H. Rept. 116-540 - BEHAVIORAL INTERVENTION GUIDELINES ACT OF 2020116th Congress (2019-2020)
Committee Report
Hide Overview| Report Type: | House Report |
|---|---|
| Accompanies: | H.R.3539 |
| Committees: | House Energy and Commerce Committee |
Report text available as:
- TXT
- PDF (PDF provides a complete and accurate display of this text.) Tip ?
116th Congress } { Report
HOUSE OF REPRESENTATIVES
2d Session } { 116-540
======================================================================
BEHAVIORAL INTERVENTION GUIDELINES ACT OF 2020
_______
September 29, 2020.--Committed to the Committee of the Whole House on
the State of the Union and ordered to be printed
_______
Mr. Pallone, from the Committee on Energy and Commerce, submitted the
following
R E P O R T
[To accompany H.R. 3539]
The Committee on Energy and Commerce, to whom was referred
the bill (H.R. 3539) to amend the Public Health Service Act to
direct the Secretary of Health and Human Services to develop
best practices for the establishment and use of behavioral
intervention teams at schools, and for other purposes, having
considered the same, reports favorably thereon with an
amendment and recommends that the bill as amended do pass.
CONTENTS
Page
I. Purpose and Summary..............................................3
II. Background and Need for the Legislation..........................3
III. Committee Hearings...............................................4
IV. Committee Consideration..........................................5
V. Committee Votes..................................................5
VI. Oversight Findings...............................................5
VII. New Budget Authority, Entitlement Authority, and Tax Expenditures5
VIII.Federal Mandates Statement.......................................5
IX. Statement of General Performance Goals and Objectives............6
X. Duplication of Federal Programs..................................6
XI. Committee Cost Estimate..........................................6
XII. Earmarks, Limited Tax Benefits, and Limited Tariff Benefits......6
XIII.Advisory Committee Statement.....................................6
XIV. Applicability to Legislative Branch..............................6
XV. Section-by-Section Analysis of the Legislation...................6
XVI. Changes in Existing Law Made by the Bill, as Reported............7
The amendment is as follows:
Strike all after the enacting clause and insert the
following:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Behavioral Intervention Guidelines Act
of 2020''.
SEC. 2. BEST PRACTICES FOR BEHAVIORAL INTERVENTION TEAMS.
The Public Health Service Act is amended by inserting after section
520G of such Act (42 U.S.C. 290bb-38) the following new section:
``SEC. 520H. BEST PRACTICES FOR BEHAVIORAL INTERVENTION TEAMS.
``(a) In General.--The Secretary, acting through the Assistant
Secretary, shall develop and periodically update--
``(1) best practices to assist elementary schools, secondary
schools, and institutions of higher education in establishing
and using behavioral intervention teams; and
``(2) a list of evidence-based threat assessment training
providers to assist personnel in elementary schools, secondary
schools, and institutions of higher education in implementing
such best practices, including with respect to training
behavioral intervention teams.
``(b) Elements.--The best practices under subsection (a)(1) shall
include guidance on the following:
``(1) How behavioral intervention teams can operate
effectively from an evidence-based, objective perspective while
protecting the constitutional and civil rights of individuals,
including any individual of concern.
``(2) The use of behavioral intervention teams to identify
individuals of concern, implement interventions, and manage
risk through the framework of the school's or institution's
rules or code of conduct, as applicable.
``(3) How behavioral intervention teams can, when assessing
an individual of concern--
``(A) seek training on evidence-based, threat-
assessment rubrics;
``(B) ensure that such teams--
``(i) have adequately trained, diverse
stakeholders with varied expertise; and
``(ii) use cross validation by a wide-range
of individual perspectives on the team; and
``(C) use violence risk assessment.
``(4) How behavioral intervention teams can avoid--
``(A) attempting to predict future behavior by the
concept of pre-crime;
``(B) inappropriately using a mental health
assessment;
``(C) inappropriately limiting or restricting law
enforcement's jurisdiction over criminal matters;
``(D) attempting to substitute the behavioral
intervention process in place of a criminal process, or
impede a criminal process, when an individual of
concern's behavior has potential criminal implications;
``(E) endangering an individual's privacy by failing
to ensure that all applicable Federal and State privacy
laws are fully complied with; or
``(F) creating school-to-prison pipelines.
``(c) Consultation.--In carrying out subsection (a)(1), the Secretary
shall consult with--
``(1) the Secretary of Education;
``(2) the Director of the National Threat Assessment Center
of the Department of Homeland Security;
``(3) the Attorney General of the United States; and
``(4) as appropriate, relevant stakeholders including--
``(A) teachers and other educators, principals,
school administrators, school board members, school
psychologists, mental health professionals, and parents
of elementary school and secondary school students;
``(B) local law enforcement agencies and campus law
enforcement administrators;
``(C) mental health mobile crisis providers;
``(D) child and adolescent psychiatrists; and
``(E) other education and mental health
professionals.
``(d) Publication.--Not later than 2 years after the date of
enactment of this section, the Secretary shall publish the best
practices under subsection (a)(1) and the list under subsection (a)(2)
on a publicly accessible website of the Department of Health and Human
Services.
``(e) Technical Assistance.--The Secretary shall provide technical
assistance to institutions of higher education, elementary schools, and
secondary schools to assist such institutions and schools in
implementing the best practices under subsection (a).
``(f) Definitions.--In this section:
``(1) The term `behavioral intervention team' means a team of
qualified individuals who--
``(A) are responsible for identifying and assessing
individuals of concern; and
``(B) develop and facilitate implementation of
evidence-based interventions to mitigate the threat of
harm to self or others posed by individuals of concern
and address the mental and behavioral health needs of
individuals of concern to reduce such threat.
``(2) The terms `elementary school', `parent', and `secondary
school' have the meanings given to such terms in section 8101
of the Elementary and Secondary Education Act of 1965 (20
U.S.C. 7801).
``(3) The term `individual of concern' means an individual
whose behavior indicates a potential threat to self or others.
``(4) The term `institution of higher education' has the
meaning given to such term in section 102 of the Higher
Education Act of 1965 (20 U.S.C. 1002).
``(5) The term `mental health assessment' means an
evaluation, primarily focused on diagnosis, determining the
need for involuntary commitment, medication management, and on-
going treatment recommendations.
``(6) The term `pre-crime' means law-enforcement efforts and
strategies to deter crime by predicting when and where criminal
activity will occur.
``(7) The term `violence risk assessment' refers to a broad
determination of the potential risk of violence based on
evidence-based literature.''.
I. Purpose and Summary
H.R. 3539, the ``Behavioral Intervention Guidelines Act of
2020'', introduced by Representatives A. Drew Ferguson IV (R-
GA), Michael C. Burgess (R-TX), Joseph P. Kennedy III (D-MA),
and Jimmy Panetta (D-CA) on June 27, 2019, requires the
Substance Abuse and Mental Health Administration (SAMHSA) to
develop best practices for schools to establish behavioral
intervention teams and properly train them on how to intervene
and avoid inappropriate use of mental health assessments and
law enforcement. Not later than one year after enactment, those
best practices shall be made publicly available on a website at
the Department of Health and Human Services (HHS). The HHS
Secretary (the Secretary) is also instructed to provide
technical assistance to educational entities to assist in
implementing such best practices.
II. Background and Need for the Legislation
According to the Centers for Disease Control and Prevention
(CDC), about three in four children aged three to 17 years with
depression also have anxiety and almost half have behavioral
problems.\1\ Additionally, suicide is the second leading cause
of death for young Americans between the age of 10 and 34.\2\
Recent data also show that among young people with mental
health needs, more than 80 percent did not receive needed
care.\3\ For those who did receive services, just 15 percent
say they received mental health services in a school
setting.\4\
---------------------------------------------------------------------------
\1\Centers for Disease Control and Prevention, Children's Mental
Health Data & Statistics (www.cdc.gov/childrensmentalhealth/data.html)
(accessed September 18, 2020).
\2\National Center for Health Statistics, Leading Causes of Death
Reports, 1981-2018 (accessed September 19, 2020).
\3\Substance Abuse and Mental Health Services Administration. Key
substance use and mental health indicators in the United States:
Results from the 2019 National Survey on Drug Use and Health (2020).
\4\Id.
---------------------------------------------------------------------------
The need to address mental health services and prevent
suicide or other self-harm was raised in the testimony before
the Committee of Arriana Gross, a high school student from
Covington, Georgia, who said, ``[i]n our school, a year doesn't
go by without a student dying by suicide. I've even known of
elementary kids who died by suicide. I am concerned that youth
suicide has become so common that my school community and our
Nation is stuck in a pattern of mourning and accepting these
deaths as something that is normal, instead of seeing them as
preventable and tragic.''\5\ In addition to elementary and
secondary school students, those in higher education are also
experiencing high levels of emotional distress. The American
College Health Association found in 2019 that over the past
year, 87 percent of college students felt overwhelmed by all
they had to do, 66 percent experienced severe anxiety, 56
percent experienced feelings of hopelessness and 13 percent
seriously considered suicide.\6\
---------------------------------------------------------------------------
\5\House Committee on Energy and Commerce, Testimony of Arriana
Gross, National Youth Advisory Board Member, Sandy Hook Promise
Students Against Violence Everywhere (SAVE) Promise Club, Hearing on
High Anxiety and Stress: Legislation to Improve Mental Health During
Crisis, 116th Cong. (June 30, 2020).
\6\American College Health Association, National College Health
Assessment II (2019) (www.acha.org/documents/ncha/NCHA-
II_SPRING_2019_US_REFERENCE_GROUP_EXECUTIVE_SUMMARY.pdf).
---------------------------------------------------------------------------
This bill would help schools address mental health issues
or self-harm of students by making available best practices for
the proper use and implementation of behavioral intervention
programs to support students and schools across the country.
Behavioral intervention teams are multi-disciplinary teams that
support students' mental health and emotional well-being by
detecting patterns, trends, and disturbances in behavior, and
by conducting outreach to students who are unable to manage
distress in healthy and constructive ways. These teams are
already active in some educational settings, such as at the
University of California, Los Angeles,\7\ Texas A&M;
University,\8\ and Virginia Tech.\9\
---------------------------------------------------------------------------
\7\UCLA Campus Human Resources, Behavioral Intervention Team,
(www.chr.ucla.edu/behavioral-intervention-team) (accessed Sep. 28,
2020).
\8\Texas A&M; University, Special Situations Team
(tellsomebody.tamu.edu/sst/?_ga=2.152478009.1448536522.1600872225-
426169545.1600872225&_ga=2.152478009.1448536522.1600872225-
426169545.1600872225) (accessed Sep. 28, 2020).
\9\Virginia Tech, Threat Assessment Team (threatassessment.vt.edu/)
(accessed Sep. 28, 2020).
---------------------------------------------------------------------------
III. Committee Hearings
For the purposes of section 103(i) of H. Res. 6 of the
116th Congress, the following hearing was used to develop or
consider H.R. 3539:
The Subcommittee on Health held a virtual legislative
hearing on June 30, 2020, entitled, ``High Anxiety and Stress:
Legislation to Improve Mental Health During Crisis.'' The
hearing focused on H.R. 3539 and 21 other bills. The
Subcommittee received testimony from the following witnesses:
The Honorable Patrick J. Kennedy, Founder of
the Kennedy Forum and former Member of Congress
Arthur C. Evans, Jr., Ph.D., Chief Executive
Officer, American Psychological Association;
Jeffrey L. Geller, M.D., M.P.H., President,
American Psychiatric Association, Professor of
Psychiatry and Director of Public Sector Psychiatry at
the University of Massachusetts Medical School
Worcester Recovery Center and Hospital
Arriana Gross, National Youth Advisory Board
Member, Sandy Hook Promise Students Against Violence
Everywhere (SAVE) Promise Club
IV. Committee Consideration
Representatives Ferguson (R-GA), Burgess (R-TX), Kennedy
(D-MA), and Panetta (D-CA) introduced H.R. 3539, the
``Behavioral Intervention Guidelines Act of 2020'', on June 27,
2019 and the bill was referred to the Committee on Energy and
Commerce. The bill was then referred to the Subcommittee on
Health on June 28, 2019. A legislative hearing was held on the
bill on June 30, 2020.
On September 9, 2020, H.R. 3539 was discharged from further
consideration by the Subcommittee on Health as the bill was
called up for markup by the full Committee on Energy and
Commerce. The full Committee met in virtual open markup session
on September 9, 2020, pursuant to notice, to consider H.R.
3539. During consideration of the bill, a manager's amendment
offered by Mr. Bilirakis of Florida was agreed to by a voice
vote. Upon conclusion of consideration of the bill, the full
Committee agreed to a motion on final passage by Mr. Pallone,
Chairman of the committee, to order H.R. 3539 reported
favorably to the House, amended, by a voice vote, a quorum
being present.
V. Committee Votes
Clause 3(b) of rule XIII of the Rules of the House of
Representatives requires the Committee to list each record vote
on the motion to report legislation and amendments thereto. The
Committee advises that there were no record votes taken on H.R.
3539, including the motion for final passage of the bill.
VI. Oversight Findings
Pursuant to clause 3(c)(1) of rule XIII and clause 2(b)(1)
of rule X of the Rules of the House of Representatives, the
oversight findings and recommendations of the Committee are
reflected in the descriptive portion of the report.
VII. New Budget Authority, Entitlement Authority, and Tax Expenditures
Pursuant to 3(c)(2) of rule XIII of the Rules of the House
of Representatives, the Committee adopts as its own the
estimate of new budget authority, entitlement authority, or tax
expenditures or revenues contained in the cost estimate
prepared by the Director of the Congressional Budget Office
pursuant to section 402 of the Congressional Budget Act of
1974.
The Committee has requested but not received from the
Director of the Congressional Budget Office a statement as to
whether this bill contains any new budget authority, spending
authority, credit authority, or an increase or decrease in
revenues or tax expenditures.
VIII. Federal Mandates Statement
The Committee adopts as its own the estimate of Federal
mandates prepared by the Director of the Congressional Budget
Office pursuant to section 423 of the Unfunded Mandates Reform
Act.
IX. Statement of General Performance Goals and Objectives
Pursuant to clause 3(c)(4) of rule XIII, the general
performance goal or objective of this legislation is to direct
the Secretary of Health and Human Services to develop best
practices for the establishment and use of behavioral
intervention teams at schools, and for other purposes.
X. Duplication of Federal Programs
Pursuant to clause 3(c)(5) of rule XIII, no provision of
H.R. 3539 is known to be duplicative of another Federal
program, including any program that was included in a report to
Congress pursuant to section 21 of Public Law 111-139 or the
most recent Catalog of Federal Domestic Assistance.
XI. Committee Cost Estimate
Pursuant to clause 3(d)(1) of rule XIII, the Committee
adopts as its own the cost estimate prepared by the Director of
the Congressional Budget Office pursuant to section 402 of the
Congressional Budget Act of 1974.
XII. Earmarks, Limited Tax Benefits, and Limited Tariff Benefits
Pursuant to clause 9(e), 9(f), and 9(g) of rule XXI, the
Committee finds that H.R. 3539 contains no earmarks, limited
tax benefits, or limited tariff benefits.
XIII. Advisory Committee Statement
No advisory committee within the meaning of section 5(b) of
the Federal Advisory Committee Act was created by this
legislation.
XIV. Applicability to Legislative Branch
The Committee finds that the legislation does not relate to
the terms and conditions of employment or access to public
services or accommodations within the meaning of section
102(b)(3) of the Congressional Accountability Act.
XV. Section-by-Section Analysis of the Legislation
Section 1. Short title
Section 1 designates that the short title may be cited as
the ``Behavioral Intervention Guidelines Act of 2020''.
Sec. 2. Best practice for behavioral intervention teams
Section 2 amends the Public Health Service Act to create a
new section 520H. In the new section, the Secretary of Health
and Human Services, acting through the Assistant Secretary of
Mental Health and Substance Use, must develop and periodically
update best practices for establishing and using behavioral
intervention teams in elementary schools, secondary schools,
and institutions of higher education. The Secretary must also
develop and periodically update a list of evidence-based threat
assessment training providers to assist personnel in
implementing such best practices and training of behavioral
health intervention teams.
The best practices developed by the Secretary must include:
how behavioral intervention teams can operate effectively; how
behavioral intervention teams can be appropriately utilized to
identify individuals of concern, intervene, and manage risk;
evidence-based training and threat assessment rubrics; and how
behavioral intervention teams can avoid predicting future
behavior, inappropriately using a mental health assessment or
restricting law enforcement's jurisdiction over criminal
matters, endangering an individual's privacy, or creating
school-to-prison pipelines.
The Secretary must consult with the Secretary of Education,
the Director of the National Threat Assessment Center of the
Department of Homeland Security, the Attorney General, and
relevant stakeholders from education, mental health, and law
enforcement backgrounds. Best practices developed under this
section must be published not later than two years after
enactment of this Act on a publicly accessible website. The
Secretary of HHS is also instructed to provide technical
assistance to educational entities to assist in implementing
such best practices.
The definition of a ``behavioral intervention team'' in
this section means a team of qualified individuals who are
responsible for identifying and assessing individuals of
concern and who develop and facilitate the implementation of
evidence-based interventions. The terms ``elementary school'',
``parent'', and ``secondary school'' have the same meanings as
under section 8101 of the Elementary and Secondary Education
Act of 1965. The term ``individual of concern'' means an
individual whose behavior indicates a potential threat to self
or others. The term ``institution of higher education'' is
consistent with the meaning under the Higher Education Act of
1965. The term ``mental health assessment'' means an
evaluation, primarily focused on diagnosis, determining the
need for involuntary commitment, medication management, and on-
going treatment recommendations. The term ``pre-crime'' means
law-enforcement efforts and strategies to deter crime by
predicting when and where criminal activity will occur. The
term ``violence risk assessment'' refers to a broad
determination of the potential risk of violence based on
evidence-based literature.''
XVI. Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (new matter is
printed in italics and existing law in which no change is
proposed is shown in roman):
PUBLIC HEALTH SERVICE ACT
* * * * * * *
TITLE V--SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION
* * * * * * *
Part B--Centers and Programs
* * * * * * *
Subpart 3--Center for Mental Health Services
* * * * * * *
SEC. 520H. BEST PRACTICES FOR BEHAVIORAL INTERVENTION TEAMS.
(a) In General.--The Secretary, acting through the Assistant
Secretary, shall develop and periodically update--
(1) best practices to assist elementary schools,
secondary schools, and institutions of higher education
in establishing and using behavioral intervention
teams; and
(2) a list of evidence-based threat assessment
training providers to assist personnel in elementary
schools, secondary schools, and institutions of higher
education in implementing such best practices,
including with respect to training behavioral
intervention teams.
(b) Elements.--The best practices under subsection (a)(1)
shall include guidance on the following:
(1) How behavioral intervention teams can operate
effectively from an evidence-based, objective
perspective while protecting the constitutional and
civil rights of individuals, including any individual
of concern.
(2) The use of behavioral intervention teams to
identify individuals of concern, implement
interventions, and manage risk through the framework of
the school's or institution's rules or code of conduct,
as applicable.
(3) How behavioral intervention teams can, when
assessing an individual of concern--
(A) seek training on evidence-based, threat-
assessment rubrics;
(B) ensure that such teams--
(i) have adequately trained, diverse
stakeholders with varied expertise; and
(ii) use cross validation by a wide-
range of individual perspectives on the
team; and
(C) use violence risk assessment.
(4) How behavioral intervention teams can avoid--
(A) attempting to predict future behavior by
the concept of pre-crime;
(B) inappropriately using a mental health
assessment;
(C) inappropriately limiting or restricting
law enforcement's jurisdiction over criminal
matters;
(D) attempting to substitute the behavioral
intervention process in place of a criminal
process, or impede a criminal process, when an
individual of concern's behavior has potential
criminal implications;
(E) endangering an individual's privacy by
failing to ensure that all applicable Federal
and State privacy laws are fully complied with;
or
(F) creating school-to-prison pipelines.
(c) Consultation.--In carrying out subsection (a)(1), the
Secretary shall consult with--
(1) the Secretary of Education;
(2) the Director of the National Threat Assessment
Center of the Department of Homeland Security;
(3) the Attorney General of the United States; and
(4) as appropriate, relevant stakeholders including--
(A) teachers and other educators, principals,
school administrators, school board members,
school psychologists, mental health
professionals, and parents of elementary school
and secondary school students;
(B) local law enforcement agencies and campus
law enforcement administrators;
(C) mental health mobile crisis providers;
(D) child and adolescent psychiatrists; and
(E) other education and mental health
professionals.
(d) Publication.--Not later than 2 years after the date of
enactment of this section, the Secretary shall publish the best
practices under subsection (a)(1) and the list under subsection
(a)(2) on a publicly accessible website of the Department of
Health and Human Services.
(e) Technical Assistance.--The Secretary shall provide
technical assistance to institutions of higher education,
elementary schools, and secondary schools to assist such
institutions and schools in implementing the best practices
under subsection (a).
(f) Definitions.--In this section:
(1) The term ``behavioral intervention team'' means a
team of qualified individuals who--
(A) are responsible for identifying and
assessing individuals of concern; and
(B) develop and facilitate implementation of
evidence-based interventions to mitigate the
threat of harm to self or others posed by
individuals of concern and address the mental
and behavioral health needs of individuals of
concern to reduce such threat.
(2) The terms ``elementary school'', ``parent'', and
``secondary school'' have the meanings given to such
terms in section 8101 of the Elementary and Secondary
Education Act of 1965 (20 U.S.C. 7801).
(3) The term ``individual of concern'' means an
individual whose behavior indicates a potential threat
to self or others.
(4) The term ``institution of higher education'' has
the meaning given to such term in section 102 of the
Higher Education Act of 1965 (20 U.S.C. 1002).
(5) The term ``mental health assessment'' means an
evaluation, primarily focused on diagnosis, determining
the need for involuntary commitment, medication
management, and on-going treatment recommendations.
(6) The term ``pre-crime'' means law-enforcement
efforts and strategies to deter crime by predicting
when and where criminal activity will occur.
(7) The term ``violence risk assessment'' refers to a
broad determination of the potential risk of violence
based on evidence-based literature.
* * * * * * *
[all]