House Education Committee Issues Report on Mental Health Matters Act (Part 1 of 3)

WASHINGTON, Oct. 15 -- The House Education and Labor Committee issued a report (H.Rpt. 117-484) on the Mental Health Matters Act (H.R. 7780), which aims to support the behavioral needs of students and youth, invest in the school-based behavioral health workforce and ensure access to mental health and substance use disorder benefits. The report was advanced by Rep. Robert C. Scott, D-Virginia, on Sept. 22, 2022.

Here are excerpts:

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Purpose and Summary

The purpose of H.R. 7780, the Mental Health Matters Act, is to improve access to behavioral health services for children, students, and workers. H.R. 7780 responds to the growing behavioral health needs of communities across the country by investing in access to behavioral health services, equipping schools to better respond to the needs of students, and improving access to behavioral health benefits in job-based health coverage.

Committee Action

116TH CONGRESS

On February 6, 2019, the Committee held a hearing titled "Examining Threats to Workers with Preexisting Conditions" which discussed in part mental health benefits. The Committee heard testimony from: Ms. Sabrina Corlette, Research Professor with the Center on Health Insurance Reforms, Georgetown University Health Policy Institute, Washington, D.C.; Mr. Chad Riedy, Alexandria, VA; Ms. Grace-Marie Turner, President, Galen Institute, Paeonian Springs, VA; and Dr. Rahul Gupta, Senior Vice President and Chief Medical and Health Officer, March of Dimes, Arlington, VA.

On September 11, 2019, the Early Childhood, Elementary, and Secondary Education (ECESE) Subcommittee held a hearing titled "The Importance of Trauma-Informed Practices in Education to Assist Students Impacted by Gun Violence and Other Adversities" which discussed the trauma students bring to and experience in school, and how it effects their behavioral health and school performance. The Committee heard testimony from: Dr. Nadine Burke Harris, Surgeon General for the State of California, San Francisco, CA; Dr. Ingrida Barker, Associate Superintendent, McDowell County Schools, Welch, WV; Ms. Joy Hofmeister, State Superintendent of Public Instruction, Oklahoma State Department of Education, Oklahoma City, OK; and Dr. Janice K. Jackson, Chief Executive Officer, Chicago Public Schools, Chicago, IL.

On June 22, 2020, the Committee held a hearing titled "Inequities Exposed: How COVID-19 Widened Racial Inequities in Education, Health, and the Workforce" on how existing disparities in health and education fields have been exacerbated by the COVID-19 pandemic. The Committee heard testimony from Dr. Camara P. Jones, Adjunct Professor, Rollins School of Public Health at Emory University; Senior Fellow and Adjunct Associate Professor, Morehouse School of Medicine; Past President, American Public Health Association, Atlanta, GA; Dr. Valerie Rawlston Wilson, Director, Program on Race, Ethnicity, and the Economy, Economic Policy Institute, Silver Spring, MD; Mr. Avid Roy, Co-Founder and President, The Foundation for Research on Equal Opportunity, Austin, TX; and Mr. John B. King, Jr., President and CEO, The Education Trust, Washington, D.C.

117TH CONGRESS

On March 25, 2021, the Early Childhood, Elementary, and Secondary Education (ECESE) Subcommittee held a hearing titled "Lessons Learned: Charting the Path to Educational Equity Post-COVID-19" to examine how the COVID-19 pandemic has impacted communities and discuss the most effective methods of ensuring the nation's public schools reopen and recover equitably. The Subcommittee heard testimony from Mr. Mark Morial J.D., President and Chief Executive Officer, National Urban League, New York, NY; Mrs. Jennifer Dale, Parent, Lake Oswego, OR; Selene Almazan, Esq., Legal Director, Council of Parent Attorneys and Advocates, Inc., Towson, MD; and Alberto Carvalho, Superintendent of Schools, Miami-Dade County Public Schools, Miami, FL.

On April 15, 2021, the Subcommittee on Health, Employment, Labor, and Pensions (HELP Subcommittee) held a hearing titled "Meeting the Moment: Improving Access to Behavioral and Mental Health Care" to examine barriers to access to behavioral health care, particularly limited coverage of mental health and substance use disorder treatment and the importance of improving enforcement of mental health parity laws. The Subcommittee heard testimony from Dr. Brian Smedley, Chief of Psychology in the Public Interest, American Psychological Association, Washington, DC; Dr. Christine Yu Moutier, Chief Medical Officer, American Foundation for Suicide Prevention, New York, NY; Mr. James Gelfand, Senior Vice President, Health Policy, The ERISA Industry Committee, Washington, DC; and Dr. Meiram Bendat, Founder, Psych-Appeal, Santa Barbara, CA.

On September 9, 2021, the ECESE Subcommittee held a hearing titled, "Back to School: Highlighting Best Practices for Safely Reopening Schools" which discussed the conditions under which schools were beginning to reopen nationally, and the state of students and teachers returning to school. The Subcommittee heard testimony from Dr. Jesus F. Jara, Superintendent of Schools, Clark County School District, Las Vegas, NV; Ms. Denise Forte, Interim Chief Executive Officer, The Education Trust, Washington, D.C.; Mr. David Zweig, Journalist, The Atlantic, New York Magazine, Wired Magazine, Hudson, NY; and Dr. Ashish K. Jha, Dean & Professor of Health Services, Policy & Practice, Brown University, Providence, RI.

On February 16, 2022, the ECESE Subcommittee held a hearing titled "Serving All Students: Promoting a Healthier, More Supportive School Environment" to discuss practices in use in public schools that are harmful to the mental health of students. The Subcommittee heard testimony from: Ms. Kristen Harper, Vice President for Public Policy and Engagement, Child Trends; Mr. Guy Stephens, Founder and Executive Director, Alliance Against Seclusion and Restraint; Ms. Morgan Craven, J.D., National Director of Policy, Advocacy and Community Engagement, Intercultural Development Research Association; and, Mr. Max Eden, Research Fellow, American Enterprise Institute.

On March 1, 2022, the HELP Subcommittee held a hearing titled "Improving Retirement Security and Access to Mental Health Benefits" to examine issues affecting access to benefits under private sector employee retirement and health benefit plans, including barriers to coverage of mental health services. The Subcommittee heard testimony from Ms. Amy Matsui, Director of Income Security and Senior Counsel, National Women's Law Center, Washington, DC; Ms. Karen Handorf, Senior Counsel, Berger Montague, Alexandria, VA; Mr. Andrew Biggs, Senior Fellow, American Enterprise Institute, Washington, DC; and Mr. Aron Szapiro, Head of Retirement Studies and Public Policy, Morningstar, Inc. and Morningstar Investment Management LLC, Chicago, IL.

On May 17, 2022, Rep. Mark DeSaulnier (D-CA-11) introduced H.R. 7780, the Mental Health Matters Act. The bill was referred to the Committee on Education and Labor.

On May 18, 2022, the Committee considered H.R. 7780 in legislative session and reported it favorably, as amended, to the House of Representatives by a vote of 26 Yeas to 18 Nays. The Committee considered the following amendments to H.R. 7780: Rep. DeSaulnier offered an amendment in the nature of a substitute to make conforming and technical changes. The amendment was adopted by voice vote.

Rep. Rick Allen (R-GA-12) offered an amendment in the nature of a substitute to strike the bill text and replace it with a new program administered by the Department of Education that would award competitive grants to state educational agencies to address the mental health needs of school. The amendment was defeated by a vote of 17 Yeas and 26 Nays.

Rep. Mary Miller (R-IL-15) offered an amendment to strike language regarding preparing mental health service providers to meet the needs of LGBTQ+ students. The amendment was defeated by a vote of 17 Yeas and 26 Nays.

Rep. Allen offered an amendment to make implementation of the Strengthening Behavioral Health Benefits Act conditional on the Department of Labor issuing a rule on mental health parity requirements. The amendment also strikes the additional funding for parity enforcement. The amendment was defeated by a vote of 17 Yeas and 27 Nays.

Rep. Diana Harshbarger (R-TN-01) offered an amendment to remove the bill's multiemployer benefits plan exemption from the bill's prohibition on discretionary clauses in employee benefit plans. The amendment was defeated by a vote of 18 Yeas and 26 Nays.

Committee Views

Communities across the United States are grappling with a devastating mental health crisis, which has only been exacerbated in recent years due to two public health emergencies--the opioid crisis and the COVID-19 pandemic. Barriers to access to behavioral health services vary and create complex challenges for vulnerable families, but Congress has tools at its disposal to better support students, workers, and communities. H.R. 7780 takes important steps to reduce the inequities caused by these barriers and include policies and priorities to meet the needs of our communities. Specifically, H.R. 7780 includes language from bills championed by members of the Committee, which are described below.

SUPPORTING THE BEHAVIORAL HEALTH NEEDS OF STUDENTS AND YOUTH

According to a recent CDC report, every year, 20 percent of all children are identified with a mental health condition, while 40 percent of all children will meet criteria for a mental health condition by age 18./1/ Examining data from 2013 to 2019, the same report found that among adolescents aged 12-17 years, 1 in 5 had experienced a major depressive episode./2/ A separate CDC report highlighted the increase in poor mental health and suicide behaviors among U.S. high school students over roughly the last decade./3/ Among high school students in 2019, the report found that more than 1 in 3 reported feeling sad or hopeless, an increase of 40 percent over the 2009 figure./4/ Equally distressing, nearly 1 in 5 high school students in 2019 had seriously considered attempting suicide./5/ On the other end of the age spectrum, findings indicate that there is evidence that even very young children experience mental health conditions./6/

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/1/Rebecca Bitsko et al., Mental Health Surveillance Among Children--United States, @013-2019, 71 Mortality & Morbidity Wkly. Rpt., Feb. 25, 2022, at 4, https://www.cdc.gov/mmwr/volumes/71/su/pdfs/su7102a1-H.pdf.

/2/Id. at 2.

/3/Ctrs. for Disease Control & Prevention, Youth Risk Behavior Survey Data Summary & Trends Report: 2009-2019 6 (2019), https://www.cdc.gov/healthyyouth/data/yrbs/pdf/YRBSDataSummaryTrendsReport2019-508.pdf.

/4/Id. at 60-61.

/5/Id. at 62.

/6/See Ruth Shim, et al., Epidemic Rates of Child and Adolescent Mental Health Disorders Require an Urgent Response, 149 Pediatrics 5 April 26, 2022 at 1, https://publications.aap.org/pediatrics/article/149/5/e2022056611/184904/Epidemic-Rates-of-Child-and-Adolescent-Mental.

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Members of marginalized communities often face additional challenges that impact mental health. Between 2009 and 2019, lesbian, gay, and bisexual students were four times more likely to have attempted suicide than their heterosexual peers./7/ Focusing specifically on transgender youth, a national quantitative cross-sectional survey published in 2020, found they are twice as likely to experience depression, seriously consider suicide, and attempt suicide compared to cisgender, lesbian, gay, bisexual, queer and questioning youth./8/ It is important to note that LGBTQ+ identities are not in themselves the cause of such challenges. Rather, these higher rates likely reflect the impact of bias, discrimination, family rejection, and other stressors./9/ COVID-19 has placed additional stressors on many children and young people and has disproportionately impacted communities of color. Over 150,000 children have lost a parent or caregiver to COVID-19, and about 65 percent of all youth experiencing COVID-19 orphanhood are children of color./10/

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/7/See Id. at 684.

/8/Myeshia Price-Feeney et al., Understanding the Mental Health of Transgender and Nonbinary Youth, 66 J. of Adolescent Health 684, 689 (2020), https://www.jahonline.org/article/S1054-139X(19)30922-X/fulltext.

/9/See, e.g., Joanna Almeida, et al., Emotional Distress Among LGBT Youth: The Influence of Perceived Discrimination Based on Sexual Orientation, 38 J. of Youth & Adolescence 1001-14 (2009).

/10/See, Dan Treglia, et al, Hidden Pain: Children Who Lost a Parent or Caregiver to COVID-19 and What the Nation Can Do to Help Them, COVID Collaborative, (Dec. 2021), https://www.covidcollaborative.us/assets/uploads/img/HIDDEN-PAIN-FINAL.pdf; Press Release, Ctrs. for Disease Control & Prevention, The Hidden U.S. COVID-19 Pandemic: Orphaned Children--More than 140,000 U.S. Children Lost a Primary or Secondary Caregiver Due to the COVID-19 Pandemic (October 2021), https://www.cdc.gov/media/releases/2021/p1007-covid-19-orphaned-children.html.

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In addition to losing parents/11/ family members,/12/ children of color have been disproportionately impacted by long-term COVID-19 complications,/13/ food insecurity,/14/ housing instability,/15/ and community violence/16/--all factors that contribute to adverse mental health outcomes. Improving equitable access to quality mental health services will provide critical support to children experiencing traumatic stress, anxiety, depression, and other mental health conditions./17/

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/11/See Susan D. Hillis, et al., COVID-19-Associated Orphanhood and Caregiver Death in the United States. Pediatrics, https://publications.aap.org/pediatrics/article/148/6/e2021053760/183446/COVID-19-Associated-Orphanhood-and-Caregiver-Death.

/12/Mike Stobbe, More than 120,000 U.S. kids had caregivers die during pandemic, (October 7, 2021), Associated Press, https://apnews.com/article/coronavirus-pandemic-science-pandemics-covid-19-pandemic-race-and-ethnicity-72ab35ef81250e5007f5674d7e0af73d.

/13/Jason Kane, Rising number of children struggle with COVID's effects, especially in Black and Latino communities, PBS News Hour, (July 23, 2021), https://www.pbs.org/newshour/show/rising-number-of-children-have-long-haul-covid-especially-in-black-and-latino-communities.

/14/Jiying Ling, Paige Duren, Lorraine Robbins, Food Insecurity and Mental Well-Being Among Low-Income Families During COVID-19 Pandemic, (September 2022), American Journal of Health Promotion, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9014344/pdf/10.1177_08901171221089627.pdf.

/15/U.S. Department of Housing and Urban Development, Office of Policy Development and Research, Promoting Mental Health Through Housing Stability, (May 13, 2022), https://www.huduser.gov/portal/pdredge/pdr-edge-trending-053122.html.

/16/Eunice Larbi, Hannah Berendzen, et al., Substance Abuse and Mental Health Services Administration, Coping with Community Violence Together, (July 27, 2022), https://www.samhsa.gov/blog/coping-community-violence-together.

/17/Cf. The Nat'l Child Traumatic Stress Network, What is Child Traumatic Stress? (2003), https://www.samhsa.gov/sites/default/files/programs_campaigns/childrens_mental_health/what-is-child-traumatic-stress.pdf (highlighting the epidemic of childhood traumatic stress).

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To highlight the urgent mental health needs of children and youth, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children's Hospital Association declared a national emergency in child and adolescent mental health in October 2021./18/ In order to respond to this national emergency, H.R. 7780 includes important Committee priorities to better support our nation's students, children, and educators during this national emergency.

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/18/Am. Acad. of Pediatrics, AAP-AACAP-CHA Declaration of a National Emergency in Child and Adolescent Mental Health, (Oct. 19, 2021) https://www.aap.org/en/advocacy/child-and-adolescent-healthy-mental-development/aap-aacap-cha-declaration-of-a-national-emergency-in-child-and-adolescent-mental-health/.

Supporting Early Childhood Mental Health

H.R. 7780 includes the text of the Early Childhood Mental Health Support Act, which was first introduced in the 116th Congress by Rep. Mark DeSaulnier (D-CA-11), Rep. Doris Matsui (D-CA-06) and Rep. Joe Kennedy III (D-MA-04). The bill was reintroduced in the 117th Congress by Rep. DeSaulnier, Rep. Matsui, and Rep. Ayanna Pressley (D-MA-07). The legislation aims to improve access to mental health supports for both children and staff in Head Start programs by requiring the U.S. Department of Health and Human Services (HHS) to identify evidence-based interventions for Head Start programs and help Head Start agencies implement these interventions to improve the health of children and staff.

The targeted funding and support of the Early Childhood Mental Health Support Act comes at a critical time for Head Start programs. The COVID-19 pandemic and opioid crisis have taken a serious toll on students' social and emotional development, leading to an increase in the number of children experiencing trauma entering Head Start./19/ As a result, children are entering Head Start with higher needs and contributing to stressful working conditions for staff; these factors, coupled with low compensation, are leading to high staff turnover./20/ Head Start was founded to help break the cycle of poverty and provide young children from low-income families comprehensive services that meet their emotional, social, health, nutritional, and educational needs./21/ Providing access to mental health services to young children is an important part of Head Start's work. In 2016, roughly one in six U.S. children between the ages of two and eight years had a diagnosed mental, behavioral, or developmental disorder./22/ Given the life-long consequences of adverse experiences and trauma on children, it is crucial that Congress develop policies to improve the mental health of our nation's young people.

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/19/See Early Childhood & Knowledge Learning Ctr., Admin. for Child. & Families, U.S. Dep't of Health & Hum. Svcs., Introduction to Head Start and the Opioid Crisis, (2020) https://eclkc.ohs.acf.hhs.gov/mental-health/article/head-start-opioid-crisis; Nat'l Head Start Assn., Confronting Head Start's Workforce Crisis 2-5 (2022), https://nhsa.org/wp-content/uploads/2022/05/2022.05-Workforce-Brief.pdf?source=email.

/20/See Nat'l Head Start Assn., supra note 15, at 2-5.

/21/Early Childhood & Knowledge Learning Ctr., Admin. for Child. & Families, U.S. Dep't of Health & Hum. Svcs. Head Start History, (2018), https://eclkc.ohs.acf.hhs.gov/about-us/article/head-start-history.

/22/Ctrs. for Disease Control & Prevention, Data and Statistics on Children's Mental Health, (2022), https://www.cdc.gov/childrensmentalhealth/data.html.

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A 2022 survey of over 900 Head Start staff states that classrooms are overrun with children exhibiting challenging behaviors, social-emotional needs, and trauma./23/ The Administration for Children and Families, the office within HHS that administers Head Start, needs additional resources both to address the increased need from the vulnerable populations of children Head Start serves and to identify the best interventions to set children on a path to school readiness and lifelong mental health wellness. The evidence is clear: the sooner children receive support, the more they thrive./24/

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/23/See Nat'l Head Start Assn., supra note 15, at 5.

/24/E.g., Ctr. on the Developing Child, Harvard University, The Impact of Early Adversity on Children's Development, 2 (2007), https://developingchild.harvard.edu/resources/inbrief-the-impact-of-early-adversity-on-childrens-development/ ("While there is no `magic age' for intervention, it is clear that, in most cases, intervening as early as possible is significantly more effective than waiting.").

Recognizing the Need to Support Children Impacted by Trauma Trauma is not merely a factor in the lives of young children--it affects between half and two-thirds of all children in the United States./25/ Described simply by the American Psychological Association as "an emotional response to a terrible event", traumatic events may include the experience of child abuse, community or school violence, or the sudden loss of a loved one./26/ According to a CDC study analyzing the long-term effects of childhood and adolescent traumatic experiences (also known as adverse childhood experiences, or ACEs) on adult health, health care costs, and life expectancy, the effects of trauma are predictive of poor mental health across an individual's lifespan./27/ Furthermore, it is estimated that the social and economic costs of trauma exposure are hundreds of billions of dollars per year./28/

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/25/Substance Abuse & Mental Health Svcs. Admin., Understanding Childhood Trauma 1, (2016), https://store.samhsa.gov/sites/default/files/d7/priv/sma16_4923_0.pdf.

/26/Am. Psych. Assn., Trauma (Sept. 13, 2022, 8:15 PM), https://www.apa.org/topics/trauma#.

/27/See Ctrs. for Disease Control & Prevention, About the CDC-Kaiser ACE Study, (Sept. 13, 2022, 8:24 PM) https://www.cdc.gov/violenceprevention/aces/about.html (linking adverse childhood experiences to increased risk of other negative health outcomes from injury to chronic disease, infections disease, and risky behaviors generally).

/28/Ctrs. for Disease Control & Prevention, Preventing Childhood Adverse Experiences (ACEs): Leveraging the Best Available Evidence 7, (2019), https://www.cdc.gov/violenceprevention/pdf/preventingACES.pdf.

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As a result of experiencing trauma, children may experience difficulties with concentration, memory, organization, and language skills that can make it difficult to adjust to a classroom setting./29/ There is also a strong correlation between students who have experienced trauma and poor learning outcomes./30/ Further, teachers, school leaders, and specialized instructional support personnel can be deeply impacted by the traumas students bring with them into the classroom each day and sustain secondary traumatic stress./31/ Given the staggering reach of trauma and widespread concerns for both student and teacher wellbeing and academic learning, it is crucial that teachers, school leaders, paraprofessionals, school-based mental health services providers, and other specialized instructional support personnel are equipped to successfully work with students who have been impacted by trauma.

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/29/See e.g., Kohske Ogata, Maltreatment Related Trauma Symptoms Affect Academic Achievement Through Cognitive Functioning: A Preliminary Examination in Japan, 5 J. of Intel. 5 (2017) https://www.mdpi.com/2079-3200/5/4/32.

/30/Rachael D. Goodman, et al., Traumatic Stress, Socioeconomic Status, and Academic Achievement Among Primary School Students 256, (2012) https://www.researchgate.net/profile/Rachael-Goodman-2/publication/232560514_Traumatic-Stress_Socioeconomic_Status_and_ Academic-Achievement_Among_Primary_School_Students/links/0a85e538fdecdbdf10000000/Traumatic-Stress-Socioeconomic-Status-and-Academic-Achievement-Among-Primary-School-Students.pdf.

/31/The Nat'l Child Traumatic Stress Network, Secondary Traumatic Stress, http://www.nctsn.org/resources/topics/secondary-traumatic-stress.

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Effective trauma-informed approaches will go beyond trauma-sensitive teaching practices employed by a single teacher in a classroom and will encompass school wide practices designed to foster safe and stable environments, cultivating a space in which students, educators, and staff members can thrive./32/ Professional development programs on trauma-informed best practices direct school staff to work together to identify student needs for referral to licensed or certified school-based mental health services providers, such as school counselors, social workers, and psychologists. These professional development activities also enable teachers and school leaders to support student mental health in ways that are effective yet appropriate given their roles./33/

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/32/Alex Shevrin Venet, The How and Why of Trauma Informed Teaching, Edutopia (Aug. 3, 2018), https://www.edutopia.org/article/how-and-why-trauma-informed-teaching.

/33/See First Book, The Impact of COVID-19 on Student Mental Health in Communities of Need, 24 (Mar. 2022) https://firstbook.org/wp-content/uploads/2022/03/FirstBook_RI_Mental_ Health_Final.pdf?utm_source=firstbook&utm_medium=page&utm_campaign=menta lhealth.

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Recognizing trauma's outsized role as a root cause of major American public health issues, during the 115th Congress, Reps. Danny K. Davis (D-IL-07) and Mike Gallagher (R-WI-08) launched the Trauma-Informed Care Caucus in the U.S. House of Representatives to increase congressional awareness of trauma-informed care./34/ Representatives Davis and Gallagher were then joined by Senator Richard Durbin (D-NY) and Senator Lisa Murkowski (R-AK) in introducing the Trauma-Informed Care for Children and Families Act/35/ in both the House and Senate, to support children who have been exposed to ACEs and other traumas. This legislation, designed to respond to needs revealed by a Government Accountability Office (GAO) study requested by Senator Durbin and Rep. Davis,/36/ was the basis for trauma-related provisions included in the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act. The SUPPORT Patients and Communities Act passed the House by a bipartisan vote of 396-14, with the support of then-Committee Chairwoman Virginia Foxx (R-NC-05)/37/; it passed the Senate and was enacted into law in 2018./38/ However, the programs in SUPPORT derived from the Trauma-Informed Care for Children and Families Act have not yet received funding.

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/34/Press Release, Office or Rep. Mike Gallagher, Gallagher Launches Bipartisan Trauma-Informed Care Caucus (May 21, 2018) https://gallagher.house.gov/media/press-releases/gallagher-launches-bipartisan-trauma-informed-care-caucus.

/35/S. 774 & H.R. 1757, 115th Cong. (2017).

/36/U.S. Gov't Accountability Off., GAO-19-388, Children Affected by Trauma, Selected States Report Various Approaches and Challenges to Supporting Children (2019) https://www.gao.gov/assets/gao-19-388.pdf.

/37/H.R. 6, 115th Cong., 2d sess., House Roll Call Vote #288, (June 22, 2018), https://clerk.house.gov/Votes/2018288.

/38/H.R. 6, 115th Cong., 2d sess., Senate Roll Call Vote #221, (Oct. 3, 2018), https://www.senate.gov/legislative/LIS/roll_call_votes/vote1152/vote_115_2_00221.htm.

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In the 116th Congress, Rep. Jahana Hayes (D-CT-05) introduced H.R. 4835, the Supporting Trauma-Informed Education Practices Act,/39/ which sought to provide mandatory funding for the programs in SUPPORT derived from the Trauma-Informed Care for Children and Families Act. H.R. 4835 was eventually included in the Elijah E. Cummings Lower Drug Costs Now Act (H.R. 3), which passed the House of Representatives in December 2019./40/ In the same Congress, Reps. Davis and Gallagher continued to champion trauma-informed care, and introduced new legislation, H.R. 3180, the Resilience Investment, Support, and Expansion (RISE) from Trauma Act, to increase support for children and adults who have been exposed to trauma by building out the trauma-informed workforce and increasing resources for communities to support children who have experienced trauma.

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/39/H.R. 4835, 116th Cong. (2019).

/40/H.R. 3, 116th Cong., 1st sess., House Roll Call Vote #682 (Dec. 12, 2019), https://clerk.house.gov/Votes/2019682.

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In the 117th Congress, Rep. Hayes reintroduced the Supporting Trauma-Informed Education Practices Act with several crucial revisions, such as including early childhood education programs as eligible entities to carry out evidence-based trauma-informed practices, as well as adding evidence-based programs to improve mental health and resiliency among teachers, school leaders, and other school personnel as an allowable use of grant funds. This was in line with recommendations the Early Childhood, Elementary, and Secondary Education (ECESE) Subcommittee heard from Kristen Harper, Vice President for Policy and Engagement of Child Trends, at a February 16, 2022 hearing who said, "Schools" primary strategy should be prevention, with health, mental health, and social services and relationship-building as schools' primary tactics."/41/ The Supporting Trauma-Informed Education Practices Act was included in H.R. 7780.

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/41/Serving All Students: Promoting a Healthier, More Supportive School Environment: Hearing Before the Subcomm. on Early Childhood, Elementary & Secondary Educ. of the H. Comm. on Educ. & Lab., 117th Cong. (2022).

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Based on longstanding bipartisan support for trauma-informed practices, and previous support for the authorization of trauma informed programs in SUPPORT, it is disappointing to see how these practices were considered during the markup to H.R. 7780. Under now-Ranking Member Foxx's leadership, the proposed Republican Amendment in the Nature of a Substitute (ANS) to the Mental Health Matters Act entirely removed competitive grants to increase student access to trauma-informed support from the legislation. In fact, the Republican ANS went so far as to strike the mere mentions of "trauma" and "trauma-informed practices" from the bill.

Finally, as a result of the SUPPORT Patients and Communities Act`s passage in the 115th Congress, and the longtime efforts of the Congressional Black Caucus` Emergency Taskforce on Youth Suicide and Mental Health, an Interagency Task Force on Trauma-Informed Care, led by the Substance Abuse and Mental Health Services Administration (SAMHSA), was established to "harness the expertise, reach, and resources of the federal government to address the impact that trauma can have on the healthy development of children."/42/ The Committee looks forward to the Task Force's forthcoming report and recommendations. Furthermore, under the Mental Health Matters Act, initiatives, activities, and programs carried out under the bill's Supporting Trauma-Informed Education Practices Act provisions must reflect the best practices for trauma-informed identification, referral and support developed by the Task Force. The Committee is eager for these efforts to serve as further exemplars of evidence-based trauma-informed support services and mental health services.

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/42/Substance Abuse & Mental Health Svcs. Admin., National Strategy for Trauma-Informed Care Operating Plan, https://www.samhsa.gov/sites/default/files/trauma-informed-care-operating-plan.pdf.

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Continues with Part 2 of 3

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