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.
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 ‘‘Give a Kid a Chance 
Omnibus Mental Health Services Act of 2003’’. 
SEC. 2. FINDINGS. 
The Congress finds as follows: 
(1) At least one in five children and adolescents 
has a diagnosable mental, emotional, or behavioral 
problem that can lead to school failure, alcohol or 
other drug use, violence, or suicide. Mental disorders 
that begin early in life have a strong effect on future 
educational success. Adolescent emotional problems 
may increase the likelihood of risk-taking behaviors, 
including gun violence, drug abuse, reckless driving, 
and early sexual activity. 
(2) From a public health promotion/disease pre-
vention perspective, it is noteworthy that children 
and adolescents with mental illnesses often don’t be-
come substance abusers until 5 to 10 years after the 
mental illness becomes apparent. This creates a win-
dow of opportunity during which time it may be pos-
sible to prevent substance abuse from occurring in 
these children. 
(3) The interaction of multiple factors has in-
creased the overall number of children suffering 
from psychological, emotional and behavioral dis-
orders. Children as a group suffer from poverty at
a higher rate than all other age groups. More than 
one in three children are raised in single-parent 
households. Children over the age of 10 years are 
frequently caring for themselves after school and 
sometimes into the evening before their parents or 
other caregivers arrive. These factors create greater 
problems with children’s emotional development. 
(4) The combination of witnessing and experi-
encing traumatic events, poverty, alienation, and 
multiple environmental and family factors including 
abuse and neglect, creates greater psychological ne-
glect and social isolation, further contributing to 
various mental health problems. The combination of 
these factors in an emotionally unhealthy climate 
combined with the availability of firearms can 
produce deadly results. 
(5) In many urban, poor and predominantly mi-
nority communities, young children are chronically 
exposed to serious violent crime during their forma-
tive years. It is the recent school violence in subur-
ban and rural communities that has increased 
awareness about the prevalence of violence in the 
lives of America’s children. Increasingly, in the 
home, community and at school, children are af-
fected by or involved in theft, vandalism, bullying, 
intimidation, intolerance, and disruption. 
(6) While the above behaviors are symptomatic 
of mental health problems requiring service interven-
tions, most children with mental health problems are 
not violent to others. They are more likely than their 
peers to be the recipients of intimidation and vio-
lence, and are the largest, most neglected group of 
children suffering from serious illness or disability. 
(7) Only one in five children with a serious 
emotional disturbance receive mental health specialty 
services, although twice as many such children re-
ceive some form of mental health intervention. Thus, 
about 75 to 80 percent fail to receive specialty serv-
ices, and the majority of these children fail to re-
ceive any services at all. 
(8) Mental health is indispensable to personal 
well-being, family and interpersonal relationships, 
and contribution to community or society. From 
early childhood until death, mental health is the 
basis for thinking and communication skills, learn-
ing, emotional growth, resilience, and self-esteem. 
(9) Mental, emotional, and behavioral disorders 
lead to irregular school attendance, difficulty with
concentration, focus, and motivation to learn basic 
academic fundamentals. 
(10) Prevention programs, early intervention, 
help from the faith-based community, and mental 
health services in the family, school, and community 
setting have proven successful and cost-effective 
using both school and community resources for re-
ducing the neglected tragedy of mental, emotional 
and behavioral problems among youth. 
(11) Mental health services personnel can pro-
vide consultation with teachers to improve classroom 
environment and provide guidance around specific 
children. Consulting with parents, they enable teach-
ers and families to work together, increasing the 
family’s involvement in their child’s academic per-
formance and psychosocial development. 
(12) The lack of mental health services in 
schools and communities where the greatest need ex-
ists has resulted in a disproportionate increase in 
children dropping out of school, becoming involved in 
delinquent activity, and becoming part of the juve-
nile and adult criminal justice systems. In fact, be-
cause of the lack of intervention and mental health 
services, more children are being certified to be tried 
as adults and are being subjected to incarceration in
the juvenile or adult criminal justice systems. These 
issues impact especially minority populations and 
those living in poverty. 
(13) Little effort has previously been directed 
toward promoting the development of mental health, 
recognizing signs of early problems and providing 
early intervention to ameliorate these problems. 
SEC. 3. MENTAL HEALTH SERVICES FOR CHILDREN, ADO-
LESCENTS AND THEIR FAMILIES. 
Title V of the Public Health Service Act (42 U.S.C. 
290aa et seq.) is amended by inserting after section 520A 
the following section: 
‘‘SEC. 520B. MENTAL HEALTH SERVICES FOR CHILDREN, 
ADOLESCENTS AND THEIR FAMILIES. 
‘‘(a) IN GENERAL.—In cooperation with the Sec-
retary of Education, the Secretary of Health and Human 
Services shall support either directly or through grants, 
contracts or cooperative agreements with public entities 
programs to promote mental health among all children, 
from birth through adolescence, and their families and to 
provide early intervention services to ameliorate identified 
mental health problems in children and adolescents. 
‘‘(b) EQUITABLE DISTRIBUTION OF GRANTS.—The 
Secretary shall provide for an equitable distribution of
grants by region, to include urban, suburban and rural 
regions, including Native American communities. 
‘‘(c) PRIORITY.—The Secretary shall give priority to 
those applicants who—
‘‘(1) provide a comprehensive, community-
based, culturally competent and developmentally ap-
propriate prevention and early intervention program 
that provides for the identification of early mental 
health problems and promotes the mental health and 
enhances the resiliency of children from birth 
through adolescence and their families; 
‘‘(2) incorporate families, schools and commu-
nities in an integral role in the program; 
‘‘(3) coordinate behavioral health care services, 
interventions, and supports in traditional and non-
traditional settings and provides a continuum of care 
for children from birth through adolescence and 
their families; 
‘‘(4) provide public health education to improve 
the public’s understanding of healthy emotional de-
velopment; 
‘‘(5) provide training, technical assistance, con-
sultation, and support for community service pro-
viders, school personnel, families and children to
promote healthy emotional development and enhance 
resiliency in children from birth through adolescence; 
‘‘(6) increase the resources available to such 
programs and provide for their sustainability by re-
quiring a commitment on the part of local commu-
nities in which the programs provide services; 
‘‘(7) provide for the evaluation of programs op-
erating under this section to ensure that they are 
providing intended services in an efficient and effec-
tive manner; and 
‘‘(8) provide school-based mental health assess-
ment and treatment services conducted by a mental 
health professional (who may be a school counselor, 
school nurse, school psychologist, clinical psycholo-
gist, or school social worker) in public elementary or 
secondary schools. 
‘‘(d) MATCHING REQUIREMENT.—A condition for an 
award under subsection (a) is that the entity involved 
agree that the entity will, with respect to the costs to be 
incurred by the entity in carrying out the purpose de-
scribed in such subsection, make available (directly or 
through donations from public or private entities) non-
Federal contributions toward such costs in an amount that 
is not less than $2 for each $3 of Federal funds provided 
in the award.
‘‘(e) DURATIONS OF GRANTS.—With respect to an 
award under subsection (a), the period during which pay-
ments under such award are made to the recipient may 
not exceed 5 years. 
‘‘(f) EVALUATION.—The Secretary shall ensure that 
entities receiving awards under subsection (a) carry out 
an evaluation of the project which will include the effec-
tiveness of program strategies, and short, intermediate, 
and long-term outcomes including the program’s overall 
impact on strengthening families with young children and 
creating environments in home, school, and community 
settings that promote healthy emotional development and 
reduce incipient mental health and substance abuse prob-
lems. Local educational agencies receiving such grants 
shall ensure that the schools receiving these funds main-
tain an average ratio of one certified or licensed—
‘‘(1) school counselor for every 250 students; 
‘‘(2) school nurse for every 700 students; 
‘‘(3) school psychologist for every 1000 stu-
dents; and 
‘‘(4) school social worker for every 800 stu-
dents. 
‘‘(g) DEFINITIONS.—For purposes of this section: 
‘‘(1) The term ‘mental health’ means a state of 
successful performance of mental function, resulting
in productive activities, fulfilling relationships with 
other people, and the ability to adapt to change and 
cope with adversity. 
‘‘(2) The term ‘mental illness’ refers to all 
diagnosable mental disorders (health conditions 
characterized by alterations in thinking, mood, or 
behavior or some combination thereof) associated 
with distress or impaired functioning or both. 
‘‘(3) The term ‘mental health problems’ refers 
to symptoms of insufficient intensity or duration to 
meet the criteria for any mental disorder. 
‘‘(4)(A) The term ‘mental health professionals’ 
refers to qualified counselors, nurses, psychologists, 
and social workers. 
‘‘(B) The terms ‘school counselor’, ‘school 
nurse’, ‘school psychologist’, and ‘school social work-
er’ mean an individual who possesses licensure or 
certification in the State involved, and who meets 
professional standards for practice in schools and re-
lated settings, as a school counselor, school nurse, 
school psychologist, or school social worker, respec-
tively. 
‘‘(5) The term ‘public entity’ means any State, 
any political subdivision of a State, including any 
local educational agency, and any Indian tribe or
tribal organization (as defined in section 4(b) and 
section 4(c) of the Indian Self-Determination and 
Education Assistance Act). 
‘‘(h) AUTHORIZATION
OF APPROPRIATION.—There 
are authorized to be appropriated to carry out this section 
$100,000,000 for fiscal year 2004 and such sums as are 
necessary for fiscal years 2005 and 2006. These funds are 
authorized to be used to carry out the provision of this 
section and cannot be utilized to supplement or supplant 
funding provided for other mental health services pro-
grams.’’.
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