I 
108TH CONGRESS 
1ST SESSION H. R. 1359
To increase the number of well-trained mental health service professionals 
(including those based in schools) providing clinical mental health care 
to children and adolescents, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 19, 2003
Mr. KENNEDY of Rhode Island (for himself, Ms. ROS-LEHTINEN, Ms. NOR-
TON, Mr. KILDEE, Mr. PLATTS, Mr. OWENS, Ms. KILPATRICK, Mr. LAN-
TOS, Mr. SERRANO, Mr. DEUTSCH, Mr. STARK, and Mr. MARIO DIAZ-
BALART of Florida) introduced the following bill; which was referred to 
the Committee on Energy and Commerce, and in addition to the Com-
mittee on Ways and Means, 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 increase the number of well-trained mental health service 
professionals (including those based in schools) providing 
clinical mental health care to children and adolescents, 
and for other purposes.
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 ‘‘Child Healthcare Crisis 
Relief Act’’.
SEC. 2. FINDINGS. 
The Congress finds the following: 
(1) The Center for Mental Health Services esti-
mates that 20 percent or 13,700,000 of the Nation’s 
children and adolescents have a diagnosable mental 
disorder, and about 2⁄3 of these children and adoles-
cents do not receive mental health care. 
(2) According to ‘‘Mental Health: A Report of 
the Surgeon General’’ in 1999, there are approxi-
mately 6,000,000 to 9,000,000 children and adoles-
cents in the United States (accounting for 9 to 13 
percent of all children and adolescents in the United 
States) who meet the definition for having a serious 
emotional disturbance. 
(3) According to the Center for Mental Health 
Services, approximately 5 to 9 percent of United 
States children and adolescents meet the definition 
for extreme functional impairment. 
(4) According to the Surgeon General’s Report, 
there are particularly acute shortages in the num-
bers of mental health service professionals serving 
children and adolescents with serious emotional dis-
orders. 
(5) According to the National Center for Edu-
cation Statistics in the Department of Education, 
there are approximately 513 students for each school
counselor in United States schools, which ratio is 
more than double the recommended ratio of 250 stu-
dents for each school counselor. 
(6) According to the Bureau of Health Profes-
sions in 2000, the demand for the services of child 
and adolescent psychiatry is projected to increase by 
100 percent by 2020. 
(7) The development and application of knowl-
edge about the impact of disasters on children, ado-
lescents, and their families has been impeded by crit-
ical shortages of qualified researchers and practi-
tioners specializing in this work. 
(8) According to the Bureau of the Census, the 
population of children and adolescents in the United 
States under the age of 18 is projected to grow by 
more than 40 percent in the next 50 years from 70 
million to more than 100 million by 2050. 
SEC. 3. LOAN REPAYMENTS, SCHOLARSHIPS, AND GRANTS 
TO IMPROVE CHILD AND ADOLESCENT MEN-
TAL HEALTH CARE. 
Part B of title VII of the Public Health Service Act 
(42 U.S.C. 293 et seq.) is amended by adding at the end 
the following:
‘‘SEC. 
742. 
LOAN 
REPAYMENTS, 
SCHOLARSHIPS, 
AND 
GRANTS TO IMPROVE CHILD AND ADOLES-
CENT MENTAL HEALTH CARE. 
‘‘(a) LOAN REPAYMENTS FOR CHILD AND ADOLES-
CENT MENTAL HEALTH SERVICE PROFESSIONALS.—
‘‘(1) ESTABLISHMENT.—The Secretary, acting 
through the Administrator of the Health Resources 
and Services Administration, may establish a pro-
gram of entering into contracts on a competitive 
basis with eligible individuals (as defined in para-
graph (2)) under which—
‘‘(A) the eligible individual agrees to be 
employed full-time for a specified period (which 
shall be at least 2 years) in providing mental 
health services to children and adolescents; and 
‘‘(B) the Secretary agrees to make, during 
the period of employment described in subpara-
graph (A), partial or total payments on behalf 
of the individual on the principal and interest 
due on the undergraduate and graduate edu-
cational loans of the eligible individual. 
‘‘(2) ELIGIBLE INDIVIDUAL.—For purposes of 
this section, the term ‘eligible individual’ means an 
individual who—
‘‘(A) is receiving specialized training or 
clinical experience in child and adolescent men-
tal health in psychiatry, psychology, school psy-
chology, psychiatric nursing, social work, school 
social work, marriage and family therapy, 
school counseling, or professional counseling 
and has less than 1 year remaining before com-
pletion of such training or clinical experience; 
or 
‘‘(B)(i) has a license in a State to practice 
allopathic medicine, osteopathic medicine, psy-
chology, school psychology, psychiatric nursing, 
social work, school social work, marriage and 
family therapy, school counseling, or profes-
sional counseling; and 
‘‘(ii)(I) is a mental health service profes-
sional who completed (but not before the end of 
the calendar year in which this Act is enacted) 
specialized training or clinical experience in 
child and adolescent mental health described in 
subparagraph (A); or 
‘‘(II) is a physician who graduated from 
(but not before the end of the calendar year in 
which this Act is enacted) an accredited child 
and adolescent psychiatry residency or fellow-
ship program in the United States.
‘‘(3) 
ADDITIONAL
ELIGIBILITY
REQUIRE-
MENTS.—The Secretary may not enter into a con-
tract under this subsection with an eligible indi-
vidual unless the individual—
‘‘(A) is a United States citizen or a perma-
nent legal United States resident; and 
‘‘(B) if enrolled in a graduate program (in-
cluding a medical residency or fellowship), has 
an acceptable level of academic standing (as de-
termined by the Secretary). 
‘‘(4) PRIORITY.—In entering into contracts 
under this subsection, the Secretary shall give pri-
ority to applicants who—
‘‘(A) are or will be working with high pri-
ority populations; 
‘‘(B) have familiarity with evidence-based 
methods in child and adolescent mental health 
services; 
‘‘(C) demonstrate financial need; and 
‘‘(D) are or will be working in the publicly 
funded sector. 
‘‘(5) MEANINGFUL LOAN REPAYMENT.—If the 
Secretary determines that funds appropriated for a 
fiscal year to carry out this subsection are not suffi-
cient to allow a meaningful loan repayment to all ex-
pected applicants, the Secretary shall limit the num-
ber of contracts entered into under paragraph (1) to 
ensure that each such contract provides for a mean-
ingful loan repayment. 
‘‘(6) AMOUNT.—
‘‘(A) MAXIMUM.—For each year that an 
eligible individual agrees under a contract 
under paragraph (1) to be employed, the Sec-
retary may agree under that contract to pay 
not more than $35,000 on behalf of the indi-
vidual. 
‘‘(B) 
CONSIDERATION.—In 
determining 
the amount of payments to be made on behalf 
of an eligible individual under a contract to be 
entered into under paragraph (1), the Secretary 
shall consider the eligible individual’s income 
and debt load. 
‘‘(7) 
APPLICABILITY
OF
CERTAIN
PROVI-
SIONS.—The provisions of sections 338E and 338F 
shall apply to the program established under para-
graph (1) to the same extent and in the same man-
ner as such provisions apply to the National Health 
Service Corps Loan Repayment Program established 
in subpart III of part D of title III.
‘‘(8) AUTHORIZATION
OF
APPROPRIATIONS.—
There is authorized to be appropriated to carry out 
this subsection $10,000,000 for each of fiscal years 
2004 through 2008. 
‘‘(b) SCHOLARSHIPS FOR STUDENTS STUDYING TO 
BECOME CHILD
AND ADOLESCENT MENTAL HEALTH 
SERVICE PROFESSIONALS.—
‘‘(1) ESTABLISHMENT.—The Secretary, acting 
through the Administrator of the Health Resources 
and Services Administration, may establish a pro-
gram to award scholarships on a competitive basis to 
eligible students (as defined in paragraph (2)) who 
agree to enter into full-time employment (as de-
scribed in paragraph (4)(C)) as a child and adoles-
cent mental health service professional after gradua-
tion or completion of a residency or fellowship. 
‘‘(2) ELIGIBLE
STUDENT.—For purposes of 
this subsection, the term ‘eligible student’ means a 
United States citizen or a permanent legal United 
States resident who—
‘‘(A) is enrolled or accepted to be enrolled 
in a graduate program that includes specialized 
training or clinical experience in child and ado-
lescent mental health in psychology, school psy-
chology, psychiatric nursing, social work, school
social work, marriage and family therapy, 
school counseling, or professional counseling; or 
‘‘(B) is enrolled or accepted to be enrolled 
in an accredited graduate training program of 
allopathic or osteopathic medicine in the United 
States and intends to complete an accredited 
residency or fellowship in child and adolescent 
psychiatry. 
‘‘(3) 
PRIORITY.—In 
awarding 
scholarships 
under this subsection, the Secretary shall give—
‘‘(A) highest priority to applicants who 
previously received a scholarship under this 
subsection and satisfy the criteria described in 
subparagraph (B); and 
‘‘(B) second highest priority to applicants 
who—
‘‘(i) demonstrate a commitment to 
working with high priority populations; 
‘‘(ii) have familiarity with evidence-
based methods in child and adolescent 
mental health services; 
‘‘(iii) demonstrate financial need; and 
‘‘(iv) are or will be working in the 
publicly funded sector.
‘‘(4) REQUIREMENTS.—The Secretary may 
award a scholarship to an eligible student under this 
subsection only if the eligible student agrees—
‘‘(A) to complete any graduate training 
program, internship, residency, or fellowship 
applicable to that eligible student under para-
graph (2); 
‘‘(B) to maintain an acceptable level of 
academic standing (as determined by the Sec-
retary) during the completion of such graduate 
training program, internship, residency, or fel-
lowship; and 
‘‘(C) to be employed full-time after gradua-
tion or completion of a residency or fellowship, 
for at least the number of years for which a 
scholarship is received by the eligible student 
under this subsection, in providing mental 
health services to children and adolescents. 
‘‘(5) USE OF SCHOLARSHIP FUNDS.—A scholar-
ship awarded to an eligible student for a school year 
under this subsection may be used only to pay for 
tuition expenses of the school year, other reasonable 
educational expenses (including fees, books, and lab-
oratory expenses incurred by the eligible student in 
the school year), and reasonable living expenses, as
such tuition expenses, reasonable educational ex-
penses, and reasonable living expenses are deter-
mined by the Secretary. 
‘‘(6) AMOUNT.—The amount of a scholarship 
under this subsection shall not exceed the total 
amount of the tuition expenses, reasonable edu-
cational expenses, and reasonable living expenses de-
scribed in paragraph (5). 
‘‘(7) 
APPLICABILITY
OF
CERTAIN
PROVI-
SIONS.—The provisions of sections 338E and 338F 
shall apply to the program established under para-
graph (1) to the same extent and in the same man-
ner as such provisions apply to the National Health 
Service Corps Scholarship Program established in 
subpart III of part D of title III. 
‘‘(8) AUTHORIZATION
OF
APPROPRIATIONS.—
There is authorized to be appropriated to carry out 
this subsection $5,000,000 for each of fiscal years 
2004 through 2008. 
‘‘(c) CLINICAL TRAINING GRANTS
FOR PROFES-
SIONALS.—
‘‘(1) ESTABLISHMENT.—The Secretary, acting 
through the Administrator of the Health Resources 
and Services Administration, in cooperation with the 
Administrator of the Substance Abuse and Mental
Health Services Administration, may establish a pro-
gram to award grants on a competitive basis to ac-
credited institutions of higher education to establish 
or expand internships or other field placement pro-
grams for students receiving specialized training or 
clinical experience in child and adolescent mental 
health in psychiatry, psychology, school psychology, 
psychiatric nursing, social work, school social work, 
marriage and family therapy, school counseling, or 
professional counseling. 
‘‘(2) PRIORITY.—In awarding grants under this 
subsection, the Secretary shall give priority to appli-
cants that—
‘‘(A) have demonstrated the ability to col-
lect data on the number of students trained in 
child and adolescent mental health and the pop-
ulations served by such students after gradua-
tion; 
‘‘(B) have demonstrated familiarity with 
evidence-based methods in child and adolescent 
mental health services; and 
‘‘(C) have programs designed to increase 
the number of professionals serving high pri-
ority populations.
‘‘(3) REQUIREMENTS.—The Secretary may 
award a grant to an applicant under this subsection 
only if the applicant agrees that—
‘‘(A) any internship or other field place-
ment program assisted under the grant will 
prioritize cultural competency; 
‘‘(B) students benefiting from any assist-
ance under this subsection will be United States 
citizens or permanent legal United States resi-
dents; 
‘‘(C) the institution will provide to the Sec-
retary such data, assurances, and information 
as the Secretary may require; and 
‘‘(D) with respect to any violation of the 
agreement between the Secretary and the insti-
tution, the institution will pay such liquidated 
damages as prescribed by the Secretary by reg-
ulation. 
‘‘(4) APPLICATION.—The Secretary shall re-
quire that any application for a grant under this 
subsection include a description of the applicant’s 
experience working with child and adolescent mental 
health issues. 
‘‘(5) AUTHORIZATION
OF
APPROPRIATIONS.—
There is authorized to be appropriated to carry out
this subsection $10,000,000 for each of fiscal years 
2004 through 2008. 
‘‘(d) PROGRESSIVE EDUCATION GRANTS FOR PARA-
PROFESSIONALS.—
‘‘(1) ESTABLISHMENT.—The Secretary, acting 
through the Administrator of the Health Resources 
and Services Administration, in cooperation with the 
Administrator of the Substance Abuse and Mental 
Health Services Administration, may establish a pro-
gram to award grants on a competitive basis to 
State-licensed mental health nonprofit and for-profit 
organizations (including accredited institutions of 
higher education) to enable such organizations to 
pay for programs for preservice or in-service training 
of paraprofessional child and adolescent mental 
health workers. 
‘‘(2) DEFINITION.—For purposes of this sub-
section, the term ‘paraprofessional child and adoles-
cent mental health worker’ means an individual who 
is not a mental health service professional, but who 
works at the first stage of contact with children and 
families who are seeking mental health services. 
‘‘(3) PRIORITY.—In awarding grants under this 
subsection, the Secretary shall give priority to appli-
cants that—
‘‘(A) have demonstrated the ability to col-
lect data on the number of paraprofessional 
child and adolescent mental health workers 
trained by the applicant and the populations 
served by these workers after the completion of 
the training; 
‘‘(B) have familiarity with evidence-based 
methods in child and adolescent mental health 
services; and 
‘‘(C) have programs designed to increase 
the number of paraprofessional child and ado-
lescent mental health workers serving high pri-
ority populations. 
‘‘(4) REQUIREMENTS.—The Secretary may 
award a grant to an organization under this sub-
section only if the organization agrees that—
‘‘(A) any training program assisted under 
the grant will prioritize cultural competency; 
‘‘(B) the organization will provide to the 
Secretary such data, assurances, and informa-
tion as the Secretary may require; and 
‘‘(C) with respect to any violation of the 
agreement between the Secretary and the orga-
nization, the organization will pay such liq-