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108th CONGRESS
1st Session
H. R. 811
To authorize the Secretary of Health and Human Services to make
demonstration grants to promote the well-being and educational
achievement of children through school-based health programs.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 13, 2003
Ms. Eddie Bernice Johnson of Texas (for herself, Mr. Cummings, Ms.
DeLauro, Mr. Davis of Illinois, Mr. Sessions, and Mr. Crane) 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 to make
demonstration grants to promote the well-being and educational
achievement of children through school-based health programs.
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 ``Student Medical Access Raising Test
Scores Health Act'', or the ``SMARTS Health Act''.
SEC. 2. FINDINGS.
The Congress finds as follows:
(1) The Journal of the American Medical Association reports
that protecting children's health requires two key elements,
which are (A) that a caring adult is engaged in the life of the
child, and (B) that there is a connection between the child and
his or her school.
(2) Schools offer the most natural community setting in
which individuals live, work, and play. Schools are a respected
element of community infrastructure and are recognized as the
most valuable element in creating connection and support for
children, families, and communities.
(3) Primary care and behavioral health services are among
the most important elements of a comprehensive approach to
promoting health and education and preventing illness in
children and youth.
(4) School safety and violence prevention are critical to
the well-being of each student, and early intervention and
mental health care significantly reduce school discipline
problems.
(5) Good health is a prerequisite for optimal learning, and
schools can help students achieve academic success by
participating in efforts that promote good health, including
access to regular medical and mental health care.
(6) Children are experiencing increasing rates of
behavioral and physical illness, such as attention deficit
hyperactivity disorder (ADHD) and asthma and diabetes, and are
experiencing increasing rates of obesity that portend
increasing rates of diabetes, heart disease, and cancer later
in life.
(7) In order to be effective, new strategies for prevention
must be built on community-based, community-designed, and
community-implemented strategies.
(8) Effective behavioral and physical health services can
be provided in a school-based setting in such a way as to
prevent later disease.
(9) Schools are ideal settings in which to provide care for
children, especially those who would otherwise have inadequate
access to health services. Limited access contributes directly
to the growing rates of disease among children. Prevention
strategies should be joined with treatment to develop an
understanding of what types of prevention can reduce rates of
illness, and therefore the need for treatment. Higher rates of
disease, even with adequate access to health services, portend
loss of vitality and higher complications from disease.
(10) School-based health programs should focus on improving
behavioral and physical health, including with respect to
obesity.
(11) By reducing the incidence of disease, effective
community-based prevention programs (whether through school-
based approaches or otherwise) result in significant savings to
the Federal Government and to the States by reducing
expenditures in Federal and State health services programs.
Such savings should be dedicated to further prevention efforts,
which in turn will result in further savings. Savings that
result from prevention programs should not be redirected to
unrelated purposes, and prevention programs that achieve
savings should not be penalized by having their funding levels
reduced.
SEC. 3. DEMONSTRATION GRANTS FOR EXPANSION OF SCHOOL-BASED HEALTH
PROGRAMS.
(a) In General.--
(1) Program of grants.--The Secretary of Health and Human
Services may make demonstration grants to eligible entities for
the purpose of expanding school-based health programs that are
operated by such entities.
(2) Consultation.--The Secretary shall coordinate the
program under this section with the program under title XIX of
the Social Security Act (relating to Medicaid); the program
under title XXI of such Act (relating to the State children's
health insurance program); programs of the Substance Abuse and
Mental Health Services Administration; programs of the Health
Resources and Services Administration; programs of the Centers
for Disease Control and Prevention; programs of the Agency for
Healthcare Research and Quality; programs of the National
Institutes of Health; and the National Center on Minority
Health and Health Disparities.
(b) Eligible Entities.--An entity is an eligible entity for
purposes of this Act if--
(1) the entity is a public or nonprofit private institution
of higher education or a local educational agency;
(2) the entity operates a school-based health program;
(3) the health services provided by such program include
preventive health services and behavioral health services,
including with respect to nutrition, physical activity, and
otherwise preventing or treating obesity; and
(4) such program is carried out in coordination with public
and nonprofit private entities in the community involved that
provide health, education, or social services to children.
(c) Certain Programs.--Grants under subsection (a) shall be made
only to the following entities (subject to the submission of an
application in accordance with subsection (d) demonstrating status as
an eligible entity), and for the following purposes:
(1) To the University of Maryland for expanding the school-
based health program operated by such University in the
vicinity of Baltimore, in the State of Maryland.
(2) To the local educational agency that operates a school-
based health program in an independent school district in the
vicinity of Dallas, in the State of Texas, for expanding such
program.
(3) To the University of New Mexico for expanding the
school-based health program operated by such University in the
State of New Mexico.
(4) To the University of California, Los Angeles, for
expanding the school-based health program operated by such
University in the vicinity of Los Angeles, in the State of
California.
(5) To the Child Study Center Outpatient Clinic, Yale
University, for expanding the school-based health program
operated by such Center in the vicinity of New Haven, in the
State of Connecticut.
(6) To the University of Illinois at Chicago, for expanding
the school-based health program operated by such University in
the vicinity of Chicago, in the State of Illinois.
(d) Application for Grant.--A grant may be made under subsection
(a) only if an application for the grant is submitted to the Secretary
and the application is in such form, is made in such manner, and
contains such agreements, assurances, and information as the secretary
determines to be necessary to carry out this section.
(e) Outcome Goals.--In making a grant under subsection (a) for a
school-based health program, the Secretary shall establish goals for
the program in terms of health outcomes for the children served by the
program. Such goals shall be based on the objectives established by the
Secretary as part of the initiative known as Healthy People 2010, or on
other measures determined by the Secretary to be appropriate.
(f) Evaluations; Report.--
(1) Evaluations.--The Secretary, directly or through grants
or contracts, shall provide for evaluations of the school-based
programs for which grants under subsection (a) are made. Such
evaluations shall determine whether the programs have met the
applicable goals under subsection (e), and shall determine the
extent to which the programs have increased the access of the
children involved to health services, have enhanced the overall
health status of the children, and have reduced disease rates.
(2) Report.--Not later than December 31, 2004, the
Secretary shall submit to the Congress a report that describes
the findings made through evaluations under paragraph (1) and
that provides the recommendations of the Secretary for a
comprehensive national program to provide grants for the
establishment and operation of school-based health programs,
including a recommendation on the amount of funds that should
be made available for the comprehensive national program,
taking into account the savings that can be achieved in Federal
and State health services programs by reducing the incidence of
disease in the populations served by the program.
(g) Definitions.--
(1) The term ``institution of higher education'' has the
meaning given such term in section 101(a) of the Higher
Education Act of 1965.
(2) The term ``local educational agency'' has the meaning
given such term in section 9101(26) of the Elementary and
Secondary Education Act of 1965.
(3) The term ``Secretary'' means the Secretary of Health
and Human Services.
(h) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2003 through 2008.
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