I 
116TH CONGRESS 
1ST SESSION H. R. 4381 
To effectively staff the public elementary schools and secondary schools of 
the United States with school-based mental health services providers. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 18, 2019 
Ms. CLARK of Massachusetts introduced the following bill; which was referred 
to the Committee on Education and Labor 
A BILL 
To effectively staff the public elementary schools and sec-
ondary schools of the United States with school-based 
mental health services providers. 
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 ‘‘Elementary and Sec-
ondary School Counseling Act’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
(1) One in 5 children ages 13 through 18 have, 
or will have, a serious mental illness. 
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(2) Eleven percent of youth have a mood dis-
order, 10 percent of youth have a behavior or con-
duct disorder, and 8 percent of youth have an anx-
iety disorder. 
(3) Fifty percent of all lifetime cases of mental 
illness begin by age 14. Thirty-seven percent of stu-
dents with a mental health condition age 14 and 
older drop out of school, which is the highest school 
dropout rate of any disability group. 
(4) Seventy percent of youth in State and local 
juvenile systems have a mental illness. 
(5) Youth with access to mental health services 
in school-based health centers are 10 times more 
likely to seek care for mental health or substance 
abuse than youth without access. 
(6) The leading counseling, guidance, and men-
tal health organizations, including the American 
School Counselor Association, the National Associa-
tion of School Psychologists, the National Associa-
tion of Social Workers, and the School Social Work 
Association of America, recommend that schools 
maintain— 
(A) a maximum student to school coun-
selor ratio of 250 to 1; 
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(B) a maximum student to school psychol-
ogist ratio of 500–700 to 1; and 
(C) a maximum student to school social 
worker ratio of 250 to 1. 
SEC. 3. DEFINITIONS. 
In this Act: 
(1) ESEA DEFINITIONS.—The terms ‘‘elemen-
tary school’’, ‘‘local educational agency’’, ‘‘secondary 
school’’, ‘‘State’’, and ‘‘State educational agency’’ 
have the meanings given the terms in section 8101 
of the Elementary and Secondary Education Act of 
1965 (20 U.S.C. 7801). 
(2) SCHOOL-BASED MENTAL HEALTH SERVICES 
PROVIDER.—The term ‘‘school-based mental health 
services provider’’ has the meaning given the term in 
section 4102 of the Elementary and Secondary Edu-
cation Act of 1965 (20 U.S.C. 7112). 
(3) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Education. 
SEC. 4. GRANTS. 
(a) PROGRAM AUTHORIZED.— 
(1) IN
GENERAL.—From the amounts made 
available under section 5 for a fiscal year, the Sec-
retary shall award grants, in amounts determined 
under subsection (b), to State educational agencies 
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to enable the State educational agencies to award 
subgrants to local educational agencies in order to 
provide school-based mental health services providers 
at public elementary schools and secondary schools 
served by the local educational agencies. 
(2) DURATION.—A grant awarded under this 
section shall be for a 5-year period and may be re-
newed for additional 5-year periods upon a showing 
of adequate progress, as determined by the Sec-
retary. 
(b) AMOUNTS OF GRANTS.— 
(1) BASE AMOUNT ALLOTMENT.— 
(A) BASE AMOUNT.—The Secretary shall 
use $2,000,000,000 of the amounts made avail-
able under section 5 for a fiscal year to provide 
a base grant for such fiscal year to each State 
educational agency that submits a complete ap-
plication, on a proportional basis based on the 
number of elementary school and secondary 
school students in each State, subject to sub-
paragraph (C). 
(B) 
RATABLE
REDUCTION.—If 
the 
amounts made available under section 5 are less 
than $2,000,000,000, the Secretary shall rat-
ably reduce the amount provided under sub-
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paragraph (A) to each State, subject to sub-
paragraph (C). 
(C) MANDATORY
MINIMUM.—No State 
shall receive less than $1,000,000 under sub-
paragraph (A) for a fiscal year. 
(2) NEED-BASED ADDITIONAL FUNDING.— 
(A) IN GENERAL.—In any fiscal year for 
which the funds made available under section 5 
are greater than $2,000,000,000, the Secretary 
shall use such additional funds to provide, on a 
competitive basis, additional amounts for the 
grants provided under this section to State edu-
cational agencies that agree to meet the match-
ing requirement under subparagraph (B). 
(B) MATCHING REQUIREMENTS.—In order 
to receive additional funding under this para-
graph, a State educational agency shall agree to 
provide matching funds, in an amount equal to 
not less than one-half of the additional amount 
provided under subparagraph (A), toward the 
costs of the activities carried out under this 
grant. 
(C) AWARD
BASIS.—The Secretary shall 
award the additional amounts under subpara-
graph (A) based on the need for school-based 
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mental health services providers in the public 
elementary schools and secondary schools in the 
State and the Secretary’s assessment of the ra-
tios included in each application under sub-
section (c)(3). 
(3) AMOUNT LIMITATION.—In no case shall the 
total amount awarded under this subsection exceed 
the amount needed to meet the recommended max-
imum student-to-provider ratios described in sub-
section (d)(1)(B) in all public elementary schools 
and secondary schools in the State. 
(c) APPLICATION.—A State educational agency desir-
ing a grant under this section shall submit an application 
at such time, in such manner, and containing such infor-
mation as the Secretary may require. Each application 
shall include— 
(1) a description of how the State educational 
agency will award subgrants to local educational 
agencies under subsection (d) consistent with the 
consideration described in subsection (b)(2)(C); 
(2) a description of how the State educational 
agency will disseminate, in a timely manner, infor-
mation regarding the subgrants and the application 
process for such subgrants to eligible local edu-
cational agencies; and 
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(3) the ratios, as of the date of application, of 
students to school-based mental health services pro-
viders in each public elementary school and sec-
ondary school in the State, in the aggregate and 
disaggregated to include— 
(A) the ratios of students to school coun-
selors, school psychologists, and school social 
workers; and 
(B) as applicable, the ratios of students to 
other school-based mental health services pro-
viders not described in subparagraph (A), in the 
aggregate and disaggregated by type of pro-
vider. 
(d) SUBGRANTS.— 
(1) IN GENERAL.—A State educational agency 
receiving a grant under this section shall use grant 
funds to award subgrants, on a competitive basis, to 
local educational agencies in the State, to enable the 
local educational agencies to— 
(A) employ a school-based mental health 
services provider at each public elementary 
school and secondary school served by the local 
educational agency; and 
(B) work toward effectively staffing the 
public elementary schools and secondary schools 
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of the State with school-based mental health 
services providers, including by meeting the rec-
ommended maximum ratios of— 
(i) 250 students per school counselor; 
(ii) 500 to 700 students per school 
psychologist; and 
(iii) 250 students per school social 
worker. 
(2) APPLICATION.—A local educational agency 
desiring a subgrant under this subsection shall sub-
mit an application to the State educational agency 
at such time, in such manner, and containing such 
information as the State educational agency may re-
quire. 
(e) GRANT AND SUBGRANT REQUIREMENTS.— 
(1) SUPPLEMENT, NOT
SUPPLANT.—Amounts 
provided under a grant or subgrant under this sec-
tion shall supplement, and not supplant, any other 
funds available to a State educational agency or 
local educational agency for school-based mental 
health services. 
(2) COMBINING
FUNDS
ALLOWED.—A State 
educational agency receiving a grant under this sec-
tion may combine funds made available under this 
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section with State or local funds to carry out the ac-
tivities described in subsection (d)(1). 
(f) REPORT.— 
(1) IN GENERAL.—A State educational agency 
receiving a grant under this section shall annually 
prepare and submit a report to the Secretary that— 
(A) evaluates the progress made in achiev-
ing the purposes of the grant; 
(B) includes the most recent student to 
provider 
ratios, 
in 
the 
aggregate 
and 
disaggregated as provided in subsection (c)(3), 
for public elementary schools and secondary 
schools in the State that were assisted under 
the grant under this section; and 
(C) describes any other resources needed 
to meet the required recommended maximum 
student to school-based mental health services 
provider ratios. 
(2) 
PUBLIC
AVAILABILITY.—The 
Secretary 
shall make all reports submitted under paragraph 
(1) available to the public, including through the 
website of the Department. 
SEC. 5. AUTHORIZATION OF APPROPRIATIONS. 
In order to provide school-based mental health serv-
ices providers in public elementary schools and secondary 
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schools in the States, there are authorized to be appro-
priated to carry out this section— 
(1) $5,000,000,000 for fiscal year 2020; and 
(2) such sums as may be necessary for each 
succeeding fiscal year. 
Æ 
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