Text of US HB 5469 (2020)

I 116TH CONGRESS 1ST SESSION H. R. 5469 To address mental health issues for youth, particularly youth of color, and for other purposes. IN THE HOUSE OF REPRESENTATIVES DECEMBER 17, 2019 Mrs. WATSON COLEMAN (for herself, Mr. HASTINGS, Ms. NORTON, Mr. CLEAVER, Ms. OMAR, Mr. DANNY K. DAVIS of Illinois, Ms. ADAMS, Mrs. HAYES, Mr. HORSFORD, and Ms. LEE of California) introduced the fol- lowing bill; which was referred to the Committee on Energy and Com- merce A BILL To address mental health issues for youth, particularly youth of color, and for other purposes. 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 ‘‘Pursuing Equity in 4 Mental Health Act of 2019’’. 5 SEC. 2. TABLE OF CONTENTS. 6 The table of contents for this Act is as follows: 7 Sec. 1. Short title. Sec. 2. Table of contents. TITLE I—MENTAL HEALTH OF STUDENTS VerDate Sep 11 2014 18:52 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6211 E:\BILLS\H5469.IH H5469 pamtmann on DSKBC07HB2PROD with BILLS 2 •HR 5469 IH Sec. 101. Amendments to the Public Health Service Act. TITLE II—HEALTH EQUITY AND ACCOUNTABILITY Sec. 201. Integrated Health Care Demonstration Program. Sec. 202. Addressing racial and ethnic minority mental health disparities re- search gaps. Sec. 203. Health professions competencies to address racial and ethnic minority mental health disparities. Sec. 204. Racial and ethnic minority behavioral and mental health outreach and education strategy. Sec. 205. Additional funds for National Institutes of Health. Sec. 206. Additional funds for National Institute on Minority Health and Health Disparities. TITLE III—OTHER PROVISIONS Sec. 301. Reauthorization of Minority Fellowship Program. Sec. 302. Commission on the Effects of Smartphone and Social Media Use on Adolescents. Sec. 303. No Federal funds for conversion therapy. TITLE I—MENTAL HEALTH OF 1 STUDENTS 2 SEC. 101. AMENDMENTS TO THE PUBLIC HEALTH SERVICE 3 ACT. 4 (a) TECHNICAL AMENDMENTS.—The second part G 5 (relating to services provided through religious organiza- 6 tions) of title V of the Public Health Service Act (42 7 U.S.C. 290kk et seq.) is amended— 8 (1) by redesignating such part as part J; and 9 (2) by redesignating sections 581 through 584 10 as sections 596 through 596C, respectively. 11 (b) SCHOOL-BASED MENTAL HEALTH AND CHIL- 12 DREN.—Section 581 of the Public Health Service Act (42 13 U.S.C. 290hh) (relating to children and violence) is 14 amended to read as follows: 15 VerDate Sep 11 2014 18:52 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H5469.IH H5469 pamtmann on DSKBC07HB2PROD with BILLS 3 •HR 5469 IH ‘‘SEC. 581. SCHOOL-BASED MENTAL HEALTH; CHILDREN 1 AND ADOLESCENTS. 2 ‘‘(a) IN GENERAL.—The Secretary, in collaboration 3 with the Secretary of Education, shall, directly or through 4 grants, contracts, or cooperative agreements awarded to 5 eligible entities described in subsection (c), assist local 6 communities and schools (including schools funded by the 7 Bureau of Indian Education) in applying a public health 8 approach to mental health services both in schools and in 9 the community. Such approach shall provide comprehen- 10 sive developmentally appropriate services and supports 11 that are linguistically and culturally appropriate and trau- 12 ma-informed, and incorporate developmentally appropriate 13 strategies of positive behavioral interventions and sup- 14 ports. A comprehensive school-based mental health pro- 15 gram funded under this section shall assist children in 16 dealing with traumatic experiences, grief, bereavement, 17 risk of suicide, and violence. 18 ‘‘(b) ACTIVITIES.—Under the program under sub- 19 section (a), the Secretary may— 20 ‘‘(1) provide financial support to enable local 21 communities to implement a comprehensive cul- 22 turally and linguistically appropriate, trauma-in- 23 formed, and developmentally appropriate, school- 24 based mental health program that— 25 VerDate Sep 11 2014 18:52 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H5469.IH H5469 pamtmann on DSKBC07HB2PROD with BILLS 4 •HR 5469 IH ‘‘(A) builds awareness of individual trauma 1 and the intergenerational, continuum of impacts 2 of trauma on populations; 3 ‘‘(B) trains appropriate staff to identify, 4 and screen for, signs of trauma exposure, men- 5 tal health disorders, or risk of suicide; and 6 ‘‘(C) incorporates positive behavioral inter- 7 ventions, family engagement, student treatment, 8 and multigenerational supports to foster the 9 health and development of children, prevent 10 mental health disorders, and ameliorate the im- 11 pact of trauma; 12 ‘‘(2) provide technical assistance to local com- 13 munities with respect to the development of pro- 14 grams described in paragraph (1); 15 ‘‘(3) provide assistance to local communities in 16 the development of policies to address child and ado- 17 lescent trauma and mental health issues and violence 18 when and if it occurs; 19 ‘‘(4) facilitate community partnerships among 20 families, students, law enforcement agencies, edu- 21 cation agencies, mental health and substance use 22 disorder service systems, family-based mental health 23 service systems, child welfare agencies, health care 24 providers (including primary care physicians, mental 25 VerDate Sep 11 2014 18:52 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H5469.IH H5469 pamtmann on DSKBC07HB2PROD with BILLS 5 •HR 5469 IH health professionals, and other professionals who 1 specialize in children’s mental health such as child 2 and adolescent psychiatrists), institutions of higher 3 education, faith-based programs, trauma networks, 4 and other community-based systems; and 5 ‘‘(5) establish mechanisms for children and ado- 6 lescents to report incidents of violence or plans by 7 other children, adolescents, or adults to commit vio- 8 lence. 9 ‘‘(c) REQUIREMENTS.— 10 ‘‘(1) IN GENERAL.—To be eligible for a grant, 11 contract, or cooperative agreement under subsection 12 (a), an entity shall— 13 ‘‘(A) be a partnership that includes— 14 ‘‘(i) a State educational agency, as de- 15 fined in section 8101 of the Elementary 16 and Secondary Education Act of 1965, in 17 coordination with one or more local edu- 18 cational agencies, as defined in section 19 8101 of the Elementary and Secondary 20 Education Act of 1965, or a consortium of 21 any entities described in subparagraph 22 (B), (C), (D), or (E) of section 8101(30) 23 of such Act; and 24 VerDate Sep 11 2014 18:52 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H5469.IH H5469 pamtmann on DSKBC07HB2PROD with BILLS 6 •HR 5469 IH ‘‘(ii) in accordance with paragraph 1 (2)(A)(i), appropriate public or private en- 2 tities that employ interventions that are 3 evidence-based, as defined in section 8101 4 of the Elementary and Secondary Edu- 5 cation Act of 1965; and 6 ‘‘(B) submit an application, that is en- 7 dorsed by all members of the partnership, 8 that— 9 ‘‘(i) specifies which member will serve 10 as the lead partner; and 11 ‘‘(ii) contains the assurances described 12 in paragraph (2). 13 ‘‘(2) REQUIRED ASSURANCES.—An application 14 under paragraph (1) shall contain assurances as fol- 15 lows: 16 ‘‘(A) The eligible entity will ensure that, in 17 carrying out activities under this section, the el- 18 igible entity will enter into a memorandum of 19 understanding— 20 ‘‘(i) with at least 1 community-based 21 mental health provider, including a public 22 or private mental health entity, health care 23 entity, family-based mental health entity, 24 trauma network, or other community-based 25 VerDate Sep 11 2014 18:52 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H5469.IH H5469 pamtmann on DSKBC07HB2PROD with BILLS 7 •HR 5469 IH entity, as determined by the Secretary 1 (and which may include additional entities 2 such as a human services agency, law en- 3 forcement or juvenile justice entity, child 4 welfare agency, agency, an institution of 5 higher education, or another entity, as de- 6 termined by the Secretary); and 7 ‘‘(ii) that clearly states— 8 ‘‘(I) the responsibilities of each 9 partner with respect to the activities 10 to be carried out, including how fam- 11 ily engagement will be incorporated in 12 the activities; 13 ‘‘(II) how school-employed and 14 school-based or community-based 15 mental health professionals will be uti- 16 lized for carrying out such responsibil- 17 ities; 18 ‘‘(III) how each such partner will 19 be accountable for carrying out such 20 responsibilities; and 21 ‘‘(IV) the amount of non-Federal 22 funding or in-kind contributions that 23 each such partner will contribute in 24 order to sustain the program. 25 VerDate Sep 11 2014 18:52 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H5469.IH H5469 pamtmann on DSKBC07HB2PROD with BILLS 8 •HR 5469 IH ‘‘(B) The comprehensive school-based men- 1 tal health program carried out under this sec- 2 tion supports the flexible use of funds to ad- 3 dress— 4 ‘‘(i) universal prevention, through the 5 promotion of the social, emotional, mental, 6 and behavioral health of all students in an 7 environment that is conducive to learning; 8 ‘‘(ii) selective prevention, through the 9 reduction in the likelihood of at risk stu- 10 dents developing social, emotional, mental, 11 behavioral health problems, suicide, or sub- 12 stance use disorders; 13 ‘‘(iii) the screening for, and early 14 identification of, social, emotional, mental, 15 behavioral problems, suicide risk, or sub- 16 stance use disorders and the provision of 17 early intervention services; 18 ‘‘(iv) the treatment or referral for 19 treatment of students with existing social, 20 emotional, mental, behavioral health prob- 21 lems, or substance use disorders; 22 ‘‘(v) the development and implementa- 23 tion of evidence-based programs to assist 24 children who are experiencing or have been 25 VerDate Sep 11 2014 18:52 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H5469.IH H5469 pamtmann on DSKBC07HB2PROD with BILLS 9 •HR 5469 IH exposed to trauma and violence, including 1 program curricula, school supports, and 2 after-school programs; and 3 ‘‘(vi) the development and implemen- 4 tation of evidence-based programs to assist 5 children who are grieving, which may in- 6 clude training for school personnel on the 7 impact of trauma and bereavement on chil- 8 dren, and services to provide support to 9 grieving children. 10 ‘‘(C) The comprehensive school-based men- 11 tal health program carried out under this sec- 12 tion will provide for in-service training of all 13 school personnel, including ancillary staff and 14 volunteers, in— 15 ‘‘(i) the techniques and supports need- 16 ed to promote early identification of chil- 17 dren with trauma histories, children who 18 are grieving, and children with a mental 19 health disorder or at risk of developing a 20 mental health disorder, or who are at risk 21 of suicide; 22 ‘‘(ii) the use of referral mechanisms 23 that effectively link such children to appro- 24 priate prevention, treatment, and interven- 25 VerDate Sep 11 2014 18:52 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H5469.IH H5469 pamtmann on DSKBC07HB2PROD with BILLS 10 •HR 5469 IH tion services in the school and in the com- 1 munity and to follow-up when services are 2 not available; 3 ‘‘(iii) strategies that promote a school- 4 wide positive environment, including strat- 5 egies to prevent bullying, which includes 6 cyber-bullying; 7 ‘‘(iv) strategies for promoting the so- 8 cial, emotional, mental, and behavioral 9 health of all students; and 10 ‘‘(v) strategies to increase the knowl- 11 edge and skills of school and community 12 leaders about the impact of trauma and vi- 13 olence and on the application of a public 14 health approach to comprehensive school- 15 based mental health programs. 16 ‘‘(D) The comprehensive school-based men- 17 tal health program carried out under this sec- 18 tion will include comprehensive training for par- 19 ents or guardians, siblings, and other family 20 members of children with mental health dis- 21 orders, and for concerned members of the com- 22 munity in— 23 ‘‘(i) the techniques and supports need- 24 ed to promote early identification of chil- 25 VerDate Sep 11 2014 18:52 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H5469.IH H5469 pamtmann on DSKBC07HB2PROD with BILLS 11 •HR 5469 IH dren with trauma histories, children who 1 are grieving, children with a mental health 2 disorder or at risk of developing a mental 3 health disorder, and children who are at 4 risk of suicide; 5 ‘‘(ii) the use of referral mechanisms 6 that effectively link such children to appro- 7 priate prevention, treatment, and interven- 8 tion services in the school and in the com- 9 munity and follow-up when such services 10 are not available; and 11 ‘‘(iii) strategies that promote a school- 12 wide positive environment, including strat- 13 egies to prevent bullying, including cyber- 14 bullying. 15 ‘‘(E) The comprehensive school-based men- 16 tal health program carried out under this sec- 17 tion will demonstrate the measures to be taken 18 to sustain the program (which may include 19 seeking funding for the program under a State 20 Medicaid plan under title XIX of the Social Se- 21 curity Act or a waiver of such a plan, or under 22 a State plan under subpart 1 of part B or part 23 E of title IV of the Social Security Act). 24 VerDate Sep 11 2014 18:52 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H5469.IH H5469 pamtmann on DSKBC07HB2PROD with BILLS 12 •HR 5469 IH ‘‘(F) The eligible entity is supported by the 1 State agency with primary responsibility for be- 2 havioral health to ensure that the comprehen- 3 sive school-based mental health program carried 4 out under this section will be sustainable after 5 funding under this section terminates. 6 ‘‘(G) The comprehensive school-based men- 7 tal health program carried out under this sec- 8 tion will be coordinated with early intervening 9 activities carried out under the Individuals with 10 Disabilities Education Act or activities funded 11 under part A of title IV of the Elementary and 12 Secondary Education Act of 1965. 13 ‘‘(H) The comprehensive school-based 14 mental health program carried out under this 15 section will be trauma-informed, evidence-based, 16 and developmentally, culturally, and linguis- 17 tically appropriate. 18 ‘‘(I) The comprehensive school-based men- 19 tal health program carried out under this sec- 20 tion will include a broad needs assessment of 21 youth who drop out of school due to policies of 22 ‘zero tolerance’ with respect to drugs, alcohol, 23 or weapons and an inability to obtain appro- 24 priate services. 25 VerDate Sep 11 2014 18:52 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\H5469.IH H5469 pamtmann on DSKBC07HB2PROD with BILLS 13 •HR 5469 IH ‘‘(J) The mental health services provided 1 through the comprehensive school-based mental 2 health program carried out under this section 3 will be provided by qualified mental and behav- 4 ioral health professionals who are certified, 5 credentialed, or licensed in compliance with ap- 6 plicable Federal and State law and regulations 7 by the State involved and who are practicing 8 within their area of expertise. 9 ‘‘(K) Students will be permitted to self- 10 refer to the mental health program for mental 11 health care and self-consent for mental health 12 crisis care to the extent permitted by State or 13 other applicable law. 14 ‘‘(3) COORDINATOR.—Any entity that is a 15 member of a partnership described in paragraph 16 (1)(A) may serve as the coordinator of funding and 17 activities under the grant if all members of the part- 18 nership agree. 19 ‘‘(4) COMPLIANCE WITH HIPAA.—A grantee 20 under this section shall be deemed to be a covered 21 entity for purposes of compliance with the regula- 22 tions promulgated under section 264(c) of the 23 Health Insurance Portability and Accountability Act 24 VerDate Sep 11 2014 18:52 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00013 Fmt 6652 Sfmt 6201 E:\BILLS\H5469.IH H5469 pamtmann on DSKBC07HB2PROD with BILLS 14 •HR 5469 IH of 1996 with respect to any patient records devel- 1 oped through activities under the grant. 2 ‘‘(5) COMPLIANCE WITH FERPA.—Section 444 3 of the General Education Provisions Act (commonly 4 known as the ‘Family Educational Rights and Pri- 5 vacy Act of 1974’) shall apply to any entity that is 6 a member of the partnership in the same manner 7 that such section applies to an educational agency or 8 institution (as that term is defined in such section). 9 ‘‘(d) PRIORITY FOR SCHOOLS WITH HIGH POVERTY 10 LEVELS.—In awarding grants, contracts, and cooperative 11 agreements under this section, the Secretary shall give 12 highest priority to eligible entities that are partnerships 13 including one or more public elementary or secondary 14 schools in which 50.1 percent or more of the students are 15 eligible for a free or reduced price lunch under the Richard 16 B. Russell National School Lunch Act. 17 ‘‘(e) GEOGRAPHICAL DISTRIBUTION.—The Secretary 18 shall ensure that grants, contracts, or cooperative agree- 19 ments under subsection (a) will be distributed equitably 20 among the regions of the country and among urban and 21 rural areas. 22 ‘‘(f) DURATION OF AWARDS.—With respect to a 23 grant, contract, or cooperative agreement under sub- 24 section (a), the period during which payments under such 25 VerDate Sep 11 2014 18:52 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00014 Fmt 6652 Sfmt 6201 E:\BILLS\H5469.IH H5469 pamtmann on DSKBC07HB2PROD with BILLS 15 •HR 5469 IH an award will be made to the recipient shall be 5 years, 1 with options for renewal. 2 ‘‘(g) EVALUATION AND MEASURES OF OUTCOMES.— 3 ‘‘(1) DEVELOPMENT OF PROCESS.—The Assist- 4 ant Secretary shall develop a fiscally appropriate 5 process for evaluating activities carried out under 6 this section. Such process shall include— 7 ‘‘(A) the development of guidelines for the 8 submission of program data by grant, contract, 9 or cooperative agreement recipients; 10 ‘‘(B) the development of measures of out- 11 comes (in accordance with paragraph (2)) to be 12 applied by such recipients in evaluating pro- 13 grams carried out under this section; and 14 ‘‘(C) the submission of annual reports by 15 such recipients concerning the effectiveness of 16 programs carried out under this section. 17 ‘‘(2) MEASURES OF OUTCOMES.— 18 ‘‘(A) IN GENERAL.—The Assistant Sec- 19 retary shall develop measures of outcomes to be 20 applied by recipients of assistance under this 21 section, and the Assistant Secretary, in evalu- 22 ating the effectiveness of programs carried out 23 under this section. Such measures shall include 24 student and family measures as provided for in 25 VerDate Sep 11 2014 18:52 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00015 Fmt 6652 Sfmt 6201 E:\BILLS\H5469.IH H5469 pamtmann on DSKBC07HB2PROD with BILLS 16 •HR 5469 IH subparagraph (B) and local educational meas- 1 ures as provided for under subparagraph (C). 2 ‘‘(B) STUDENT AND FAMILY MEASURES OF 3 OUTCOMES.—The measures for outcomes devel- 4 oped under paragraph (1)(B) relating to stu- 5 dents and families shall, with respect to activi- 6 ties carried out under a program under this 7 section, at a minimum include provisions to 8 evaluate whether the program is effective in— 9 ‘‘(i) increasing social and emotional 10 competency; 11 ‘‘(ii) improving academic outcomes, 12 including as measured by proficiency on 13 the annual assessments under section 14 1111(b)(2) of the Elementary and Sec- 15 ondary Education Act of 1965; 16 ‘‘(iii) reducing disruptive and aggres- 17 sive behaviors; 18 ‘‘(iv) improving child functioning; 19 ‘‘(v) reducing substance use disorders; 20 ‘‘(vi) reducing rates of suicide; 21 ‘‘(vii) reducing suspensions, truancy, 22 expulsions, and violence; 23 ‘‘(viii) increasing high school gradua- 24 tion rates, calculated using the four-year 25 VerDate Sep 11 2014 18:52 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00016 Fmt 6652 Sfmt 6201 E:\BILLS\H5469.IH H5469 pamtmann on DSKBC07HB2PROD with BILLS 17 •HR 5469 IH adjusted cohort graduation rate or the ex- 1 tended-year adjusted cohort graduation 2 rate (as such terms are defined in section 3 8101 of the Elementary and Secondary 4 Education Act of 1965); 5 ‘‘(ix) improving attendance rates and 6 rates of chronic absenteeism; 7 ‘‘(x) improving access to care for men- 8 tal health disorders, including access to 9 mental health services that are trauma-in- 10 formed, and developmentally, linguistically, 11 and culturally appropriate; 12 ‘‘(xi) improving health outcomes; and 13 ‘‘(xii) decreasing disparities among 14 vulnerable and protected populations in 15 outcomes described in clauses (i) through 16 (viii). 17 ‘‘(C) LOCAL EDUCATIONAL OUTCOMES.— 18 The outcome measures developed under para- 19 graph (1)(B) relating to local educational sys- 20 tems shall, with respect to activities carried out 21 under a program under this section, at a min- 22 imum include provisions to evaluate— 23 VerDate Sep 11 2014 18:52 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00017 Fmt 6652 Sfmt 6201 E:\BILLS\H5469.IH H5469 pamtmann on DSKBC07HB2PROD with BILLS 18 •HR 5469 IH ‘‘(i) the effectiveness of comprehensive 1 school mental health programs established 2 under this section; 3 ‘‘(ii) the effectiveness of formal part- 4 nership linkages among child and family 5 serving institutions, community support 6 systems, and the educational system; 7 ‘‘(iii) the progress made in sustaining 8 the program once funding under the grant 9 has expired; 10 ‘‘(iv) the effectiveness of training and 11 professional development programs for all 12 school personnel that incorporate indica- 13 tors that measure cultural and linguistic 14 competencies under the program in a man- 15 ner that incorporates appropriate cultural 16 and linguistic training; 17 ‘‘(v) the improvement in perception of 18 a safe and supportive learning environment 19 among school staff, students, and parents; 20 ‘‘(vi) the improvement in case-finding 21 of students in need of more intensive serv- 22 ices and referral of identified students to 23 prevention, early intervention, and clinical 24 services; 25 VerDate Sep 11 2014 18:52 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00018 Fmt 6652 Sfmt 6201 E:\BILLS\H5469.IH H5469 pamtmann on DSKBC07HB2PROD with BILLS 19 •HR 5469 IH ‘‘(vii) the improvement in the imme- 1 diate availability of clinical assessment and 2 treatment services within the context of 3 the local community to students posing a 4 danger to themselves or others; 5 ‘‘(viii) the increased successful matric- 6 ulation to postsecondary school; 7 ‘‘(ix) reduced suicide rates; 8 ‘‘(x) reduced referrals to juvenile jus- 9 tice; and 10 ‘‘(xi) increased educational equity. 11 ‘‘(3) SUBMISSION OF ANNUAL DATA.—An eligi- 12 ble entity described in subsection (c) that receives a 13 grant, contract, or cooperative agreement under this 14 section shall annually submit to the Assistant Sec- 15 retary a report that includes data to evaluate the 16 success of the program carried out by the entity 17 based on whether such program is achieving the pur- 18 poses of the program. Such reports shall utilize the 19 measures of outcomes under paragraph (2) in a rea- 20 sonable manner to demonstrate the progress of the 21 program in achieving such purposes. 22 ‘‘(4) EVALUATION BY ASSISTANT SECRETARY.— 23 Based on the data submitted under paragraph (3), 24 the Assistant Secretary shall annually submit to 25 VerDate Sep 11 2014 18:52 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00019 Fmt 6652 Sfmt 6201 E:\BILLS\H5469.IH H5469 pamtmann on DSKBC07HB2PROD with BILLS 20 •HR 5469 IH Congress a report concerning the results and effec- 1 tiveness of the programs carried out with assistance 2 received under this section. 3 ‘‘(5) LIMITATION.—An eligible entity shall use 4 not more than 20 percent of amounts received under 5 a grant under this section to carry out evaluation 6 activities under this subsection. 7 ‘‘(h) INFORMATION AND EDUCATION.—The Sec- 8 retary shall establish comprehensive information and edu- 9 cation programs to disseminate the findings of the knowl- 10 edge development and application under this section to the 11 general public and to health care professionals. 12 ‘‘(i) AMOUNT OF GRANTS AND AUTHORIZATION OF 13 APPROPRIATIONS.— 14 ‘‘(1) AMOUNT OF GRANTS.—A grant under this 15 section shall be in an amount that is not more than 16 $2,000,000 for each of the first 5 fiscal years fol- 17 lowing the date of enactment of the Pursuing Equity 18 in Mental Health Act of 2019. The Secretary shall 19 determine the amount of each such grant based on 20 the population of children up to age 21 of the area 21 to be served under the grant. 22 ‘‘(2) AUTHORIZATION OF APPROPRIATIONS.— 23 There is authorized to be appropriated to carry out 24 this section, $250,000,000 for each of the first 5 fis- 25 VerDate Sep 11 2014 18:52 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00020 Fmt 6652 Sfmt 6201 E:\BILLS\H5469.IH H5469 pamtmann on DSKBC07HB2PROD with BILLS 21 •HR 5469 IH cal years following the date of enactment of the Pur- 1 suing Equity in Mental Health Act of 2019.’’. 2 (c) CONFORMING AMENDMENT.—Part G of title V of 3 the Public Health Service Act (42 U.S.C. 290hh et seq.), 4 as amended by subsection (b), is further amended by strik- 5 ing the part designation and heading and inserting the 6 following: 7 ‘‘PART G—SCHOOL-BASED MENTAL HEALTH’’. 8 TITLE II—HEALTH EQUITY AND 9 ACCOUNTABILITY 10 SEC. 201. INTEGRATED HEALTH CARE DEMONSTRATION 11 PROGRAM. 12 Part D of title V of the Public Health Service Act 13 (42 U.S.C. 290dd et seq.) is amended by adding at the 14 end the following: 15 ‘‘SEC. 550. INTERPROFESSIONAL HEALTH CARE TEAMS FOR 16 PROVISION OF BEHAVIORAL HEALTH CARE 17 IN PRIMARY CARE SETTINGS. 18 ‘‘(a) GRANTS.—The Secretary, acting through the 19 Assistant Secretary for Mental Health and Substance 20 Abuse, shall award grants to eligible entities for the pur- 21 pose of establishing interprofessional health care teams 22 that provide behavioral health care. 23 ‘‘(b) ELIGIBLE ENTITIES.—To be eligible to receive 24 a grant under this section, an entity shall be a Federally 25 VerDate Sep 11 2014 18:52 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00021 Fmt 6652 Sfmt 6201 E:\BILLS\H5469.IH H5469 pamtmann on DSKBC07HB2PROD with BILLS 22 •HR 5469 IH qualified health center (as defined in section 1861(aa) of 1 the Social Security Act), rural health clinic, or behavioral 2 health program, serving a high proportion of individuals 3 from racial and ethnic minority groups (as defined in sec- 4 tion 1707(g)). 5 ‘‘(c) SCIENTIFICALLY BASED.—Integrated health 6 care funded through this section shall be scientifically 7 based, taking into consideration the results of the most 8 recent peer-reviewed research available. 9 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—To 10 carry out this section, there is authorized to be appro- 11 priated $20,000,000 for each of the first 5 fiscal years 12 following the date of enactment of the Pursuing Equity 13 in Mental Health Act of 2019.’’. 14 SEC. 202. ADDRESSING RACIAL AND ETHNIC MINORITY 15 MENTAL HEALTH DISPARITIES RESEARCH 16 GAPS. 17 Not later than 6 months after the date of the enact- 18 ment of this Act, the Director of the National Institute 19 on Minority Health and Health Disparities shall enter into 20 an arrangement with the National Academy of Sciences 21 (or, if the National Academy of Sciences declines to enter 22 into such an arrangement, an arrangement with the Insti- 23 tute of Medicine, the Patient Centered Outcomes Research 24 VerDate Sep 11 2014 18:52 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00022 Fmt 6652 Sfmt 6201 E:\BILLS\H5469.IH H5469 pamtmann on DSKBC07HB2PROD with BILLS 23 •HR 5469 IH Institute, the Agency for Healthcare Quality, or another 1 appropriate entity)— 2 (1) to conduct a study with respect to mental 3 health disparities in racial and ethnic minority 4 groups (as defined in section 1707(g) of the Public 5 Health Service Act (42 U.S.C. 300u–6(g))); and 6 (2) to submit to the Congress a report on the 7 results of such study, including— 8 (A) a compilation of information on the dy- 9 namics of mental disorders in such racial and 10 ethnic minority groups; and 11 (B) a compilation of information on the 12 impact of exposure to community violence, ad- 13 verse childhood experiences, and other psycho- 14 logical traumas on mental disorders in such ra- 15 cial and minority groups. 16 SEC. 203. HEALTH PROFESSIONS COMPETENCIES TO AD- 17 DRESS RACIAL AND ETHNIC MINORITY MEN- 18 TAL HEALTH DISPARITIES. 19 (a) IN GENERAL.—The Secretary of Health and 20 Human Services, acting through the Assistant Secretary 21 for Mental Health and Substance Use, shall award grants 22 to qualified national organizations for the purposes of— 23 (1) developing, and disseminating to health pro- 24 fessional educational programs curricula or core 25 VerDate Sep 11 2014 18:52 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00023 Fmt 6652 Sfmt 6201 E:\BILLS\H5469.IH H5469 pamtmann on DSKBC07HB2PROD with BILLS 24 •HR 5469 IH competencies addressing mental health disparities 1 among racial and ethnic minority groups for use in 2 the training of students in the professions of social 3 work, psychology, psychiatry, marriage and family 4 therapy, mental health counseling, and substance 5 abuse counseling; and 6 (2) certifying community health workers and 7 peer wellness specialists with respect to such cur- 8 ricula and core competencies and integrating and ex- 9 panding the use of such workers and specialists into 10 health care to address mental health disparities 11 among racial and ethnic minority groups. 12 (b) CURRICULA; CORE COMPETENCIES.—Organiza- 13 tions receiving funds under subsection (a) may use the 14 funds to engage in the following activities related to the 15 development and dissemination of curricula or core com- 16 petencies described in subsection (a)(1): 17 (1) Formation of committees or working groups 18 comprised of experts from accredited health profes- 19 sions schools to identify core competencies relating 20 to mental health disparities among racial and ethnic 21 minority groups. 22 (2) Planning of workshops in national fora to 23 allow for public input into the educational needs as- 24 VerDate Sep 11 2014 18:52 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00024 Fmt 6652 Sfmt 6201 E:\BILLS\H5469.IH H5469 pamtmann on DSKBC07HB2PROD with BILLS 25 •HR 5469 IH sociated with mental health disparities among racial 1 and ethnic minority groups. 2 (3) Dissemination and promotion of the use of 3 curricula or core competencies in undergraduate and 4 graduate health professions training programs na- 5 tionwide. 6 (4) Establishing external stakeholder advisory 7 boards to provide meaningful input into policy and 8 program development and best practices to reduce 9 mental health disparities among racial and ethnic 10 minority groups. 11 (c) DEFINITIONS.—In this section: 12 (1) QUALIFIED NATIONAL ORGANIZATION.—The 13 term ‘‘qualified national organization’’ means a na- 14 tional organization that focuses on the education of 15 students in programs of social work, psychology, 16 psychiatry, and marriage and family therapy. 17 (2) RACIAL AND ETHNIC MINORITY GROUP.— 18 The term ‘‘racial and ethnic minority group’’ has the 19 meaning given to such term in section 1707(g) of 20 the Public Health Service Act (42 U.S.C. 300u– 21 6(g)). 22 (d) AUTHORIZATION OF APPROPRIATIONS.—There 23 are authorized to be appropriated to carry out this section 24 VerDate Sep 11 2014 18:52 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00025 Fmt 6652 Sfmt 6201 E:\BILLS\H5469.IH H5469 pamtmann on DSKBC07HB2PROD with BILLS 26 •HR 5469 IH such sums as may be necessary for each of the first 5 1 fiscal years following the date of enactment of this Act. 2 SEC. 204. RACIAL AND ETHNIC MINORITY BEHAVIORAL 3 AND MENTAL HEALTH OUTREACH AND EDU- 4 CATION STRATEGY. 5 Part D of title V of the Public Health Service Act 6 (42 U.S.C. 290dd et seq.) is amended by adding at the 7 end the following new section: 8 ‘‘SEC. 553. BEHAVIORAL AND MENTAL HEALTH OUTREACH 9 AND EDUCATION STRATEGY. 10 ‘‘(a) IN GENERAL.—The Secretary, acting through 11 the Assistant Secretary, shall, in coordination with advo- 12 cacy and behavioral and mental health organizations serv- 13 ing racial and ethnic minority groups, develop and imple- 14 ment an outreach and education strategy to promote be- 15 havioral and mental health and reduce stigma associated 16 with mental health conditions and substance abuse among 17 racial and ethnic minority groups. Such strategy shall— 18 ‘‘(1) be designed to— 19 ‘‘(A) meet the diverse cultural and lan- 20 guage needs of the various racial and ethnic mi- 21 nority groups; and 22 ‘‘(B) be developmentally and age-appro- 23 priate; 24 VerDate Sep 11 2014 18:52 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00026 Fmt 6652 Sfmt 6201 E:\BILLS\H5469.IH H5469 pamtmann on DSKBC07HB2PROD with BILLS 27 •HR 5469 IH ‘‘(2) increase awareness of symptoms of mental 1 illnesses common among such groups, taking into 2 account differences within subgroups, such as gen- 3 der, gender identity, age, or sexual orientation, of 4 such groups; 5 ‘‘(3) provide information on evidence-based, cul- 6 turally and linguistically appropriate and adapted 7 interventions and treatments; 8 ‘‘(4) ensure full participation of, and engage, 9 both consumers and community members in the de- 10 velopment and implementation of materials; and 11 ‘‘(5) seek to broaden the perspective among 12 both individuals in these groups and stakeholders 13 serving these groups to use a comprehensive public 14 health approach to promoting behavioral health that 15 addresses a holistic view of health by focusing on the 16 intersection between behavioral and physical health. 17 ‘‘(b) REPORTS.—Beginning not later than 1 year 18 after the date of the enactment of this section and annu- 19 ally thereafter, the Secretary, acting through the Assistant 20 Secretary, shall submit to Congress, and make publicly 21 available, a report on the extent to which the strategy de- 22 veloped and implemented under subsection (a) increased 23 behavioral and mental health outcomes associated with 24 VerDate Sep 11 2014 18:52 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00027 Fmt 6652 Sfmt 6201 E:\BILLS\H5469.IH H5469 pamtmann on DSKBC07HB2PROD with BILLS 28 •HR 5469 IH mental health conditions and substance abuse among ra- 1 cial and ethnic minority groups. 2 ‘‘(c) DEFINITION.—In this section, the term ‘racial 3 and ethnic minority group’ has the meaning given to that 4 term in section 1707(g). 5 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 6 is authorized to be appropriated to carry out this section 7 $10,000,000 for the first fiscal year following the date of 8 enactment of the Pursuing Equity in Mental Health Act 9 of 2019.’’. 10 SEC. 205. ADDITIONAL FUNDS FOR NATIONAL INSTITUTES 11 OF HEALTH. 12 (a) IN GENERAL.—In addition to amounts otherwise 13 authorized to be appropriated to the National Institutes 14 of Health, there is authorized to be appropriated to such 15 Institutes $100,000,000 for each of the first 5 fiscal years 16 following the date of enactment of this Act to build rela- 17 tions with communities and conduct or support clinical re- 18 search, including clinical research on racial or ethnic dis- 19 parities in physical and mental health. 20 (b) DEFINITION.—In this section, the term ‘‘clinical 21 research’’ has the meaning given to such term in section 22 409 of the Public Health Service Act (42 U.S.C. 284d). 23 VerDate Sep 11 2014 18:52 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00028 Fmt 6652 Sfmt 6201 E:\BILLS\H5469.IH H5469 pamtmann on DSKBC07HB2PROD with BILLS 29 •HR 5469 IH SEC. 206. ADDITIONAL FUNDS FOR NATIONAL INSTITUTE 1 ON MINORITY HEALTH AND HEALTH DISPARI- 2 TIES. 3 In addition to amounts otherwise authorized to be ap- 4 propriated to the National Institute on Minority Health 5 and Health Disparities, there is authorized to be appro- 6 priated to such Institute $650,000,000 for each of the 7 first 5 fiscal years following the date of enactment of this 8 Act. 9 TITLE III—OTHER PROVISIONS 10 SEC. 301. REAUTHORIZATION OF MINORITY FELLOWSHIP 11 PROGRAM. 12 Section 597(c) of the Public Health Service Act (42 13 U.S.C. 297ll(c)) is amended by striking ‘‘$12,669,000 for 14 each of fiscal years 2018 through 2022’’ and inserting 15 ‘‘$25,000,000 for each of the first 5 fiscal years following 16 the date of enactment of the Pursuing Equity in Mental 17 Health Act of 2019’’. 18 SEC. 302. COMMISSION ON THE EFFECTS OF SMARTPHONE 19 AND SOCIAL MEDIA USE ON ADOLESCENTS. 20 (a) IN GENERAL.—Not later than 6 months after the 21 date of enactment of this Act, the Secretary of Health and 22 Human Services shall establish a commission, to be known 23 as the Commission on the Effects of Smartphone and So- 24 cial Media Usage on Adolescents, to examine— 25 VerDate Sep 11 2014 18:52 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00029 Fmt 6652 Sfmt 6201 E:\BILLS\H5469.IH H5469 pamtmann on DSKBC07HB2PROD with BILLS 30 •HR 5469 IH (1) the extent of smartphone and social media 1 use in schools; and 2 (2) the effects of such use on— 3 (A) the emotional and physical health of 4 students; and 5 (B) the academic performance of students. 6 (b) MEMBERSHIP.— 7 (1) NUMBER.—The Commission shall consist of 8 15 members appointed by the Secretary. 9 (2) COMPOSITION.—The members of the Com- 10 mission— 11 (A) shall not include any government offi- 12 cials or employees; and 13 (B) shall include representatives of aca- 14 demia, technology companies, and advocacy 15 groups. 16 (c) GUIDELINES.—The Secretary shall authorize the 17 Commission to establish guidelines for its operation. 18 (d) REPORT.—Not later than 1 year after its estab- 19 lishment, the Commission shall submit to the Congress, 20 and make publicly available, a report on the findings and 21 conclusions of the Commission. 22 (e) DEFINITIONS.—In this section: 23 (1) The term ‘‘Commission’’ means the Com- 24 mission on the Effects of Smartphone and Social 25 VerDate Sep 11 2014 18:52 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00030 Fmt 6652 Sfmt 6201 E:\BILLS\H5469.IH H5469 pamtmann on DSKBC07HB2PROD with BILLS 31 •HR 5469 IH Media Usage on Adolescents established under sub- 1 section (a). 2 (2) The term ‘‘Secretary’’ means the Secretary 3 of Health and Human Services. 4 (f) SUNSET.—Not later than 6 months after the 5 Commission submits the report required by subsection (c), 6 the Secretary shall terminate the Commission. 7 SEC. 303. NO FEDERAL FUNDS FOR CONVERSION THERAPY. 8 (a) IN GENERAL.—No Federal funds may be used 9 for conversion therapy. 10 (b) DISCOURAGING STATES FROM FUNDING CON- 11 VERSION THERAPY.—Beginning on the date that is 180 12 days after the date of enactment of this Act, any State 13 that funds conversion therapy shall be ineligible to be 14 awarded a grant or other financial assistance under any 15 program of the Substance Abuse and Mental Health Serv- 16 ices Administration, including any program under title V 17 of the Public Health Service Act (42 U.S.C. 290aa et 18 seq.). 19 (c) DEFINITIONS.—For purposes of this section: 20 (1) CONVERSION THERAPY.—The term ‘‘conver- 21 sion therapy’’— 22 (A) means any practice or treatment by 23 any person that seeks to change another indi- 24 vidual’s sexual orientation or gender identity, 25 VerDate Sep 11 2014 18:52 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00031 Fmt 6652 Sfmt 6201 E:\BILLS\H5469.IH H5469 pamtmann on DSKBC07HB2PROD with BILLS 32 •HR 5469 IH including efforts to change behaviors or gender 1 expressions, or to eliminate or reduce sexual or 2 romantic attractions or feelings toward individ- 3 uals of the same gender, if such person receives 4 monetary compensation in exchange for any 5 such practice or treatment; and 6 (B) does not include any practice or treat- 7 ment, which does not seek to change sexual ori- 8 entation or gender identity, that— 9 (i) provides assistance to an individual 10 undergoing a gender transition; or 11 (ii) provides acceptance, support, and 12 understanding of a client or facilitation of 13 a client’s coping, social support, and iden- 14 tity exploration and development, including 15 sexual orientation-neutral interventions to 16 prevent or address unlawful conduct or un- 17 safe sexual practices. 18 (2) GENDER IDENTITY.—The term ‘‘gender 19 identity’’ means the gender-related identity, appear- 20 ance, mannerisms, or other gender-related character- 21 istics of an individual, regardless of the individual’s 22 designated sex at birth. 23 VerDate Sep 11 2014 18:52 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00032 Fmt 6652 Sfmt 6201 E:\BILLS\H5469.IH H5469 pamtmann on DSKBC07HB2PROD with BILLS 33 •HR 5469 IH (3) PERSON.—The term ‘‘person’’ means any 1 individual, partnership, corporation, cooperative, as- 2 sociation, or any other entity. 3 (4) SEXUAL ORIENTATION.—The term ‘‘sexual 4 orientation’’ means homosexuality, heterosexuality, 5 or bisexuality. 6 (5) STATE.—The term ‘‘State’’ has the mean- 7 ing given to such term in section 2 of the Public 8 Health Service Act (42 U.S.C. 201). 9 Æ VerDate Sep 11 2014 18:52 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00033 Fmt 6652 Sfmt 6301 E:\BILLS\H5469.IH H5469 pamtmann on DSKBC07HB2PROD with BILLS