To amend the Public Health Service Act with respect to mental health services for children, adolescents and their families.

January 7, 2003

Ms. JACKSON-LEE of Texas introduced the following bill; which was referred to the Committee on Energy and Commerce

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 Representatives 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 2003'.

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 prevention perspective, it is noteworthy that children and adolescents with mental illnesses often don't become substance abusers until 5 to 10 years after the mental illness becomes apparent. This creates a window of opportunity during which time it may be possible to prevent substance abuse from occurring in these children.

(3) The interaction of multiple factors has increased the overall number of children suffering from psychological, emotional and behavioral disorders. 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 experiencing traumatic events, poverty, alienation, and multiple environmental and family factors including abuse and neglect, creates greater psychological neglect 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 minority communities, young children are chronically exposed to serious violent crime during their formative years. It is the recent school violence in suburban 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 affected by or involved in theft, vandalism, bullying, intimidation, intolerance, and disruption.

(6) While the above behaviors are symptomatic of mental health problems requiring service interventions, 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 violence, 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 receive some form of mental health intervention. Thus, about 75 to 80 percent fail to receive specialty services, and the majority of these children fail to receive 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, learning, 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 reducing the neglected tragedy of mental, emotional and behavioral problems among youth.

(11) Mental health services personnel can provide consultation with teachers to improve classroom environment and provide guidance around specific children. Consulting with parents, they enable teachers and families to work together, increasing the family's involvement in their child's academic performance and psychosocial development.

(12) The lack of mental health services in schools and communities where the greatest need exists has resulted in a disproportionate increase in children dropping out of school, becoming involved in delinquent activity, and becoming part of the juvenile and adult criminal justice systems. In fact, because 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, ADOLESCENTS AND THEIR FAMILIES.

Title V of the Public Health Service Act (42 U.S.C. 290aa et seq.) is amended by inserting after section 520A the following section:

`SEC. 520B. MENTAL HEALTH SERVICES FOR CHILDREN, ADOLESCENTS AND THEIR FAMILIES.

`(a) IN GENERAL- In cooperation with the Secretary 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 appropriate 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 communities 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 development;

`(5) provide training, technical assistance, consultation, and support for community service providers, 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 requiring a commitment on the part of local communities in which the programs provide services;

`(7) provide for the evaluation of programs operating under this section to ensure that they are providing intended services in an efficient and effective manner; and

`(8) provide school-based mental health assessment and treatment services conducted by a mental health professional (who may be a school counselor, school nurse, school psychologist, clinical psychologist, 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 described 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 payments 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 effectiveness 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 problems. Local educational agencies receiving such grants shall ensure that the schools receiving these funds maintain 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 students; and

`(4) school social worker for every 800 students.

`(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 worker' mean an individual who possesses licensure or certification in the State involved, and who meets professional standards for practice in schools and related settings, as a school counselor, school nurse, school psychologist, or school social worker, respectively.

`(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 2004 and such sums as are necessary for fiscal years 2005 and 2006. 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 programs.'.

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