II 118th CONGRESS 2d Session S. 4407 IN THE SENATE OF THE UNITED STATES May 23, 2024 Mr. Merkley (for himself, Mr. Bennet , Mr. Blumenthal , Mr. Booker , Mr. Brown , Ms. Butler , Mr. Casey , Mr. Coons , Mr. Durbin , Mr. Fetterman , Mr. Heinrich , Ms. Hirono , Mr. Kaine , Mr. King , Ms. Klobuchar , Mr. Murphy , Mr. Padilla , Mr. Reed , Mrs. Shaheen , Ms. Smith , Mr. Van Hollen , and Mr. Wyden ) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To effectively staff the high-need public elementary schools and secondary schools of the United States with school-based mental health services providers.

1. Short title This Act may be cited as the Elementary and Secondary School Counseling Act . 2. Findings Congress finds the following: (1) One in 5 children ages 13 through 18 has, or will have, a serious mental illness. (2) 11 percent of youth have a mood disorder, 10 percent of youth have a behavior or conduct disorder, and 8 percent of youth have an anxiety disorder. (3) 50 percent of all lifetime cases of mental illness begin by age 14. 37 percent of students 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) 70 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 mental health organizations, including the American School Counselor Association, the National Association of School Psychologists, the National Association of Social Workers, and the School Social Work Association of America, recommend that schools maintain— (A) a maximum student to school counselor ratio of 250 to 1; (B) a maximum student to school psychologist ratio of 500 to 1; and (C) a maximum student to school social worker ratio of 250 to 1. 3. Definitions In this Act: (1) ESEA Definitions The terms elementary 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) High-need school The term high-need school has the meaning given the term in section 2211(b) of the Elementary and Secondary Education Act of 1965 ( 20 U.S.C. 6631(b) ). (3) Outlying area The term outlying area means an outlying area specified in section 8101(36)(A) of the Elementary and Secondary Education Act of 1965 ( 20 U.S.C. 7801(36)(A) ). (4) School-based mental health services provider The term school-based mental health services provider includes a State-icensed or State certified school counselor, school psychologist, school social worker, community-based mental health provider organization, or other State licensed or certified mental health professional qualified under State law to provide mental health services to children and adolescents. (5) Secretary The term Secretary means the Secretary of Education. 4. Grants and subgrants to increase access to school-based mental health services providers at high-need schools (a) Reservations and grants (1) Reservations From the total amount made available under section 5 for a fiscal year, the Secretary shall reserve— (A) one-half of 1 percent for the Secretary of the Interior for the activities described in subsection (e)(1) in schools operated or funded by the Bureau of Indian Education; (B) one-half of 1 percent for allotments for the outlying areas to be distributed among the outlying areas on the basis of their relative need for assistance in carrying out the activities described in subsection (e)(1), as determined by the Secretary; and (C) not more than 2 percent for the administration of this Act, and to provide technical assistance relating to this Act. (2) Grants (A) In general From the total amount made available under section 5 for a fiscal year and remaining after funds are reserved under paragraph (1) of this subsection, the Secretary shall award grants to States in accordance with subparagraph (B) to enable the States to award subgrants to local educational agencies in order to increase access to school-based mental health services providers at high-need schools served by the local educational agencies. (B) Formula Subject to subparagraph (C), the Secretary shall award a grant to each State with an approved application under subsection (d) in an amount that bears the same relationship to the remaining amount described in subparagraph (A) as the amount such State received under part A of title I of the Elementary and Secondary Education Act of 1965 ( 20 U.S.C. 6311 et seq. ), as determined on the basis of the most recent fiscal year for which data are available, bears to the amount received under such part ( 20 U.S.C. 6311 et seq. ) by all States with such an approved application, as so determined. (C) Small state minimum No State receiving a grant under this paragraph shall receive less than one-half of 1 percent of the total grant amount awarded under this paragraph. (b) Duration An allotment awarded under this section shall be for a 5-year period and may be renewed for additional 5-year periods upon a showing of adequate progress on meeting the goals of the allotment, as determined by the Secretary. (c) Matching requirements In order to receive a grant under this Act, a State shall agree to provide matching funds, in an amount equal to 20 percent of the amount of the grant amount, toward the costs of the activities carried out under the grant. (d) Application For any State desiring to receive a grant under this Act, the State educational agency shall submit an application at such time, in such manner, and containing such information as the Secretary may require. Each application shall include, at a minimum— (1) an assurance that the State will use the allotment only for the activities described in subsection (e)(1); (2) a description of how the State will award subgrants to local educational agencies under subsection (e); (3) a description of how the State will disseminate, in a timely manner, information regarding the subgrants and the application process for such subgrants to local educational agencies; and (4) the ratios, as of the date of application, of students to school-based mental health services providers in each public elementary school and secondary school in the State, in the aggregate and disaggregated to include— (A) the ratios of students to school counselors, school psychologists, and school social workers; and (B) as applicable, the ratios of students to other school-based mental health services providers not described in subparagraph (A), in the aggregate and disaggregated by type of provider. (e) Subgrants (1) In general A State receiving a grant under this Act shall use such grant to award subgrants, on a competitive basis, to local educational agencies in the State, to enable the local educational agencies to— (A) recruit and retain school-based mental health services providers or contract with community mental health centers to work at high-need schools served by the local educational agency; and (B) work toward effectively staffing the high-need schools served by the local educational agency with school-based mental health services providers, including by meeting the recommended maximum ratios of— (i) 250 students per school counselor; (ii) 500 students per school psychologist; and (iii) 250 students per school social worker. (2) Priority In awarding subgrants under this subsection, a State shall give priority to local educational agencies that serve a significant number of high-need schools. (3) Application A local educational agency desiring a subgrant under this subsection shall submit an application to the applicable State at such time, in such manner, and containing such information as the State may require, including information on how the local educational agency will prioritize assisting high-need schools with the largest numbers or percentages of students from low-income families. (f) Allotment and subgrant requirements (1) Supplement, not supplant Amounts provided as a grant to a State or as a subgrant to a local educational agency under this section shall supplement, and not supplant, any other funds available to such State or local educational agency for school-based mental health services. (2) Combining funds allowed A State receiving a grant under this section may combine funds made available under this section with State or local funds to carry out the activities described in subsection (e)(1). (g) Reports (1) Local educational agencies A local educational agency that receives a subgrant under this section shall submit an annual report to the State that awarded such subgrant on the activities carried out with the subgrant funds. Each such report shall— (A) describe the activities carried out using subgrant funds; (B) enumerate the number of school-based mental health services providers (in the aggregate and disaggregated by each type of provider listed in subsection (d)(4)) who— (i) were employed by or otherwise served in high-need public elementary and secondary schools under the jurisdiction of the local educational agency for the year covered by the report; and (ii) were supported with funds from the subgrant or matching funds during such year; and (C) include the most recent student to school-based mental health services provider ratios listed in subsection (d)(4) for each high-need school under the jurisdiction of the local educational agency that was supported with the subgrant. (2) State educational agencies A State receiving a grant under this section shall annually prepare and submit a report to the Secretary that— (A) evaluates the progress made in achieving the recommended maximum student to school-based mental health services provider ratios described in subsection (e)(1)(B); (B) includes the most recent student to provider ratios, in the aggregate and disaggregated as provided in subsection (d)(4), for public elementary schools and secondary schools in the State that were assisted with such allotment; and (C) describes any other resources needed to meet the recommended maximum student to school-based mental health services provider ratios described in subsection (e)(1)(B). (3) Public availability The Secretary shall— (A) submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Education and the Workforce of the House of Representatives, each report received under paragraph (2); and (B) make such reports available to the public, including through the website of the Department. 5. Authorization of appropriations There are authorized to be appropriated to carry out this Act— (1) $5,000,000,000 for fiscal year 2025; and (2) such sums as may be necessary for each succeeding fiscal year.