I 
118TH CONGRESS 
1ST SESSION H. R. 6091 
To amend the Elementary and Secondary Education Act of 1965 to direct 
the Secretary of Education to make grants to States for assistance 
in hiring additional school-based mental health and student service pro-
viders. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 26, 2023 
Ms. LEE of California (for herself, Ms. TOKUDA, Mr. THANEDAR, Ms. CROCK-
ETT, Ms. SALINAS, Mrs. WATSON COLEMAN, and Mrs. CHERFILUS- 
MCCORMICK) introduced the following bill; which was referred to the 
Committee on Education and the Workforce 
A BILL 
To amend the Elementary and Secondary Education Act 
of 1965 to direct the Secretary of Education to make 
grants to States for assistance in hiring additional 
school-based mental health and student service 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 ‘‘Student Support Act’’. 
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SEC. 2. SCHOOL-BASED MENTAL HEALTH AND STUDENT 
SERVICE PROVIDERS. 
(a) IN GENERAL.—Part A of title IV of the Elemen-
tary and Secondary Education Act of 1965 (20 U.S.C. 
7101 et seq.) is amended by adding at the end the fol-
lowing: 
‘‘SUBPART 3—SCHOOL-BASED MENTAL HEALTH AND 
STUDENT SERVICE PROVIDERS 
‘‘SEC. 4131. FINDINGS. 
‘‘Congress finds the following: 
‘‘(1) The Surgeon General of the Public Health 
Service has found that 1 in 6 children (ages 2 to 8) 
has a diagnosable mental disorder and 1 in 10 chil-
dren and adolescents suffer from mental illness se-
vere enough to cause some level of impairment. 
However, 75 to 80 percent of children in need of 
mental health services do not receive needed treat-
ment. The short- and long-term consequences of un-
treated childhood mental disorders are costly, in 
both human and fiscal terms. 
‘‘(2) Thirty-seven percent of students with a 
mental health condition age 14 and older drop out 
of school—the highest dropout rate of any disability 
group. 
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‘‘(3) Fifty percent of all lifetimes cases of men-
tal illness begin by the age of 14 and 75 percent by 
age 24. 
‘‘(4) In June 2010, the American Academy of 
Pediatrics called for all pediatricians to screen chil-
dren and adolescents for mental illness and sub-
stance use. 
‘‘(5) Just over half (50.6 percent) of children 
with a mental health condition aged 8–15 received 
mental health services in the previous year. 
‘‘(6) African Americans and Hispanic Ameri-
cans each use mental health services at about one- 
half the rate of Caucasian Americans and Asian 
Americans at about one-third the rate. 
‘‘(7) School counselors, school social workers, 
school psychologists, other qualified psychologists, 
and child and adolescent psychiatrists are critically 
needed to help these children and to provide a vari-
ety of crucial support services as 70–80 percent of 
children and adolescents who receive mental health 
services access these services in school settings. 
‘‘(8) Across the United States, there are insuffi-
cient resources for school-based counseling profes-
sionals, and often students do not get the help they 
need. The 2017 national average ratio of students to 
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school counselors in elementary and secondary 
schools was 482 to 1. 
‘‘(9) United States public schools need more 
mental health professionals because participation in 
the use of school-based mental health centers 
(SBHC) was positively associated with increases in 
grade point average (GPA) and attendance. 
‘‘(10) According to the leading counseling, guid-
ance, and mental health organizations, including the 
American School Counselor Association, the Na-
tional Association of Social Psychologists, the Na-
tional Association of Social Workers, and the School 
Social Work Association of America, the maximum 
recommended ratio of— 
‘‘(A) students to school counselors is 250 
to 1; 
‘‘(B) students to school psychologists is 
500 to 1; and 
‘‘(C) students to school social workers is 
250 to 1. 
‘‘(11) A recent study revealed a national aver-
age ratio of 1,653 students per school psychologist, 
despite the 1:500–700 recommendation from the 
National Association of Social Psychologists. This 
deficit is further compounded by studies predicting 
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a 2–4 percent shortage of school psychologists over 
the next 10 years due to retirement. In some 
schools, there are no school-based mental health and 
student service providers available to assist students 
in times of crisis, or at any other time. 
‘‘(12) Counselor-to-student ratios in 35 States 
exceed 1:400 despite recommendations from the 
American School Counselor Association for a 1:250 
ratio. Only three States—Vermont, Wyoming & New 
Hampshire—meet the recommended ratio. This 
shortage occurs during a time when the National 
Center on Education Statistics forecasts that the 
Nation’s number of public school students (Pre-K to 
12th) will grow by 7 percent between 2011 and 
2022, particularly in States that already spend the 
least money per student. 
‘‘(13) Model programs using school-based men-
tal health and student service providers have positive 
effects on emotional, behavioral and academic out-
comes, such as reductions in aggressive and disrup-
tive behavior, referrals to the principal’s office, the 
use of weapons, force, or threats, and increased stu-
dents’ feelings of safety. Studies also find that men-
tal health programs can have a range of positive out-
comes across all grade levels, including gains in 
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achievement test scores, grade point averages, course 
credit completion, as well as decreases in absences 
and substance use. 
‘‘SEC. 4132. PURPOSES. 
‘‘The purposes of this subpart are to assist States 
and local educational agencies in hiring additional school- 
based mental health providers, including additional school 
counselors, school psychologists, other qualified psycholo-
gists, child and adolescent psychiatrists, and school social 
workers to achieve each of the following: 
‘‘(1) To reduce the ratios of school-based men-
tal health and student service providers to students 
in elementary and secondary schools in the United 
States to the following minimum ratios rec-
ommended by the leading counseling, guidance, and 
mental health organizations, including the American 
School Counselor Association, the National Associa-
tion of Social Psychologists, the National Associa-
tion of Social Workers, and the School Social Work 
Association of America: 
‘‘(A) One school counselor for every 250 
students. 
‘‘(B) One school psychologist for every 500 
to 700 students. 
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‘‘(C) One school social worker for every 
250 students. 
‘‘(2) To provide evidence-based school mental 
health and student services through a whole school 
and interdisciplinary approach. 
‘‘(3) To remove emotional, behavioral, and psy-
chosocial barriers to learning so as to enhance stu-
dents’ classroom preparedness, overall school per-
formance, decrease rates of absenteeism, and ability 
to problem solve and set goals. 
‘‘(4) To support school staff and teachers in 
improving classroom management, conducting be-
havioral interventions to improve school discipline, 
and developing the awareness and skills to identify 
the need for mental health services. 
‘‘(5) To support parental involvement in im-
proving the school behavior and academic success of 
their children. 
‘‘(6) To improve the overall mental, behavioral, 
social, and psychology assessment and trajectory of 
each student who seeks mental health services. 
‘‘(7) To ensure each student feels comfortable 
and has all the resources they need to continue short 
and/or long-term mental health treatment. 
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‘‘SEC. 4133. DEFINITIONS. 
‘‘In this subpart, the following definitions apply: 
‘‘(1) CHILD.—The term ‘child’ means an indi-
vidual who is not less than 5 years old and not more 
than 17 years old. 
‘‘(2) 
CHILD
AND
ADOLESCENT
PSYCHIA-
TRIST.—The term ‘child and adolescent psychiatrist’ 
has the meaning given such term in section 5421(e). 
‘‘(3) CHILD IN POVERTY.—The term ‘child in 
poverty’ means a child from a family with an income 
below the poverty line. 
‘‘(4) MENTAL HEALTH AND STUDENT SERVICE 
PROVIDER.—The term ‘mental health and student 
service provider’ means a qualified individual who 
provides mental health and student services, includ-
ing any individual who is a qualified school coun-
selor, a qualified school psychologist or any other 
qualified psychologist, a child or adolescent psychia-
trist, or a qualified school social worker. 
‘‘(5) MENTAL
HEALTH
AND
STUDENT
SERV-
ICES.—The term ‘mental health and student serv-
ices’ includes direct, individual, and group services 
provided to students, parents, and school personnel 
by mental health and student service providers, and 
the coordination of prevention strategies in schools 
or community-based programs. 
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‘‘(6) OTHER QUALIFIED PSYCHOLOGIST.—The 
term ‘other qualified psychologist’ has the meaning 
given such term in section 5421(e). 
‘‘(7) POVERTY LINE.—The term ‘poverty line’ 
means the poverty line (as defined by the Office of 
Management and Budget, and revised annually in 
accordance with section 673(2) of the Community 
Services Block Grant Act (42 U.S.C. 9902(2))) ap-
plicable to a family of the size involved. 
‘‘(8) SCHOOL COUNSELOR.—The term ‘school 
counselor’ means an individual who has documented 
competence in counseling children and adolescents in 
a school setting and who— 
‘‘(A) possesses State licensure or certifi-
cation granted by an independent professional 
regulatory authority; 
‘‘(B) possesses national certification in 
school counseling or a specialty of counseling 
granted by an independent professional organi-
zation; or 
‘‘(C) holds a minimum of a master’s de-
gree in school counseling from a program ac-
credited by the Council for Accreditation of 
Counseling and Related Educational Programs 
or the equivalent. 
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‘‘(9) 
SCHOOL
PSYCHOLOGIST.—The 
term 
‘school psychologist’ means an individual who— 
‘‘(A) possesses a minimum of 60 graduate 
semester hours in school psychology from an in-
stitution of higher education and has completed 
1,200 clock hours in a supervised school psy-
chology internship, of which 600 hours shall be 
in a school setting; 
‘‘(B) possesses State licensure or certifi-
cation in school psychology in the State in 
which the individual works; or 
‘‘(C) possesses national certification by the 
National School Psychology Certification Board. 
‘‘(10) SCHOOL
SOCIAL
WORKER.—The term 
‘school social worker’ means an individual who— 
‘‘(A) holds a master’s degree in social work 
from a program accredited by the Council on 
Social Work Education; 
‘‘(B) is licensed or certified by the State in 
which services are provided; or 
‘‘(C) possesses a national credential or na-
tional certification as a school social work spe-
cialist granted by an independent professional 
organization. 
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‘‘(11) STATE.—The term ‘State’ means each of 
the several States, the District of Columbia, and the 
Commonwealth of Puerto Rico. 
‘‘SEC. 4134. SCHOOL-BASED MENTAL HEALTH AND STU-
DENT SERVICE PROVIDER GRANT PROGRAM. 
‘‘(a) IN GENERAL.—In accordance with this subpart, 
the Secretary shall make grants to eligible States to assist 
local educational agencies in those States in hiring addi-
tional school-based mental health and student service pro-
viders. 
‘‘(b) ALLOCATION
OF
FUNDS.—From the total 
amount appropriated for a fiscal year to carry out this 
subpart, the Secretary shall— 
‘‘(1) make available 1 percent of such amount 
to the Secretary of the Interior (on behalf of the Bu-
reau of Indian Affairs) and the outlying areas for 
activities that carry out the purposes of this subpart; 
and 
‘‘(2) make available in the form of grants to 
each eligible State an amount equal to the sum of— 
‘‘(A) an amount that bears the same rela-
tionship to 50 percent of such total amount as 
the number of children in poverty who reside in 
the State bears to the number of such children 
in all States; and 
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‘‘(B) an amount that bears the same rela-
tionship to 50 percent of such total amount as 
the number of children enrolled in public and 
private nonprofit elementary schools and sec-
ondary schools in the State bears to the number 
of children enrolled in all such schools in all 
States. 
‘‘(c) MINIMUM GRANT.—Notwithstanding subsection 
(b), no grant under this section shall be for an amount 
less than $1,000,000. 
‘‘(d) REALLOCATION.—The Secretary shall reallocate 
to States that have received approval under subsection 
(e)(2) any funds allocated under subsection (b) to a State 
that fails to submit an application that is approved by the 
Secretary. 
‘‘(e) APPLICATION BY STATE.— 
‘‘(1) IN GENERAL.—To be eligible to receive a 
grant under this subpart, a State shall submit an 
application to the Secretary at such time, in such 
manner, and containing such information as the Sec-
retary may require. 
‘‘(2) APPROVAL.—The Secretary may not ap-
prove an application under this subsection unless the 
State submitting the application— 
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‘‘(A) presents a plan, which the Secretary 
considers to be reasonable, under which the 
State will make grants, in accordance with the 
purposes of this subpart, to local educational 
agencies to fund the hiring of additional school 
counselors, school psychologists, other qualified 
psychologists, child and adolescent psychia-
trists, and school social workers; and 
‘‘(B) provides an assurance that the State 
will provide the matching amount required 
under subsection (g). 
‘‘(f) USE OF FUNDS BY STATE.— 
‘‘(1) IN
GENERAL.—In accordance with this 
subsection, the total of the amounts made available 
to a State under this section and the amounts of the 
non-Federal match required under subsection (g) 
may only be used by a State to make grants to local 
educational agencies to assist such agencies in hiring 
additional school-based mental health and student 
service providers. 
‘‘(2) ADMINISTRATIVE COSTS.—In each fiscal 
year, a State may use not more than 5 percent of 
the assistance made available to it under this sub-
part for the administrative costs of the State in car-
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rying out the State’s responsibilities under this sub-
part. 
‘‘(3) ALLOCATION
OF
FUNDS.—In making 
grants in accordance with this subsection, the State 
shall allocate from the total described in paragraph 
(1) to each local educational agency an amount 
equal to the sum of— 
‘‘(A) an amount that bears the same rela-
tionship to 50 percent of such total as the num-
ber of children in poverty who reside in the 
school district served by the local educational 
agency bears to the number of such children 
who reside in all the school districts in the 
State; and 
‘‘(B) an amount that bears the same rela-
tionship to 50 percent of such total as the num-
ber of children enrolled in public and private 
nonprofit elementary schools and secondary 
schools in the school district served by the local 
educational agency bears to the number of chil-
dren enrolled in all such schools in the State. 
‘‘(4) MINIMUM GRANT.—Notwithstanding para-
graph (3), no grant made by a State in accordance 
with this subsection shall be for an amount less than 
$50,000. 
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‘‘(5) SOURCE OF DATA.—For purposes of para-
graph (3), the State shall use data from the most 
recent fiscal year for which satisfactory data are 
available, except that the State may adjust such 
data, or use alternative child poverty data, if the 
State demonstrates to the Secretary’s satisfaction 
that such adjusted or alternative data more accu-
rately reflect the relative incidence of children who 
are living in poverty and who reside in the school 
districts in the State. 
‘‘(6) APPLICATION
BY
LOCAL
EDUCATIONAL 
AGENCIES.—A State may require that, in order to 
be eligible for a grant made by the State in accord-
ance with this subsection, a local educational agency 
shall submit an application to the State at such 
time, in such manner, and containing such informa-
tion as the State may require. 
‘‘(g) MATCHING FUNDS.— 
‘‘(1) IN GENERAL.—As a condition of receiving 
a grant under this section, the Secretary shall re-
quire that a State provide from non-Federal sources 
an amount equal to the amount of the grant. 
‘‘(2) LOCAL CONTRIBUTION.—In making grants 
to local educational agencies in accordance with this 
subsection, a State may require that a local edu-
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cational agency match a portion of the amount of 
the grant made to the agency. 
‘‘(3) FORM.—The non-Federal share required 
by this subsection may be provided in cash or in 
kind, fairly evaluated, and may include facilities, 
equipment, or services. 
‘‘(h) FUNDS TO BE SUPPLEMENTARY.—Assistance 
made available under this subpart shall be used to supple-
ment, and may not supplant, Federal, State, or local funds 
used for employing school-based mental health and stu-
dent service providers. 
‘‘(i) DATA COLLECTION AND REPORT.— 
‘‘(1) IN
GENERAL.—For each fiscal year for 
which it receives assistance under this subpart, a 
State shall collect data describing how the assistance 
is used. 
‘‘(2) REPORT.—Not later than 1 year after as-
sistance is made available to a State under this sub-
part, the State shall transmit to the Secretary a re-
port on the data described in paragraph (1), includ-
ing information with respect to each local edu-
cational agency to which the State made a grant 
with assistance made available under this subpart— 
‘‘(A) the number of school counselors, 
school psychologists, other qualified psycholo-
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gists, child and adolescent psychiatrists, and 
school social workers employed by local edu-
cational agency; and 
‘‘(B) the ratio of students to school coun-
selors, the ratio of students to school psycholo-
gists or other qualified psychologists, the ratio 
of students to child and adolescent psychia-
trists, and the ratio of students to school social 
workers. 
‘‘(3) SOURCE OF FUNDS.—A State may use a 
portion of the assistance permitted to be used for 
administrative costs to carry out its responsibilities 
under this subsection. 
‘‘(4) PUBLICATION.—The Secretary shall make 
data received under this subsection publicly available 
on an annual basis. 
‘‘SEC. 4135. AUTHORIZATION OF APPROPRIATIONS. 
‘‘There are authorized to be appropriated to carry out 
this subpart $100,000,000 for each of fiscal years 2024 
through 2028.’’. 
(b) CLERICAL AMENDMENT.—The table of contents 
for the Elementary and Secondary Education Act of 1965 
(20 U.S.C. 6301 et seq.) is amended by inserting after 
the item relating to section 4121 the following: 
‘‘SUBPART 3—SCHOOL-BASED MENTAL HEALTH AND STUDENT SERVICE 
PROVIDERS 
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‘‘Sec. 4131. Findings. 
‘‘Sec. 4132. Purposes. 
‘‘Sec. 4133. Definitions. 
‘‘Sec. 4134. School-based mental health and student service provider grant pro-
gram. 
‘‘Sec. 4135. Authorization of appropriations.’’. 
Æ 
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