,i #aafth ,,congress #ast ,session ,h4 ,r4 #aaji ,,in ,,the ,,house ,,of ,,representatives ,february #h1 #bjai,mrs4 ,napolitano 7for herself1 ,mr4 ,katko1 ,mr4 ,lowenthal1 ,ms4 ,del,bene1 ,mr4 ,tonko1 ,mr4 ,cicilline1 ,mr4 ,payne1 ,mr4 ,lujn1 ,mr4 ,doggett1 ,ms4 ,mc,collum1 ,mr4 ,moulton1 ,mr4 ,schiff1 ,mr4 ,welch1 ,mr4 ,heck1 ,mr4 ,grijalva1 ,ms4 ,hill of ,california1 ,ms4 ,judy ,chu of ,california1 ,mr4 ,kilmer1 ,ms4 ,wilson of ,florida1 ,ms4 ,kelly of ,illinois1 ,miss ,rice of ,new ,york1 ,mr4 ,ryan1 ,mr4 ,khanna1 ,mr4 ,reed1 ,mr4 ,larsen of ,washington1 ,ms4 ,jackson ,lee1 ,ms4 ,moore1 ,mr4 ,de,saulnier1 ,ms4 ,pingree1 ,mrs4 ,lawrence1 ,ms4 ,speier1 ,mr4 ,panetta1 ,mr4 ,soto1 ,ms4 ,roybal-,allard1 ,mrs4 ,watson ,coleman1 ,mr4 ,ruppersberger1 ,mr4 ,crdenas1 ,mr4 ,aguilar1 ,mr4 ,gomez1 ,mr4 ,de,fazio1 ,mr4 ,mc,govern1 ,mr4 ,blumenauer1 ,ms4 ,omar1 ,mrs4 ,murphy1 ,mr4 ,sablan1 ,mr4 ,gallego1 ,mr4 ,suozzi1 ,mr4 ,cohen1 ,mr4 ,cisneros1 ,ms4 ,matsui1 ,ms4 ,snchez1 ,ms4 ,kuster of ,new ,hampshire1 ,mrs4 ,carolyn ,b4 ,maloney of ,new ,york1 ,ms4 ,johnson of ,texas1 ,mr4 ,raskin1 ,mr4 ,carbajal1 ,ms4 ,castor of ,florida1 and ,mr4 ,mc,nerney7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce ,a ,,bill ,to amend the ,public ,health ,service ,act to revise and extend projects relating to children and to provide access to school-based comprehensive mental health programs4 #a4 ,short title ,this ,act may be cited as the ,mental ,health ,services for ,students ,act of #bjai4 #b4 ,purposes ,the purposes of this ,act are to-- 7#a7 revise1 increase funding for1 and expand the scope of the ,project ,,aware ,state ,educational ,agency ,grant ,program carried out by the ,secretary of ,health and ,human ,services1 in order to provide access to more comprehensive school-based mental health services and supports2 7#b7 provide for comprehensive staff development for school and community service personnel working in the school2 7#c7 provide for comprehensive training to improve health and academic outcomes for children with1 or at risk for1 mental health disorders1 for parents or guardians1 siblings1 and other family members of such children1 and for concerned members of the community2 7#d7 provide for comprehensive1 universal1 evidence-based screening to identify children and adolescents with potential mental health disorders or unmet emotional health needs2 7#e7 recognize best practices for the delivery of mental health care in school-based settings1 including school-based health centers2 7#f7 provide for comprehensive training for parents or guardians1 siblings1 other family members1 and concerned members of the community on behalf of children and adolescents experiencing mental health trauma1 disorder1 or disability2 and 7#g7 establish formal working relationships between health1 human service1 and educational entities that support the mental and emotional health of children and adolescents in the school setting4 #c4 ,amendments to the ,public ,health ,service ,act 7a7 ,technical amendments ,the second part ,g 7relating to services provided through religious organizations7 of title ,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bijkk et seq47 is amended-- 7#a7 by redesignating such part as part ,j2 and 7#b7 by redesignating sections #eha through #ehd as sections #eif through #eif;,c1 respectively4 7b7 ,school-,based mental health and children ,section #eha of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;hh7 7relating to children and violence7 is amended to read as follows3 #eha4 ,school-based mental health2 children and adolescents 7a7 ,in general ,the ,secretary1 in collaboration with the ,secretary of ,education1 shall1 directly or through grants1 contracts1 or cooperative agreements awarded to eligible entities described in subsection 7c71 assist local communities and schools 7including schools funded by the ,bureau of ,indian ,education7 in applying a public health approach to mental health services both in schools and in the community4 ,such approach shall provide comprehensive developmentally appropriate services and supports that are linguistically and culturally appropriate and trauma-informed1 and incorporate developmentally appropriate strategies of positive behavioral interventions and supports4 ,a comprehensive school-based mental health program funded under this section shall assist children in dealing with traumatic experiences1 grief1 bereavement1 risk of suicide1 and violence4 7b7 ,activities ,under the program under subsection 7a71 the ,secretary may-- 7#a7 provide financial support to enable local communities to implement a comprehensive culturally and linguistically appropriate1 trauma-informed1 and developmentally appropriate1 school-based mental health program that-- 7,a7 builds awareness of individual trauma and the intergenerational1 continuum of impacts of trauma on populations2 7,b7 trains appropriate staff to identify1 and screen for1 signs of trauma exposure1 mental health disorders1 or risk of suicide2 and 7,c7 incorporates positive behavioral interventions1 family engagement1 student treatment1 and multigenerational supports to foster the health and development of children1 prevent mental health disorders1 and ameliorate the impact of trauma2 7#b7 provide technical assistance to local communities with respect to the development of programs described in paragraph 7#a72 7#c7 provide assistance to local communities in the development of policies to address child and adolescent trauma and mental health issues and violence when and if it occurs2 7#d7 facilitate community partnerships among families1 students1 law enforcement agencies1 education agencies1 mental health and substance use disorder service systems1 family-based mental health service systems1 child welfare agencies1 health care providers 7including primary care physicians1 mental health professionals1 and other professionals who specialize in children's mental health such as child and adolescent psychiatrists71 institutions of higher education1 faith-based programs1 trauma networks1 and other community-based systems2 and 7#e7 establish mechanisms for children and adolescents to report incidents of violence or plans by other children1 adolescents1 or adults to commit violence4 7c7 ,requirements 7#a7 ,in general ,to be eligible for a grant1 contract1 or cooperative agreement under subsection 7a71 an entity shall-- 7,a7 be a partnership that includes-- 7i7 a ,state educational agency1 as defined in section #haja of the ,elementary and ,secondary ,education ,act of #aife1 in coordination with one or more local educational agencies1 as defined in section #haja of the ,elementary and ,secondary ,education ,act of #aife1 or a consortium of any entities described in subparagraph 7,b71 7,c71 7,d71 or 7,e7 of section #haja7cj7 of such ,act2 and 7ii7 in accordance with paragraph 7#b77;,a77i71 appropriate public or private entities that employ interventions that are evidence-based1 as defined in section #haja of the ,elementary and ,secondary ,education ,act of #aife2 and 7,b7 submit an application1 that is endorsed by all members of the partnership1 that-- 7i7 specifies which member will serve as the lead partner2 and 7ii7 contains the assurances described in paragraph 7#b74 7#b7 ,required assurances ,an application under paragraph 7#a7 shall contain assurances as follows3 7,a7 ,the eligible entity will ensure that1 in carrying out activities under this section1 the eligible entity will enter into a memorandum of understanding-- 7i7 with at least #a community-based mental health provider1 including a public or private mental health entity1 health care entity1 family-based mental health entity1 trauma network1 or other community-based entity1 as determined by the ,secretary 7and which may include additional entities such as a human services agency1 law enforcement or juvenile justice entity1 child welfare agency1 agency1 an institution of higher education1 or another entity1 as determined by the ,secretary72 and 7ii7 that clearly states-- 7,i7 the responsibilities of each partner with respect to the activities to be carried out1 including how family engagement will be incorporated in the activities2 7,,ii7 how school-employed and school-based or community-based mental health professionals will be utilized for carrying out such responsibilities2 7,,iii7 how each such partner will be accountable for carrying out such responsibilities2 and 7,,iv7 the amount of non-,federal funding or in-kind contributions that each such partner will contribute in order to sustain the program4 7,b7 ,the comprehensive school-based mental health program carried out under this section supports the flexible use of funds to address-- 7i7 universal prevention1 through the promotion of the social1 emotional1 mental1 and behavioral health of all students in an environment that is conducive to learning2 7ii7 selective prevention1 through the reduction in the likelihood of at risk students developing social1 emotional1 mental1 behavioral health problems1 suicide1 or substance use disorders2 7iii7 the screening for1 and early identification of1 social1 emotional1 mental1 behavioral problems1 suicide risk1 or substance use disorders and the provision of early intervention services2 7iv7 the treatment or referral for treatment of students with existing social1 emotional1 mental1 behavioral health problems1 or substance use disorders2 7v7 the development and implementation of evidence-based programs to assist children who are experiencing or have been exposed to trauma and violence1 including program curricula1 school supports1 and after-school programs2 and 7vi7 the development and implementation of evidence-based programs to assist children who are grieving1 which may include training for school personnel on the impact of trauma and bereavement on children1 and services to provide support to grieving children4 7,c7 ,the comprehensive school-based mental health program carried out under this section will provide for in-service training of all school personnel1 including ancillary staff and volunteers1 in-- 7i7 the techniques and supports needed to promote early identification of children with trauma histories1 children who are grieving1 and children with a mental health disorder or at risk of developing a mental health disorder1 or who are at risk of suicide2 7ii7 the use of referral mechanisms that effectively link such children to appropriate prevention1 treatment1 and intervention services in the school and in the community and to follow-up when services are not available2 7iii7 strategies that promote a school-wide positive environment1 including strategies to prevent bullying1 which includes cyber-bullying2 7iv7 strategies for promoting the social1 emotional1 mental1 and behavioral health of all students2 and 7v7 strategies to increase the knowledge and skills of school and community leaders about the impact of trauma and violence and on the application of a public health approach to comprehensive school-based mental health programs4 7,d7 ,the comprehensive school-based mental health program carried out under this section will include comprehensive training for parents or guardians1 siblings1 and other family members of children with mental health disorders1 and for concerned members of the community in-- 7i7 the techniques and supports needed to promote early identification of children with trauma histories1 children who are grieving1 children with a mental health disorder or at risk of developing a mental health disorder1 and children who are at risk of suicide2 7ii7 the use of referral mechanisms that effectively link such children to appropriate prevention1 treatment1 and intervention services in the school and in the community and follow-up when such services are not available2 and 7iii7 strategies that promote a school-wide positive environment1 including strategies to prevent bullying1 including cyber-bullying4 7,e7 ,the comprehensive school-based mental health program carried out under this section will demonstrate the measures to be taken to sustain the program 7which may include seeking funding for the program under a ,state ,medicaid plan under title ,,xix of the ,social ,security ,act or a waiver of such a plan1 or under a ,state plan under subpart #a of part ,b or part ,e of title ,,iv of the ,social ,security ,act74 7,f7 ,the eligible entity is supported by the ,state agency with primary responsibility for behavioral health to ensure that the comprehensive school-based mental health program carried out under this section will be sustainable after funding under this section terminates4 7,g7 ,the comprehensive school-based mental health program carried out under this section will be coordinated with early intervening activities carried out under the ,individuals with ,disabilities ,education ,act or activities funded under part ,a of title ,,iv of the ,elementary and ,secondary ,education ,act of #aife4 7,h7 ,the comprehensive school-based mental health program carried out under this section will be trauma-informed1 evidence-based1 and developmentally1 culturally1 and linguistically appropriate4 7,i7 ,the comprehensive school-based mental health program carried out under this section will include a broad needs assessment of youth who drop out of school due to policies of zero tolerance with respect to drugs1 alcohol1 or weapons and an inability to obtain appropriate services4 7,j7 ,the mental health services provided through the comprehensive school-based mental health program carried out under this section will be provided by qualified mental and behavioral health professionals who are certified1 credentialed1 or licensed in compliance with applicable ,federal and ,state law and regulations by the ,state involved and who are practicing within their area of expertise4 7,k7 ,students will be permitted to self-refer to the mental health program for mental health care and self-consent for mental health crisis care to the extent permitted by ,state or other applicable law4 7#c7 ,coordinator ,any entity that is a member of a partnership described in paragraph 7#a77;,a7 may serve as the coordinator of funding and activities under the grant if all members of the partnership agree4 7#d7 ,compliance with ,,hipaa ,a grantee under this section shall be deemed to be a covered entity for purposes of compliance with the regulations promulgated under section #bfd7;c7 of the ,health ,insurance ,portability and ,accountability ,act of #aiif with respect to any patient records developed through activities under the grant4 7#e7 ,compliance with ,,ferpa ,section #ddd of the ,general ,education ,provisions ,act 7commonly known as the ,family ,educational ,rights and ,privacy ,act of #aigd7 shall apply to any entity that is a member of the partnership in the same manner that such section applies to an educational agency or institution 7as that term is defined in such section74 7d7 ,geographical distribution ,the ,secretary shall ensure that grants1 contracts1 or cooperative agreements under subsection 7a7 will be distributed equitably among the regions of the country and among urban and rural areas4 7e7 ,duration of awards ,with respect to a grant1 contract1 or cooperative agreement under subsection 7a71 the period during which payments under such an award will be made to the recipient shall be #e years1 with options for renewal4 7f7 ,evaluation and measures of outcomes 7#a7 ,development of process ,the ,assistant ,secretary shall develop a fiscally appropriate process for evaluating activities carried out under this section4 ,such process shall include-- 7,a7 the development of guidelines for the submission of program data by grant1 contract1 or cooperative agreement recipients2 7,b7 the development of measures of outcomes 7in accordance with paragraph 7#b77 to be applied by such recipients in evaluating programs carried out under this section2 and 7,c7 the submission of annual reports by such recipients concerning the effectiveness of programs carried out under this section4 7#b7 ,measures of outcomes 7,a7 ,in general ,the ,assistant ,secretary shall develop measures of outcomes to be applied by recipients of assistance under this section1 and the ,assistant ,secretary1 in evaluating the effectiveness of programs carried out under this section4 ,such measures shall include student and family measures as provided for in subparagraph 7,b7 and local educational measures as provided for under subparagraph 7,c74 7,b7 ,student and family measures of outcomes ,the measures for outcomes developed under paragraph 7#a77;,b7 relating to students and families shall1 with respect to activities carried out under a program under this section1 at a minimum include provisions to evaluate whether the program is effective in-- 7i7 increasing social and emotional competency2 7ii7 improving academic outcomes1 including as measured by proficiency on the annual assessments under section #aaaa7;b77#b7 of the ,elementary and ,secondary ,education ,act of #aife2 7iii7 reducing disruptive and aggressive behaviors2 7iv7 improving child functioning2 7v7 reducing substance use disorders2 7vi7 reducing rates of suicide2 7vii7 reducing suspensions1 truancy1 expulsions1 and violence2 7viii7 increasing high school graduation rates1 calculated using the four-year adjusted cohort graduation rate or the extended-year adjusted cohort graduation rate 7as such terms are defined in section #haja of the ,elementary and ,secondary ,education ,act of #aife72 7ix7 improving attendance rates and rates of chronic absenteeism2 7x7 improving access to care for mental health disorders1 including access to mental health services that are trauma-informed1 and developmentally1 linguistically1 and culturally appropriate2 7xi7 improving health outcomes2 and 7xii7 decreasing disparities among vulnerable and protected populations in outcomes described in clauses 7i7 through 7viii74 7,c7 ,local educational outcomes ,the outcome measures developed under paragraph 7#a77;,b7 relating to local educational systems shall1 with respect to activities carried out under a program under this section1 at a minimum include provisions to evaluate-- 7i7 the effectiveness of comprehensive school mental health programs established under this section2 7ii7 the effectiveness of formal partnership linkages among child and family serving institutions1 community support systems1 and the educational system2 7iii7 the progress made in sustaining the program once funding under the grant has expired2 7iv7 the effectiveness of training and professional development programs for all school personnel that incorporate indicators that measure cultural and linguistic competencies under the program in a manner that incorporates appropriate cultural and linguistic training2 7v7 the improvement in perception of a safe and supportive learning environment among school staff1 students1 and parents2 7vi7 the improvement in case-finding of students in need of more intensive services and referral of identified students to prevention1 early intervention1 and clinical services2 7vii7 the improvement in the immediate availability of clinical assessment and treatment services within the context of the local community to students posing a danger to themselves or others2 7viii7 the increased successful matriculation to postsecondary school2 7ix7 reduced suicide rates2 7x7 reduced referrals to juvenile justice2 and 7xi7 increased educational equity4 7#c7 ,submission of annual data ,an eligible entity described in subsection 7c7 that receives a grant1 contract1 or cooperative agreement under this section shall annually submit to the ,assistant ,secretary a report that includes data to evaluate the success of the program carried out by the entity based on whether such program is achieving the purposes of the program4 ,such reports shall utilize the measures of outcomes under paragraph 7#b7 in a reasonable manner to demonstrate the progress of the program in achieving such purposes4 7#d7 ,evaluation by ,assistant ,secretary ,based on the data submitted under paragraph 7#c71 the ,assistant ,secretary shall annually submit to ,congress a report concerning the results and effectiveness of the programs carried out with assistance received under this section4 7#e7 ,limitation ,an eligible entity shall use not more than #bj percent of amounts received under a grant under this section to carry out evaluation activities under this subsection4 7g7 ,information and education ,the ,secretary shall establish comprehensive information and education programs to disseminate the findings of the knowledge development and application under this section to the general public and to health care professionals4 7h7 ,amount of grants and authorization of appropriations 7#a7 ,amount of grants ,a grant under this section shall be in an amount that is not more than #b1jjj1jjj for each of the first #e fiscal years following the date of enactment of the ,mental ,health ,services for ,students ,act of #bjai4 ,the ,secretary shall determine the amount of each such grant based on the population of children up to age #ba of the area to be served under the grant4 7#b7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section1 #bjj1jjj1jjj for each of the first #e fiscal years following the date of enactment of the ,mental ,health ,services for ,students ,act of #bjai4 4 7c7 ,conforming amendment ,part ,g of title ,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;hh et seq471 as amended by subsection 7b71 is further amended by striking the part designation and heading and inserting the following3 ,g ,school-based mental health 4