Mental Health Services for Students Act of 2021

II 117TH CONGRESS 1ST SESSION S. 1841 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 programs. IN THE SENATE OF THE UNITED STATES MAY 26, 2021 Ms. SMITH (for herself, Mr. WHITEHOUSE, Mr. BLUMENTHAL, Mr. WYDEN, Mr. MURPHY, Mr. SANDERS, and Mr. VAN HOLLEN) introduced the fol- lowing bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 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 programs. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Mental Health Services 4 for Students Act of 2021’’. 5 SEC. 2. PURPOSES. 6 The purposes of this Act are to— 7 VerDate Sep 11 2014 04:33 Jun 11, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1841.IS S1841 kjohnson on DSK79L0C42PROD with BILLS 2 •S 1841 IS (1) revise, increase funding for, and expand the 1 scope of the Project AWARE State Educational 2 Agency Grant Program carried out by the Secretary 3 of Health and Human Services, in order to provide 4 access to more comprehensive school-based mental 5 health services and supports; 6 (2) provide for comprehensive staff development 7 for school and community service personnel working 8 in public schools; 9 (3) provide for comprehensive training to im- 10 prove health and academic outcomes for children 11 with, or at risk for, mental health disorders, for par- 12 ents or guardians, siblings, and other family mem- 13 bers of such children, and for concerned members of 14 the community; 15 (4) provide for comprehensive, universal, evi- 16 dence-based screening to identify children and ado- 17 lescents with potential mental health disorders or 18 unmet emotional health needs; 19 (5) recognize best practices for the delivery of 20 mental health care in school-based settings, includ- 21 ing school-based health centers; 22 (6) provide for comprehensive training for par- 23 ents or guardians, siblings, other family members, 24 and concerned members of the community on behalf 25 VerDate Sep 11 2014 04:33 Jun 11, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1841.IS S1841 kjohnson on DSK79L0C42PROD with BILLS 3 •S 1841 IS of children and adolescents experiencing mental 1 health trauma, disorder, or disability; and 2 (7) establish formal working relationships be- 3 tween health, human service, and educational enti- 4 ties that support the mental and emotional health of 5 children and adolescents in the school setting. 6 SEC. 3. AMENDMENTS TO THE PUBLIC HEALTH SERVICE 7 ACT. 8 (a) TECHNICAL AMENDMENTS.—The second part G 9 (relating to services provided through religious organiza- 10 tions) of title V of the Public Health Service Act (42 11 U.S.C. 290kk et seq.) is amended— 12 (1) by redesignating such part as part J; and 13 (2) by redesignating sections 581 through 584 14 as sections 596 through 596C, respectively. 15 (b) SCHOOL-BASED MENTAL HEALTH AND CHIL- 16 DREN.—Section 581 of the Public Health Service Act (42 17 U.S.C. 290hh) (relating to children and violence) is 18 amended to read as follows: 19 ‘‘SEC. 581. SCHOOL-BASED MENTAL HEALTH; CHILDREN 20 AND ADOLESCENTS. 21 ‘‘(a) IN GENERAL.—The Secretary, in collaboration 22 with the Secretary of Education, shall, directly or through 23 grants, contracts, or cooperative agreements awarded to 24 eligible entities described in subsection (c), assist local 25 VerDate Sep 11 2014 04:33 Jun 11, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1841.IS S1841 kjohnson on DSK79L0C42PROD with BILLS 4 •S 1841 IS communities and public schools (including schools funded 1 by the Bureau of Indian Education) in applying a public 2 health approach to mental health services both in public 3 schools and in the community. Such approach shall pro- 4 vide comprehensive developmentally appropriate services 5 and supports that are linguistically and culturally appro- 6 priate and trauma-informed, and incorporate develop- 7 mentally appropriate strategies of positive behavioral 8 interventions and supports. A comprehensive school-based 9 mental health program funded under this section shall as- 10 sist children in dealing with traumatic experiences, grief, 11 bereavement, risk of suicide, and violence. 12 ‘‘(b) ACTIVITIES.—Under the program under sub- 13 section (a), the Secretary may— 14 ‘‘(1) provide financial support to enable local 15 communities to implement a comprehensive cul- 16 turally and linguistically appropriate, trauma-in- 17 formed, and developmentally appropriate, school- 18 based mental health program that— 19 ‘‘(A) builds awareness of individual trauma 20 and the intergenerational, continuum of impacts 21 of trauma on populations; 22 ‘‘(B) trains appropriate staff to identify, 23 and screen for, signs of trauma exposure, men- 24 tal health disorders, or risk of suicide; and 25 VerDate Sep 11 2014 04:33 Jun 11, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1841.IS S1841 kjohnson on DSK79L0C42PROD with BILLS 5 •S 1841 IS ‘‘(C) incorporates positive behavioral inter- 1 ventions and supports, family engagement, stu- 2 dent treatment, and multigenerational supports 3 to foster the health and development of chil- 4 dren, prevent mental health disorders, and ame- 5 liorate the impact of trauma; 6 ‘‘(2) provide technical assistance to local com- 7 munities with respect to the development of pro- 8 grams described in paragraph (1); 9 ‘‘(3) provide assistance to local communities in 10 the development of policies to address child and ado- 11 lescent trauma and mental health issues and violence 12 when and if it occurs; 13 ‘‘(4) facilitate community partnerships among 14 families, students, law enforcement agencies, edu- 15 cation agencies, mental health and substance use 16 disorder service systems, family-based mental health 17 service systems, child welfare agencies, health care 18 providers (including primary care physicians, mental 19 health professionals, and other professionals who 20 specialize in children’s mental health such as child 21 and adolescent psychiatrists), institutions of higher 22 education, faith-based programs, trauma networks, 23 and other community-based systems; and 24 VerDate Sep 11 2014 04:33 Jun 11, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1841.IS S1841 kjohnson on DSK79L0C42PROD with BILLS 6 •S 1841 IS ‘‘(5) establish best practice mechanisms for 1 children and adolescents to report to school staff, 2 such as educators, school leaders, or school-based 3 health professionals, incidents of violence or plans by 4 other children, adolescents, or adults to inflict harm 5 on themselves or others. 6 ‘‘(c) REQUIREMENTS.— 7 ‘‘(1) IN GENERAL.—To be eligible for a grant, 8 contract, or cooperative agreement under subsection 9 (a), an entity shall— 10 ‘‘(A) be a partnership that includes— 11 ‘‘(i) a State educational agency, as de- 12 fined in section 8101 of the Elementary 13 and Secondary Education Act of 1965, in 14 coordination with one or more local edu- 15 cational agencies, as defined in section 16 8101 of the Elementary and Secondary 17 Education Act of 1965, or a consortium of 18 any entities described in subparagraph 19 (B), (C), (D), or (E) of section 8101(30) 20 of such Act; and 21 ‘‘(ii) in accordance with paragraph 22 (2)(A)(i), appropriate public or private en- 23 tities that employ interventions that are 24 evidence-based, as defined in section 8101 25 VerDate Sep 11 2014 04:33 Jun 11, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1841.IS S1841 kjohnson on DSK79L0C42PROD with BILLS 7 •S 1841 IS of the Elementary and Secondary Edu- 1 cation Act of 1965; and 2 ‘‘(B) submit an application, that is en- 3 dorsed by all members of the partnership, 4 that— 5 ‘‘(i) specifies which member will serve 6 as the lead partner; and 7 ‘‘(ii) contains the assurances described 8 in paragraph (2). 9 ‘‘(2) REQUIRED ASSURANCES.—An application 10 under paragraph (1) shall contain assurances as fol- 11 lows: 12 ‘‘(A) The eligible entity will ensure that, in 13 carrying out activities under this section, the el- 14 igible entity will enter into a memorandum of 15 understanding— 16 ‘‘(i) with at least 1 community-based 17 mental health provider, including a public 18 or private mental health entity, health care 19 entity, family-based mental health entity, 20 trauma network, or other community-based 21 entity, as determined by the Secretary 22 (and which may include additional entities 23 such as a human services agency, law en- 24 forcement or juvenile justice entity, child 25 VerDate Sep 11 2014 04:33 Jun 11, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1841.IS S1841 kjohnson on DSK79L0C42PROD with BILLS 8 •S 1841 IS welfare agency, an institution of higher 1 education, or another entity, as determined 2 by the Secretary); and 3 ‘‘(ii) that clearly states— 4 ‘‘(I) the responsibilities of each 5 partner with respect to the activities 6 to be carried out, including how fam- 7 ily engagement will be incorporated in 8 the activities; 9 ‘‘(II) how school-employed and 10 school-based or community-based 11 mental health professionals will be uti- 12 lized for carrying out such responsibil- 13 ities; 14 ‘‘(III) how each such partner will 15 be accountable for carrying out such 16 responsibilities; and 17 ‘‘(IV) the amount of non-Federal 18 funding or in-kind contributions that 19 each such partner will contribute in 20 order to sustain the program. 21 ‘‘(B) The comprehensive school-based men- 22 tal health program carried out under this sec- 23 tion supports the flexible use of funds to ad- 24 dress— 25 VerDate Sep 11 2014 04:33 Jun 11, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S1841.IS S1841 kjohnson on DSK79L0C42PROD with BILLS 9 •S 1841 IS ‘‘(i) universal prevention, through the 1 promotion of the social, emotional, mental, 2 and behavioral health of all students in an 3 environment that is conducive to learning; 4 ‘‘(ii) selective prevention, through the 5 reduction in the likelihood of at-risk stu- 6 dents developing social, emotional, mental, 7 behavioral health problems, suicide, or sub- 8 stance use disorders; 9 ‘‘(iii) the screening for, and early 10 identification of, social, emotional, mental, 11 behavioral problems, suicide risk, or sub- 12 stance use disorders and the provision of 13 early intervention services; 14 ‘‘(iv) the treatment or referral for 15 treatment of students with existing social, 16 emotional, mental, behavioral health prob- 17 lems, or substance use disorders; 18 ‘‘(v) the development and implementa- 19 tion of evidence-based programs to assist 20 children who are experiencing or have been 21 exposed to trauma and violence, including 22 program curricula, school supports, and 23 after-school programs; and 24 VerDate Sep 11 2014 04:33 Jun 11, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S1841.IS S1841 kjohnson on DSK79L0C42PROD with BILLS 10 •S 1841 IS ‘‘(vi) the development and implemen- 1 tation of evidence-based programs to assist 2 children who are grieving, which may in- 3 clude training for school personnel on the 4 impact of trauma and bereavement on chil- 5 dren, and services to provide support to 6 grieving children. 7 ‘‘(C) The comprehensive school-based men- 8 tal health program carried out under this sec- 9 tion will provide for in-service training of all 10 school personnel, including ancillary staff and 11 volunteers, in— 12 ‘‘(i) the techniques and supports need- 13 ed to promote early identification of chil- 14 dren with trauma histories, children who 15 are grieving, and children with a mental 16 health disorder or at risk of developing a 17 mental health disorder, or who are at risk 18 of suicide; 19 ‘‘(ii) the use of referral mechanisms 20 that effectively link such children to appro- 21 priate prevention, treatment, and interven- 22 tion services in the school and in the com- 23 munity and to follow-up when services are 24 not available; 25 VerDate Sep 11 2014 04:33 Jun 11, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S1841.IS S1841 kjohnson on DSK79L0C42PROD with BILLS 11 •S 1841 IS ‘‘(iii) strategies that promote a school- 1 wide positive environment, including strat- 2 egies to prevent discrimination, bullying, 3 and harassment, which includes both 4 cyberstalking and cyber-bullying; 5 ‘‘(iv) strategies for promoting the so- 6 cial, emotional, mental, and behavioral 7 health of all students; and 8 ‘‘(v) strategies to increase the knowl- 9 edge and skills of school and community 10 leaders about the impact of trauma and vi- 11 olence and on the application of a public 12 health approach to comprehensive school- 13 based mental health programs. 14 ‘‘(D) The comprehensive school-based men- 15 tal health program carried out under this sec- 16 tion will include comprehensive training for par- 17 ents or guardians, siblings, and other family 18 members of children with mental health dis- 19 orders, and for concerned members of the com- 20 munity in— 21 ‘‘(i) the techniques and supports need- 22 ed to promote early identification of chil- 23 dren with trauma histories, children who 24 are grieving, children with a mental health 25 VerDate Sep 11 2014 04:33 Jun 11, 2021 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S1841.IS S1841 kjohnson on DSK79L0C42PROD with BILLS 12 •S 1841 IS disorder or at risk of developing a mental 1 health disorder, and children who are at 2 risk of suicide; 3 ‘‘(ii) the use of referral mechanisms 4 that effectively link such children to appro- 5 priate prevention, treatment, and interven- 6 tion services in the school and in the com- 7 munity and follow-up when such services 8 are not available; and 9 ‘‘(iii) strategies that promote a school- 10 wide positive environment, including strat- 11 egies to prevent discrimination, bullying, 12 and harassment, which includes both 13 cyberstalking and cyber-bullying. 14 ‘‘(E) The comprehensive school-based men- 15 tal health program carried out under this sec- 16 tion will demonstrate the measures to be taken 17 to sustain the program (which may include 18 seeking funding for the program under a State 19 Medicaid plan under title XIX of the Social Se- 20 curity Act or a waiver of such a plan, or under 21 a State plan under subpart 1 of part B or part 22 E of title IV of the Social Security Act). 23 ‘‘(F) The eligible entity is supported by the 24 State agency with pri [Text truncated for display. 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