I
106TH CONGRESS
1ST SESSION
H. R. 3455
To amend the Public Health Service Act with respect to mental health
services for children, adolescents and their families.
IN THE HOUSE OF REPRESENTATIVES
NOVEMBER 18, 1999
Ms. JACKSON-LEE of Texas (for herself, Ms. MILLENDER-MCDONALD, Ms.
KILPATRICK, Ms. LEE, Ms. SCHAKOWSKY, Mr. GREEN of Texas, Mr.
MCDERMOTT, Mr. EDWARDS, Mr. PALLONE, Mr. KUCINICH, Mrs. MINK
of Hawaii, Mr. RANGEL, Mr. BARRETT of Wisconsin, Mr. SAWYER, Mr.
MENENDEZ, Mr. PASTOR, Mr. CRAMER, Mrs. MEEK of Florida, Ms.
BROWN of Florida, Mr. DAVIS of Illinois, Mr. CLYBURN, Mr. TOWNS,
Mrs. NAPOLITANO, Ms. PELOSI, Mr. FARR of California, Mr. CUMMINGS,
Mr. UDALL of Colorado, Mr. FORD, Mr. MARTINEZ, Mr. FORBES, Mr.
RODRIQUEZ, Mr. JEFFERSON, Mr. GONZALEZ, Mr. FATTAH, Mr.
LARSON, Mr. OWENS, Mr. BALDACCI, Mr. PASCRELL, Mr. WEYGAND,
Mr. BACA, Mr. MEEKS of New York, Mr. BAIRD, Mr. STRICKLAND, and
Mr. LAMPSON) introduced the following bill; which was referred to the
Committee on 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 1999’’.
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 520B
the following section:
‘‘SEC. 520C. 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 2000 and such sums as are
necessary for fiscal years 2001 and 2002. 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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