Health Equity and Accountability Act of 2026

“(a) In general.— The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall award grants, contracts, or cooperative agreements to eligible entities for the purpose of improving their ability to provide pediatric behavioral health services, including by—

(1) constructing or modernizing sites of care for pediatric behavioral health services;

(2) expanding capacity to provide pediatric behavioral health services, including enhancements to digital infrastructure, telehealth capabilities, or other improvements to patient care infrastructure;

(3) supporting the reallocation of existing resources to accommodate pediatric behavioral health patients, including by converting or adding a sufficient number of beds to establish or increase the hospital’s inventory of licensed and operational, short-term psychiatric and substance use inpatient beds; and

(4) addressing gaps in the continuum of care for children, by expanding capacity to provide intermediate levels of care, such as intensive outpatient services, partial hospitalization programs, and day programs that can prevent hospitalizations and support children as they transition back to their homes and communities.

(b) Eligibility.— To be eligible to seek an award under this section, an entity shall be a hospital or rural health clinic that predominantly treats individuals under the age of 21, including any hospital that receives funds under section 340E.

(c) Authorization of appropriations.— To carry out this section, there is authorized to be appropriated such sums as may be necessary for each of fiscal years 2027 through 2031.

(d) Supplement, not supplant.— Funds provided under this section shall be used to supplement, not supplant Federal and non-Federal funds available for carrying out the activities described in this section.

(e) Reporting.—

(1) Reports from award recipients.— Not later than 180 days after the completion of activities funded by an award under this section, the entity that received such award shall submit a report to the Secretary on the activities conducted using funds from such award, and other information as the Secretary may require.

(2) Reports to Congress.— Not later than one year after the completion of activities funded by an award under this section, the Secretary shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate a report on the projects and activities conducted with funds awarded under this section, and the outcome of such projects and activities. Such report shall include—

(A) the number of projects supported by awards made under this section;

(B) an overview of the impact, if any, of such projects on pediatric health care infrastructure, including any impact on access to pediatric mental health and substance use disorder services;

(C) recommendations for improving the investment program under this section; and

(D) any other considerations as the Secretary determines appropriate.”.

(a) School-Based mental health and children.— Section 581 of the Public Health Service Act (42 U.S.C. 290hh) is amended to read as follows:

“581. School-based mental health; children and adolescents.—

(a) In general.— The Secretary, in consultation with the Secretary of Education, shall, through grants, contracts, or cooperative agreements awarded to eligible entities described in subsection (c), provide comprehensive school-based mental health services and supports to assist children in local communities and schools (including schools funded by the Bureau of Indian Education) dealing with traumatic experiences, grief, bereavement, risk of suicide, and violence. Such services and supports shall—

(1) be developmentally, linguistically, and culturally appropriate;

(2) be trauma-informed; and

(3) incorporate positive behavioral interventions and supports.

(b) Activities.— Grants, contracts, or cooperative agreements awarded under subsection (a), shall, as appropriate, be used for—

(1) implementation of school- and community-based mental health programs that—

(A) build awareness of individual trauma and the intergenerational, continuum of impacts of trauma on populations;

(B) train appropriate staff to identify, and screen for, signs of trauma exposure, mental health disorders, or risk of suicide; and

(C) incorporate positive behavioral interventions, family engagement, student treatment, and multigenerational supports to foster the health and development of children, prevent mental health disorders, and ameliorate the impact of trauma;

(2) technical assistance to local communities with respect to the development of programs described in paragraph (1);

(3) facilitating community partnerships among families, students, law enforcement agencies, education agencies, mental health and substance use disorder service systems, family-based mental health service systems, child welfare agencies, health care providers (including primary care physicians, mental health professionals, and other professionals who specialize in children’s mental health such as child and adolescent psychiatrists), institutions of higher education, faith-based programs, trauma networks, and other community-based systems to address child and adolescent trauma, mental health issues, and violence; and

(4) establishing mechanisms for children and adolescents to report incidents of violence or plans by other children, adolescents, or adults to commit violence.

(c) Requirements.—

(1) In general.— To be eligible for a grant, contract, or cooperative agreement under subsection (a), an entity shall be a partnership that includes—

(A) a State educational agency, as defined in section 8101 of the Elementary and Secondary Education Act of 1965, in coordination with one or more local educational agencies, as defined in section 8101 of the Elementary and Secondary Education Act of 1965, or a consortium of any entities described in subparagraph (B), (C), (D), or (E) of section 8101(30) of such Act; and

(B) at least 1 community-based mental health provider, including a public or private mental health entity, health care entity, family-based mental health entity, trauma network, or other community-based entity, as determined by the Secretary (and which may include additional entities such as a human services agency, law enforcement or juvenile justice entity, child welfare agency, an institution of higher education, or another entity, as determined by the Secretary).

(2) Compliance with HIPAA.— Any patient records developed by covered entities through activities under the grant shall meet the regulations promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996.

(3) Compliance with FERPA.— Section 444 of the General Education Provisions Act (commonly known as the “Family Educational Rights and Privacy Act of 1974”) shall apply to any entity that is a member of the partnership in the same manner that such section applies to an educational agency or institution (as that term is defined in such section).

(d) Geographical distribution.— The Secretary shall ensure that grants, contracts, or cooperative agreements under subsection (a) will be distributed equitably among the regions of the country and among urban and rural areas.

(e) Duration of awards.— With respect to a grant, contract, or cooperative agreement under subsection (a), the period during which payments under such an award will be made to the recipient shall be 5 years, with options for renewal.

(f) Evaluation and measures of outcomes.—

(1) Development of process.— The Assistant Secretary shall develop a fiscally appropriate process for evaluating activities carried out under this section. Such process shall include—

(A) the development of guidelines for the submission of program data by grant, contract, or cooperative agreement recipients;

(B) the development of measures of outcomes (in accordance with paragraph (2)) to be applied by such recipients in evaluating programs carried out under this section; and

(C) the submission of annual reports by such recipients concerning the effectiveness of programs carried out under this section.

(2) Measures of outcomes.— The Assistant Secretary shall develop measures of outcomes to be applied by recipients of assistance under this section to evaluate the effectiveness of programs carried out under this section, including outcomes related to the student, family, and local educational systems supported by this Act.

(3) Submission of annual data.— An eligible entity described in subsection (c) that receives a grant, contract, or cooperative agreement under this section shall annually submit to the Assistant Secretary a report that includes data to evaluate the success of the program carried out by the entity based on whether such program is achieving the purposes of the program. Such reports shall utilize the measures of outcomes under paragraph (2) in a reasonable manner to demonstrate the progress of the program in achieving such purposes.

(4) Evaluation by assistant secretary.— Based on the data submitted under paragraph (3), the Assistant Secretary shall annually submit to Congress a report concerning the results and effectiveness of the programs carried out with assistance received under this section.

(5) Limitation.— An eligible entity shall use not more than 20 percent of amounts received under a grant under this section to carry out evaluation activities under this subsection.

(g) Information and education.— The Secretary shall disseminate best practices based on the findings of the knowledge development and application under this section.

(h) Amount of grants and authorization of appropriations.—

(1) Amount of grants.— A grant under this section shall be in an amount that is not more than $2,000,000 for each of the first 5 fiscal years following the date of enactment of the Health Equity and Accountability Act 2026. The Secretary shall determine the amount of each such grant based on the population of children up to age 21 of the area to be served under the grant.

(2) Authorization of appropriations.— There is authorized to be appropriated to carry out this section, $300,000,000 for each of fiscal years 2027 through 2030.”.

(b) Conforming amendment.— Part G of title V of the Public Health Service Act (42 U.S.C. 290hh et seq.), as amended by subsection (a), is amended by striking the part designation and heading and inserting the following:

Section 1903 of the Social Security Act (42 U.S.C. 1396b) is amended by adding at the end the following new subsection:

“(cc) Youth and young adult intervention services.—

(1) In general.— Notwithstanding section 1902(a)(1) (relating to Statewideness), section 1902(a)(10)(B) (relating to comparability), section 1902(a)(23)(A) (relating to freedom of choice of providers), or section 1902(a)(27) (relating to provider agreements), a State may, during the 5-year period beginning on the first day of the fiscal year quarter that begins on or after January 1, 2027, provide medical assistance for qualifying youth and young adult mental health and substance use intervention services (as defined in paragraph (2)(C)) under a State plan amendment or waiver approved under section 1115 or 1915(c).

(2) Definitions.— For the purposes of this subsection:

(A) Priority service.— The term priority service means any of the following, if voluntarily received and provided in a manner that maintains the privacy and confidentiality of patient information consistent with Federal and State requirements:

(i) Qualifying community-based mobile crisis intervention services, as defined in section 1947.

(ii) Telehealth.

(iii) Youth peer support.

(iv) Screening for adverse childhood experiences.

(v) Trauma responsive care.

(vi) Other priority services for youth, as defined by the Secretary.

(B) Qualified mental health provider.— The term qualified mental health provider means a behavioral health care professional who is capable of conducting an assessment of an individual described in subparagraph (C)(i), in accordance with the professional’s permitted scope of practice under State law, and any other professional or paraprofessional with appropriate expertise in youth and young adult behavioral health or mental health, including a social worker, peer support specialist, recovery coach, community health worker, mental health clinician, and any other provider designated by the State and approved by the Secretary.

(C) Qualifying youth and young adult mental health and substance use intervention services defined.— The term qualifying youth and young adult mental health and substance use intervention services means, with respect to a State, items and services for which medical assistance is available under the State plan under this title or a waiver of such plan, that are—

(i) furnished to an individual 16 to 25 years of age who is—

(I) experiencing a mental health or substance use disorder crisis;

(II) an offender, as defined in section 3 of the Workforce Innovation and Opportunity Act;

(III)

(aa) experiencing homelessness (as defined in section 41403(6) of the Violence Against Women Act of 1994);

(bb) a homeless child or youth (as defined in section 725(2) of the McKinney-Vento Homeless Assistance Act);

(cc) a runaway, is in foster care, or has aged out of the foster care system;

(dd) a child eligible for assistance under section 477; or

(ee) in an out-of-home placement;

(IV) an individual who is pregnant or parenting, including—

(aa) a custodial or non-custodial mother or father; or

(bb) an expectant mother;

(V) a youth who is an individual with a disability (as defined in section 3 of the Americans with Disabilities Act of 1990);

(VI) a low-income youth requiring additional assistance to enter or complete an educational program or to secure or hold employment; or

(VII) living in a community that has faced acute or long-term exposure to substantial discrimination, historical oppression, intergenerational poverty, civil unrest, or a high rate of violence or drug overdose deaths, as determined by the Secretary;

(ii) furnished by a qualified mental health provider; and

(iii) a priority service.

(D) Telehealth.— The term telehealth means use of electronic information and telecommunications technologies, including voice only audio, text, remote patient monitoring, and mHealth through applications, to support clinical mental health care, patient and professional health-related education, public health, and health administration.

(3) Payments.— Notwithstanding section 1905(b), beginning January 1, 2027, during each of the first 20 fiscal quarters that a State meets the requirements described in paragraph (4), the Federal medical assistance percentage applicable to amounts expended by the State for medical assistance for qualifying youth and young adult mental health and substance use intervention services furnished during such quarter shall be equal to 100 percent.

(4) Requirements.— The requirements described in this paragraph are the following:

(A) The State demonstrates, to the satisfaction of the Secretary, that the State will be able to support—

(i) the provision of qualifying youth and young adult mental health and substance use intervention services in accordance with paragraph (1); and

(ii) coordination between qualified mental health providers and substance use teams and community partners, including health care providers, to enable the provision of services, needed referrals, and other activities identified by the Secretary.

(B) The State provides assurances satisfactory to the Secretary that—

(i) any additional Federal funds received by the State for qualifying youth and young adult mental health and substance use intervention services provided under this subsection that are attributable to the increased Federal medical assistance percentage under paragraph (3) will be used to supplement, and not supplant, the level of State funds expended for such services for fiscal year 2027;

(ii) if the State made qualifying youth and young adult mental health and substance use intervention services available in a region of the State in fiscal year 2026 the State will continue to make such services available in such region under this subsection at the same level that the State made such services available in such fiscal year; and

(iii) the State will conduct the evaluation and assessment, and submit the report, required under paragraph (5).

(5) State evaluation and report.—

(A) State evaluation.— Not later than 4 fiscal quarters after a State begins providing qualifying youth and young adult mental health and substance use intervention services in accordance with this subsection, the State shall enter into a contract with an independent entity or organization to conduct an evaluation for the purposes of—

(i) determining the effect of the provision of such services on—

(I) emergency room visits;

(II) use of ambulatory services;

(III) hospitalizations;

(IV) the involvement of law enforcement in mental health or substance use disorder crisis events; and

(V) the diversion of individuals from jails or similar settings; and

(ii) assessing—

(I) the types of services provided to individuals;

(II) the types of events to which such services responded;

(III) cost savings or cost-effectiveness attributable to such services;

(IV) the experiences of individuals who receive such services;

(V) the successful connection of individuals with follow-up services; and

(VI) other relevant outcomes identified by the Secretary.

(B) Comparison to historical measures.— The contract described in subparagraph (A) shall specify that the evaluation conducted under such contract is based on a comparison of the historical measures of State performance with respect to the outcomes specified under such subparagraph to the State’s performance with respect to such outcomes during the period beginning with the first quarter in which the State begins providing qualifying youth and young adult mental health and substance use intervention services in accordance with this subsection.

(C) Report.— Not later than 2 years after a State begins to provide qualifying youth and young adult mental health and substance use intervention services in accordance with this subsection, the State shall submit a report to the Secretary on the following:

(i) The results of the evaluation conducted under subparagraph (A).

(ii) The number of individuals who received qualifying youth and young adult mental health and substance use intervention services.

(iii) Demographic information regarding such individuals when available, including the race and ethnicity, age, sex, sexual orientation, gender identity, and geographic location of such individuals.

(iv) The processes and models developed by the State to provide qualifying youth and young adult mental health and substance use intervention services under the State plan or a waiver of such plan, including the processes developed to provide referrals for, or coordination with, follow-up care and services.

(v) Lessons learned regarding the provision of such services.

(D) Public availability.— The State shall make the report required under subparagraph (C) publicly available, including on the website of the appropriate State agency, upon submission of such report to the Secretary.

(6) Best practices report.—

(A) In general.— Not later than 3 years after the first State begins to provide qualifying youth and young adult mental health and substance use intervention services in accordance with this subsection, the Secretary shall submit a report to Congress that—

(i) identifies the States that elected to provide such services in accordance with this subsection;

(ii) summarizes the information reported by such States under paragraph (5)(C); and

(iii) identifies best practices for the effective delivery of youth and young adult mental health and substance use intervention services.

(B) Public availability.— The report required under subparagraph (A) shall be made publicly available, including on the website of the Department of Health and Human Services, upon submission to Congress.

(7) Nondiscrimination.—

(A) Federally funded activities.—

(i) For the purpose of applying the prohibitions against discrimination on the basis of age under the Age Discrimination Act of 1975, on the basis of handicap under section 504 of the Rehabilitation Act of 1973, on the basis of sex under title IX of the Education Amendments of 1972, or on the basis of race, color, or national origin under title VI of the Civil Rights Act of 1964, programs and activities funded in whole or in part with funds made available under this subsection are considered to be programs and activities receiving Federal financial assistance.

(ii) No person shall on the ground of sex or religion be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity funded in whole or in part with funds made available under this subsection.

(B) Compliance.—

(i) In general.— Whenever the Secretary finds that a State, or an entity that has received a payment from an allotment to a State for medical assistance for qualifying youth and young adult mental health and substance use intervention services furnished under this subsection, has failed to comply with a provision of law referred to in subparagraph (A)(i), with subparagraph (A)(ii), or with an applicable regulation (including one prescribed to carry out subparagraph (A)(ii)), the Secretary shall notify the chief executive officer of the State and shall request such chief executive officer to secure compliance.

(ii) Failure or refusal to secure compliance.— If the chief executive officer of a State fails or refuses to secure compliance within a reasonable period of time, not to exceed 60 days, as requested under clause (i), the Secretary may—

(I) refer the matter to the Attorney General with a recommendation that an appropriate civil action be instituted;

(II) exercise the powers and functions provided by title VI of the Civil Rights Act of 1964, the Age Discrimination Act of 1975, or section 504 of the Rehabilitation Act of 1973, as may be applicable; or

(III) take such other action as may be provided by law.

(C) Authority of attorney general; civil actions.— When a matter is referred to the Attorney General pursuant to subparagraph (B)(ii)(I), or whenever the Attorney General has reason to believe that an entity is engaged in a pattern or practice in violation of a provision of law referred to in clause (i) or (ii) of subparagraph (A), the Attorney General may bring a civil action in any appropriate district court of the United States for such relief as may be appropriate, including injunctive relief.”.

(a) In general.— Section 1912(b)(1) of the Public Health Service Act (42 U.S.C. 300x–1(b)(1)) is amended—

(1) by redesignating subparagraph (E) as subparagraph (F); and

(2) by inserting after subparagraph (D) the following:

“(E) Early intervention and prevention programs for transition-age youth.— The plan shall describe the State’s plans to carry out demonstration grants or contracts for early intervention and prevention programs for transition-age youth of 16 to 25 years of age who meet one or more of the criteria specified in section 129(a)(1)(B) of the Workforce Innovation and Opportunity Act to be considered out-of-school youth.”.

(b) Set-Aside.— Section 1920 of the Public Health Service Act (42 U.S.C. 300x–9) is amended by adding at the end the following:

“(e) Early intervention and prevention programs for transition-Age youth.—

(1) In general.— Except as provided in paragraph (2), a State shall expend at least 15 percent of the amount of the allotment of the State pursuant to a funding agreement under section 1911 for each fiscal year to support programs described in section 1912(b)(1)(E).

(2) State flexibility.— In lieu of expending 15 percent of the amount of the allotment for a fiscal year as required by paragraph (1), a State may elect to expend not less than 30 percent of such amount to support such programs by the end of two consecutive fiscal years.”.

(a) Guidance.—

(1) In general.— Not later than 1 year after the date of the enactment of this Act, the Secretary of Health and Human Services shall issue and disseminate guidance to States to clarify strategies to overcome existing barriers and increase access to telehealth under the Medicaid program under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) and the Children’s Health Insurance Program under title XXI of such Act (42 U.S.C. 1397aa et seq.).

(2) Contents.— The guidance described in paragraph (1) shall include technical assistance and best practices regarding—

(A) telehealth delivery of services furnished under such programs;

(B) recommended voluntary billing codes, modifiers, and place-of-service designations for telehealth and other virtual health care services;

(C) the simplification or alignment (including through reciprocity) of provider licensing, credentialing, and enrollment protocols with respect to telehealth across States, State Medicaid plans under such title XIX, and Medicaid managed care organizations, including during national public health emergencies;

(D) existing strategies States can use to integrate telehealth and other virtual health care services into value-based health care models; and

(E) examples of States that have used waivers under the Medicaid program to test expanded access to telehealth, including during the emergency period described in section 1135(g)(1)(B) of the Social Security Act (42 U.S.C. 1320b–5(g)(1)(B)).

(b) Studies and reports to Congress.—

(1) Telehealth impact on health care access.—

(A) In general.— Not later than 1 year after the date of the enactment of this Act, the Medicaid and CHIP Payment and Access Commission shall conduct a study, and submit to Congress a report, on the impact of telehealth on health care access, utilization, cost, and outcomes, broken down by race, ethnicity, sex, age, disability status, and ZIP Code, with respect to a minimum of 10 States across geographic regions of the United States.

(B) Report contents.— The report required under subparagraph (A) shall—

(i) evaluate cost, access, utilization, outcomes, and patient experience data from across the health care field, including States, Medicaid managed care organizations, provider organizations, and other organizations that provide or pay for telehealth under the Medicaid program under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) and the Children’s Health Insurance Program under title XXI of such Act (42 U.S.C. 1397aa et seq.);

(ii) identify barriers and potential solutions to provider entry and participation in telehealth that States are experiencing, as well as barriers to providing telehealth across State lines, including during times of public health crisis or public health emergency;

(iii) determine the frequency at which out-of-State telehealth is provided to patients enrolled in the Medicaid program under such title XIX and the potential impact on access to telehealth if State Medicaid policies were more aligned; and

(iv) identify and evaluate opportunities for more alignment among such policies to promote access to telehealth across all States, State Medicaid plans under such title XIX, State child health plans under such title XXI, and Medicaid managed care organizations, including the potential for regional compacts or reciprocity agreements.

(2) Federal agency telehealth collaboration.—

(A) In general.— Not later than 1 year after the date of the enactment of this Act, the Comptroller General of the United States shall conduct a study, and submit to Congress a report, evaluating collaboration between Federal agencies with respect to telehealth services furnished under the Medicaid program under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) or the Children's Health Insurance Program under title XXI of such Act (42 U.S.C. 1397aa et seq.) to individuals under the age of 18, including such services furnished to such individuals in early care and education settings.

(B) Report contents.— The report required under subparagraph (A) shall include recommendations on—

(i) opportunities for Federal agencies to improve collaboration with respect to the telehealth services described in such subparagraph; and

(ii) opportunities for collaboration between Federal agencies to expand telehealth access to individuals under the age of 18 that are enrolled in the programs described in such subparagraph, including in early care and education settings.

Part Q of title III of the Public Health Service Act (as amended by section 5001) is amended by adding at the end the following:

“399Z–4. Youth and young adult mental health promotion, prevention, intervention, and treatment.—

(a) Grants.— The Secretary shall—

(1) award grants to eligible entities to develop, maintain, or enhance youth and young adult mental health promotion, prevention, intervention, and treatment programs, including—

(A) programs for youth and young adults who may be likely to develop, are showing early signs of, or have been diagnosed with a mental health condition, including a serious emotional disturbance; and

(B) infrastructure and organization change at a State, tribal, or territorial level to improve cross-system collaboration, service capacity, and expertise related to youth and young adults; and

(2) ensure that programs funded through grants under this section use community-driven, evidence-informed, or evidence-based models, practices, and methods that are, as appropriate, culturally and linguistically appropriate, and can be replicated in other appropriate settings.

(b) Eligible transition age youth and entities.— In this section:

(1) Eligible entity.— The term eligible entity means—

(A) a local educational agency;

(B) a State educational agency;

(C) an institution of higher education (or consortium of such institutions), which may include a recovery program at an institution of higher education;

(D) a local board, or a one-stop operator, as defined in section 3 of the Workforce Innovation and Opportunity Act;

(E) a nonprofit organization with appropriate expertise in providing services or programs for children, adolescents, or young adults, excluding a school;

(F) a State, political subdivision of a State, Indian tribe, or tribal organization; or

(G) a high school or dormitory serving high school students that receives funding from the Bureau of Indian Education.

(2) Eligible transition age youth.— The term eligible transition age youth means a youth or young adult from age 16 to not more than 25 years of age who is—

(A) an out-of-school youth as defined in section 129(a)(1)(B) of the Workforce Innovation and Opportunity Act;

(B) a homeless individual (as defined in section 41403(6) of the Violence Against Women Act of 1994), a homeless child or youth (as defined in section 725(2) of the McKinney-Vento Homeless Assistance Act) a runaway, in foster care or has aged out of the foster care system, a child eligible for assistance under section 477 of the Social Security Act, or in an out-of-home placement;

(C) an individual who is pregnant or parenting, as referred to in section 129(a)(1)(B) of the Workforce Innovation and Opportunity Act;

(D) a youth who is an individual with a disability, as referred to in section 129(a)(1)(B) of the Workforce Innovation and Opportunity Act;

(E) a low-income individual who requires additional assistance to enter or complete an educational program or to secure or hold employment, as referred to in section 129(a)(1)(B) of the Workforce Innovation and Opportunity Act; or

(F) living in a community that has faced acute or long-term exposure to substantial discrimination, historical oppression, intergenerational poverty, civil unrest, a high rate of violence, or drug overdose deaths.

(c) Application.— An eligible entity seeking a grant under subsection (a) shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require.

(d) Use of funds for mental health promotion, prevention, intervention and treatment programs.— An eligible entity may use amounts awarded under a grant under subsection (a)(1) to carry out the following:

(1) Creation, implementation, and expansion of services and supports that are culturally and linguistically appropriate and youth guided, involve and include family and community members (including business leaders and faith-based organizations), and provide for continuity of care between child- and adult-serving systems to ensure seamless transition.

(2) Infrastructure and organization change at a State, Tribal, or territorial level to improve cross-system collaboration, service capacity, and expertise related to youth and young adults with, or at risk of, mental health conditions and substance use disorders as they transition into adult roles and responsibilities.

(3) Public awareness and cross-system provider training for individuals employed at institutions of higher education and community colleges, behavioral health providers, individuals working in the criminal justice system, primary care providers, vocational service providers, and child welfare workers.

(e) Matching funds.— The Secretary may not award a grant under this section to an eligible entity unless the eligible entity agrees, with respect to the costs to be incurred by the eligible entity in carrying out the activities described in subsection (d), to make available non-Federal contributions (in cash or in kind) toward such costs in an amount that is not less than 10 percent of the total amount of Federal funds provided in the grant.

(f) Authorization of appropriations.— To carry out this section, there are authorized to be appropriated $25,000,000 for each of fiscal years 2027 through 2036.”.

Part D of title V of the Public Health Service Act (42 U.S.C. 290dd et seq.), as amended by section 6203, is amended by adding at the end the following:

“556. Behavioral outreach and education strategy.—

(a) In general.— The Secretary, acting through the Assistant Secretary for Mental Health and Substance Use, shall, in coordination with advocacy and behavioral organizations serving populations of Asian American, African American, Native Hawaiian, Pacific Islander, Indigenous, Middle Eastern and North African (in this section referred to as “MENA”), and Hispanic and Latino/a/x individuals or communities, develop and implement an outreach and education strategy to promote behavioral health, emphasize that behavioral health conditions are treatable and that reasonable accommodations under section 504 of the Rehabilitation Act of 1973 and titles II and III of the Americans with Disabilities Act of 1990 are necessary and may help, as well as reduce stigma associated with mental health conditions and substance use disorder among the Asian American, African American, Native Hawaiian, Pacific Islander, Indigenous, MENA, and Hispanic and Latino/a/x populations. Such strategy shall—

(1) be designed to—

(A) meet the diverse cultural and language needs of the various Asian American, African American, Indigenous, MENA, Native Hawaiian, Pacific Islander, and Hispanic and Latino/a/x populations; and

(B) ensure that approaches recommended in the strategy are developmentally (with respect to the beneficiary’s relative age and experience) and age appropriate, as well as cognitively accessible to persons with cognitive disabilities;

(2) increase awareness of symptoms of mental illnesses common among such populations, taking into account differences within subgroups (such as gender, gender identity, age, sexual orientation, disability, and ethnicity) of such populations;

(3) provide information on evidence-based, culturally and linguistically appropriate and adapted interventions and treatments;

(4) ensure full participation of, and engage, both consumers and community members representing the communities of focus in the development and implementation of materials; and

(5) seek to broaden the perspective among both individuals in such communities and stakeholders serving such communities to use a comprehensive public health approach to promoting behavioral health that addresses a holistic view of health by focusing on the intersection between behavioral and physical health.

(b) Reports.— Beginning not later than 1 year after the date of the enactment of this section and annually thereafter, the Secretary, acting through the Assistant Secretary, shall submit to the Congress, and make publicly available, a report on the extent to which the strategy developed and implemented under subsection (a) increased behavioral health outcomes associated with mental health conditions and substance use disorder among Asian American, African American, Native Hawaiian, Pacific Islander, Indigenous, MENA, and Hispanic and Latino/a/x populations.

(c) Authorization of appropriations.— There is authorized to be appropriated to carry out this section $15,000,000 for each of fiscal years 2027 through 2032.”.

Not later than 9 months after the date of the enactment of this Act, the Director of the National Institutes of Health, in consultation with the Director of the National Institute of Mental Health and the Assistant Secretary of Substance Use and Mental Health, shall enter into an arrangement with the National Academies of Sciences, Engineering, and Medicine (or, if the National Academies of Sciences, Engineering, and Medicine decline to enter into such an arrangement, the Patient-Centered Outcomes Research Institute, the Agency for Healthcare Research and Quality, or another appropriate entity)—

(1) to conduct a study with respect to mental health disparities research gaps in racial and ethnic minority groups (as defined in section 1707(g) of the Public Health Service Act (42 U.S.C. 300u–6(g))); and

(2) to submit to the Congress a report on the results of such study, including—

(A) a compilation of information on the prevalence of mental health outcomes in such racial and ethnic minority groups; and

(B) an assessment of information on the impact of exposure to community violence, adverse childhood experiences, structural bias, and other psychological traumas on mental health outcomes in such racial and minority groups.

(a) In general.— The Secretary of Health and Human Services, acting through the Director of the Office of Minority Health of the Centers for Disease Control and Prevention (established pursuant to section 1707A of the Public Health Service Act (42 U.S.C. 300u–6a)) (in this section referred to as the “Secretary”), shall conduct research on the adverse health effects associated with interactions with law enforcement.

(b) Effects among racial and ethnic minorities.— The research under subsection (a) shall include research on—

(1) the health consequences, both individual and community-wide, of trauma related to violence committed by law enforcement among racial and ethnic minorities; and

(2) the disproportionate burden of morbidity and mortality associated with such trauma.

(c) Report.— Not later than 1 year after the date of enactment of this Act, the Secretary shall—

(1) complete the research under this section; and

(2) submit to the Congress a report on the findings, conclusions, and recommendations resulting from such research.

Not later than 180 days after the date of enactment of this Act, the Assistant Secretary for Mental Health and Substance Use shall—

(1) conduct a study to—

(A) determine which geographic areas of the United States have shortages of racially and ethnically diverse mental health providers, as well as mental health providers trained to work with racially and ethnically diverse clients and clients with multiple mental health, cognitive, and developmental disabilities; and

(B) assess the preparedness of mental health providers to deliver culturally and linguistically appropriate, affordable, and accessible services; and

(2) submit a report to Congress on the results of such study.

(a) GAO report.— Not later than 2 years after the date of enactment of this Act, the Comptroller General of the United States shall submit to Congress a report on barriers to care for persons with co-occurring conditions and access to care in the United States. Such report shall include the information and recommendations described in subsection (b).

(b) Content of report.— The report under subsection (a) shall include—

(1) an assessment of current barriers to behavioral health and substance use disorder treatment for low-income, uninsured, and Medicaid-enrolled adults, and recommendations for addressing such barriers, particularly for women and diverse racial and ethnic groups;

(2) an assessment of—

(A) how many adults have a behavioral health condition and options for adults to receive behavioral health and substance use disorder treatment in nonexpansion States;

(B) Medicaid expansion States who provide behavioral health coverage for newly eligible enrollees;

(C) how enrollment in coverage affects treatment availability; and

(D) the impacts of COVID–19 to receiving and accessing treatment for behavioral health, substance use disorders, and diverse racial and ethnic groups, and recommendations for addressing such barriers;

(3) an assessment of current barriers, inclusive of social determinants of health and cultural barriers, that prevent adults from receiving behavioral health and substance use disorder treatment, and recommendations for addressing such barriers, particularly for low-income women and adults from racial and ethnic groups;

(4) an assessment of disparities in access to addiction counselors and mental or behavioral health care providers acting in accordance with State law, stratified by race, ethnicity, gender identity, geographic location, and insurance type, and recommendations to promote greater access equity; and

(5) recommendations to promote greater equity in access to care for behavioral services and substance use disorders, particularly for low-income women and adults from diverse racial and ethnic groups.

(a) Study.—

(1) In general.— The Secretary, acting through the Assistant Secretary for Mental Health and Substance Use (referred to in this section as the Secretary), in coordination with the Director of the National Institutes of Health, the Director of the Centers for Disease Control and Prevention, and the Director of the Office of Minority Health, shall conduct a study on behavioral health among AANHPI youth.

(2) Elements.— Such study required under paragraph (1) shall include an assessment of—

(A) the prevalence, risk factors, and root causes of mental health challenges, substance misuse, and mental health and substance use disorders among AANHPI youth;

(B) the prevalence among AANHPI youth of attempted suicide, nonfatal substance use overdose, and death by suicide or substance use overdose; and

(C) AANHPI youth that received treatment for mental health and substance use disorders.

(b) Report.— Not later than 1 year after the date of the enactment of this Act, the Secretary shall submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives, and make publicly available, a report on the findings of the study conducted under subsection (a), including—

(1) identification of the barriers to accessing behavioral health services for AANHPI youth;

(2) identification of root causes of mental health challenges and substance misuse among AANHPI youth;

(3) recommendations for actions to be taken by the Secretary to improve behavioral health among AANHPI youth;

(4) recommendations for legislative or administrative action to improve the behavioral health of AANHPI youth experiencing depression, suicide, and overdose, and to reduce the prevalence of depression, suicide, and overdose among AANHPI youth; and

(5) such other recommendations as the Secretary determines appropriate.

(c) Data.— Any data included in the study or report under this section shall be disaggregated by race, ethnicity, age, sex, gender identity, sexual orientation, geographic region, disability status, and other relevant factors, in a manner that protects personal privacy and that is consistent with applicable Federal and State privacy law.

(d) Authorization of appropriations.— For purposes of carrying out this section, there is authorized to be appropriated $1,500,000 for fiscal year 2027.

(a) Study.—

(1) In general.— The Secretary, acting through the Assistant Secretary for Mental Health and Substance Use (referred to in this section as the Secretary), in coordination with the Administrator of the Health Resources and Services Administration, the Secretary of Labor, and the Director of the Office of Minority Health, shall conduct a study on strategies for increasing the behavioral health professional workforce that identify as AANHPI.

(2) Elements.— Such study required under paragraph (1) shall consider—

(A) the total number of licensed behavioral health providers in the United States who identify as AANHPI;

(B) with respect to each such provider, information regarding the current type of license, geographic area of practice, and type of employer (such as hospital, Federally qualified health center, school, or private practice);

(C) information regarding the cultural and linguistic capabilities of such providers, including languages spoken proficiently; and

(D) the relevant barriers to enrollment in behavioral health professional education programs and entering the behavioral workforce for AANHPI individuals.

(b) Report.— Not later than 1 year after the date of the enactment of this Act, the Secretary shall submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives, and make publicly available, a report on the findings of the study conducted under subsection (a), including—

(1) identification of AANHPI licensed behavioral health providers’ knowledge and awareness of the barriers to quality behavioral health care services faced by AANHPI individuals, including stigma, limited English proficiency, and lack of health insurance coverage;

(2) recommendations for actions to be taken by the Secretary to increase the number of AANHPI licensed behavioral health professionals;

(3) recommendations for legislative or administrative action to improve the enrollment of AANHPI individuals in behavioral health professional education programs; and

(4) such other recommendations as the Secretary determines appropriate.

(c) Data.— Any data included in the study or report under this section shall be disaggregated by race, ethnicity, age, sex, gender identity, sexual orientation, geographic region, disability status, and other relevant factors, in a manner that protects personal privacy and that is consistent with applicable Federal and State privacy law.

(d) Definition.— In this section the term licensed behavioral health provider means any individual licensed to provide mental health or substance use disorder services, including in the professions of social work, psychology, psychiatry, marriage and family therapy, mental health counseling, and substance use disorder counseling.

(e) Authorization of appropriations.— For purposes of carrying out this section, there is authorized to be appropriated $1,500,000 for fiscal year 2027.

(a) In general.— Section 1942(a) of the Public Health Service Act (42 U.S.C. 300x–52(a)) is amended—

(1) by redesignating paragraphs (2) and (3) as paragraphs (5) and (6), respectively; and

(2) by inserting after paragraph (1) the following:

“(2) services provided by the State to adults with a serious mental illness and children with a serious emotional disturbance who are members of racial and ethnic minority groups, including—

(A) the extent to which such services are provided to such adults and children; and

(B) the outcomes experienced by such adults and children as a result of the provision of such services, including with respect to—

(i) diversions from hospitalization and criminal justice system involvement;

(ii) treatment for first episode psychosis or undefined psychosis;

(iii) reductions in suicide and increased utilization of appropriate treatments and interventions for suicidal ideation;

(iv) response through crisis services, including mobile crisis services;

(v) treatment of individuals who are experiencing homelessness or housing insecurity and individuals residing in rural communities; and

(vi) increased patient family and caregiver engagement and education on serious mental illness to reduce social stigma and promote healthy social support for patients;

(3) any outreach by the State to, and the hiring of, providers of mental health services from multiple disciplines (such as a psychologist, psychiatrist, peer support provider, or social worker) who are members of racial and ethnic minority groups;

(4) any outreach by the State to providers from multiple disciplines of mental health services—

(A) to provide training on culturally effective, culturally affirming, and linguistically competent services; and

(B) to increase awareness of community-defined practices by practitioners of racial and ethnic minority groups;”.

(b) Applicability.— The amendments made by subsection (a) shall apply with respect to funding agreements entered into under section 1911 or 1921 of the Public Health Service Act (42 U.S.C. 300x; 42 U.S.C. 300x–21) on or after the date of the enactment of this Act.

(a) Data analysis and strategy implementation To prevent and mitigate childhood trauma.— Title XXXI of the Public Health Service Act (42 U.S.C. 300kk) is amended by adding at the end the following:

“3102. Data analysis and strategy implementation to prevent and mitigate childhood trauma.—

(a) In general.— The Secretary shall establish a program—

(1) to support the development and implementation of programs that use data analysis methods to identify and facilitate strategies for early intervention and prevention, in order to prevent and mitigate childhood trauma and support communities and families, including—

(A) improving connections through care coordination;

(B) aligning community initiatives in targeted areas of need; and

(C) expanding community capacity through cross-sector collaboration; and

(2) to evaluate the effectiveness of these programs in improving outcomes for children.

(b) Grants.— The Secretary shall award grants to up to 5 eligible entities to carry out the activities described in subsection (a).

(c) Use of funds.— A grant for activities under this section shall be used to support the development and implementation of programs that use data analysis methods to identify and facilitate strategies for early intervention and prevention, in order to prevent and mitigate childhood trauma and support communities and families, including as follows:

(1) Utilize data analysis methods to—

(A) identify specific geographic areas, such as census tracts, with a high prevalence of adverse childhood experiences and significant risk factors for poor outcomes for children (such as increased risk of experiencing adverse childhood experiences), including areas with high rates of—

(i) poor public health outcomes including illness, disease, suicide, and mortality;

(ii) exclusionary discipline practices, including suspensions, expulsions, and referrals to law enforcement, as well as low graduation rates;

(iii) substance use disorders;

(iv) poverty;

(v) foster system involvement or referrals;

(vi) housing instability and homelessness;

(vii) food insecurity;

(viii) inequity, including disparities in income, wealth, employment, educational attainment, health care access, and public health outcomes, along lines of race, sex, sexuality and gender identity, ethnicity, or nationality;

(ix) incarceration rates; or

(x) other indicators of adversity as defined by the Secretary; and

(B) identify strategies to improve outcomes for children aged 0 through 17 that build on strengths in communities that could be further supported, including—

(i) existing support networks for families; and

(ii) enhanced connections to community-based organizations.

(2) Implement strategies identified pursuant to paragraph (1)(B) to facilitate outreach and involvement of children and their caregivers in Federal, State, or local programs that provide reparative, gender-responsive, culturally specific, and trauma-informed prevention services, and for which children and their caregivers are eligible, including—

(A) home visiting programs;

(B) training and education on parenting skills;

(C) substance use disorder prevention and treatment that is voluntary and noncoercive;

(D) mental health supports and care that is voluntary and noncoercive;

(E) family and intimate partner violence prevention services;

(F) child advocacy center programming;

(G) economic and nutrition support services;

(H) housing support services, including emergency and temporary shelter for those experiencing homelessness and housing insecurity, as well as stable, long-term housing;

(I) voluntary, noncoercive, gender-responsive, and culturally specific mental health supports in school and early childhood education center-based settings;

(J) wraparound programs for transitioning youth and youth currently in the foster system;

(K) programming to support the health and well-being of lesbian, gay, bisexual, transgender, and intersex children and their families; and

(L) family resource center services.

(d) Special rules.—

(1) Primary payer restriction.— The Secretary may not award a grant under this section to an eligible entity for a service if the service to be provided is available pursuant to the State plan approved under title XIX of the Social Security Act for the State in which the program funded by the grant is being conducted unless the State and all eligible subdivisions involved—

(A) will enter into agreements with public or nonprofit private entities under which the entities will provide the service; and

(B) demonstrate that the State and all eligible subdivisions will ensure that the entities providing the service—

(i) will seek payment for each such service rendered in accordance with the usual payment schedule under the State plan; and

(ii) the entities have entered into a participation agreement and are qualified to receive payments under such plan.

(2) Implementation.— An eligible entity that receives a grant under this section may use—

(A) not more than 25 percent of the amounts made available through the grant for the first 24 months of the grant period to utilize data analysis methods to—

(i) identify specific geographic areas where care coordination, prevention and early intervention, and facilitation services will be provided; and

(ii) identify support and intervention services to improve outcomes for children located in a geographic area identified under subsection (c)(1)(A); and

(B) not more than 10 percent of the grant in each subsequent year to continue data analysis activities.

(3) Administration.— An eligible entity that receives a grant under this section may not use more than 5 percent of amounts received through the grant for administration, reporting, and program oversight functions, including the development of systems to improve data collection and data sharing for the purposes of improving services and the provision of care.

(4) Priority.—

(A) In general.— In awarding grants under this section, the Secretary shall give priority, to the extent practical, to eligible entities that use community-based system dynamic modeling as the primary data analysis method.

(B) System dynamic modeling defined.— The term system dynamic modeling means a method of data analysis and predictive modeling that includes—

(i) utilization of community-based participatory research methods for involving community in the process of understanding and changing systems and evaluating outcomes of grants;

(ii) consideration of a multitude of environmental risk factors and ascertainment of the significance of contributing community risk factors for purposes of identifying strategies to reduce adverse child outcomes, including—

(I) maltreatment cases;

(II) involvement with the juvenile criminal legal system or foster system;

(III) exclusionary school discipline; or

(IV) exposure to violence; and

(iii) identification of cross-sector responses involving reparative, trauma-informed, culturally specific, gender-responsive, and community-based organizations to reduce adverse child outcomes.

(5) Subgrant.—

(A) In general.— An eligible entity that receives a grant under this section shall use at least 25 percent of the total amount of the grant to make subgrants to organizations that aid in implementing the strategy identified under subsection (c)(1)(B) for preventing and mitigating childhood trauma and supporting communities and families.

(B) Eligibility.— To be eligible to receive a subgrant under this paragraph, an organization shall prepare and submit to the eligible entity an application in such form, and containing such information, as the eligible entity may require, including evidence that the—

(i) needs of the population to be served are urgent and are not met by the services currently available in the geographic area; and

(ii) organization has the capacity to provide the services listed in subsection (c)(2).

(C) Supplement, not supplant.— Subgrant funds received pursuant to this paragraph by an organization shall be used to supplement and not supplant State or local funds provided to the partnership organization for services listed in subsection (c)(2).

(e) Application.— To be eligible to receive a grant under this section, an eligible entity shall submit to the Secretary an application in such form, and containing such information, as the Secretary may require, to include the following:

(1) A demonstration that—

(A) the applicant utilizes trauma-informed, culturally specific, and gender-responsive practices, including a demonstration of the extent to which the applicant has trained staff in these practices;

(B) the applicant has the capacity to administer the grant, including conducting all required data analysis activities; and

(C) services will be provided to children and families in an accessible, culturally relevant, and linguistically specific manner consistent with local needs.

(2) A preliminary analysis of how the applicant will use the grant to—

(A) identify the geographic area or areas to be served using data analysis methods;

(B) utilize data analysis methods to identify strategies to improve outcomes for children in the geographic area;

(C) facilitate strategies identified through care coordination efforts; and

(D) track data for evaluation of outcomes.

(3) A detailed project plan for the use of the grant that includes anticipated technical assistance needs.

(4) Additional funding sources, including State and local funds, supporting the prevention and mitigation of adverse childhood experiences.

(f) Grant amount.— The amount of a grant under this section shall not exceed $9,500,000.

(g) Period of a grant.— The period of a grant under this section shall not exceed 7 years.

(h) Service provision without regard to ability To pay.— As a condition on receipt of a grant under this section, an eligible entity shall agree that any assistance provided to an individual through the grant will be provided without regard to—

(1) the ability of the individual to pay for such services;

(2) the current or past health condition of the individual to be served;

(3) the immigration status of the individual to be served;

(4) the sexual orientation and gender identity of the individual to be served; and

(5) any prior involvement of the individual in the criminal legal system.

(i) Prohibitions.— In addition to any other prohibitions determined by the Secretary, an eligible entity may not use a grant under this section to—

(1) use data analysis methods to inform individual case decisions, including child removal or placement decisions, or to target services at certain individuals or families;

(2) require any individual or family to participate in any service or program as a condition of receipt of a benefit to which the individual or family is otherwise eligible;

(3) increase the presence or funding of law enforcement surveillance, involvement, or activity in implementing the strategies identified under subsection (c)(1)(B); or

(4) enable the practice of conversion therapy.

(j) Evaluation.—

(1) Data model evaluation.— Not later than 36 months after the date of enactment of this section, the Assistant Secretary for Planning and Evaluation of the Department of Health and Human Services, in coordination with the grantees receiving a grant under this section, shall complete an evaluation of the effectiveness of the data model accuracy of the grant program under this section to address each of the following:

(A) Determining the effectiveness of the grantees’ use of data analysis methods to identify geographic areas pursuant to subsection (c)(1).

(B) Examining the grantees’ development and utilization of data analysis methods.

(C) Examining the grantees’ ability to effectively utilize data analysis methods in future prevention work.

(D) Establishing a method for rigorously evaluating the activities of grantees and comparing the reduction of child and family exposure to adverse experiences in other communities with similar demographics.

(E) Examining the grantees’ utilization of community-based system dynamics modeling methods and other community engagement methods.

(2) Program evaluation.— Not later than 6 years after the date of enactment of this section, the Assistant Secretary for Planning and Evaluation of the Department of Health and Human Services, in coordination with eligible entities receiving grants under this section, shall complete an evaluation of the effectiveness of the grant program under this section.

(3) Data Collection.—

(A) In general.— The Assistant Secretary for Planning and Evaluation of the Department of Health and Human Services and each eligible entity receiving a grant under this section shall collect any relevant data necessary to complete the evaluations required by paragraphs (1) and (2) to include—

(i) the activities funded by the grant under this section, including development and implementation data analysis methods;

(ii) the number of children and of families receiving coordination and facilitation of care and services; and

(iii) the effect of activities supported by the grant under this section on the local area serviced by the program, including such effects on—

(I) children and adolescents’ health and well-being;

(II) the number of children who enter into or depart from foster services; and

(III) homelessness and housing insecurity.

(B) Study.—

(i) In general.— Not later than 7 years after the date of enactment of this section, the Assistant Secretary for Planning and Evaluation of the Department of Health and Human Services shall—

(I) complete a study on the results of the grant program under this section using the community-based participatory action research method, which focuses on social, structural, and physical environmental inequities through active involvement of community members, clients, organizational representatives, and researchers in all aspects of the research process; and

(II) submit a report on the results of the study to the Congress.

(ii) Partners.— In conducting the study under clause (i), the Assistant Secretary for Planning and Evaluation of the Department of Health and Human Services shall ensure that partners and persons that have participated in the grant program under this section on every level, especially those such partners or persons receiving services and support through the program, have an opportunity to contribute their expertise to evaluating the strategy and outcomes.

(k) Report.— Not later than 3 months after the completion of the evaluation required by subsection (j)(2), the Assistant Secretary for Planning and Evaluation of the Department of Health and Human Services shall submit to Congress and make available to the public on the internet website of the Department of Health and Human Services a report based upon the evaluation under subsection (j)(2), to include—

(1) the impact of the program under this section on homelessness and housing insecurity, substance use disorder and drug deaths, incarceration, foster system involvement, and other child and family outcomes as identified by the Assistant Secretary for Planning and Evaluation of the Department of Health and Human Services;

(2) an analysis of which elements of the program should be replicated and scaled by governmental or non-governmental entities; and

(3) such recommendations for legislation and administrative action as the Secretary determines appropriate.

(l) Definitions.— In this section:

(1) The term adverse childhood experience means a potentially traumatic experience that occurs in childhood and can have a tremendous impact on the child’s lifelong health and opportunity outcomes, such as any of the following:

(A) Abuse, such as any of the following:

(i) Emotional and psychological abuse.

(ii) Physical abuse.

(iii) Sexual abuse.

(B) Household challenges such as any of the following:

(i) A household member is treated violently.

(ii) A household member has a substance use disorder.

(iii) A household member has a mental health condition.

(iv) Parental separation or divorce.

(v) A household member is incarcerated, is placed in immigrant detention, or has been deported.

(vi) A household member has a life-threatening illness such as COVID–19.

(C) Neglect.

(D) Living in—

(i) impoverished communities that lack access to human services;

(ii) areas of high unemployment neighborhoods; or

(iii) communities experiencing de facto segregation.

(E) Experiencing food insecurity and poor nutrition.

(F) Witnessing violence.

(G) Involvement with the foster system.

(H) Experiencing discrimination.

(I) Dealing with historical and ongoing traumas due to systemic and interpersonal racism.

(J) Dealing with historical and ongoing traumas regarding systemic and interpersonal sexism, homophobia, biphobia, and transphobia.

(K) Dealing with the threat of deportation or detention as a result of immigration status.

(L) The impacts of multigenerational poverty resulting from limited educational and economic opportunities.

(M) Living through natural disasters such as earthquakes, forest fires, floods, or hurricanes.

(2) The term eligible entity means a State or local health department.

(3) The term practice of conversion therapy—

(A) means any practice or treatment by any person that seeks to change another individual’s sexual orientation or gender identity, including efforts to change behaviors or gender expressions, or to eliminate or reduce sexual or romantic attractions or feelings toward individuals of the same gender, if such person receives monetary compensation in exchange for any such practice or treatment; and

(B) does not include any practice or treatment that does not seek to change sexual orientation or gender identity and—

(i) provides assistance to an individual undergoing a gender transition; or

(ii) provides acceptance, support, and understanding of a client or facilitation of a client’s coping, social support, and identity exploration and development.

(m) Authorization of appropriations.— There is authorized to be appropriated to carry out this section for the period of fiscal years 2027 through 2033—

(1) to carry out subsection (a)(1) through the award of grants under subsection (b)—

(A) $47,500,000 for grants; and

(B) such sums as may be necessary for the administrative costs of carrying out such subsection; and

(2) $7,500,000 to carry out the evaluation under subsection (a)(2).”.

(b) Care coordination grants.— Part E of title XII of the Public Health Service Act (42 U.S.C. 300d–51 et seq.) is amended by adding at the end the following new section:

“1255. Care coordination grants.—

(a) In general.— The Secretary shall award grants to eligible entities to establish or expand trauma-informed care coordination services to support—

(1) children aged 0 through 5 at risk of adverse childhood experiences; and

(2) their caregivers, including prenatal people of any age.

(b) Number of grants.— Subject to the availability of appropriations, the Secretary shall award not fewer than 9 and not more than 40 grants under this section.

(c) Amount of grants.— Subject to the availability of appropriations, the amount of a grant under this section for a fiscal year shall be—

(1) not less than $250,000; and

(2) not more than $1,000,000.

(d) Eligible entities.— To be eligible to receive a grant under this section, an entity shall be a local government or Indian Tribe, acting through the public health department thereof if such government or Tribe has a public health department.

(e) Priority.—

(1) In general.— In awarding grants under this section, the Secretary shall give priority to eligible entities proposing to serve communities with a high need for trauma-informed care coordination services, as demonstrated by indicators such as—

(A) pregnant people who face barriers to prenatal care;

(B) mortality or morbidity of people giving birth or infants;

(C) caretakers and parents who are living with a mental health condition or substance use disorder;

(D) a high prevalence of community violence, including domestic violence, as demonstrated by instances of homicide and public health statistics, including treatment of injury or trauma;

(E) high proportions of low-income children;

(F) a high prevalence of child fatalities or near fatalities related to child abuse and neglect;

(G) significant disparities in health outcomes for people giving birth and infants;

(H) a high rate of exclusionary discipline and referrals to law enforcement; and

(I) a high rate of homelessness and housing instability.

(2) Data from Tribal areas.— The Secretary, acting through the Director of the Indian Health Service, shall consult with Indian Tribes to establish criteria to measure indicators of need, for purposes of paragraph (1), with respect to Tribal areas.

(f) Use of funds.—

(1) Required uses.—

(A) In general.— A grant received under this section shall be used to establish or expand gender-responsive, culturally specific, trauma-informed care coordination services, including by instituting and conducting risk and needs assessments including—

(i) using strengths-based approaches focused on protective factors for children and their caregivers, including prenatal people of any age; and

(ii) inputting screening results into a centralized intake system to promote a single point of access system across providers and services.

(B) Training.— A grant received under this section shall be used to ensure that individuals employed through the grant funds, in whole or in part, have received sufficient and up-to-date training on trauma-informed care and strategies that are reparative, culturally sensitive, gender responsive, and healing centered.

(2) Permissible uses.— A grant received under this section may be used for any of the following:

(A) Employing care coordinators, case managers, community health workers, certified infant mental health specialists, and outreach and engagement specialists to work with children and their caregivers, including prenatal individuals, to prevent and respond to adverse childhood experiences by connecting clients with culturally specific, trauma-informed care treatment services, including economic, social, food, and housing supports.

(B) Providing training described in paragraph (1)(B) to community health providers and community partners.

(C) Expanding, enhancing, modifying, and connecting the existing network of community programs and services to achieve a more comprehensive and coordinated system of care approach, including—

(i) developing local infrastructure to bolster and shape community support systems and map and build access to services in a coordinated and comprehensive way; and

(ii) creating infrastructure to conduct outreach to children and families, including those experiencing homelessness and housing instability, so they acquire access to the services and supports they need and the benefits to which they are entitled.

(D) Compiling information on resources (including any referral services) available through community-based organizations and local, State, and Federal agencies, such as—

(i) programs addressing social determinants of health, including—

(I) emergency, temporary, and long-term housing;

(II) programs that offer free or affordable and nutritious food;

(III) vocational and workforce development; and

(IV) transportation supports;

(ii) home visiting programs for new parents and their infants;

(iii) workforce development programs to support caregivers in skill building;

(iv) trauma-responsive, parenting skills-building programs;

(v) the continuum of substance use prevention, intervention, and treatment programs and mental health support programs, including programs with trauma-informed, gender-responsive, and culturally specific counseling; and

(vi) childcare support and early childhood education, including Head Start and Early Head Start programs.

(E) Subject to subsection (g)(1), establishing or updating a database that compiles data used to track the effectiveness of the care coordination services funded through the grant.

(F) Developing and implementing referral partnership agreements with community-based organizations, parent organizations, substance use disorder treatment providers and facilities, housing and shelter providers, health care providers, mental health care providers, and Federal and State offices and programs that implement practices to support children ages 0 through 5 who are at risk of adverse childhood experiences and their caregivers, including prenatal people. Such practices shall include—

(i) a bilateral “warm handoff” system whereby a grantee understands the needs of the children and their families, and families are involved in addressing these needs; and

(ii) an active service connection whereby the children and families are each actively connected with a resource in a well-coordinated way that ensures availability and direct contact.

(G) Supporting cross-system planning and collaboration among employees who may work in emergency medical services, health care services, public health, early childhood education, and substance use disorder treatment and recovery support.

(H) Providing or subsidizing services to address barriers that children, prenatal individuals, and caregivers face to utilizing community resources and services, such as by providing or subsidizing transportation or childcare costs as applicable and within reasonable amounts.

(I) Creating or expanding infrastructure and investing in technology, including the provision of communications technology and internet service to children and their caregivers, to enable increased telemedicine capabilities to reach participants.

(3) Indian tribes.— In the case of an eligible entity that is an Indian Tribe, the Secretary may waive such provisions of this subsection as the Secretary determines appropriate.

(4) Prohibitions.— In addition to any other prohibitions determined by the Secretary, an eligible entity may not use a grant under this section to—

(A) use data analysis methods to inform individual case decisions, including child removal or placement decisions, or to target services at certain individuals or families;

(B) require any individual or family to participate in any service or program as a condition of receipt of a benefit to which the individual or family is otherwise eligible; or

(C) increase the presence or funding of law enforcement surveillance, involvement, or activity in connection with trauma-informed care coordination services supported pursuant to this section.

(g) Requirements.— As a condition on receipt of a grant under this section, an eligible entity shall agree to each of the following funding conditions:

(1) Restriction of funding allocation.— The eligible entity will not use more than 30 percent of the funds made available to the entity through the grant (for the total grant period) to establish or update a database pursuant to subsection (f)(2)(E).

(2) Accessible setting.—

(A) In general.— The eligible entity will ensure that all care coordination services provided through the grant are provided in a setting that is accessible, including through mobile settings, to—

(i) low-income or no-income individuals, including individuals experiencing homelessness or housing instability; and

(ii) individuals in rural areas.

(B) Community outreach.— In complying with subparagraph (A), the eligible entity will ensure that at least 50 percent of the care coordination services provided through the grant occur in community settings that are convenient to the children and caregivers who are being served, such as homes, schools, and shelters, whether for initial outreach or as part of long-term care.

(3) Supplement, not supplant.— The grant will be used to supplement, not supplant other Federal, State, or local funds available for care coordination services.

(4) Confidentiality.— The eligible entity will maintain the confidentiality of individuals receiving services through the grant in a manner consistent with applicable law.

(5) Partnering; risk stratification.— In providing care coordination services through the grant, the eligible entity will—

(A) partner with community-based organizations with experience serving child populations prenatally through age 5;

(B) coordinate with the local agency responsible for administering the State plan approved under title XIX of the Social Security Act; and

(C) employ risk stratification to develop different effective models of care for different populations based on their needs.

(h) Application.—

(1) In general.— To seek a grant under this section, an eligible entity shall submit an application to the Secretary at such time, in such manner, and containing such information, as the Secretary may require.

(2) Contents.— An application under paragraph (1) shall, at a minimum, contain each of the following:

(A) Goals to be achieved through the grant, including the activities that will be undertaken to achieve those goals.

(B) The number of individuals likely to be served through the grant, including demographic data on the populations to be served.

(C) Existing programs and services that can be used to significantly increase the proportion of children and families who receive needed supports and services.

(D) A plan for expanding, coordinating, or modifying the existing network of programs and services to meet the needs of children and families for preventing and mitigating the traumatic impact of adverse childhood experiences.

(E) A demonstration of the ability of the eligible entity to reach the individuals to be served, including by partnering with local stakeholders.

(F) An indication of how the personnel involved are reflective of the communities to be served.

(G) A list of stakeholders with whom the entity plans to partner or consult.

(i) Reporting by grantees.— Not later than 4 years after the date of enactment of this section, an eligible entity receiving a grant under this section shall submit to the Secretary a report on the activities funded through the grant. Such report shall include, at a minimum, a description of—

(1) the number of individuals served through activities funded through the grant, including demographics as applicable;

(2) the number of referrals made through the grant and the rate of such referrals successfully linked or closed;

(3) a qualitative analysis or number of collaborative partnerships with other organizations in carrying out the activities funded through the grant;

(4) the number of services provided to individuals through the grant;

(5) aggregated and de-identified outcomes experienced by individuals served through the grant such as—

(A) the rate of successful service connections;

(B) any increases in development of protective factors for children;

(C) any increase in development of protective factors for the caregivers;

(D) any mitigation of the negative outcomes associated with adverse childhood experiences or decreased likelihood of children experiencing an adverse childhood experience as evidenced by—

(i) decreased presence of law enforcement or other punitive State surveillance in the community;

(ii) a parent completing substance use treatment;

(iii) a parent receiving voluntary treatment for mental health-related conditions;

(iv) a family entering into or maintaining a stable housing situation;

(v) a family achieving or maintaining economic security;

(vi) a parent achieving or maintaining job stability; or

(vii) a child meeting developmental markers for school readiness; and

(E) reports of satisfaction with the coordination of care by people served; and

(6) any other information required by the Secretary.

(j) Convening participants for sharing lessons learned.— After the period of all grants awarded under this section has concluded, the Assistant Secretary for Planning and Evaluation of the Department of Health and Human Services shall provide an in-person or online opportunity for persons participating in the programs funded through this section to share with each other—

(1) lessons learned;

(2) challenges experienced; and

(3) ideas for next steps and solutions.

(k) Compiling findings and conclusions.— After providing the opportunity required by subsection (j), the Secretary shall—

(1) compile the findings and conclusions of grantees under this section on the provision of care coordination services described in subsection (a);

(2) submit a report on such findings and conclusions to the appropriate congressional committees; and

(3) make such report publicly available.

(l) Definitions.— In this section:

(1) Adverse childhood experience.— The term adverse childhood experience means a potentially traumatic experience that occurs in childhood and can have a tremendous impact on the child’s lifelong health and opportunity outcomes, such as any of the following:

(A) Abuse, such as any of the following:

(i) Emotional and psychological abuse.

(ii) Physical abuse.

(iii) Sexual abuse.

(B) Household challenges such as any of the following:

(i) A household member is treated violently.

(ii) A household member has a substance use disorder.

(iii) A household member has a mental health condition.

(iv) Parental separation or divorce.

(v) A household member is incarcerated, is placed in immigrant detention, or has been deported.

(vi) A household member has a life-threatening illness such as COVID–19.

(C) Neglect.

(D) Living in—

(i) impoverished communities that lack access to human services;

(ii) areas of high unemployment neighborhoods; or

(iii) communities experiencing de facto segregation.

(E) Experiencing food insecurity and poor nutrition.

(F) Witnessing violence.

(G) Involvement with the foster system.

(H) Experiencing discrimination.

(I) Dealing with historical and ongoing traumas due to systemic and interpersonal racism.

(J) Dealing with historical and ongoing traumas regarding systemic and interpersonal sexism, homophobia, biphobia, and transphobia.

(K) Dealing with the threat of deportation or detention as a result of immigration status.

(L) The impacts of multigenerational poverty resulting from limited educational and economic opportunities.

(M) Living through natural disasters such as earthquakes, forest fires, floods, or hurricanes.

(2) Care coordination.— The term care coordination means an active, ongoing process that—

(A) assists children ages 0 through 5 at risk of, or who have experienced, an adverse childhood experience, and their caregivers, including prenatal people of any age, to identify, access, and use community resources and services;

(B) is client centered and comprehensive of the services a child or caregiver may need;

(C) ensures a closed loop referral by obtaining feedback from the families served; and

(D) works across systems and services to promote collaboration to effectively meet the needs of community members.

(3) Indian Tribe.— The term Indian Tribe has the meaning given such term in section 4 of the Indian Self-Determination and Education Assistance Act.

(4) Protective factors.— The term protective factors refers to any supportive element in a child or caretaker’s life that helps the child or caretaker to withstand trauma such as a stable school environment or supportive peer relationships.

(m) Authorization of appropriations.—

(1) In general.— To carry out this section, there is authorized to be appropriated $15,000,000 for each of the 5 fiscal years following the fiscal year in which this section is enacted.

(2) Grants to Indian tribes.— Of the amount made available to carry out this section for a fiscal year, the Secretary shall use not less than 10 percent of such amount for grants to eligible entities that are Indian Tribes.

(3) Administrative expenses.— Of the amount made available to carry out this section for a fiscal year, the Secretary may use not more than 15 percent of such amount for administrative expenses, including the expenses of the Assistant Secretary for Planning and Evaluation of the Department of Health and Human Services for compiling and reporting information.

(4) Technical assistance.— Of the amount made available to carry out this section for a fiscal year, the Secretary may reserve up to 5 percent of such amount to provide technical assistance to eligible entities in preparing and submitting applications under this section.”.

(a) Access to clinical social workers.— Section 1833(a)(1) of the Social Security Act (42 U.S.C. 1395l(a)(1)) is amended—

(1) in subparagraph (D)(ii), by striking “such negotiated rate,,” and inserting “such negotiated rate,”; and

(2) in subparagraph (F)(ii) by striking “75 percent of the amount determined for payment of a psychologist under clause (L)” and inserting “85 percent of the fee schedule amount provided under section 1848”.

(b) Access to clinical social worker services provided to residents of skilled nursing facilities.—

(1) In general.— Section 1888(e)(2)(A)(ii) of the Social Security Act (42 U.S.C. 1395yy(e)(2)(A)(ii)), as amended by section 6101(a)(5), is amended by inserting “clinical social worker services,” after “peer support specialist services (as defined in section 1861(rrr)(3)),”.

(2) Conforming amendment.— Section 1861(hh)(2) of the Social Security Act (42 U.S.C. 1395x(hh)(2)) is amended by striking “and other than services furnished to an inpatient of a skilled nursing facility which the facility is required to provide as a requirement for participation”.

(c) Access to the complete set of clinical social worker services.— Section 1861(hh)(2) of the Social Security Act (42 U.S.C. 1395x(hh)(2)) is amended by striking “for the diagnosis and treatment of mental illnesses (other than services” and inserting “(including services for the diagnosis and treatment of mental illnesses or services for health and behavior assessment and intervention (identified as of January 1, 2022, by HCPCS codes 96150 through 96161 (and any succeeding codes)), but not including services”.

(d) Effective date.— The amendments made by this section shall apply to items and services furnished on or after January 1, 2027.

(a) Program authorized.— The Secretary shall carry out a program under which eligible graduate institutions may enter into an agreement with the Secretary to cover a portion of the cost of attendance of a participating student, which contributions shall be matched by equivalent contributions towards such cost of attendance by the Secretary.

(b) Designation of program.— The program under this section shall be known as the “Mental Health Excellence in Schools Program”.

(c) Agreements.— The Secretary shall enter into an agreement with each eligible graduate institution seeking to participate in the program under this section. Each agreement shall specify the following:

(1) The manner (whether by direct grant, scholarship, or otherwise) in which the eligible graduate institution will contribute to the cost of attendance of a participating student.

(2) The maximum amount of the contribution to be made by the eligible graduate institution with respect to any particular participating student in any given academic year.

(3) The maximum number of individuals for whom the eligible graduate institution will make contributions in any given academic year.

(4) That the eligible graduate institution, in selecting participating students to receive assistance under the program, shall prioritize the participating students described in subsection (d)(2).

(5) That the eligible graduate institution shall require, as a condition for receiving assistance under the program, participating students to agree to remain in a school-based mental health field for a period of not less than 3 years.

(6) Such other matters as the Secretary and the eligible graduate institution determine appropriate.

(d) Outreach.— The Secretary shall—

(1) make publicly available and periodically update on the internet website of the Department of Education a list of the eligible graduate institutions participating in the program under this section that shall specify, for each such graduate institution, appropriate information on the agreement between the Secretary and such eligible graduate institution under subsection (c); and

(2) conduct outreach about the program under this section to participating students who, as undergraduates—

(A) received a Federal Pell Grant under section 401 of the Higher Education Act of 1965 (20 U.S.C. 1070a); or

(B) attended an institution listed in section 371(a) of the Higher Education Act of 1965 (20 U.S.C. 1067q(a)).

(e) Matching contributions.— The Secretary may provide a contribution of not more than 50 percent of the cost of attendance of a participating student if the eligible graduate institution at which such student is enrolled enters into an agreement under subsection (c) with the Secretary to match such contribution.

(f) Monitoring and evaluation.— As a condition of participation in the program under this section, each eligible graduate institution shall agree to submit an annual report to the Secretary describing—

(1) the number of students served by the program;

(2) the percentage of tuition cost covered by the program;

(3) the number of participating students who were also recipients of a Federal Pell Grant; and

(4) as applicable, the graduation rates and post-graduate employment of participating students.

(g) Interim report.— Not later than 2 years after the first contributions are provided under this section, the Secretary shall submit an interim report to Congress based on the annual reports required by subsection (f).

(h) Independent national evaluation.—

(1) In general.— Not later than 4 years after the date of enactment of this Act, the Secretary shall provide for the commencement of an independent national evaluation of the outcomes and effectiveness of the program under this section.

(2) Report to congress.— Not later than 90 days after receiving the results of such independent national evaluation, the Secretary shall submit a report to Congress containing the findings of the evaluation and the Secretary’s recommendations for improvements to the program.

(i) Definitions.— In this section:

(1) Cost of attendance.— The term cost of attendance has the meaning given the term in section 472 of the Higher Education Act of 1965 (20 U.S.C. 1087ll).

(2) Eligible graduate institution.— The term eligible graduate institution means an institution of higher education that offers a program of study that leads to a graduate degree—

(A) in school psychology that is accredited or approved by the National Association of School Psychologists' Program Accreditation Board or the Commission on Accreditation of the American Psychological Association and that prepares students in such program for the State licensing or certification examination in school psychology at the specialist level;

(B) in an accredited school counseling program that prepares students in such program for the State licensing or certification examination in school counseling;

(C) in school social work that is accredited by the Council on Social Work Education and that prepares students in such program for the State licensing or certification examination in school social work;

(D) in another school-based mental health field that prepares students in such program for the State licensing or certification examination in such field, if applicable; or

(E) in any combination of study described in subparagraphs (A) through (D).

(3) Institution of higher education.— The term institution of higher education has the meaning given the term in section 101 of the Higher Education Act of 1965 (20 U.S.C. 1001).

(4) Participating student.— The term participating student means an individual who is enrolled in a graduate degree program in a school-based mental health field at a participating eligible graduate institution.

(5) School-based mental health field.— The term school-based mental health field means any of the following fields:

(A) School counseling.

(B) School social work.

(C) School psychology.

(D) Any other field of study that leads to employment as a school-based mental health services provider, as determined by the Secretary.

(6) School-based mental health services provider.— The term school-based mental health services provider has the meaning given the term in section 4102 of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 7112).

(7) Secretary.— The term Secretary means the Secretary of Education.

(j) Authorization of appropriations.— There are authorized to be appropriated to carry out this section—

(1) $20,000,000 for fiscal year 2027;

(2) $30,000,000 for fiscal year 2028; and

(3) $50,000,000 for each of fiscal years 2029 through 2031.

(a) School social worker grants.—

(1) Purposes.— The purpose of this section is to assist States and local educational agencies in hiring additional school social workers in order to increase access to mental health and other student support services to students in elementary schools and secondary schools in the United States to the minimum ratios recommended by the National Association of Social Workers and the School Social Work Association of America of 1 school social worker for every 250 students, and 1 school social worker for every 50 students when a social worker is providing services to students with intensive needs.

(2) ESEA amendments.—

(A) In general.— Subpart 4 of part F of title IV of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 7291 et seq.) is amended by adding at the end the following:

“4645. Grants for school social workers.—

(a) Grants authorized.—

(1) In general.— From the amounts appropriated under subsection (h), the Secretary shall award grants to high-need local educational agencies to enable such agencies to retain school social workers employed by such agencies or to hire additional school social workers.

(2) Duration.— A grant awarded under this section shall be awarded for a period not to exceed 4 years.

(3) Supplement, not supplant.— Funds made available under this section shall be used to supplement, and not to supplant, other Federal, State, or local funds used for hiring and retaining school social workers.

(b) Application.—

(1) In general.— To be eligible to receive a grant under this section, a high-need local educational agency shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require.

(2) Contents.— An application submitted under paragraph (1) shall include an assurance that each school social worker who receives assistance under the grant will provide the services described in subsection (d), and a description of the specific services to be provided by such social worker.

(c) Use of funds.— A high-need local educational agency receiving a grant under this section—

(1) shall use the grant—

(A) to achieve a ratio of not less than 1 school social worker for every 250 students served by the agency, by—

(i) retaining school social workers employed by such agency; or

(ii)

(I) employing additional school social workers; or

(II) hiring contractors to serve as school social workers only in a case in which—

(aa) the local educational agency demonstrates to the Secretary that the agency—

(AA) has not been able to employ a sufficient number of school social workers under subclause (I) to achieve such ratio despite strong and continuing efforts to recruit and employ school social workers; and

(BB) hiring contractors is the only viable option to ensure students have adequate access to school social work services; and

(bb) each such contractor meets the requirements of subparagraphs (A) and (B) of subsection (g)(2); and

(B) to ensure that each school social worker who receives assistance under such grant provides the services described in subsection (d); and

(2) may use the grant to reimburse school social workers who receive assistance under such grant for—

(A) in the case of a school served by the agency in which the majority of students are higher risk students, to hire or retain additional school social workers in accordance with clauses (i) and (ii) of paragraph (1)(A) to achieve a ratio of not less than 1 school social worker for every 50 students;

(B) travel expenses incurred during home visits and other school-related trips;

(C) any additional expenses incurred by such social workers in rendering any service described in subsection (d); and

(D) the cost of clinical social work supervision for such social workers.

(d) Responsibilities of a school social worker.— A school social worker who receives assistance under a grant under this section shall provide the following services:

(1) Identifying high-need students in each school that the social worker serves, and targeting services provided at the school to such students.

(2) Providing students, in each school that the school social worker serves, social work services to promote school engagement and improve academic outcomes, including—

(A) counseling and crisis intervention;

(B) trauma-informed services;

(C) evidence-based educational, behavioral, and mental health services (such as implementing multi-tiered programs and practices, monitoring progress, and evaluating service effectiveness);

(D) addressing the social and emotional learning needs of students;

(E) promoting a school climate and culture conducive to student learning and teaching excellence (such as promoting effective school policies and administrative procedures, enhancing the professional capacity of school personnel, and facilitating engagement between student, family, school, and community);

(F) providing access to school-based and community-based resources (such as promoting a continuum of services, mobilizing resources and promoting assets, and providing leadership, interdisciplinary collaboration, systems coordination, professional consultation, and connecting students and families to resource systems);

(G) working with students, families, schools, and communities to address barriers to educational attainment (such as homelessness and housing insecurity, lack of transportation, food insecurity, equity, social justice issues, access to quality education, and school, family, and community risk factors);

(H) providing assistance to schools and teachers to design social-emotional, educational, behavioral, and mental health interventions;

(I) case management activities to coordinate the delivery of and access to the appropriate social work services to the highest-need students;

(J) home visits to meet the family of students in need of social work services in the home environment;

(K) supervising or coordinating school social work services at the local educational agency level; and

(L) other services the Secretary determines, in partnership with students, educators, and community member voices, are necessary to be carried out by such a social worker.

(e) Grant renewal.—

(1) In general.— A grant awarded under this section may be renewed for additional periods with the same duration as the original grant period.

(2) Continuing eligibility application.— To be eligible for a renewal under this section, a high-need local educational agency shall submit to the Secretary, for each renewal, a report on the progress of such agency in retaining and hiring school social workers to achieve the ratio of not less than 1 school social worker for every 250 students served by the agency, and shall include—

(A) a description of the staffing expansion of school social workers funded through the original grant received under this section; and

(B) a description of the work conducted by such social workers for higher risk students.

(f) Technical assistance.—

(1) In general.— The Secretary shall provide technical assistance to high-need local educational agencies, including such agencies that do not have adequate staff, in applying for grants under this section.

(2) Extension of application period.— The Secretary shall extend any application period for a grant under this section for any high-need local educational agency that—

(A) submits to the Secretary a written notification of the intent to apply for a grant under this section before requesting technical assistance under paragraph (1); and

(B) after submitting the notification under paragraph (1), requests such technical assistance.

(g) Definitions.— In this section:

(1) High-need local educational agency.— The term high-need local educational agency has the meaning given the term in section 200 of the Higher Education Act of 1965 (20 U.S.C. 1021).

(2) School social worker.— The term school social worker means an individual who—

(A) has a graduate degree in social work from a social work program that is accredited by the Council on Social Work Education; and

(B) meets all other State and local credentialing requirements for practicing as a social worker in an elementary school or secondary school.

(h) Authorization for appropriations.— There is authorized to be appropriated to carry out this section, $100,000,000 for each of fiscal years 2027 through 2031.”.

(B) Table of contents.— The table of contents in section 2 of the Elementary and Secondary Education Act of 1965 is amended by inserting after the item relating to section 4644 the following:

(b) National technical assistance center for school social work.—

(1) In general.— The Secretary of Education, acting through the Assistant Secretary, shall establish an evaluation, documentation, dissemination, and technical assistance resource center to provide appropriate information, training, and technical assistance to States, political subdivisions of States, federally recognized Indian Tribes, Tribal organizations, institutions of higher education, State and local educational agencies, and individual students and educators with respect to hiring and retaining school social workers at elementary schools and secondary schools served by local educational agencies.

(2) Responsibilities of the Center.— The center established under paragraph (1) shall conduct activities for the purpose of—

(A) developing and continuing statewide or Tribal strategies for improving the effectiveness of the school social work workforce;

(B) studying the costs and effectiveness of school social work programs at institutions of higher education to identify areas of improvement and provide information on relevant issues of importance to national, Tribal, and State policymakers;

(C) working with Federal agencies and other national, Tribal, and State stakeholders to collect, evaluate, and disseminate data regarding school social work ratios, outcomes and best practices of school-based mental health services, and the impact of expanding the number of school social workers within elementary schools and secondary schools; and

(D) establishing partnerships among national, Tribal, State, and local governments, and local educational agencies, institutions of higher education, non-profit organizations, and State and national trade associations, for the purposes of—

(i) data collection and dissemination;

(ii) establishing a school social work workforce development program;

(iii) documenting the success of school social work methods on a national level; and

(iv) conducting other activities determined appropriate by the Secretary.

(3) Definitions.— In this subsection:

(A) ESEA terms.— Except as otherwise provided, any term used in this subsection that is defined in section 8101 of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 7801) shall have the meaning given that term in such section.

(B) School social worker.— The term school social worker has the meaning given the term in section 4645(g) of the Elementary and Secondary Education Act of 1965.

(a) Opioid grants.— Section 1003(b)(4) of the 21st Century Cures Act (42 U.S.C. 290ee–3a(b)(4)) is amended—

(1) by redesignating subparagraph (F) as subparagraph (G); and

(2) by inserting after subparagraph (E) the following:

“(F) Supporting opioid abuse prevention and treatment services within a State provided by State and local agencies for children and caregivers, kinship care families, and kinship caregivers through—

(i) workforce recruitment and training;

(ii) health care services (including such services described in subparagraph (D)); and

(iii) foster and adoptive parent recruitment and training.”.

(b) Definitions.— Section 1003(h) of the 21st Century Cures Act (42 U.S.C. 290ee–3a(h)) is amended—

(1) by redesignating paragraphs (2) through (4) as paragraphs (4) through (6), respectively; and

(2) by inserting after paragraph (1) the following:

“(2) Kinship care family.— The term kinship care family means a family with a kinship caregiver.

(3) Kinship caregiver.— The term kinship caregiver means a relative of a child by blood, marriage, or adoption, who—

(A) lives with the child;

(B) is the primary caregiver of the child because the biological or adoptive parent of the child is unable or unwilling to serve as the primary caregiver of the child; and

(C) has a legal relationship to the child or is raising the child informally.”.

(c) Authorization of appropriations.— Section 1003(i)(1) of the 21st Century Cures Act (42 U.S.C. 290ee–3a(i)(1)) is amended by striking “2023 through 2027” and inserting “2027 through 2031”.

(d) Set aside.— Section 1003(i)(3) of the 21st Century Cures Act (42 U.S.C. 290ee–3a(i)(3)) is amended by inserting before the period at the end “, and set aside 1 percent to carry out subsection (b)(4)(F)”.

(a) Substance Use and Mental Health Services Administration.— The Public Health Service Act (42 U.S.C. 201 et seq.) is amended—

(1) in section 464H(c) (42 U.S.C. 285n(c)), section 464R(c) (42 U.S.C. 285p(c)), and subsections (b) and (c)(1) of section 2303 (42 U.S.C. 300cc–2), by striking “Administrator of the Substance Abuse and Mental Health Services Administration” each place it appears and inserting “Assistant Secretary for Mental Health and Substance Use”;

(2) in title V (42 U.S.C. 290aa et seq.)—

(A) in the title heading, by striking “Abuse” and inserting “Use”; and

(B) in section 501 (42 U.S.C. 290aa)—

(i) in the section heading, by striking “Abuse” and inserting “Use”; and

(ii) in subsection (f)(4), by striking “Substance Abuse and Mental Health Administration” and inserting “Substance Use and Mental Health Services Administration”; and

(3) by striking “Substance Abuse and Mental Health Services Administration” each place it appears and inserting “Substance Use and Mental Health Services Administration”.

(b) Center for Substance Use Services; Center for Substance Use Prevention Services.—

(1) In general.— The Public Health Service Act (42 U.S.C. 201 et seq.) is amended—

(A) in part B of title V (42 U.S.C. 290bb et seq.)—

(i) in subpart 1, in the subpart heading, by striking “Abuse Treatment” and inserting “Use Services”;

(ii) in subpart 2, in the subpart heading, by striking “Abuse Prevention” and inserting “Use Prevention Services”;

(iii) in section 507 (42 U.S.C. 290bb), in the section heading, by striking “Abuse Treatment” and inserting “Use Services”;

(iv) in section 513(a) (42 U.S.C. 290bb–6(a)), in the subsection heading, by striking “Abuse Treatment” and inserting “Use Services”; and

(v) in section 515 (42 U.S.C. 290bb–21), in the section heading, by striking “Abuse Prevention” and inserting “Use Prevention Services”;

(B) in section 1932(b)(3) (42 U.S.C. 300x–32(b)(3)), in the paragraph heading, by striking “abuse prevention” and inserting “use prevention services”;

(C) in section 1935(b)(2) of the Public Health Service Act (42 U.S.C. 300x–35(b)(2)), in the paragraph heading, by striking “abuse prevention” and inserting “use prevention services”;

(D) by striking “Center for Substance Abuse Treatment” each place it appears and inserting “Center for Substance Use Services”; and

(E) by striking “Center for Substance Abuse Prevention” each place it appears and inserting “Center for Substance Use Prevention Services”.

(c) Authorities.— The Secretary of Health and Human Services shall delegate to the Substance Use and Mental Health Services Administration, the Center for Substance Use Services, and the Center for Substance Use Prevention Services all duties and authorities that, as of the date of enactment of this Act, were vested in the Substance Abuse and Mental Health Services Administration, the Center for Substance Abuse Treatment, and the Center for Substance Abuse Prevention, respectively.

(d) References.—

(1) In general.— Except as provided in paragraph (2), any reference in any law, regulation, map, document, paper, or other record of the United States—

(A) to the Substance Abuse and Mental Health Services Administration shall be deemed to be a reference to the Substance Use and Mental Health Services Administration;

(B) to the Center for Substance Abuse Treatment of such Administration shall be deemed to be a reference to the Center for Substance Use Services of such Administration; and

(C) to the Center for Substance Abuse Prevention of such Administration shall be deemed to be a reference to the Center for Substance Use Prevention Services of such Administration.

(2) Effect.— Paragraph (1) shall not be construed to alter or affect section 6001(d) of the 21st Century Cures Act (42 U.S.C. 290aa note), providing that a reference to the Administrator of the Substance Abuse and Mental Health Services Administration shall be construed to be a reference to the Assistant Secretary for Mental Health and Substance Use.

(3) References to SAMHSA.— Notwithstanding this section or the amendments made by this section, the Secretary of Health and Human Services may continue to use the acronym SAMHSA to refer to the Substance Use and Mental Health Services Administration in regulations, maps, documents, papers, and other records of the United States.

Part D of title V of the Public Health Service Act (42 U.S.C. 290dd et seq.), as amended by section 6501, is amended by adding at the end the following new section:

“557. Behavioral and mental health outreach and education strategy.—

(a) In general.— The Secretary, acting through the Assistant Secretary, shall, in coordination with advocacy and behavioral and mental health organizations serving populations of Hispanic and Latino individuals or communities, develop and implement an outreach and education strategy to promote behavioral and mental health and reduce stigma associated with mental health conditions and substance abuse among the Hispanic and Latino populations. Such strategy shall—

(1) be designed to—

(A) meet the diverse cultural and language needs of the various Hispanic and Latino populations; and

(B) be developmentally and age appropriate;

(2) increase awareness of symptoms of mental illnesses common among such populations, taking into account differences within subgroups, such as gender, gender identity, age, sexual orientation, or ethnicity, of such populations;

(3) provide information on evidence-based, culturally and linguistically appropriate and adapted interventions and treatments;

(4) ensure full participation of, and engage, both consumers and community members in the development and implementation of materials; and

(5) seek to broaden the perspective among both individuals in these communities and stakeholders serving these communities to use a comprehensive public health approach to promoting behavioral health that addresses a holistic view of health by focusing on the intersection between behavioral and physical health.

(b) Reports.— Beginning not later than 1 year after the date of the enactment of this section and annually thereafter, the Secretary, acting through the Assistant Secretary, shall submit to Congress, and make publicly available, a report on the extent to which the strategy developed and implemented under subsection (a) improved behavioral and mental health outcomes associated with mental health conditions and substance abuse among Hispanic and Latino populations.

(c) Authorization of appropriations.— There is authorized to be appropriated to carry out this section $1,000,000 for fiscal year 2027.”.

(a) Findings.— Congress finds that farmworkers—

(1) are vital to the economy and food supply of the United States; and

(2) who are disproportionately affected by stress and anxiety, often lack access to behavioral health care services.

(b) Farm and Ranch Stress Assistance Network.— Section 7522 of the Food, Conservation, and Energy Act of 2008 (7 U.S.C. 5936) is amended—

(1) by inserting “farm work,” after “ranching,” each place it appears;

(2) in subsection (b)—

(A) in paragraph (1)(D), by striking “or” at the end;

(B) by redesignating paragraph (2) as paragraph (3);

(C) by inserting after paragraph (1) the following:

“(2) to initiate, expand, or sustain programs that deliver peer-to-peer mental health support to individuals who are engaged in farming, ranching, farm work, and other occupations relating to agriculture; or”; and

(D) in paragraph (3) (as so redesignated), by striking “paragraph (1) and subsection (a)” and inserting “paragraphs (1) and (2) and subsection (a)”; and

(3) in subsection (d), by striking “2023” and inserting “2031”.

Not later than 1 year after the date of enactment of this Act, the Secretary of Health and Human Services shall provide education and outreach to stakeholders about the Medicare Benefit Policy Manual with respect to occupational therapy services furnished to individuals under the Medicare program for the treatment of a substance use or mental health disorder diagnosis using applicable Healthcare Common Procedure Coding System (HCPCS) codes.

Part D of title V of the Public Health Service Act (42 U.S.C. 290dd), as amended by section 6708, is amended by adding at the end the following:

“558. Training community mental wellness workers.—

(a) In general.— The Secretary, acting through the Assistant Secretary, may award grants to eligible entities to implement community mental wellness worker training programs.

(b) Use of funds.— An eligible entity that receives a grant under this section shall use the funds received through such grant to carry out a community mental wellness worker training program, which may include—

(1) supporting training, certification, and supervision during and after training of community mental wellness workers and community mental wellness supervisors—

(A) to screen for common mental health and substance use conditions; and

(B) to deliver evidence-informed, culturally and linguistically competent counseling and interviewing interventions addressing basic psychosocial or psychotherapeutic treatment needs of persons with or at risk for mental and substance use disorders, including safety planning and interventions to reduce suicide risk; and

(2) covering costs associated with—

(A) the acquisition and use of digital platforms to provide the screening, training, supervision, and ongoing quality assurance monitoring, outcomes evaluation, and delivery of evidence-based treatments;

(B) the delivery of counseling and interviewing interventions described in paragraph (1)(B); and

(C) the clinical supervision (during and after training) of community mental wellness workers and the certification of such workers upon the completion of required training.

(c) Community mental wellness technical assistance.—

(1) In general.— The Secretary may provide appropriate training and technical assistance to eligible entities receiving a grant under this section in meeting the requirements of this section, including by—

(A) consulting with such recipients on evidence-based employment practices for community mental wellness workers, including assistance with integrating community wellness workers into the workflows of such recipients and other eligible entities;

(B) identifying a diverse array of candidates for community mental wellness worker training; and

(C) identifying behavioral health providers who may benefit from and employ community mental wellness workers.

(2) Additional dissemination of technical assistance.— The information and resources provided by the Secretary under paragraph (1) shall be made available to States, political subdivisions of States, Indian Tribes and Tribal organizations (as defined in section 4 of the Indian Self-Determination and Education Assistance Act), outpatient and inpatient substance use treatment providers, other community-based behavioral health organizations, and other entities as the Secretary determines appropriate.

(d) Priority.— In awarding grants under this section, the Secretary shall give priority to eligible entities that are located—

(1) in an area with rates of poverty and unemployment that exceed the average in the United States, as determined by the survey conducted by the Secretary of Commerce commonly referred to as the ‘American Community Survey’ (or any successor survey);

(2) in a medically underserved community;

(3) in an area with rates of substance use that exceed the average in the United States, as determined by the National Institute on Drug Abuse; or

(4) serving communities with rates of individuals who are dually eligible for both the Medicare program under title XVIII of the Social Security Act and the Medicaid program under title XIX of such Act that exceed the average in the United States.

(e) Malpractice and negligence suits against community behavioral health clinic and community mental health centers.—

(1) In general.— Except as inconsistent with this subsection, the provisions of section 224, including subsections (g), (h), (i), (j), (k), and (l) of such section, shall apply with respect to acts and omissions of a covered entity that occur during the period of the grant under this section, to the same extent and in the same manner as such provisions apply with respect to an entity described in subsection (g)(4) of such section 224, and any officer, governing board member, employee, or contractor of such an entity.

(2) List required.— Each covered entity described in paragraph (3)(A) shall submit to the Secretary, and update as necessary, a list of each officer, governing board member, employee, or contractor participating in the entity’s program funded through a grant under this section.

(3) Covered entity defined.— In this subsection, the term “covered entity” means an entity that—

(A) is an eligible entity (as defined in subsection (g)(3)) in receipt of a grant under this section; and

(B)

(i) is an officer, governing board member, or employee of such an entity or a contractor of such an entity who is a physician or other licensed or certified health care practitioner; and

(ii) is participating in the entity’s program funded through a grant under this section, as indicated in a list submitted pursuant to paragraph (2).

(4) Delayed applicability.— This subsection applies beginning with respect to the first full fiscal year that begins after the date of the enactment of this section.

(f) Report.—

(1) Submission.— The Secretary shall submit to Congress—

(A) not later than one year after the date of enactment of this section, an interim report on the results of the grant program under this section; and

(B) not later than the end of fiscal year 2031, a final report of such results.

(2) Contents.— The reports required by paragraph (1) shall each include—

(A) the total number of community mental wellness workers participating in the grant program under this section; and

(B) the total number of community mental wellness workers who obtained certification through such participation.

(g) Definitions.— In this section:

(1) The term community mental wellness worker means an individual trained and certified by an eligible entity to assist with providing basic screening and evidence-based treatments to individuals with a mild to moderate mental health or substance use disorder, including depression, anxiety, post-traumatic stress disorder, and alcohol use disorder.

(2) The term culturally and linguistically competent means, with respect to the provision of counseling and interviewing interventions, providing such services in a manner that acknowledges, and is responsive to, cultural differences that may derive from characteristics of the individual receiving such services, including—

(A) gender;

(B) sex;

(C) sexual orientation;

(D) race or ethnicity;

(E) nationality;

(F) socioeconomic level;

(G) immigration status;

(H) disability;

(I) Tribal affiliation; and

(J) veteran status.

(3) The term eligible entity means—

(A) a certified community behavioral health clinic (as described in section 223(a) of the Protecting Access to Medicare Act of 2014);

(B) a community mental health center (as described in section 1913(c));

(C) a hospital that is described in section 501(c) of the Internal Revenue Code of 1986 and exempt from taxation under section 501(a) of such Code; and

(D) such other community behavioral health organizations as the Secretary may specify, in consultation with—

(i) State authorities responsible for regulating substance use and mental health providers and facilities receiving reimbursement under a State plan under title XIX of the Social Security Act (or a waiver of such plan); and

(ii) other State substance abuse and mental health agencies.

(4) The term medically underserved community has the meaning given such term in section 799B.

(h) Funding.—

(1) Authorization of appropriations.— There are authorized to be appropriated to carry out this section, $25,000,000 for each of fiscal years 2027 through 2031.

(2) Allocation.— Of the funds authorized to be appropriated to carry out this section for a fiscal year, not less than 20 percent shall be reserved for the provision of training and technical assistance under subsection (c).”.