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108th CONGRESS
1st Session
H. R. 3063
To authorize the Secretary of Health and Human Services, the Secretary
of Education, and the Attorney General to make 10 grants to
demonstration facilities to implement evidence-based preventive-
screening tools to detect mental illness and suicidal tendencies in
school-age youth at selected facilities.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
September 10, 2003
Ms. DeLauro (for herself, Mr. Waxman, Mr. Serrano, Mr. Towns, Mr.
Grijalva, Mrs. Christensen, and Mr. Acevedo-Vila) introduced the
following bill; which was referred to the Committee on Energy and
Commerce, and in addition to the Committee on Education and the
Workforce, for a period to be subsequently determined by the Speaker,
in each case for consideration of such provisions as fall within the
jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To authorize the Secretary of Health and Human Services, the Secretary
of Education, and the Attorney General to make 10 grants to
demonstration facilities to implement evidence-based preventive-
screening tools to detect mental illness and suicidal tendencies in
school-age youth at selected facilities.
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 ``Children's Mental Health Screening
and Prevention Act of 2003''.
SEC. 2. FINDINGS.
The Congress finds as follows:
(1) Over the past 20 years, advances in scientific research
have changed the way of thinking about children's mental health
and proven that the same mental disorders that afflict adults
can also occur in children and adolescents.
(2) In January 2001, the Report of the Surgeon General's
Conference on Children's Mental Health noted that 74 percent of
individuals age 21 with mental disorders had prior problems,
indicating that children's mental disorders often persist into
adulthood.
(3) Scientific research has demonstrated that early
identification and treatment of mental disorders in youth
greatly improves a child or adolescent's prognosis throughout
his or her lifetime.
(4) In January 2001, the Surgeon General noted that, while
1 in 10 children and adolescents in the United States suffers
from mental illness severe enough to cause some level of
impairment, only 1 in 5 of such children and adolescents
receives needed mental health treatment.
(5) According to an interim report by the President's New
Freedom Commission on Mental Health, about 7 to 9 percent of
all children who are 9 to 17 years of age (about 1 or 2 in
every classroom) have a serious emotional disturbance.
(6) In September 2002, the National Council on Disability
noted that between 60 and 70 percent of youth in the juvenile
justice system have an emotional disturbance and almost 50
percent have co-occurring disabilities.
(7) The World Health Organization has reported that youth
neuropsychiatric disorders will rise by over 50 percent by
2020, making such disorders 1 of the top 5 causes of
disability, morbidity, and mortality among children and
adolescents.
(8) Psychological autopsy studies have found that 90
percent of youths who end their own lives have depression or
another diagnosable mental or substance abuse disorder at the
time of their deaths, verifying a link between mental illness
and suicide.
(9) According to an interim report by the President's New
Freedom Commission on Mental Health, more than 30,000 lives are
lost every year to suicide, which is a largely preventable
public health problem.
(10) In 1999, the Surgeon General recognized that mental
illness and substance abuse disorders are, in fact, the
greatest risk factors for suicidal behavior, and that properly
identifying and treating mental illness and substance abuse
disorders are an important part of suicide prevention
activities.
(11) The National Council on Disability has also stated
that ``the failure to identify and treat mental disabilities
between children and youth has serious consequences, including
school failure, involvement with the justice system and other
tragic outcomes,'' including ``the growing problem of teen
suicides and/or suicide attempts''.
(12) The Centers for Disease Control and Prevention
reported that in 2000 suicide was the 3rd leading cause of
death among youth 15 to 24 years of age.
(13) The Substance Abuse and Mental Health Services
Administration reported that in 1999 almost 3,000,000 youth
were at risk for suicide, but only 36 percent received mental
health treatment.
(14) According to the Youth Risk Behavior Surveillance
System of the Centers for Disease Control and Prevention, among
high school students surveyed in 2001, 19 percent had seriously
considered attempting suicide, almost 15 percent had made a
specific plan to attempt suicide, almost 9 percent had
attempted suicide, and almost 3 percent had made an attempt at
suicide that required medical attention.
(15) The Centers for Disease Control and Prevention
reported that each year in the United States, almost as many
adolescents and young adults commit suicide as die from all
natural causes combined, including leukemia, birth defects,
pneumonia, influenza, and AIDS.
(16) In January 2001, the Surgeon General issued a goal to
``improve the assessment of and recognition of mental health
needs in children'' in part by encouraging ``early
identification of mental health needs in existing preschool,
child care, education, health, welfare, juvenile justice, and
substance abuse treatment systems''.
(17) In May 2003, the National Council on Disability noted
that ``despite calls for significant prevention and early
intervention efforts in schools and the juvenile justice
system, there is little evidence that such efforts are
widespread''. The Council also found that ``the absence is
notable because research suggests that such programming may be
the only effective method for reducing the involvement of youth
with disabilities in the juvenile justice system''.
(18) The April 2003 Outline of the Final Report for the
President's New Freedom Commission on Mental Health states that
``evidence-based practice interventions should be tested in
demonstration projects with oversight by a public-private
consortium of stakeholders''.
(19) An interim report by the President's New Freedom
Commission on Mental Health concludes that there is a range of
effective treatments, services, and supports to facilitate
recovery from mental illness, but the current system can not
efficiently deliver them.
(20) The efforts, initiatives, and activities of the
Federal Government should be used to support evidence-based
preventive-screening tools to detect mental illness and
suicidal tendencies in school-age youth.
SEC. 3. MENTAL HEALTH SCREENING DEMONSTRATION PROJECT.
(a) In General.--The Secretary of Health and Human Services, the
Secretary of Education, and the Attorney General, acting jointly and in
consultation with the Directors (as that term is defined in subsection
(k)), shall make 10 grants to demonstration facilities to implement
evidence-based preventive-screening tools to detect mental illness and
suicidal tendencies in school-age youth and to refer those youth in
need of assessment or treatment.
(b) Equitable Geographic Distribution.--To the extent practicable,
the Secretaries shall ensure an equitable distribution of grants under
this section among the geographic regions of the United States.
(c) Period of Grants.--Each grant made under subsection (a) shall
be for a period of 3 years.
(d) Application Requirements.--
(1) In general.--To seek a grant under this section, a
demonstration facility shall submit an application at such time
and in such manner as the Secretaries reasonably require.
(2) Contents.--An application submitted by a demonstration
facility for a grant under subsection (a) shall--
(A) demonstrate that the facility has formed a
multidisciplinary project implementation committee;
(B) specify an evidence-based preventive-screening
tool to be implemented with the grant;
(C) demonstrate that the facility has the means to
obtain the necessary resources and tools, other than
personnel, to implement the specified evidence-based
preventive-screening tool;
(D) demonstrate that the facility has existing
staff, will hire new staff, or will partner with staff
from a local, licensed mental health or medical
organization, and has the ability to train staff--
(i) to implement the specified evidence-
based screening tool;
(ii) to case manage youth with symptoms or
indicators for mental illness, suicidal
ideation, or suicide attempts; and
(iii) to work with the parents or guardians
of youth with symptoms or indicators for mental
illness, suicidal ideation, or suicide attempts
to help them understand the youth's outcome and
treatment options;
(E) identify the location (which need not be at the
facility) where the specified evidence-based
preventive-screening tool will be implemented;
(F) demonstrate that the facility has obtained full
approval to screen at such location;
(G) identify the sample of school-age youth to be
screened;
(H) identify a method for obtaining written consent
from the parent or legal guardian of any minor
participating in the demonstration project;
(I) identify licensed mental health providers
(including mental health professionals, hospitals,
residential treatment centers, or outpatient clinics)
in the community where the facility is located that
will partner with the facility to provide further
mental health assessments and treatment for
participating youth with symptoms or indicators of
mental illness, and demonstrate the ability of those
providers to accept referrals; and
(J) contain such other information as the
Secretaries reasonably require.
(e) Multidisciplinary Project Implementation Committee.--The
Secretaries may not make a grant to a demonstration facility under
subsection (a) for a demonstration project unless the facility agrees
to the following:
(1) The multidisciplinary project implementation committee
formed under subsection (d)(2)(A) will consist of the
following:
(A) Representatives of the facility.
(B) Representatives of the location where the
specified evidence-based preventive screening tool will
be implemented (if that location is other than the
demonstration facility).
(C) A facility case manager (as that position is
described in subsection (d)(2)(D)(ii)).
(D) Mental health providers in the community.
(E) Mental health consumers or family members of
mental health consumers.
(F) Parents or guardians of any school-aged youth
to be screened.
(2) When possible, the multidisciplinary project
implementation committee will follow the guidance of any
suicide prevention plan endorsed by State or local government
officials or local public health officials.
(3) The multidisciplinary project implementation committee
will be responsible for ensuring compliance with the
representations made by the facility in its grant application.
(4) The multidisciplinary project implementation committee
will coordinate and collaborate with mental health providers in
the community, including those identified in subsection
(d)(2)(I), to guarantee that all youth with symptoms or
indicators for mental illness, suicidal ideation, or suicide
attempts receive appropriate and affordable treatment
regardless of the financial or insurance status of the youth's
parent or guardian.
(f) Information Collection.--The Secretaries may not make a grant
to an applicant under subsection (a) for a demonstration project unless
the applicant agrees to collect the following:
(1) Information on the demographics of youth participating
in the project, including--
(A) the number of youth invited to participate in
the project, including the number of such youth
disaggregated by age, gender, and ethnicity; and
(B) the number of youth with symptoms or indicators
for mental illness requiring clinical consultation or
assessment, including such number disaggregated by
disorder.
(2) Information on the outcomes of evidence-based
preventive-screening tools, including--
(A) the number of screening refusals, due to lack
of consent by a parent or legal guardian or refusal of
the youth;
(B) the number of youth with symptoms or indicators
for all mental illnesses, including such number
disaggregated by disorder; and
(C) post assessment, the number of youth with
positive outcomes for suicidal ideation or suicide
attempts.
(3) Information on referrals based on outcomes, including--
(A) the number of youth referred for clinical
interviews to determine the need for further evaluation
or treatment;
(B) the number of youth referred for further
evaluation or treatment, including such number
disaggregated by type and location of treatment;
(C) the number of youth and their parents or legal
guardians who accept referrals for further evaluation
or treatment; and
(D) the number of youth and their parents or legal
guardians who refuse referrals for further evaluation
or treatment.
(4) To the extent practicable, information on treatment
based on referrals, including the number of appointments kept
by referred youth.
(5) To the extent practicable, information on suicide
attempts, suicide rates, and access to evidence-based mental
health screening and suicide prevention programs among school-
age youth in the designated jurisdiction in which the grantee
is located for the 3 years preceding the commencement of the
project.
(6) To the extent practicable, data on barriers to care
encountered by referred youth, including but not limited to
linguistic barriers, transportation difficulties, lack of
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