,,ii #aacth ,,congress #ast ,session ,s4 #aaf ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,january #bc 7legislative day1 ,january #c71 #bjac ,mr4 ,reed 7for himself1 ,ms4 ,murkowski1 ,mr4 ,durbin1 ,ms4 ,collins1 ,mr4 ,udall of ,new ,mexico1 ,mrs4 ,murray1 ,mr4 ,lautenberg1 ,mr4 ,blumenthal1 ,mr4 ,coons1 ,ms4 ,klobuchar1 ,ms4 ,stabenow1 and ,mr4 ,begich7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to revise and extend provisions under the ,garrett ,lee ,smith ,memorial ,act4 #a4 ,short title ,this ,act may be cited as the ,garrett ,lee ,smith ,memorial ,act ,reauthorization of #bjac4 #b4 ,suicide prevention technical assistance center 7a7 ,repeal ,section #ebj;,c of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#cd7 is repealed4 7b7 ,suicide prevention technical assistance center ,title ,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;aa et seq47 7as amended by subsection 7a77 is amended by inserting after section #ebj;,b the following3 #ebj;,c4 ,suicide prevention technical assistance center 7a7 ,program authorized ,the ,secretary1 acting through the ,administrator of the ,substance ,abuse and ,mental ,health ,services ,administration1 shall establish a research1 training1 and technical assistance resource center to provide appropriate information1 training1 and technical assistance to ,states1 political subdivisions of ,states1 federally recognized ,indian tribes1 tribal organizations1 institutions of higher education1 public organizations1 or private nonprofit organizations concerning the prevention of suicide among all ages1 particularly among groups that are at high risk for suicide4 7b7 ,responsibilities of the center ,the center established under subsection 7a7 shall-- 7#a7 assist in the development or continuation of statewide and tribal suicide early intervention and prevention strategies for all ages1 particularly among groups that are at high risk for suicide2 7#b7 ensure the surveillance of suicide early intervention and prevention strategies for all ages1 particularly among groups that are at high risk for suicide2 7#c7 study the costs and effectiveness of statewide and tribal suicide early intervention and prevention strategies in order to provide information concerning relevant issues of importance to ,state1 tribal1 and national policymakers2 7#d7 further identify and understand causes and associated risk factors for suicide for all ages1 particularly among groups that are at high risk for suicide2 7#e7 analyze the efficacy of new and existing suicide early intervention and prevention techniques and technology for all ages1 particularly among groups that are at high risk for suicide2 7#f7 ensure the surveillance of suicidal behaviors and nonfatal suicidal attempts2 7#g7 study the effectiveness of ,state-sponsored statewide and tribal suicide early intervention and prevention strategies for all ages particularly among groups that are at high risk for suicide on the overall wellness and health promotion strategies related to suicide attempts2 7#h7 promote the sharing of data regarding suicide with ,federal agencies involved with suicide early intervention and prevention1 and ,state-sponsored statewide and tribal suicide early intervention and prevention strategies for the purpose of identifying previously unknown mental health causes and associated risk factors for suicide among all ages particularly among groups that are at high risk for suicide2 7#i7 evaluate and disseminate outcomes and best practices of mental health and substance use disorder services at institutions of higher education2 and 7#aj7 conduct other activities determined appropriate by the ,secretary4 7c7 ,authorization of appropriations ,for the purpose of carrying out this section1 there are authorized to be appropriated #e1jjj1jjj for each of the fiscal years #bjad through #bjah4 4 #c4 ,youth suicide intervention and prevention strategies ,section #ebj;,e of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#cf7 is amended to read as follows3 #ebj;,e4 ,youth suicide early intervention and prevention strategies 7a7 ,in general ,the ,secretary1 acting through the ,administrator of the ,substance ,abuse and ,mental ,health ,services ,administration1 shall award grants or cooperative agreements to eligible entities to-- 7#a7 develop and implement ,state-sponsored statewide or tribal youth suicide early intervention and prevention strategies in schools1 educational institutions1 juvenile justice systems1 substance use disorder programs1 mental health programs1 foster care systems1 and other child and youth support organizations2 7#b7 support public organizations and private nonprofit organizations actively involved in ,state-sponsored statewide or tribal youth suicide early intervention and prevention strategies and in the development and continuation of ,state-sponsored statewide youth suicide early intervention and prevention strategies2 7#c7 provide grants to institutions of higher education to coordinate the implementation of ,state-sponsored statewide or tribal youth suicide early intervention and prevention strategies2 7#d7 collect and analyze data on ,state-sponsored statewide or tribal youth suicide early intervention and prevention services that can be used to monitor the effectiveness of such services and for research1 technical assistance1 and policy development2 and 7#e7 assist eligible entities1 through ,state-sponsored statewide or tribal youth suicide early intervention and prevention strategies1 in achieving targets for youth suicide reductions under title ,v of the ,social ,security ,act4 7b7 ,eligible entity 7#a7 ,definition ,in this section1 the term eligible entity means-- 7,a7 a ,state2 7,b7 a public organization or private nonprofit organization designated by a ,state to develop or direct the ,state-sponsored statewide youth suicide early intervention and prevention strategy2 or 7,c7 a federally recognized ,indian tribe or tribal organization 7as defined in the ,indian ,self-,determination and ,education ,assistance ,act7 or an urban ,indian organization 7as defined in the ,indian ,health ,care ,improvement ,act7 that is actively involved in the development and continuation of a tribal youth suicide early intervention and prevention strategy4 7#b7 ,limitation ,in carrying out this section1 the ,secretary shall ensure that a ,state does not receive more than one grant or cooperative agreement under this section at any one time4 ,for purposes of the preceding sentence1 a ,state shall be considered to have received a grant or cooperative agreement if the eligible entity involved is the ,state or an entity designated by the ,state under paragraph 7#a77;,b74 ,nothing in this paragraph shall be constructed to apply to entities described in paragraph 7#a77;,c74 7c7 ,preference ,in providing assistance under a grant or cooperative agreement under this section1 an eligible entity shall give preference to public organizations1 private nonprofit organizations1 political subdivisions1 institutions of higher education1 and tribal organizations actively involved with the ,state-sponsored statewide or tribal youth suicide early intervention and prevention strategy that-- 7#a7 provide early intervention and assessment services1 including screening programs1 to youth who are at risk for mental or emotional disorders that may lead to a suicide attempt1 and that are integrated with school systems1 educational institutions1 juvenile justice systems1 substance use disorder programs1 mental health programs1 foster care systems1 and other child and youth support organizations2 7#b7 demonstrate collaboration among early intervention and prevention services or certify that entities will engage in future collaboration2 7#c7 employ or include in their applications a commitment to evaluate youth suicide early intervention and prevention practices and strategies adapted to the local community2 7#d7 provide timely referrals for appropriate community-based mental health care and treatment of youth who are at risk for suicide in child-serving settings and agencies2 7#e7 provide immediate support and information resources to families of youth who are at risk for suicide2 7#f7 offer access to services and care to youth with diverse linguistic and cultural backgrounds2 7#g7 offer appropriate postsuicide intervention services1 care1 and information to families1 friends1 schools1 educational institutions1 juvenile justice systems1 substance use disorder programs1 mental health programs1 foster care systems1 and other child and youth support organizations of youth who recently completed suicide2 7#h7 offer continuous and up-to-date information and awareness campaigns that target parents1 family members1 child care professionals1 community care providers1 and the general public and highlight the risk factors associated with youth suicide and the life-saving help and care available from early intervention and prevention services2 7#i7 ensure that information and awareness campaigns on youth suicide risk factors1 and early intervention and prevention services1 use effective communication mechanisms that are targeted to and reach youth1 families1 schools1 educational institutions1 and youth organizations2 7#aj7 provide a timely response system to ensure that child-serving professionals and providers are properly trained in youth suicide early intervention and prevention strategies and that child-serving professionals and providers involved in early intervention and prevention services are properly trained in effectively identifying youth who are at risk for suicide2 7#aa7 provide continuous training activities for child care professionals and community care providers on the latest youth suicide early intervention and prevention services practices and strategies2 7#ab7 conduct annual self-evaluations of outcomes and activities1 including consulting with interested families and advocacy organizations2 7#ac7 provide services in areas or regions with rates of youth suicide that exceed the national average as determined by the ,centers for ,disease ,control and ,prevention2 and 7#ad7 obtain informed written consent from a parent or legal guardian of an at-risk child before involving the child in a youth suicide early intervention and prevention program4 7d7 ,requirement for direct services ,not less than #he percent of grant funds received under this section shall be used to provide direct services1 of which not less than #e percent shall be used for activities authorized under subsection 7a77#c74 7e7 ,consultation and policy development 7#a7 ,in general ,in carrying out this section1 the ,secretary shall collaborate with relevant ,federal agencies and suicide working groups responsible for early intervention and prevention services relating to youth suicide4 7#b7 ,consultation ,in carrying out this section1 the ,secretary shall consult with-- 7,a7 ,state and local agencies1 including agencies responsible for early intervention and prevention services under title ,,xix of the ,social ,security ,act1 the ,state ,children's ,health ,insurance ,program under title ,,xxi of the ,social ,security ,act1 and programs funded by grants under title ,v of the ,social ,security ,act2 7,b7 local and national organizations that serve youth at risk for suicide and their families2 7,c7 relevant national medical and other health and education specialty organizations2 7,d7 youth who are at risk for suicide1 who have survived suicide attempts1 or who are currently receiving care from early intervention services2 7,e7 families and friends of youth who are at risk for suicide1 who have survived suicide attempts1 who are currently receiving care from early intervention and prevention services1 or who have completed suicide2 7,f7 qualified professionals who possess the specialized knowledge1 skills1 experience1 and relevant attributes needed to serve youth at risk for suicide and their families2 and 7,g7 third-party payers1 managed care organizations1 and related commercial industries4 7#c7 ,policy development ,in carrying out this section1 the ,secretary shall-- 7,a7 coordinate and collaborate on policy development at the ,federal level with the relevant ,department of ,health and ,human ,services agencies and suicide working groups2 and 7,b7 consult on policy development at the ,federal level with the private sector1 including consumer1 medical1 suicide prevention advocacy groups1 and other health and education professional-based organizations1 with respect to ,state-sponsored statewide or tribal youth suicide early intervention and prevention strategies4 7f7 ,rule of construction2 religious and moral accommodation ,nothing in this section shall be construed to require suicide assessment1 early intervention1 or treatment services for youth whose parents or legal guardians object based on the parents' or legal guardians' religious beliefs or moral objections4 7g7 ,evaluations and report 7#a7 ,evaluations by eligible entities ,not later than #ah months after receiving a grant or cooperative agreement under this section1 an eligible entity shall submit to the ,secretary the results of an evaluation to be conducted by the entity concerning the effectiveness of the activities carried out under the grant or agreement4 7#b7 ,report ,not later than #b years after the date of enactment of this section1 the ,secretary shall submit to the appropriate committees of ,congress a report concerning the results of-- 7,a7 the evaluations conducted under paragraph 7#a72 and 7,b7 an evaluation conducted by the ,secretary to analyze the effectiveness and efficacy of the activities conducted with grants1 collaborations1 and consultations under this section4 7h7 ,rule of construction2 student medication ,nothing in this section shall be construed to allow school personnel to require that a student obtain any medication as a condition of attending school or receiving services4 7i7 ,prohibition ,funds appropriated to carry out this section1 section #ebg1 or section #ebi shall not be used to pay for or refer for abortion4 7j7 ,parental consent ,states and entities receiving funding under this section shall obtain prior written1 informed consent from the child's parent or legal guardian for assessment services1 school-sponsored programs1 and treatment involving medication related to youth suicide conducted in elementary and secondary schools4 ,the requirement of the preceding sentence does not apply in the following cases3 7#a7 ,in an emergency1 where it is necessary to protect the immediate health and safety of the student or other students4 7#b7 ,other instances1 as defined by the ,state1 where parental consent cannot reasonably be obtained4 7k7 ,relation to education provisions ,nothing in this section shall be construed to supersede section #ddd of the ,general ,education ,provisions ,act1 including the requirement of prior parental consent for the disclosure of any education records4 ,nothing in this section shall be construed to modify or affect parental notification requirements for programs authorized under the ,elementary and ,secondary ,education ,act of #aife 7as amended by the ,no ,child ,left ,behind ,act of #bjja2 ,public ,law #ajg-aaj74 7l7 ,definitions ,in this section3 7#a7 ,early intervention ,the term early intervention means a strategy or approach that is intended to prevent an outcome or to alter the course of an existing condition4 7#b7 ,educational institution2 institution of higher education2 school ,the term-- 7,a7 educational institution means a school or institution of higher education2 7,b7 institution of higher education has the meaning given such term in section #aja of the ,higher ,education ,act of #aife2 and 7,c7 school means an elementary or secondary school 7as such terms are defined in section #iaja of the ,elementary and ,secondary ,education ,act of #aife74 7#c7 ,prevention ,the term prevention means a strategy or approach that reduces the likelihood or risk of onset1 or delays the onset1 of adverse health problems that have been known to lead to suicide4 7#d7 ,youth ,the term youth means individuals who are between #aj and #bd years of age4 7m7 ,authorization of appropriations ,for the purpose of carrying out this section1 there are authorized to be appropriated #cb1jjj1jjj for each of the fiscal years #bjad through #bjah4 4 #d4 ,mental health and substance use disorders services and outreach on campus ,section #ebj;,e-#b of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#cf;b7 is amended to read as follows3 #ebj;,e-#b4 ,mental health and substance use disorders services on campus 7a7 ,in general ,the ,secretary1 acting through the ,director of the ,center for ,mental ,health ,services and in consultation with the ,secretary of ,education1 shall award grants on a competitive basis to institutions of higher education to enhance services for students with mental health or substance use disorders and to develop best practices for the delivery of such services4 7b7 ,uses of funds ,amounts received under a grant under this section shall be used for #a or more of the following activities3 7#a7 ,the provision of mental health and substance use disorder services to students1 including prevention1 promotion of mental health1 voluntary screening1 early intervention1 voluntary assessment1 treatment1 and management of mental health and substance abuse disorder issues4 7#b7 ,the provision of outreach services to notify students about the existence of mental health and substance use disorder services4 7#c7 ,educating students1 families1 faculty1 staff1 and communities to increase awareness of mental health and substance use disorders4 7#d7 ,the employment of appropriately trained staff1 including administrative staff4 7#e7 ,the provision of training to students1 faculty1 and staff to respond effectively to students with mental health and substance use disorders4 7#f7 ,the creation of a networking infrastructure to link colleges and universities with providers who can treat mental health and substance use disorders4 7#g7 ,developing1 supporting1 evaluating1 and disseminating evidence-based and emerging best practices4 7c7 ,implementation of activities using grant funds ,an institution of higher education that receives a grant under this section may carry out activities under the grant through-- 7#a7 college counseling centers2 7#b7 college and university psychological service centers2 7#c7 mental health centers2 7#d7 psychology training clinics2 7#e7 institution of higher education supported1 evidence-based1 mental health and substance use disorder programs2 or 7#f7 any other entity that provides mental health and substance use disorder services at an institution of higher education4 7d7 ,application ,to be eligible to receive a grant under this section1 an institution of higher education shall prepare and submit to the ,secretary an application at such time and in such manner as the ,secretary may require4 ,at a minimum1 such application shall include the following3 7#a7 ,a description of identified mental health and substance use disorder needs of students at the institution of higher education4 7#b7 ,a description of ,federal1 ,state1 local1 private1 and institutional resources currently available to address the needs described in paragraph 7#a7 at the institution of higher education4 7#c7 ,a description of the outreach strategies of the institution of higher education for promoting access to services1 including a proposed plan for reaching those students most in need of mental health services4 7#d7 ,a plan1 when applicable1 to meet the specific mental health and substance use disorder needs of veterans attending institutions of higher education4 7#e7 ,a plan to seek input from community mental health providers1 when available1 community groups and other public and private entities in carrying out the program under the grant4 7#f7 ,a plan to evaluate program outcomes1 including a description of the proposed use of funds1 the program objectives1 and how the objectives will be met4 7#g7 ,an assurance that the institution will submit a report to the ,secretary each fiscal year concerning the activities carried out with the grant and the results achieved through those activities4 7e7 ,special considerations ,in awarding grants under this section1 the ,secretary shall give special consideration to applications that describe programs to be carried out under the grant that-- 7#a7 demonstrate the greatest need for new or additional mental and substance use disorder services1 in part by providing information on current ratios of students to mental health and substance use disorder health professionals2 and 7#b7 demonstrate the greatest potential for replication4 7f7 ,requirement of matching funds 7#a7 ,in general ,the ,secretary may make a grant under this section to an institution of higher education only if the institution agrees to make available 7directly or through donations from public or private entities7 non-,federal contributions in an amount that is not less than #a for each #a of ,federal funds provided under the grant1 toward the costs of activities carried out with the grant 7as described in subsection 7b77 and other activities by the institution to reduce student mental health and substance use disorders4 7#b7 ,determination of amount contributed ,non-,federal contributions required under paragraph 7#a7 may be in cash or in kind4 ,amounts provided by the ,federal ,government1 or services assisted or subsidized to any significant extent by the ,federal ,government1 may not be included in determining the amount of such non-,federal contributions4 7#c7 ,waiver ,the ,secretary may waive the application of paragraph 7#a7 with respect to an institution of higher education if the ,secretary determines that extraordinary need at the institution justifies the waiver4 7g7 ,reports ,for each fiscal year that grants are awarded under this section1 the ,secretary shall conduct a study on the results of the grants and submit to the ,congress a report on such results that includes the following3 7#a7 ,an evaluation of the grant program outcomes1 including a summary of activities carried out with the grant and the results achieved through those activities4 7#b7 ,recommendations on how to improve access to mental health and substance use disorder services at institutions of higher education1 including efforts to reduce the incidence of suicide and substance use disorders4 7h7 ,definitions ,in this section1 the term institution of higher education has the meaning given such term in section #aja of the ,higher ,education ,act of #aife4 7i7 ,authorization of appropriations ,for the purpose of carrying out this section1 there are authorized to be appropriated #g1jjj1jjj for each of the fiscal years #bjad through #bjah4 4