of 
programs carried out under this section. 
‘‘(2) MEASURES OF OUTCOMES.— 
‘‘(A) IN
GENERAL.—The Administrator 
shall develop measures of outcomes to be ap-
plied by recipients of assistance under this sec-
tion, and the Administrator, in evaluating the 
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effectiveness of programs carried out under this 
section. Such measures shall include student 
and family measures as provided for in sub-
paragraph (B) and local educational measures 
as provided for under subparagraph (C). 
‘‘(B) STUDENT AND FAMILY MEASURES OF 
OUTCOMES.—The measures of outcomes devel-
oped under paragraph (1)(B) relating to stu-
dents and families shall, with respect to activi-
ties carried out under a program under this 
section, at a minimum include provisions to 
evaluate— 
‘‘(i) whether the program resulted in 
an increase in social and emotional com-
petency; 
‘‘(ii) whether the program resulted in 
an increase in academic competency; 
‘‘(iii) whether the program resulted in 
a reduction in disruptive and aggressive 
behaviors; 
‘‘(iv) whether the program resulted in 
improved family functioning; 
‘‘(v) whether the program resulted in 
a reduction in substance use disorders; 
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‘‘(vi) whether the program resulted in 
a reduction in suspensions, truancy, expul-
sions and violence; 
‘‘(vii) whether the program resulted in 
increased graduation rates; and 
‘‘(viii) whether the program resulted 
in improved access to care for mental 
health disorders. 
‘‘(C) LOCAL EDUCATIONAL OUTCOMES.— 
The outcome measures developed under para-
graph (1)(B) relating to local educational sys-
tems shall, with respect to activities carried out 
under a program under this section, at a min-
imum include provisions to evaluate— 
‘‘(i) the effectiveness of comprehensive 
school mental health programs established 
under this section; 
‘‘(ii) the effectiveness of formal part-
nership linkages among child and family 
serving institutions, community support 
systems, and the educational system; 
‘‘(iii) the progress made in sustaining 
the program once funding under the grant 
has expired; 
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‘‘(iv) the effectiveness of training and 
professional development programs for all 
school personnel that incorporate indica-
tors that measure cultural and linguistic 
competencies under the program in a man-
ner that incorporates appropriate cultural 
and linguistic training; 
‘‘(v) the improvement in perception of 
a safe and supportive learning environment 
among school staff, students, and parents; 
‘‘(vi) the improvement in case-finding 
of students in need of more intensive serv-
ices and referral of identified students to 
early intervention and clinical services; 
‘‘(vii) the improvement in the imme-
diate availability of clinical assessment and 
treatment services to students posing a 
danger to themselves or others; 
‘‘(viii) the increased successful matric-
ulation to postsecondary school; and 
‘‘(ix) reduced referrals to juvenile jus-
tice 
‘‘(3) SUBMISSION OF ANNUAL DATA.—An entity 
that receives a grant, contract, or cooperative agree-
ment under this section shall annually submit to the 
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Administrator a report that includes data to evalu-
ate the success of the program carried out by the en-
tity based on whether such program is achieving the 
purposes of the program. Such reports shall utilize 
the measures of outcomes under paragraph (2) in a 
reasonable manner to demonstrate the progress of 
the program in achieving such purposes. 
‘‘(4) EVALUATION BY ADMINISTRATOR.—Based 
on the data submitted under paragraph (3), the Ad-
ministrator shall annually submit to Congress a re-
port concerning the results and effectiveness of the 
programs carried out with assistance received under 
this section. 
‘‘(g) INFORMATION
AND
EDUCATION.—The Sec-
retary shall establish comprehensive information and edu-
cation programs to disseminate the findings of the knowl-
edge development and application under this section to the 
general public and to health care professionals. 
‘‘(h) AMOUNT OF GRANTS AND AUTHORIZATION OF 
APPROPRIATIONS.— 
‘‘(1) AMOUNT OF GRANTS.—A grant under this 
section shall be in an amount that is not more than 
$1,000,000 for each of grant years 2010 through 
2014. The Secretary shall determine the amount of 
each such grant based on the population of children 
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up to age 21 of the area to be served under the 
grant. 
‘‘(2) AUTHORIZATION
OF
APPROPRIATIONS.— 
There is authorized to be appropriated to carry out 
this section, $200,000,000 for each of fiscal years 
2010 through 2014.’’. 
(c) CONFORMING AMENDMENT.—Part G of title V of 
the Public Health Service Act (42 U.S.C. 290hh et seq.), 
as amended by this section, is further amended by striking 
the part heading and inserting the following: 
‘‘PART VII—SCHOOL-BASED MENTAL HEALTH’’. 
Æ 
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