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108th CONGRESS
1st Session
H. R. 81
To amend the Public Health Service Act with respect to mental health
services for children, adolescents and their families.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
January 7, 2003
Ms. Jackson-Lee of Texas introduced the following bill; which was
referred to the Committee on Energy and Commerce
_______________________________________________________________________
A BILL
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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