In this task, you are given text for US Congressional and California state bills, your task is to generate a summary for this bill.

[EX Q]: SECTION 1. SHORT TITLE.

This Act may be cited as the ''Rural Emergency Acute Care Hospital
Act''.

SEC. 2. FINDINGS.

Congress finds the following:
(1) According to the University of North Carolina's Center
for Health Services Research, 55 rural hospitals have closed in
the Unites States since January 2010.
(2) In 2014, iVantage conducted a study for the National
Rural Health Association and found 283 hospitals at risk of
closure based upon performance indicators that matched those
facilities already forced to close in this decade.
(3) Researchers at the University of North Carolina
identified inpatient volume as a substantial contributing
factor to the financial performance of rural hospitals, with
many of the at-risk hospitals having an average daily bed
census of less than 2.
(4) Adverse impacts to the local economy and the loss of
timely access to emergency medical care are 2 major effects of
rural hospital closures.
(5) According to the National Center for Rural Health
Works, the typical rural hospital creates over 140 jobs and
generates $6,800,000 in compensation while serving an average
population of 14,600.
(6) The 2014 iVantage study estimates that the 283 at-risk
hospitals could result in the loss of 36,000 health care jobs,
50,000 community jobs, and $10,600,000,000 in gross domestic
product.
(7) Time is the most critical factor for achieving
successful outcomes in emergency medicine, and emergency
medical clinicians refer to the time-sensitive period during
which successful outcomes may be best achieved as the ''golden
hour''.
(8) The National Conference of State Legislatures states
that 60 percent of trauma deaths in the United States occur in
rural areas, where only 15 percent of the population is
represented.
(9) The disproportionate percentage of trauma deaths in
rural areas is likely attributable in large part to a
combination of response time to the scene and distance to the
nearest emergency room to stabilize trauma victims.
(10) The percentage of trauma deaths occurring in rural
areas could continue to increase as more rural hospitals close,
further limiting access to emergency services and requiring
patients to travel longer distances to receive emergency
medical care.
(11) The creation of a rural emergency hospital designation
under the Medicare program will allow facilities in rural areas
to provide emergency medical services without having to
maintain inpatient beds.
(12) In addition to providing emergency care, rural
emergency hospitals could convert the space previously used for
inpatient services to provide other medical services including,
but not limited to, observation care, skilled nursing facility
care, infusion services, hemodialysis, home health, hospice,
nursing home care, population health, and telemedicine
services.

SEC. 3. RURAL EMERGENCY HOSPITAL PROGRAM.

(a) In General.--
(1) Rural emergency hospital and services defined.--Section
1861 of the Social Security Act (42 U.S.C. 1395x) is amended--
(A) in subsection (e), in the last sentence of the
matter following paragraph (9), by inserting ''or a
rural emergency hospital (as defined in section
1861(iii)(1))'' before the period at the end; and
(B) by adding at the end the following subsection:

''Rural Emergency Hospital; Rural Emergency Hospital Outpatient
Services

''(iii)(1) The term 'rural emergency hospital' means a facility
that--
''(A)(i) as of December 31, 2014--
''(I) was a critical access hospital; or
''(II) was a hospital with not more than 50
beds located in a county (or equivalent unit of
local government) in a rural area (as defined
in section 1886(d)(2)(D)), or was a hospital
with not more than 50 beds that was treated as
being located in a rural area pursuant to
section 1886(d)(8)(E); or
''(ii) was a critical access hospital described in
clause (i)(I) or a hospital described in clause (i)(II)
that ceased operations during the period beginning on
the date that is 5 years prior to the date of the
enactment of this subsection and ending on December 30,
2014;
''(B) provides 24-hour emergency medical care and
observation care that does not exceed an annual per patient
average of 24 hours or more than 1 midnight;
''(C) does not provide any acute care inpatient beds and
has protocols in place for the timely transfer of patients who
require acute care inpatient services or other inpatient
services;
''(D) has elected to be designated as a rural emergency
hospital;
''(E) has received approval to operate as a rural emergency
hospital from the State under section 1834(r)(3)(A); and
''(F) is certified by the Secretary under section
1834(r)(3)(B).
''(2) The term 'rural emergency hospital outpatient services' means
medical and other health services furnished by a rural emergency
hospital on an outpatient basis.
''(3) Nothing in this subsection or section 1834(r)(3) shall be
construed to prohibit a rural emergency hospital from providing
extended care services.''.
(2) Payment for rural emergency hospital services.--
(A) In general.--Section 1833(a) of the Social
Security Act (42 U.S.C. 1395l(a)) is amended--
(i) in paragraph (8), by striking ''and''
at the end;
(ii) in paragraph (9), by striking the
period at the end and inserting ''; and''; and
(iii) by inserting after paragraph (9) the
following new paragraph:
''(10) in the case of rural emergency hospital emergency
services and services provided by a rural emergency hospital or
other provider of ambulance services to transport patients who
require acute care inpatient services or other inpatient
services from such rural emergency hospital to a hospital or
critical access hospital, the amounts described in section
1834(r).''.
(B) Payment amount.--Section 1834 of the Social
Security Act (42 U.S.C. 1395m) is amended by adding at
the end the following subsection:
''(r) Payment Rules Relating to Rural Emergency Hospitals.--
''(1) Payment for rural emergency hospital outpatient
services.--
''(A) In general.--The amount of payment for rural
emergency hospital outpatient services of a rural
emergency hospital is equal to 110 percent of the
reasonable costs of providing such services.
''(B) Telehealth services.--For purposes of this
paragraph, in determining the reasonable costs of
providing rural emergency hospital outpatient services,
costs associated with having a backup physician
available via a telecommunications system shall be
considered reasonable costs.
''(2) Payment for transportation services.--The amount of
payment for services provided by a rural emergency hospital or
other provider of ambulance services to transport patients who
require acute care inpatient services or other inpatient
services from such rural emergency hospital to a hospital or
critical access hospital is equal to 110 percent of the
reasonable costs of providing such services.
''(3) Requirements for rural emergency hospitals.--
''(A) State approval to operate as a rural
emergency hospital.--No payment shall be made under
this subsection to a facility, or to a provider of
ambulance services providing transportation services
from such facility, unless the State in which the
facility is located has approved the facility's
designation as a rural emergency hospital.
''(B) Certification of rural emergency hospital.--
''(i) In general.--No payment shall be made
under this subsection to a facility, or to a
provider of ambulance services providing
transportation services from such facility,
unless the facility has been certified by the
Secretary as a rural emergency hospital.
''(ii) Certification requirements.--The
Secretary shall certify a facility as a rural
emergency hospital if the facility--
''(I) meets the criteria for rural
emergency hospitals described in
subparagraphs (A) through (E) of
section 1861(iii)(1);
''(II) either--
''(aa) is verified by the
American College of Surgeons as
having the resources required
of a level IV trauma center or
higher; or
''(bb) employs healthcare
professionals that successfully
completed the Advanced Trauma
Life Support Course offered by
the American College of
Surgeons within the preceding 4
years;
''(III) has in effect a transfer
agreement with a level I or level II
trauma center; and
''(IV) meets such staff training
and certification requirements as the
Secretary may require.
''(4) Coinsurance.--
''(A) In general.--The amount of payment for rural
emergency hospital services or transportation services
made to a rural emergency hospital or other provider of
ambulance services under this subsection shall be
reduced by the coinsurance amount described in
subparagraph (B).
''(B) Coinsurance amount.--The coinsurance amount
described in this subparagraph, with respect to an item
or service provided by a rural emergency hospital or
provider of ambulance services, shall be calculated in
the same manner as the coinsurance amount for an
outpatient critical access hospital service is
calculated under section 1866(a)(2).''.
(b) Waiver of Distance Requirement for Replacement CAHs; Subsequent
Redesignation of Rural Emergency Hospitals as CAHs.--Section 1820(c)(2)
of the Social Security Act (42 U.S.C. 1395i-4(c)(2)) is amended--
(1) in subparagraph (B)(i)(I), by inserting ''subject to
subparagraph (F),'' before ''is located''; and
(2) by adding at the end the following new subparagraphs:
''(F) Option to waive distance requirement.--
Beginning on the date of the enactment of this
subparagraph, for every critical access hospital
located in a State that is certified as a rural
emergency hospital under section 1834(r)(3)(B), the
State shall have the option of waiving the distance
requirement described in subparagraph (B)(i)(I) with
respect to another facility located in the State that
is seeking designation as a critical access hospital
under this paragraph.
''(G) Redesignation of a rural emergency hospital
as a critical access hospital.--A rural emergency
hospital that was previously designated as a critical
access hospital under this paragraph may elect to be
redesignated as a critical access hospital (in the same
manner that the hospital was originally designated as a
critical access hospital) at any time, subject to such
conditions as the Secretary may establish.''.
(c) Studies and Reports.--
(1) Studies.--The Secretary of Health & Human Services
shall conduct 3 studies to evaluate the impact of rural
emergency hospitals on the availability of health care and
health outcomes in rural areas (as defined in section
1886(d)(2)(D) of the Social Security Act (42 U.S.C. 1395ww)).
The Secretary shall conduct a study--
(A) 2 years after the date of the enactment of this
Act;
(B) 5 years after the date of the enactment of this
Act; and
(C) 10 years after the date of the enactment of
this Act.
(2) Reports.--Not later than 6 months after each date that
the Secretary of Health & Human Services is required to conduct
a study under paragraph (1), the Secretary shall submit a
report to Congress containing the results of each such study.
(d) Effective Date.--The amendments made by this section shall
apply to items and services furnished on or after the date that is 1
year after the date of the enactment of this Act.

SEC. 4. INCLUSION OF EMERGENCY MEDICINE AS HEALTH SERVICES UNDER THE
NATIONAL HEALTH SERVICE CORPS.

Section 331(a)(3)(D) of the Public Health Service Act (42 U.S.C.
254d(a)(3)(D)) is amended by inserting '', and includes emergency
medicine provided by physicians in a rural emergency hospital (as
defined in section 1861(iii) of the Social Security Act)'' before the
period.

SEC. 5. PERMITTING HOSPITALS WITH APPROVED RESIDENCY PROGRAMS IN
EMERGENCY MEDICINE TO INCLUDE TIME SPENT BY INTERNS AND
RESIDENTS IN THE EMERGENCY DEPARTMENT OF A RURAL HOSPITAL
IN FULL-TIME EQUIVALENT COUNT.

(a) Indirect Medical Education.--Section 1886(d)(5)(B)(iv) of the
Social Security Act (42 U.S.C. 1395ww(d)(5)(B)(iv)) is amended by
adding at the end the following new subclause:
''(III) Effective for discharges occurring on or after
October 1, 2015, all of the time spent in patient care
activities in the emergency department of a rural hospital by
interns and residents in emergency medicine from a hospital
with an approved medical residency training program (as defined
in subsection (h)(5)(A)) in such specialty shall be included in
determining the number of full-time equivalent interns and
residents in such program if the hospital with such program
incurs the costs of the stipends and fringe benefits of the
interns or residents during the time the interns or residents
spend in that rural hospital in accordance with subclause (II).
In this subclause, the term 'rural hospital' means a hospital
that is located in a rural area (as defined for purposes of
paragraph (2)(D)).''.
(b) Direct Medical Education.--Section 1886(h)(4)(E) of the Social
Security Act (42 U.S.C. 1395(h)(4)) is amended--
(1) in clause (ii), by striking the period at the end and
inserting ''; and'';
(2) by inserting after clause (ii) the following new
clause:
''(iii) effective for cost reporting
periods beginning on or after July 1, 2015, all
of the time so spent in the emergency
department of a rural hospital by residents in
emergency medicine from a hospital with an
approved medical residency training program in
such specialty shall be counted towards the
determination of full-time equivalency in such
program if the hospital with such program bears
all, or substantially all, of the costs of
training such residents in the rural hospital.
In this subparagraph, the term 'rural hospital'
means a hospital that is located in a rural
area (as defined for purposes of subsection
(d)(2)(D)).''; and
(3) by adding at the end the following new sentence: ''For
purposes of this subparagraph, the emergency department of a
rural hospital described in clause (iii) is a nonprovider
setting.''.
[EX A]: Rural Emergency Acute Care Hospital Act This bill amends title XVIII (Medicare) of the Social Security Act to designate as a rural emergency hospital any facility that as of December 31, 2014, was: a critical access hospital (CAH) or a hospital with at most 50 beds located in a county in a rural area or treated as located in a rural area, or one of such hospitals that ceased operations during the period beginning five years before enactment of this Act and ending on December 30, 2014. A rural emergency hospital: must provide 24-hour emergency medical care and observation care not exceeding an annual per patient average of 24 hours or more than 1 midnight, does not provide any acute care inpatient beds and has protocols in place for the timely transfer of patients who require acute care inpatient services or other inpatient services, has elected to be designated as a rural emergency hospital, has received approval to operate as one from the state, and is certified by the Department of Health and Human Services (HHS). Medicare part B (Supplementary Medical Insurance Benefits) shall cover rural emergency hospital emergency services as well as ambulance services provided by a rural emergency hospital or other provider to transport patients who require acute care inpatient services or other inpatient services from the rural emergency hospital to a hospital or a CAH. Payment for rural emergency hospital outpatient services of a rural emergency hospital, including telehealth and ambulance services, shall be 110% percent of their reasonable costs. Rural emergency hospitals must be approved by the state and certified by HHS. States shall have the option of waiving a specified distance requirement between a CAH certified as a rural emergency hospital and another facility located in the state that is seeking designation as a CAH. Primary health services which the National Health Service Corps may provide under the Public Health Service Act shall include emergency medicine provided by physicians in a rural emergency hospital. Hospitals with approved residency programs in emergency medicine shall include time spent by interns and residents in the emergency department of a rural hospital in the full-time equivalent count with respect to reimbursement for the indirect (stipend, fringe benefit) and direct (all or substantially all training) costs of medical education in subsection (d) hospitals. (Generally, a subsection [d] hospital is an acute care hospital, particularly one that receives payments under Medicare's inpatient prospective payment system [IPPS] when providing covered inpatient services to eligible beneficiaries.)

[EX Q]: SECTION 1. INCREASE IN CONTRIBUTION LIMITS AND AMOUNTS AT WHICH PHASE
OUT OF DEDUCTION BEGINS FOR INDIVIDUAL RETIREMENT ACCOUNT
CONTRIBUTIONS.

(a) Increase in Maximum Amount of Contribution to Individual
Retirement Accounts.--
(1) In general.--Subparagraph (A) of section 219(b)(1) of
the Internal Revenue Code of 1986 (relating to maximum amount
of deduction) is amended by striking ''$2,000'' and inserting
''the applicable amount''.
(2) Applicable amount.--Subsection (b) of section 219 of
such Code is amended by adding at the end the following new
paragraph:
''(5) Applicable amount.--
''(A) In general.--For purposes of paragraph (1),
the term 'applicable amount' means--
''(i) for any taxable year beginning in
1997, $2,500,
''(ii) for any taxable year beginning after
1997 and before 2006, the applicable amount
determined under this paragraph for the
preceding taxable year, increased by $500, and
''(iii) for any taxable year beginning
after 2005, $7,000.
''(B) Inflation adjustment.--In the case of a
taxable year beginning in a calendar year after 2006,
the $7,000 amount contained in subparagraph (A)(iii)
shall be increased by an amount equal to--
''(i) such dollar amount, multiplied by
''(ii) the cost-of-living adjustment under
section 1(f)(3) for the calendar year in which
the taxable year begins, determined by
substituting 'calendar year 2005' for 'calendar
year 1992' in subparagraph (B) thereof.
If any amount as adjusted under the preceding sentence
is not a multiple of $10, such amount shall be rounded
to the nearest multiple of $10.''
(b) Increase of Amounts at Which Phase-Out Of Deduction For IRA
Contributions Begins.--
(1) In general.--Clauses (i) and (ii) of section
219(g)(3)(B) of such Code (relating to limitation on deduction
for active participants in certain pension plans) are amended
to read as follows:
''(i) in the case of a taxpayer filing a
joint return--
''(I) for taxable years beginning
in 1997, $50,000,
''(II) for taxable years beginning
after 1997 and before 2003, the
applicable dollar amount determined
under this subclause for the preceding
taxable year, increased by $10,000, and
''(III) for taxable years beginning
after 2002, $110,000.
''(ii) in the case of any other taxpayer
(other than a married individual filing a
separate return)--
''(I) for taxable years beginning
in 1997, $30,000,
''(II) for taxable years beginning
after 1997 and before 2003, the
applicable dollar amount determined
under this subclause for the preceding
taxable year, increased by $5,000, and
''(III) for taxable years beginning
after 2002, $60,000, and''
(2) Inflation adjustment.--Paragraph (3) of section 219(g)
of such Code is amended by adding at the end the following new
subparagraph:
''(C) Inflation adjustment.--In the case of a
taxable year beginning in a calendar year after 2003,
the $110,000 amount contained in subparagraph
(B)(i)(III) and the $60,000 amount contained in
subparagraph (B)(ii)(III) shall each be increased by an
amount equal to--
''(i) such dollar amount, multiplied by
''(ii) the cost-of-living adjustment under
section 1(f)(3) for the calendar year in which
the taxable year begins, determined by
substituting 'calendar year 2004' for 'calendar
year 1992' in subparagraph (B) thereof.
If any amount as adjusted under the preceding sentence
is not a multiple of $100, such amount shall be rounded
to the nearest multiple of $100.''
(c) Conforming Amendments.--
(1) Paragraph (1) of section 408(a) of such Code is amended
by striking ''$2,000'' and inserting ''the applicable amount
(as in effect under section 219(b) for such taxable year)''.
(2) Subparagraph (B) of section 408(b)(2) of such Code is
amended by striking ''$2,000'' and inserting ''the applicable
amount in effect under section 219(b) for the taxable year of
such individual''.
(3) Subsection (b) of section 408 of such Code is amended
in the last sentence by striking '$2,000'' and inserting ''the
applicable amount in effect under section 219(b) for such
taxable year''.
(4) Subparagraph (A) of section 408(d)(5) of such Code is
amended by striking ''dollar amount'' and inserting
''applicable amount''.
(5) Subsection (j) of section 408 of such Code is amended
by striking ''$2,000'' and inserting ''applicable''.
(d) Effective Date.--The amendments made by this section shall
apply to taxable years beginning after December 31, 1996.

SEC. 2. PENALTY-FREE DISTRIBUTIONS FROM INDIVIDUAL RETIREMENT PLANS,
401(k) PLANS, ETC.

(a) Distributions Related to First Homes, Education, or Adoption.--
(1) In general.--Paragraph (2) of section 72(t) (relating
to exceptions to 10-percent additional tax on early
distributions from qualified retirement plans) is amended by
adding at the end the following new subparagraph:
''(E) Certain distributions from individual
retirement plans, 401(k) plans, etc.--Distributions to
an individual from an individual retirement plan, or
from amounts attributable to employer contributions
made pursuant to elective deferrals described in
subparagraph (A) or (C) of section 402(g)(3) or section
501(c)(18)(D)(iii), to the extent such distributions do
not exceed the sum of--
''(i) qualified first-time homebuyer
distributions (as defined in paragraph (7))
made during the taxable year,
''(ii) qualified education expenses (as
defined in paragraph (8)) of the taxpayer for
the taxable year, and
''(iii) qualified adoption expenses (as
defined in section 23(d), determined without
regard to section 23(d)(2)(B)) paid or incurred
by the taxpayer during the taxable year.''
(2) Definitions.--Section 72(t) is amended by adding at the
end the following new paragraphs:
''(7) Qualified first-time homebuyer distributions.--For
purposes of paragraph (2)(E)(i)--
''(A) In general.--The term 'qualified first-time
homebuyer distribution' means any payment or
distribution received by an individual to the extent
such payment or distribution is used by the individual
before the close of the 60th day after the day on which
such payment or distribution is received to pay
qualified acquisition costs with respect to a principal
residence of a first-time homebuyer who is such
individual, the spouse of such individual, or any
child, grandchild, or ancestor of such individual or
the individual's spouse.
''(B) Qualified acquisition costs.--For purposes of
this paragraph, the term 'qualified acquisition costs'
means the costs of acquiring, constructing, or
reconstructing a residence. Such term includes any
usual or reasonable settlement, financing, or other
closing costs.
''(C) First-time homebuyer; other definitions.--For
purposes of this paragraph--
''(i) First-time homebuyer.--The term
'first-time homebuyer' means any individual
if--
''(I) such individual (and if
married, such individual's spouse) had
no present ownership interest in a
principal residence during the 2-year
period ending on the date of
acquisition of the principal residence
to which this paragraph applies, and
''(II) subsection (h) or (k) of
section 1034 did not suspend the
running of any period of time specified
in section 1034 with respect to such
individual on the day before the date
the distribution is applied pursuant to
subparagraph (A).
''(ii) Principal residence.--The term
'principal residence' has the same meaning as
when used in section 1034.
''(iii) Date of acquisition.--The term
'date of acquisition' means the date--
''(I) on which a binding contract
to acquire the principal residence to
which subparagraph (A) applies is
entered into, or
''(II) on which construction or
reconstruction of such a principal
residence is commenced.
''(D) Special rule where delay in acquisition.--If
any distribution from any individual retirement plan
fails to meet the requirements of subparagraph (A)
solely by reason of a delay or cancellation of the
purchase or construction of the residence, the amount
of the distribution may be contributed to an individual
retirement plan as provided in section 408(d)(3)(A)(i)
(determined by substituting '120 days' for '60 days' in
such section), except that--
''(i) section 408(d)(3)(B) shall not be
applied to such contribution, and
''(ii) such amount shall not be taken into
account in determining whether section
408(d)(3)(A)(i) applies to any other amount.
''(8) Qualified education expenses.--For purposes of
paragraph (2)(E)(ii)--
''(A) In general.--The term 'qualified higher
education expenses' means tuition, fees, books,
supplies, and equipment required for the education of--
''(i) the taxpayer,
''(ii) the taxpayer's spouse, or
''(iii) any child (as defined in section
151(c)(3)), grandchild, or ancestor of the
taxpayer or the taxpayer's spouse,
whether or not such education takes place at an
eligible educational institution (as defined in section
135(c)(3)).
''(B) Coordination with savings bond provisions.--
The amount of qualified education expenses for any
taxable year shall be reduced by any amount excludable
from gross income under section 135.''
(3) Conforming amendment.--Subparagraph (B) of section
72(t)(2) is amended by striking ''or (D)'' and inserting '',
(D), or (E)''.
(b) Penalty-Free Distributions for Certain Unemployed Individuals
Not Limited to Health Insurance Costs and Allowed From 401(k) Plans,
Etc.--Subparagraph (D) of section 72(t)(2) is amended--
(1) in clause (i), by inserting '', or from amounts
attributable to employer contributions made pursuant to
elective deferrals described in subparagraph (A) or (C) of
section 402(g)(3) or section 501(c)(18)(D)(iii),'' after
''individual retirement plan'',
(2) in clause (i), by inserting ''and'' at the end of
subclause (I), by striking '', and'' at the end of subclause
(II) and inserting a period, and by striking subclause (III),
and
(3) by striking ''for health insurance premiums'' in the
heading.
(c) Unlimited Penalty-Free Distributions for Medical Care and
Expanded Definition of Dependents for Purposes of Such Distributions.--
Subparagraph (B) of section 72(t)(2) is amended by striking ''medical
care'' and all that follows and inserting ''medical care, determined--
''(i) without regard to whether the
employee itemizes deductions for such taxable
year, and
''(ii) in the case of a distribution from
an individual retirement plan, or from amounts
attributable to employer contributions made
pursuant to elective deferrals described in
subparagraph (A) or (C) of section 402(g)(3) or
section 501(c)(18)(D)(iii)--
''(I) without regard to whether or
not such expenses exceed 7.5 percent of
adjusted gross income, and
''(II) by treating an individual's
dependents as including all children
and grandchildren of the individual (or
of such individual's spouse), and all
ancestors of the individual (or of such
individual's spouse).''
(d) Effective Date.--The amendments made by this section shall
apply to payments and distributions in taxable years beginning after
December 31, 1996.
[EX A]: Amends the Internal Revenue Code to increase the: (1) maximum deduction for individual retirement account contributions; and (2) income amount at which phase-out of that deduction begins.
Exempts from the early distribution penalty: (1) distributions from certain types of retirement plans for first-time home buyer, education, or adoption expenses; and (2) for unemployed individuals (currently, for unemployed individuals for health insurance premiums). Modifies requirements regarding penalties for medical care early distributions.

[EX Q]: SECTION 1. RESOURCE STAFF FOR STUDENTS.

Title X of the Elementary and Secondary Education Act of 1965 (20
U.S.C. 8001 et. seq) is amended by adding at the end the following:

''PART L--RESOURCE STAFF FOR STUDENTS

''SEC. 10993. FINDINGS.

''Congress finds the following:
''(1) Although 7,500,000 children under the age of 18
require mental health services, fewer than 1 in 5 of these
children receive the services.
''(2) Across the United States, counseling professionals
have an extremely busy caseload and often students do no get
the help they need. The current national average ratio of
students to counselors in elementary and secondary schools is
513:1.
''(3) Schools in the United States need more mental health
professionals, and the funds needed to hire staff to
specifically serve students.
''(4) The maximum recommended ratio of students-to-
counselors is 250:1.
''(5) Existing counselors are severely taxed to perform
duties that are largely administrative in nature, such as
scheduling. They are burdened with many demands regarding
placement in colleges, texting, career guidance, and the like.
''(6) Student populations are expected to grow
significantly over the next few years. School-based services
for students will be in great demand. With expected large scale
retirements, more than 100,000 new dedicated resource staff for
students will be needed to increase student-to-staff service
availability.
''(7) Federal support for reducing the student-to-staff
ratio would pay for itself, through reduced violence and
substance abuse, and through improvements in students' academic
achievement.

''SEC. 10994. PURPOSES.

''The purposes of this part are to assist local educational
agencies in recruiting, training, and hiring 100,000 school-based
resource staff to specifically work with students--
''(1) to reduce the student-to-counseling ratios
nationally, in grades 6-12, to an average of 1 such staff for
every 250 students as recommended in a report by the Institute
of Medicine of the National Academy of Sciences relating to
schools and health, issued in 1997;
''(2) to help address the mental, emotional, and
developmental needs of public school students; and
''(3) to support other school staff and teachers in
reaching students early before problems arise, conducting
behavioral interventions to improve school discipline, and
developing the awareness and skills to identify early warning
signs of violence and the need for mental health services.

''SEC. 10995. STUDENT RESOURCE STAFF PROGRAM.

''(a) In General.--In accordance with this section, the Secretary
shall make grants to local educational agencies to assist such agencies
in providing resource staff to meet students' needs.
''(b) Distribution.--In making grants under this section, the
Secretary shall ensure that there is a fair distribution of grants
nationwide.
''(c) Duration.--Each grant made under this section shall be for a
period not to exceed 3 years.
''(d) Application.--
''(1) In general.--Each local educational agency seeking a
grant under this section shall submit an application to the
Secretary at such time, in such manner, and accompanied by such
information as the Secretary may reasonably require.
''(2) Contents.--Each application for a grant under this
section shall--
''(A) describe the secondary public school
population to be targeted by the program, the
particular personal, social, emotional, education, and
career development needs of such population, and the
current school counseling resources available for
meeting such needs;
''(B) describe the activities, services, and
training to be provided by the program and the specific
approaches to be used to meet the needs described in
subparagraph (A);
''(C) describe the methods to be used to evaluate
the outcomes and effectiveness of the program;
''(D) document that the applicant has the personnel
qualified to develop, implement, and administer the
program; and
''(E) assure that the funds made available under
this part for any fiscal year will be used to
supplement and, to the extent practicable, increase the
level of funds that would otherwise be available from
non-Federal sources for the program described in the
application, and in no case supplant such funds from
non-Federal sources.
''(e) Use of Funds.--Funds made available to local educational
agencies under this section shall be used to provide resource staff in
accordance with the purposes described in section 10994.
''(f) Definition.--For purposes of this part the term 'resource
staff' means an individual who has documented competence and training
in mental health to be able to provide services to children and
adolescents in a school setting and who--
''(1) possesses State licensure or certification in mental
health granted by an independent professional regulatory
authority;
''(2) possesses national certification in mental health or
in a related specialty granted by an independent professional
organization;
''(3) holds a minimum of a master's degree in school
counseling from a program accredited by the Council for
Accreditation of Counseling and Related Educational Programs or
the equivalent;
''(4) possesses a minimum of 60 graduate semester hours in
school psychology from an institution of higher education and
has completed 1,200 clock hours in a supervised school
psychology internship, of which 600 hours shall be in the
school setting, and possesses State licensure or certification
in school psychology in the State in which the individual
works; or
''(5) holds a master's degree in social work and is
licensed or certified by the State in which services are to be
provided or holds a school social work specialist credential.
''(g) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this part $2,800,000,000 for fiscal year
2002, $3,000,000,000 for fiscal year 2003, $3,200,000,000 for fiscal
year 2004, and $3,500,000,000 for fiscal year 2005 and each fiscal year
thereafter.''.
[EX A]:
Amends the Elementary and Secondary Education Act of 1965 to establish a grants program for Resource Staff for Students. Direct the Secretary of Education to make such grants to local educational agencies for recruiting, training, and hiring 100,000 individuals to serve as school-based resource staff who have documented competence and training in mental health, as well as other specified minimum qualifications.Requires such resource staff to work with students to: (1) reduce the student-to-counseling ratios nationally, in grades 6-12, to an average of one such staff member for every 250 students; (2) help address the mental, emotional, and developmental needs of public school students; and (3) support other school staff and teachers in reaching students early before problems arise, conducting behavioral interventions to improve school discipline, and developing the awareness and skills to identify early warning signs of violence and the need for mental health services.