Trauma-Informed Care for Children and Families Act of 2017
This bill establishes: (1) the Interagency Task Force on Trauma-Informed Care; (2) the National Law Enforcement Child and Youth Trauma Coordinating Center; (3) the Native American Technical Assistance Resource Center to provide trauma-informed technical assistance; and (4) Medicaid demonstration projects to test innovative, trauma-informed approaches for delivering early and periodic screening, diagnostic, and treatment services to eligible children. The Centers for Disease Control and Prevention must encourage states to collect and report data on adverse childhood experiences.
The bill amends the Public Health Service Act, the Elementary and Secondary Education Act of 1965, title XIX (Medicaid) of the Social Security Act, and other laws to revise or establish provisions related to trauma, including provisions regarding the National Child Traumatic Stress Initiative, Performance Partnership Pilots, health professional shortage areas, and training of school personnel, court personnel, and health care providers. The Department of Education may award grants for the improvement of trauma support services and mental health care for children in educational settings.
[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[S. 774 Introduced in Senate (IS)]
<DOC>
115th CONGRESS
1st Session
S. 774
To address the psychological, developmental, social, and emotional
needs of children, youth, and families who have experienced trauma, and
for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
March 29, 2017
Ms. Heitkamp (for herself, Mr. Durbin, Mr. Franken, and Mr. Booker)
introduced the following bill; which was read twice and referred to the
Committee on Health, Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To address the psychological, developmental, social, and emotional
needs of children, youth, and families who have experienced trauma, and
for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Trauma-Informed Care for Children
and Families Act of 2017''.
SEC. 2. FINDINGS.
Congress makes the following findings:
(1) The 2007 Great Smoky Mountains Study, a representative
longitudinal study of children, found that by age 16, more than
67 percent of the children had been exposed to 1 or more
traumatic events, such as child maltreatment, domestic
violence, or sexual assault.
(2) According to a 2009 Office of Juvenile Justice and
Delinquency Prevention study of children ages 0 through 17,
more than 60 percent of the children surveyed were exposed to
violence within the past year, either directly or indirectly.
(3) According to the Administration for Children and
Families, the rate of substantiated reports of child
maltreatment in fiscal year 2015 was 9.2 per 1,000 children
ages 0 through 17, with children under age 1 having the highest
rate of 24.2 per 1,000 children.
(4) According to the Office of Juvenile Justice and
Delinquency Prevention, a longitudinal study of youth detained
at a juvenile detention center in Chicago showed that 92.5
percent of youth had experienced at least 1 trauma, and 84
percent had experienced more than 1 trauma.
(5) The National Intimate Partner and Sexual Violence
Survey conducted by the Centers for Disease Control and
Prevention revealed that nearly 1 in 5 women reported having
been the victim of a rape at some time during their lives.
Seventy-eight percent experienced their first rape before the
age of 25.
(6) A 2017 study found that abuse and maltreatment suffered
as a child was associated with post-traumatic stress disorder
and opioid-related misuse as an adult, and recommended that
trauma history and post-traumatic stress disorder symptom
severity be addressed as part of opioid addiction treatment.
(7) Findings from the Adverse Childhood Experiences Study
conducted by the Centers for Disease Control and Prevention
have shown that adverse childhood experiences predispose
children towards negative trajectories from infancy through
adolescence. Followup representative studies have shown the
long-range impact of early trauma exposure on adult health
conditions, including heart disease, asthma, and mental health.
(8) According to a subsequent study conducted by the
Centers for Disease Control and Prevention, adults who had been
exposed to multiple adverse childhood experiences were
significantly more likely to be unemployed, to be living in
poverty, and not to have graduated high school than adults who
had zero adverse childhood experiences.
(9) According to a 2008 finding by the National Child
Traumatic Stress Network, educators who work directly with
traumatized children and adolescents are particularly
vulnerable to secondary traumatic stress, experiencing burnout,
fatigue, irritability, and other symptoms, and can be supported
through early recognition of that stress, self-care, and
trauma-informed support systems.
(10) Findings from a 2012 study conducted by the Centers
for Disease Control and Prevention included an estimate that
the total lifetime burden of child maltreatment cases that
occur each year in the United States, including medical,
welfare, and criminal justice costs, is $124,000,000,000.
(11) According to the Centers for Disease Control and
Prevention's National Health and Nutrition Examination Survey,
only half of children ages 8 through 15 with a mental disorder
had received treatment for their disorder within the past year.
Children with anxiety disorders such as post-traumatic stress
disorder were the least likely to be treated, with only 32.2
percent having received treatment for a mental disorder in the
past year.
(12) According to a 2014 report of the Institute of
Medicine and National Research Council of the National
Academies entitled ``New Directions in Child Abuse and Neglect
Research'', research has shown that child abuse and neglect
experiences resulted in higher risk for behavioral health
problems (such as depression and substance use) throughout
life, but that with informed prevention approaches, child abuse
and neglect can be both preventable and manageable.
(13) According to a 2017 finding by the National Child
Traumatic Stress Network, of the children served by the Network
with problems in the clinical range when entering care, 83
percent showed significant improvements in post-traumatic
stress disorder, behavioral problems, or traumatic stress
symptoms after receiving evidence-based treatments.
(14) According to a 2008 Washington State report on
prevention programs that assessed both cost and effectiveness,
evidence-based, two-generational child trauma treatments such
as Parent-Child Interaction Therapy return $3.64 per dollar of
cost.
TITLE I--DEVELOPMENT OF BEST PRACTICES
SEC. 101. TASK FORCE TO DEVELOP BEST PRACTICES FOR TRAUMA-INFORMED
IDENTIFICATION, REFERRAL, AND SUPPORT.
(a) Establishment of Task Force To Identify, Evaluate, Recommend,
Maintain, and Update Best Practices.--
(1) Establishment.--There is established a task force, to
be known as the Interagency Task Force on Trauma-Informed Care.
(2) Main duties.--The task force shall--
(A) identify, evaluate, recommend, maintain, and
update, as described in subsection (c) and in
accordance with subsection (d), a set of best practices
with respect to children and youth, and their families
as appropriate, who have experienced or are at risk of
experiencing trauma; and
(B) carry out other duties as described in
subsection (c).
(b) Task Force Composition.--
(1) Composition.--The task force shall be composed of
Federal employees, consisting of the Assistant Secretary for
Mental Health and Substance Use (referred to in this section as
the ``Assistant Secretary'', except where another Assistant
Secretary is specifically named) and 1 representative of each
of--
(A) the National Center for Injury Prevention and
Control of the Centers for Disease Control and
Prevention;
(B) the Center for Mental Health Services of the
Substance Abuse and Mental Health Services
Administration;
(C) the Center for Substance Abuse Prevention of
that Administration;
(D) the Center for Substance Abuse Treatment of
that Administration;
(E) the Center for Behavioral Health Statistics and
Quality of that Administration;
(F) the Maternal and Child Health Bureau of the
Health Resources and Services Administration;
(G) the Center for Medicaid and CHIP Services;
(H) the National Institute of Mental Health;
(I) the Eunice Kennedy Shriver National Institute
of Child Health and Human Development;
(J) the National Institute on Drug Abuse;
(K) the National Institute on Alcohol Abuse and
Alcoholism;
(L) the Administration on Children, Youth and
Families of the Administration for Children and
Families;
(M) the Administration for Native Americans of the
Administration for Children and Families;
(N) the Office of Child Care of the Administration
for Children and Families;
(O) the Office of Head Start of the Administration
for Children and Families;
(P) the Office of Refugee Resettlement of the
Administration for Children and Families;
(Q) the Indian Health Service of the Department of
Health and Human Services;
(R) the Office of Minority Health of the Department
of Health and Human Services;
(S) the Office of the Assistant Secretary for
Planning and Evaluation;
(T) the Office of Juvenile Justice and Delinquency
Prevention of the Department of Justice;
(U) the Office of Community Oriented Policing
Services of the Department of Justice;
(V) the Office on Violence Against Women of the
Department of Justice;
(W) the National Center for Education Evaluation
and Regional Assistance of the Department of Education;
(X) the Office of Safe and Healthy Students of the
Department of Education;
(Y) the Office of Special Education and
Rehabilitative Services of the Department of Education;
(Z) the Office of Indian Education of the
Department of Education;
(AA) the Bureau of Indian Affairs of the Department
of the Interior;
(BB) the Bureau of Indian Education of the
Department of the Interior;
(CC) the Veterans Health Administration of the
Department of Veterans Affairs;
(DD) the Office of Special Needs Assistance
Programs of the Department of Housing and Urban
Development; and
(EE) such other Federal agencies as--
(i) the Assistant Secretary recommends to
the President; and
(ii) the President determines to be
appropriate.
(2) Appointment.--
(A) In general.--Each member of the task force,
other than the Assistant Secretary, shall be appointed
by the Secretary or other head of the entire Federal
agency that contains the office or other unit of
government that the member represents.
(B) Date of appointments.--The heads of Federal
agencies with appointing authority under this paragraph
shall appoint the corresponding members of the task
force not later than 6 months after the date of
enactment of this Act.
(3) Chairperson.--The task force shall be chaired by the
Assistant Secretary.
(c) Task Force Duties.--The task force shall--
(1) not later than 1 year after the date of enactment of
this Act, and not less often than annually thereafter--
(A) identify and evaluate a set of evidence-based,
evidence-informed, and promising best practices, which
may include practices already supported by offices of
the Department of Health and Human Services, including
the National Mental Health and Substance Use Policy
Laboratory, the Department of Justice, the Department
of Education, or another Federal agency, with respect
to--
(i) the early identification of children
and youth, and their families as appropriate,
who have experienced or are at risk of
experiencing trauma;
(ii) the expeditious referral of such
children and youth, and their families as
appropriate, that require specialized services
to the appropriate trauma-informed support
(including treatment) services, in accordance
with applicable privacy laws; and
(iii) the implementation of trauma-informed
approaches and interventions in child and
youth-serving schools, organizations, homes,
and other settings to foster safe, stable, and
nurturing environments and relationships that
prevent and mitigate the effects of trauma;
(B) recommend such set of best practices, including
disseminating the set, to the Department of Health and
Human Services, the Department of Justice, the
Department of Education, other Federal agencies as
appropriate, State, tribal, and local government
agencies, including State, local, and tribal
educational agencies, and other entities (including
recipients of relevant Federal grants, professional
associations, health professional organizations,
national and State accreditation bodies, and schools)
that the Assistant Secretary determines to be
appropriate, and to the general public; and
(C) maintain and update, as appropriate, the set of
best practices recommended under subparagraph (B);
(2) not later than 2 years after the date of enactment of
this Act--
(A) prepare an integrated task force strategy
report concerning how the task force and member
agencies will collaborate, prioritize options for, and
implement a coordinated approach to preventing trauma,
and identifying and ensuring the appropriate
interventions and supports for children, youth, and
their families as appropriate, who have experienced or
are at risk of experiencing trauma;
(B) submit the report to the appropriate committees
of Congress; and
(C) make the report publicly available; and
(3) not later than 1 year after the date of enactment of
this Act, and as often as practicable but not less often than
annually thereafter, coordinate, to the extent feasible, among
the offices and other units of government represented on the
task force, research, data collection, and evaluation regarding
models described in subsection (d)(1)(C), identify gaps in or
populations or settings not served by models described in that
subsection, solicit feedback on the models, from the
stakeholders described in subsection (d)(1)(B), coordinate,
among the offices and other units of government represented on
the task force, the awarding of grants related to preventing
and mitigating trauma, and establish procedures to enable the
offices and units of government to share technical expertise
related to preventing and mitigating trauma.
(d) Best Practices.--
(1) In general.--In identifying, evaluating, recommending,
maintaining, and updating the set of best practices under
subsection (c), the task force shall--
(A) consider findings from evidence-based,
evidence-informed, and promising practice-based models,
including from institutions of higher education,
community practice (including tribal experience),
recognized professional associations, and programs of
the Department of Health and Human Services, the
Department of Justice, the Department of Education, and
other Federal agencies (including the National Mental
Health and Substance Use Policy Laboratory and offices
in such agencies that maintain registries and
clearinghouses of relevant models), that reflect the
science of healthy child, youth, and family
development, and have been developed, implemented, and
evaluated to demonstrate effectiveness or positive
measurable outcomes;
(B) engage with, and solicit and receive feedback
from--
(i) faculty at institutions of higher
education, community practitioners associated
with the community practice described in
subparagraph (A), and recognized professional
associations that represent the experience and
perspectives of individuals who provide
services in covered settings, to obtain
observations and practical recommendations on
the best practices; and
(ii) the public, by--
(I) holding at least one public
meeting to solicit recommendations and
information relating to the best
practices; and
(II) providing notice of the
meeting in the Federal Register;
(C) recommend models for settings in which
individuals may come into contact with children and
youth, and their families as appropriate, who have
experienced or are at risk of experiencing trauma,
including schools, hospitals, settings where health
care providers, including primary care and pediatric
providers, provide services, preschool and early
childhood education and care settings, home visiting
settings, after-school program facilities, child
welfare agency facilities, public health agency
facilities, mental health treatment facilities,
substance abuse treatment facilities, faith-based
institutions, domestic violence centers, homeless
services system facilities, refugee services system
facilities, juvenile justice system facilities, and law
enforcement agency facilities;
(D) recommend best practices that are evidence-
based, are evidence-informed, or are promising and
practice-based, and that include guidelines for--
(i)(I) training of front-line service
providers, including teachers, providers from
child- or youth-serving organizations, health
care providers, individuals who are mandatory
reporters of child abuse or neglect, and first
responders, in understanding and identifying
early signs and risk factors of trauma in
children and youth, and their families as
appropriate, including through screening
processes; and
(II) implementing appropriate responses;
(ii) procedures or systems that--
(I) are designed to quickly refer
children and youth, and their families
as appropriate, who have experienced or
are at risk of experiencing trauma to,
and ensure the children, youth, and
appropriate family members receive, the
appropriate trauma-informed screening
and support, including treatment; or
(II) use partnerships that--
(aa) include local social
services organizations or
clinical mental health or
health care service providers
with expertise in furnishing
support services (including
trauma-informed treatment) to
prevent or mitigate the effects
of trauma;
(bb) may be partnerships
that co-locate or integrate
services, such as by providing
services at school-based health
centers; and
(cc) are designed to make
such quick referrals, and
ensure the receipt of
screening, support, and
treatment, described in
subclause (I);
(iii) educating children and youth to--
(I) understand trauma;
(II) identify the signs, effects,
or symptoms of trauma; and
(III) build the resilience and
coping skills to mitigate the effects
of experiencing trauma;
(iv) multi-generational interventions to--
(I) support, including through
skills building, parents (with an
appropriate emphasis on fathers),
foster parents, adult caregivers, and
front-line service providers described
in clause (i)(I) in fostering safe,
stable, and nurturing environments and
relationships that prevent and mitigate
the effects of trauma for children and
youth who have experienced or are at
risk of experiencing trauma;
(II) assist parents, foster
parents, and adult caregivers in
learning to access resources related to
such prevention and mitigation; and
(III) provide tools to prevent and
address caregiver or secondary trauma,
as appropriate;
(v) community interventions for underserved
areas that have faced trauma through acute or
long-term exposure to substantial
discrimination, historical or cultural
oppression, intergenerational poverty, civil
unrest, a high rate of violence, or a high rate
of drug overdose mortality;
(vi) assisting parents and guardians in
understanding eligibility for and obtaining
certain health benefits coverage, including
coverage under a State Medicaid plan under
title XIX of the Social Security Act (42 U.S.C.
1396 et seq.) of screening and treatment for
children and youth, and their families as
appropriate, who have experienced or are at
risk of experiencing trauma;
(vii) utilizing trained nonclinical
providers (such as peers through peer support
models, mentors, clergy, and other community
figures), to--
(I) expeditiously link children and
youth, and their families as
appropriate, who have experienced or
are at risk of experiencing trauma, to
the appropriate trauma-informed
screening and support (including
clinical treatment) services; and
(II) provide ongoing care or case
management services;
(viii) collecting and utilizing data from
screenings, referrals, or the provision of
services and supports, conducted in the covered
settings, to evaluate and improve processes for
trauma-informed support and outcomes;
(ix)(I) improving disciplinary practices in
early childhood education and care settings and
schools, including use of positive disciplinary
strategies that are effective at reducing the
incidence of punitive school disciplinary
actions, including school suspensions and
expulsions; and
(II) providing the training described in
clause (i) to child care providers and to
school personnel, including school resource
officers, teacher assistants, administrators,
and heads of charter schools; and
(x) incorporating trauma-informed
considerations into educational, preservice,
and continuing education opportunities, for the
use of health professional and education
organizations, national and State accreditation
bodies for health care and education providers,
health and education professional schools or
accredited graduate schools, and other relevant
training and educational entities;
(E) recommend best practices that--
(i) include practices that are culturally
sensitive, linguistically appropriate, age- and
gender-relevant, and appropriate for lesbian,
gay, bisexual, transgender, and queer
populations;
(ii) can be applied across underserved
geographic areas; and
(iii) engage entire organizations in
training and skill building related to the best
practices; and
(F) recommend best practices that are designed not
to lead to unwarranted custody loss or criminal
penalties for parents or guardians in connection with
children and youth who have experienced or are at risk
of experiencing trauma.
(e) Authorization of Appropriations.--To carry out this section,
there are authorized to be appropriated $3,000,000 for fiscal year 2018
and $1,000,000 for each of fiscal years 2019 through 2022.
(f) Definitions.--In this section:
(1) Covered recipient.--The term ``covered recipient''
means a department or other entity described in subsection
(c)(1)(B).
(2) Covered setting.--The term ``covered setting'' means a
setting described in subsection (d)(1)(C).
SEC. 102. DONALD J. COHEN NATIONAL CHILD TRAUMATIC STRESS INITIATIVE.
Section 582(f) of the Public Health Service Act (42 U.S.C. 290hh-
1(f)) is amended--
(1) by striking ``$46,887,000'' and inserting
``$66,887,000''; and
(2) by adding at the end the following: ``Of the amounts
appropriated under this subsection for each of fiscal years
2018 through 2022, $7,500,000 shall be allocated to the
operation of the coordinating center of the National Child
Traumatic Stress Initiative for purposes of gathering and
reporting data, evaluating models, and providing technical
assistance.''.
TITLE II--DISSEMINATION AND IMPLEMENTATION OF BEST PRACTICES
SEC. 201. USE OF GRANT FUNDS FOR TRAINING IN BEST PRACTICES RELATING TO
CHILD AND YOUTH TRAUMA AND COMMUNITY SUPPORT.
(a) Head Start Act.--
(1) In general.--Section 640(a) of the Head Start Act (42
U.S.C. 9835(a)) is amended--
(A) by redesignating paragraph (7) as paragraph
(8); and
(B) by inserting after paragraph (6) the following:
``(7) Any of the funds allocated under this subsection for
Head Start programs (including Early Head Start programs), for
training and technical assistance activities, or for
collaboration grants may be used to provide training for
administrators and other staff of Head Start agencies in the
best practices developed under section 101 of the Trauma-
Informed Care for Children and Families Act of 2017.''.
(2) Conforming amendments.--
(A) Section 640(a)(2)(C)(i) of the Head Start Act
(42 U.S.C. 9835(a)(2)(C)(i)), in the matter preceding
subclause (I), by inserting after ``training and
technical assistance activities'' the following:
``(such as training in the best practices developed
under section 101 of the Trauma-Informed Care for
Children and Families Act of 2017)''.
(B) Sections 641A(h)(1)(B) and 645(d)(3) of the
Head Start Act (42 U.S.C. 9836a(h)(1)(B), 9840(d)(3))
are amended by striking ``640(a)(7)'' and inserting
``640(a)(8)''.
(C) Section 642B(a)(2)(B)(i) of the Head Start Act
(42 U.S.C. 9837b(a)(2)(B)(i)) is amended by inserting
before the semicolon the following: ``(such as by
providing training for administrators and other staff
of those agencies in the best practices developed under
section 101 of the Trauma-Informed Care for Children
and Families Act of 2017)''.
(D) Section 648 of the Head Start Act (42 U.S.C.
9843) is amended--
(i) in subsection (a)(3)(B)(i), by
inserting after ``systems'' the following:
``(such as systems that include training in the
best practices developed under section 101 of
the Trauma-Informed Care for Children and
Families Act of 2017)'';
(ii) in subsection (b)(2)(C), by inserting
before the semicolon the following: ``(such as
training in the best practices developed under
section 101 of the Trauma-Informed Care for
Children and Families Act of 2017)''; and
(iii) in subsection (d)(1)(G), by inserting
after ``staff training'' the following ``(such
as training in the best practices developed
under section 101 of the Trauma-Informed Care
for Children and Families Act of 2017)''.
(b) Child Care and Development Block Grant.--Section 658G(b)(1) of
the Child Care and Development Block Grant Act of 1990 (42 U.S.C.
9858e(b)(1)) is amended--
(1) in subparagraph (G), by striking ``; and'' and
inserting a semicolon;
(2) in subparagraph (H), by striking the period and
inserting ``; and''; and
(3) by adding at the end the following:
``(I) providing training in the best practices
developed under section 101 of the Trauma-Informed Care
for Children and Families Act of 2017 for
administrators of child care programs, and child care
providers, that receive assistance under this
subchapter.''.
(c) Social Services Block Grant.--Section 2002(a)(2)(B) of the
Social Security Act (42 U.S.C. 1397a(a)(2)(B) is amended--
(1) in clause (ii), by striking ``and'' after the
semicolon;
(2) in clause (iii), by striking the period at the end and
inserting ``; and''; and
(3) by adding at the end the following new clause:
``(iv) training for providers in the best
practices developed under section 101 of the
Trauma-Informed Care for Children and Families
Act of 2017.''.
(d) Maternal and Child Health Services Block Grant.--Section 504 of
the Social Security Act (42 U.S.C. 704) is amended by adding at the end
the following new subsection:
``(e) A State may use a portion of the amounts described in
subsection (a) for the purpose of providing training for licensed
health care providers and public health agencies in the best practices
developed under section 101 of the Trauma-Informed Care for Children
and Families Act of 2017.''.
(e) Maternal, Infant, and Early Childhood Home Visiting (MIECHV).--
Section 511(i)(2) of the Social Security Act (42 U.S.C. 711(i)(2)) is
amended--
(1) by redesignating subparagraphs (D) through (G) as
subparagraphs (E) through (H), respectively; and
(2) by inserting after subparagraph (C) the following new
subparagraph:
``(D) Section 504(e) (relating to the use of funds
for training in the best practices developed under
section 101 of the Trauma-Informed Care for Children
and Families Act of 2017).''.
(f) Child Welfare Services.--Section 422(b)(4)(B) of the Social
Security Act (42 U.S.C. 622(b)(4)(B)) is amended by inserting before
the semicolon ``(which may include training in the best practices
developed under section 101 of the Trauma-Informed Care for Children
and Families Act of 2017)''.
(g) Federal Payments for Foster Care and Adoption Assistance.--
Section 474(a)(3)(A) of the Social Security Act (42 U.S.C.
674(a)(3)(A)) is amended by inserting ``, and including training in the
best practices developed under section 101 of the Trauma-Informed Care
for Children and Families Act of 2017'' after ``enrolled in such
institutions''.
(h) Healthy Start Initiative.--Section 330H(e) of the Public Health
Service Act (42 U.S.C. 254c-8(e)) is amended by adding at the end the
following:
``(3) Training providers in best practices relating to
trauma.--Any of the funds appropriated under paragraph (1) may
be used to provide training for providers in the best practices
developed under section 101 of the Trauma-Informed Care for
Children and Families Act of 2017.''.
(i) Block Grants for Community Mental Health Services.--Section
1920 of the Public Health Service Act (42 U.S.C. 300x-9) is amended by
adding at the end the following:
``(d) Training Providers in Best Practices Relating to Trauma.--
Except as specified in subsection (c), any of the funds appropriated
under subsection (a) may be used to provide training for providers in
the best practices developed under section 101 of the Trauma-Informed
Care for Children and Families Act of 2017.''.
(j) Block Grants for Prevention and Treatment of Substance Abuse.--
Section 1935 of the Public Health Service Act (42 U.S.C. 300x-35) is
amended by adding at the end the following:
``(c) Allocations for Training Providers in Best Practices Relating
to Trauma.--Any of the funds appropriated under subsection (a) may be
used to provide training for providers in the best practices developed
under section 101 of the Trauma-Informed Care for Children and Families
Act of 2017.''.
(k) Use of Grant Funds for Training Providers in Best Practices
Relating to Trauma.--
(1) School-based health centers.--Section 399Z-1(l) of the
Public Health Service Act (42 U.S.C. 280h-5(l)) is amended by
adding ``Any of the funds appropriated under this subsection
may be used to provide training for providers in the best
practices developed under section 101 of the Trauma-Informed
Care for Children and Families Act of 2017.'' after the first
sentence.
(2) Community health centers.--Section 330(r) of the Public
Health Service Act (42 U.S.C. 254b(r)) is amended by adding at
the end the following:
``(5) Training providers in best practices relating to
trauma.--Any of the funds appropriated under this subsection
may be used to provide training for providers in the best
practices developed under section 101 of the Trauma-Informed
Care for Children and Families Act of 2017.''.
(l) Supporting Effective Instruction; Local Use of Funds.--Section
2103(b)(3) of the Elementary and Secondary Education Act of 1965 (20
U.S.C. 6613(b)(3)) is amended--
(1) in subparagraph (O), by striking ``and'' after the
semicolon;
(2) by redesignating subparagraph (P) as subparagraph (Q);
and
(3) by inserting after subparagraph (O) the following:
``(P) providing training for school personnel,
including teachers, principals, other school leaders,
specialized instructional support personnel, and
paraprofessionals, in the best practices developed
under section 101 of the Trauma-Informed Care for
Children and Families Act of 2017; and''.
(m) Student Support and Academic Enrichment.--
(1) State use of funds.--Section 4104(b) of the Elementary
and Secondary Education Act of 1965 (20 U.S.C. 7114(b)) is
amended--
(A) in paragraph (2), by striking ``or'' at the
end;
(B) in paragraph (3) by striking the period at the
end and inserting ``; or''; and
(C) by adding at the end the following:
``(4) providing training for teachers, administrators,
school counselors, mental health professionals, and other
appropriate personnel in the best practices developed under
section 101 of the Trauma-Informed Care for Children and
Families Act of 2017.''.
(2) Local use of funds.--Paragraph (5) of section 4108 of
the Elementary and Secondary Education Act of 1965 (20 U.S.C.
7118) is amended--
(A) in subparagraph (H), by striking ``or'' at the
end;
(B) in subparagraph (I), by striking the period at
the end and inserting ``; or''; and
(C) by adding at the end the following:
``(J) providing training for teachers,
administrators, school counselors, mental health
professionals, and other appropriate personnel in the
best practices developed under section 101 of the
Trauma-Informed Care for Children and Families Act of
2017.''.
(n) 21st Century Community Learning Centers.--
(1) State use of funds.--Section 4202(c)(3) of the
Elementary and Secondary Education Act of 1965 (20 U.S.C.
7172(c)(3)) is amended--
(A) by redesignating subparagraphs (H), (I), and
(G), as subparagraphs (G), (H), and (I), respectively;
and
(B) by adding at the end the following:
``(J) Providing training for teachers,
administrators, school counselors, mental health
professionals, and other appropriate personnel
(including appropriate personnel involved with programs
and activities that advance student academic
achievement and support student success during
nonschool hours) in the best practices developed under
section 101 of the Trauma-Informed Care for Children
and Families Act of 2017.''.
(2) Local use of funds.--Section 4205(a) of the Elementary
and Secondary Education Act of 1965 (20 U.S.C. 7175(a)) is
amended--
(A) in paragraph (13), by striking ``and'' at the
end;
(B) in paragraph (14), by striking the period at
the end and inserting ``; and''; and
(C) by adding at the end the following:
``(15) training for teachers, administrators, school
counselors, mental health professionals, and other appropriate
personnel in the best practices developed under section 101 of
the Trauma-Informed Care for Children and Families Act of
2017.''.
(o) Full-Service Community Schools.--Section 4625(e) of the
Elementary and Secondary Education Act of 1965 (20 U.S.C. 7275(e)) is
amended--
(1) in paragraph (2), by striking ``and'' after the
semicolon;
(2) by redesignating paragraph (3) as paragraph (4); and
(3) by inserting after paragraph (2) the following:
``(3) provide training for teachers, administrators, school
counselors, mental health professionals, and other appropriate
personnel (including appropriate personnel involved with the
full-service community school) in the best practices developed
under section 101 of the Trauma-Informed Care for Children and
Families Act of 2017; and''.
(p) National Activities for Schools.--Section 4631(a)(1)(B) of the
Elementary and Secondary Education Act of 1965 (20 U.S.C.
7281(a)(1)(B)) is amended by striking ``or conducting a national
evaluation.'' and inserting ``, conducting a national evaluation, or
providing training for teachers, administrators, school counselors,
mental health professionals, and other appropriate personnel in the
best practices developed under section 101 of the Trauma-Informed Care
for Children and Families Act of 2017.''.
(q) IDEA.--Section 638 of the Individuals with Disabilities
Education Act (20 U.S.C. 1438) is amended--
(1) in paragraph (4), by striking ``and'' after the
semicolon;
(2) in paragraph (5), by striking the period at the end and
inserting ``; and''; and
(3) by adding at the end the following:
``(6) to provide training for appropriate personnel who
provide direct early intervention services for infants and
toddlers with disabilities in the best practices developed
under section 101 of the Trauma-Informed Care for Children and
Families Act of 2017.''.
(r) Special Supplemental Nutrition Program for Women, Infants, and
Children.--Section 17(f) of the Child Nutrition Act of 1966 (42 U.S.C.
1786(f)) is amended by adding at the end the following:
``(27) Best practices.--A State agency may use a portion of
the amounts made available to the State agency under this
section for the purpose of providing training for local
agencies in the best practices developed under section 101 of
the Trauma-Informed Care for Children and Families Act of
2017.''.
(s) Community Services Block Grant Act.--
(1) State activities.--Section 675C(b)(1)(A) of the
Community Services Block Grant Act (42 U.S.C. 9907(b)(1)(A)) is
amended by inserting after ``providing training'' the
following: ``(which may include providing training, to the
entities that are providers of services to children and youth,
in the best practices developed under section 101 of the
Trauma-Informed Care for Children and Families Act of 2017)''.
(2) National activities.--Section 678A(a)(1)(A) of the
Community Services Block Grant Act (42 U.S.C. 9913(a)(1)(A)) is
amended by inserting after ``training'' the following: ``(which
may include providing training, to the entities that are
providers of services to children and youth, in the best
practices developed under section 101 of the Trauma-Informed
Care for Children and Families Act of 2017)''.
(t) Runaway and Homeless Youth Act.--Section 342 of the Runaway and
Homeless Youth Act (42 U.S.C. 5714-22) is amended by inserting after
``technical assistance and training'' the following: ``(which may
include providing training, to providers of services under this title,
in the best practices developed under section 101 of the Trauma-
Informed Care for Children and Families Act of 2017)''.
(u) Programs of the Office of Refugee Resettlement.--Section
462(b)(1) of the Homeland Security Act of 2002 (6 U.S.C. 279(b)(1)) is
amended--
(1) in subparagraph (K), by striking ``and'' at the end;
(2) in subparagraph (L), by striking the period and
inserting ``; and''; and
(3) by adding at the end the following:
``(M) at the election of the Director, providing
training, to providers responsible for the care of the
unaccompanied alien children, in the best practices
developed under section 101 of the Trauma-Informed Care
for Children and Families Act of 2017.''.
(v) Child Abuse Prevention and Treatment.--
(1) National clearinghouse.--Section 103(b) of the Child
Abuse Prevention and Treatment Act (42 U.S.C. 5104) is
amended--
(A) in paragraph (8), by striking ``and'' at the
end;
(B) in paragraph (9), by striking the period and
inserting ``; and''; and
(C) by adding at the end the following:
``(10) disseminate information regarding the best practices
developed under section 101 of the Trauma-Informed Care for
Children and Families Act of 2017 for individuals and officials
described in paragraph (8).''.
(2) Research and assistance activities.--Section 104(b)(1)
of that Act (42 U.S.C. 5105(b)(1)) is amended by adding at the
end the following: ``Such assistance may include technical
assistance regarding the best practices developed under section
101 of the Trauma-Informed Care for Children and Families Act
of 2017.''.
(3) Training.--Section 105(a)(1) of that Act (42 U.S.C.
5106(a)(1)) is amended--
(A) in subparagraph (L), by striking ``and'' at the
end;
(B) in subparagraph (M), by striking the period and
inserting ``; and''; and
(C) by adding at the end the following:
``(D) for providing training in the best practices
developed under section 101 of the Trauma-Informed Care
for Children and Families Act of 2017 to individuals
and entities described in this paragraph.''.
(4) State child abuse or neglect prevention and treatment
programs.--Section 106(a) of that Act (42 U.S.C. 5106a(a)) is
amended--
(A) in paragraph (13), by striking ``or'' at the
end;
(B) in paragraph (14), by striking the period and
inserting ``; or''; and
(C) by adding at the end the following:
``(15) providing training in the best practices developed
under section 101 of the Trauma-Informed Care for Children and
Families Act of 2017 for employees of agencies or systems
described in paragraph (12), (13), or (14).''.
(5) Community-based grants for the prevention of child
abuse and neglect.--Section 205(b) of that Act (42 U.S.C.
5116e(b)) is amended--
(A) in paragraph (5), by striking ``and'' at the
end;
(B) in paragraph (6), by striking the period and
inserting ``; and''; and
(C) by adding at the end the following:
``(7) provide training in the best practices developed
under section 101 of the Trauma-Informed Care for Children and
Families Act of 2017 for providers of programs, activities, or
services described in this subsection.''.
(w) Grants for Juvenile and Family Court Personnel.--Section 222(1)
of the Victims of Child Abuse Act of 1990 (42 U.S.C. 13022(1)) is
amended by inserting ``(which may include providing training, to the
entities that are providers of services to children and youth, in the
best practices developed under section 101 of the Trauma-Informed Care
for Children and Families Act of 2017)'' after ``technical assistance
and training''.
(x) Grants To Support Families in the Justice System.--Section
1301(c) of the Victims of Trafficking and Violence Protection Act of
2000 (42 U.S.C. 10420(c)) is amended by adding at the end the
following:
``(3) Best practices for trauma-informed care for children
and families.--In making grants under subsection (b), the
Attorney General shall take into account the extent to which
the applicant is using the best practices developed under
section 101 of the Trauma-Informed Care for Children and
Families Act of 2017.''.
SEC. 202. ESTABLISHMENT OF LAW ENFORCEMENT CHILD AND YOUTH TRAUMA
COORDINATING CENTER.
(a) Establishment of Center.--
(1) In general.--The Attorney General shall establish a
National Law Enforcement Child and Youth Trauma Coordinating
Center (referred to in this section as the ``Center'') to
provide assistance to State, local, and tribal law enforcement
agencies in interacting with children and youth who have been
exposed to violence or other trauma, and their families as
appropriate.
(2) Age range.--The Center shall determine the age range of
children and youth to be covered by the activities of the
Center.
(b) Duties.--The Center shall provide assistance to State, local,
and tribal law enforcement agencies by--
(1) disseminating information on the best practices for law
enforcement officers developed under section 101, which may
include best practices based on evidence-based and evidence-
informed models from programs of the Department of Justice and
the Office of Justice Services of the Bureau of Indian Affairs,
such as--
(A) models developed in partnership with national
law enforcement organizations, Indian tribes, or
clinical researchers; and
(B) models that include--
(i) trauma-informed approaches to conflict
resolution, de-escalation, and crisis
intervention training;
(ii) early interventions that link child
and youth witnesses and victims, and their
families as appropriate, to appropriate trauma-
informed services; and
(iii) supporting officers who experience
secondary trauma;
(2) providing professional training and technical
assistance; and
(3) awarding grants under subsection (c).
(c) Grant Program.--
(1) In general.--The Attorney General, acting through the
Center, may award grants to State, local, and tribal law
enforcement agencies or to multi-disciplinary consortia to--
(A) enhance the awareness of best practices
developed under section 101 for trauma-informed
responses to children and youth who have been exposed
to violence or other trauma, and their families as
appropriate; and
(B) provide professional training and technical
assistance in implementing the best practices described
in subparagraph (A).
(2) Application.--Any State, local, or tribal law
enforcement agency seeking a grant under this subsection shall
submit an application to the Attorney General at such time, in
such manner, and containing such information as the Attorney
General may require.
(3) Use of funds.--A grant awarded under this subsection
may be used to--
(A) provide training to law enforcement officers on
the best practices developed under section 101,
including how to identify early signs of trauma and
violence exposure when interacting with children and
youth; and
(B) establish, operate, and evaluate a referral and
partnership program with trauma-informed clinical
mental health, substance use, health care, or social
service professionals in the community in which the law
enforcement agency serves.
(d) Authorization of Appropriations.--There are authorized to be
appropriated to the Attorney General--
(1) $15,000,000 for each of fiscal years 2018 through 2022
to award grants under subsection (c); and
(2) $2,000,000 for each of fiscal years 2018 through 2022
for other activities of the Center.
SEC. 203. ESTABLISHMENT OF NATIVE AMERICAN TECHNICAL ASSISTANCE
RESOURCE CENTER.
(a) Definitions.--In this section:
(1) Indian tribe; tribal organization.--The terms ``Indian
tribe'' and ``tribal organization'' have the meanings given the
terms in section 4 of the Indian Self-Determination and
Education Assistance Act (25 U.S.C. 5304).
(2) 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).
(3) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services, acting--
(A) through the Assistant Secretary for Mental
Health and Substance Use; and
(B) after consultation with--
(i) the Director of the Bureau of Indian
Education of the Department of the Interior;
and
(ii) the Director of the Indian Health
Service.
(b) Establishment of Center.--The Secretary shall establish and
operate a Native American Technical Assistance Resource Center
(referred to in this section as the ``Center'') to provide assistance
to Indian tribes.
(c) Duties.--The Center shall provide assistance to the Indian
tribes by--
(1) providing trauma-informed technical assistance to
tribal organizations in implementing the best practices
developed under section 101; and
(2) disseminating the best practices to the tribal
organizations, to schools that serve students from the Indian
tribes, to health care entities that serve the Indian tribes,
to child welfare systems that serve children and youth from the
Indian tribes, to law enforcement agencies that serve the
Indian tribes, to criminal justice and court systems that serve
the Indian tribes, and other relevant entities.
(d) Grant Program.--
(1) In general.--The Secretary may award grants to
nonprofit organizations or institutions of higher education, to
operate the Center.
(2) Application.--An organization or institution seeking a
grant under this subsection shall submit an application to the
Secretary at such time, in such manner, and containing such
information as the Secretary may require.
(e) Authorization of Appropriations.--There is authorized to be
appropriated to the Secretary, to carry out this section, $2,000,000
for each of fiscal years 2018 through 2021.
SEC. 204. GRANTS TO IMPROVE TRAUMA SUPPORT SERVICES AND MENTAL HEALTH
CARE FOR CHILDREN AND YOUTH IN EDUCATIONAL SETTINGS.
Part A of title IV of the Elementary and Secondary Education Act of
1965 (20 U.S.C. 7101 et seq.) is amended by adding at the end the
following:
``Subpart 3--Grants To Improve Trauma Support Services and Mental
Health Care for Children and Youth in Educational Settings
``SEC. 4131. GRANTS TO IMPROVE TRAUMA SUPPORT SERVICES AND MENTAL
HEALTH CARE FOR CHILDREN AND YOUTH IN EDUCATIONAL
SETTINGS.
``(a) Grants, Contracts, and Cooperative Agreements Authorized.--
The Secretary is authorized to award grants to, or enter into contracts
or cooperative agreements with, State educational agencies, local
educational agencies, Indian tribes or their tribal educational
agencies, a school operated by the Bureau of Indian Education, or a
Regional Corporation (as defined in section 3 of the Alaska Native
Claims Settlement Act (43 U.S.C. 1602)) for the purpose of increasing
student access to quality trauma support services and mental health
care by developing innovative programs to link local school systems
with local trauma-informed support and mental health systems, including
those under the Indian Health Service.
``(b) Duration.--With respect to a grant, contract, or cooperative
agreement awarded or entered into under this section, the period during
which payments under such grant, contract or agreement are made to the
recipient may not exceed 5 years.
``(c) Use of Funds.--An entity that receives a grant, contract, or
cooperative agreement under this section shall use amounts made
available through such grant, contract, or cooperative agreement for
any of the following:
``(1) To enhance, improve, or develop collaborative efforts
between school-based service systems and trauma-informed
support and mental health service systems to provide, enhance,
or improve prevention, screening, referral, and treatment
services to students.
``(2) To enhance the availability of trauma support
services and school-based counseling programs, and provide
appropriate referrals and interventions for students
potentially in need of mental health services.
``(3) To provide universal trauma screenings to identify
students in need of specialized support.
``(4) To implement multi-tiered positive behavioral
interventions and supports, or other trauma-informed models of
support.
``(5) To provide training to teachers, teacher assistants,
specialized instructional support personnel, and mental health
professionals to--
``(A) develop safe, stable, and nurturing learning
environments that prevent and mitigate the effects of
trauma, including through social and emotional
learning; or
``(B) improve school capacity to identify, refer,
and provide services, as appropriate, to students in
need of trauma support or behavioral health services.
``(6) To provide technical assistance and consultation to
school systems and mental health agencies as well as to
families participating in the program carried out under this
section.
``(7) To provide linguistically appropriate and culturally
competent services.
``(8) To evaluate the effectiveness of the program carried
out under this section in increasing student access to quality
trauma support services and mental health care, and make
recommendations to the Secretary about the sustainability of
the program.
``(9) To engage and utilize expertise provided by
institutions of higher education, such as a Tribal College or
University, as defined in section 316(b) of the Higher
Education Act of 1965.
``(10) To provide trainings and implement procedures
pursuant to the relevant best practices developed under section
101 of the Trauma-Informed Care for Children and Families Act
of 2017.
``(d) Applications.--To be eligible to receive a grant, contract,
or cooperative agreement under this section, an entity described in
subsection (a) shall submit an application to the Secretary at such
time, in such manner, and containing such information as the Secretary
may reasonably require, such as the following:
``(1) A description of the program to be funded under the
grant, contract, or cooperative agreement.
``(2) A description of how such program will increase
access to quality trauma support services and mental health
care for students.
``(3) A description of how the applicant will establish
trauma support services or a school-based counseling program,
or both, that provide immediate prevention and mental health
services to the school community as necessary.
``(4) An assurance that--
``(A) persons providing services under the grant,
contract, or cooperative agreement are adequately
trained to provide such services;
``(B) the services will be provided in accordance
with subsection (c);
``(C) teachers, administrators, specialized
instructional support personnel, parents or guardians,
representatives of local Indian tribes, and other
school personnel are aware of the program; and
``(D) parents or guardians of students
participating in services under this section will be
engaged and involved in the design and implementation
of the services.
``(5) An assurance that the applicant will support and
integrate existing school-based services with the program in
order to provide appropriate mental health services for
students.
``(6) An assurance that the applicant will establish a
program that will support students and the school in improving
the school climate in order to support an environment conducive
to learning.
``(e) Interagency Agreements.--
``(1) Designation of lead agency.--A recipient of a grant,
contract, or cooperative agreement under this section shall
designate a lead agency to direct the establishment of an
interagency agreement among local educational agencies,
juvenile justice authorities, mental health agencies, and other
relevant entities in the State, in collaboration with local
entities, such as Indian tribes.
``(2) Contents.--The interagency agreement shall ensure the
provision of the services described in subsection (c),
specifying with respect to each agency, authority, or entity--
``(A) the financial responsibility for the
services;
``(B) the conditions and terms of responsibility
for the services, including quality, accountability,
and coordination of the services; and
``(C) the conditions and terms of reimbursement
among the agencies, authorities, or entities that are
parties to the interagency agreement, including
procedures for dispute resolution.
``(f) Evaluation.--The Secretary shall evaluate each program
carried out under this section and shall disseminate the findings with
respect to each such evaluation to appropriate public, tribal, and
private entities.
``(g) Distribution of Awards.--The Secretary may ensure that
grants, contracts, and cooperative agreements awarded or entered into
under this section are equitably distributed among the geographical
regions of the United States and among tribal, urban, suburban, and
rural populations.
``(h) Rule of Construction.--Nothing in this section shall be
construed--
``(1) to prohibit an entity involved with a program carried
out under this section from reporting a crime that is committed
by a student to appropriate authorities; or
``(2) to prevent State and tribal law enforcement and
judicial authorities from exercising their responsibilities
with regard to the application of Federal, tribal, and State
law to crimes committed by a student.
``(i) Supplement, Not Supplant.--Any services provided through
programs carried out under this section shall supplement, and not
supplant, existing mental health services, including any services
required to be provided under the Individuals with Disabilities
Education Act.
``(j) Consultation With Indian Tribes.--In carrying out subsection
(a), the Secretary shall, in a timely manner, meaningfully consult,
engage, and cooperate with Indian tribes and their representatives to
ensure notice of eligibility.
``(k) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $6,000,000 for the period of
fiscal years 2018 through 2023.''.
TITLE III--UNDERSTANDING THE SCOPE OF TRAUMA EXPOSURE
SEC. 301. CDC SURVEILLANCE AND DATA COLLECTION FOR CHILD, YOUTH, AND
ADULT TRAUMA.
(a) Data Collection.--The Director of the Centers for Disease
Control and Prevention (referred to in this section as the
``Director'') shall authorize and encourage States to collect and
report data on adverse childhood experiences through the Behavioral
Risk Factor Surveillance System and the Youth Risk Behavior
Surveillance System. In collecting and reporting such data, States
shall use the appropriate modules developed under section 302(2)(B), in
addition to other appropriate modules.
(b) Timing.--The collection of data authorized under subsection (a)
may occur in fiscal year 2019 and every 2 years thereafter.
(c) Data From Tribal and Rural Areas.--The Director shall require
that each State, in collecting data in accordance with subsection (a),
ensure that, as appropriate, data from tribal and rural areas within
such State is included by oversampling from such areas.
(d) Authorization of Appropriations.--To carry out this section,
there are authorized to be appropriated $64,000,000 for the period of
fiscal years 2019 through 2021.
SEC. 302. CDC ANALYSIS OF CHILD, YOUTH, AND ADULT TRAUMA.
The Secretary of Health and Human Services, acting through the
Director of the Centers for Disease Control and Prevention, shall--
(1) conduct an analysis of--
(A) the prevalence of child, youth, and adult
trauma experienced in the United States, including
assessments of the types of the most prominent adverse
childhood experiences, and disparities by race and
ethnicity, by geographic distribution, and by
socioeconomic status;
(B) the public health impact of adverse childhood
experiences, including the correlation of such
experiences with trends in life expectancy and whether
the scope of such experiences constitutes a public
health epidemic;
(C) modules that measure and assess adverse
childhood experiences, for development and ultimate
inclusion in the Youth Risk Behavior Surveillance
System; and
(D) outcomes modules that measure and evaluate the
utilization and efficacy of trauma-informed
interventions, such as mental health services or other
clinical or sub-clinical care, for ultimate inclusion
in the Youth Risk Behavior Surveillance System and the
Behavioral Risk Factor Surveillance System; and
(2) not later than 1 year after the date of enactment of
this Act, submit to Congress a report on the analysis under
paragraph (1) that includes recommendations on--
(A) what communities can do to mitigate the impact
of adverse childhood experiences and how Indian tribes,
social service providers, law enforcement, health care
practitioners, public health agencies, educational
institutions, and other community stakeholders may
collaborate to improve efforts to identify, connect to
appropriate services, and provide treatment and support
for children and youth, and their families as
appropriate, who have experienced or are at risk of
experiencing trauma;
(B) modules for inclusion in the appropriate
surveillance systems, as described in subparagraphs (C)
and (D) of paragraph (1); and
(C) how the Centers for Disease Control and
Prevention can utilize data collected through
surveillance systems to target specific populations or
geographic locations with a high incidence of measured
Adverse Childhood Experiences, including by considering
such data when awarding grants and contracts to
entities serving such populations or locations.
SEC. 303. GOVERNMENT ACCOUNTABILITY STUDY ON BARRIERS TO AND
OPPORTUNITIES FOR TRAUMA-INFORMED IDENTIFICATION AND
TREATMENT.
(a) Study.--
(1) In general.--The Comptroller General shall conduct a
study of the barriers to, and the opportunities for increasing,
the early identification and treatment of children and youth,
and their families as appropriate, who have experienced or are
at risk of experiencing trauma.
(2) Contents.--In conducting the study, the Comptroller
General shall examine--
(A) ways in which such identification and treatment
could be facilitated in early childhood education and
care settings and elementary and secondary schools,
such as through improved teacher preparation,
professional development, and curriculum design, and
the development of the cognitive and social-emotional
skills of students;
(B)(i) the extent to which State Medicaid plans use
early and periodic screening, diagnostic, and treatment
services (as defined in section 1905(r) of the Social
Security Act (42 U.S.C. 1396d(r)) that are provided in
accordance with the requirements of section 1902(a)(43)
of such Act (42 U.S.C. 1396a(a)(43))) to provide
trauma-informed services to children and youth, and
their families as appropriate, who have experienced or
are at risk of experiencing trauma;
(ii) barriers to increased utilization of such
screening, diagnostic, and treatment services; and
(iii) the impact of State Medicaid plan design and
State regulatory decisions on the provision of such
services;
(C) the feasibility of, State experiences with, and
considerations regarding, systematic collection and
sharing of data that--
(i) is carried out by health care
providers, State, local, and tribal educational
agencies, social service providers, law
enforcement, and any other entity providing
services in a covered setting (as defined in
section 101(f));
(ii) relies on common data measures,
fosters communication and coordination across
covered settings (as so defined), and promotes
shared accountability for the data; and
(iii) relates to the screening, referral,
and support of children and youth, and their
families as appropriate, who have experienced
or are at risk of experiencing trauma;
(D) privacy and consent issues affecting
identification and treatment of children and youth who
have experienced or are at risk of experiencing trauma,
including considerations regarding information
collected and reported by providers and regarding
parental consent;
(E)(i) the comprehensive, coordinated, and
multisector process through which State, local, and
tribal educational agencies locate, identify, and
screen infants and toddlers with disabilities, and
children with disabilities (including such children who
are youth), under the Individuals with Disabilities
Education Act (20 U.S.C. 1400 et seq.); and
(ii) considerations, strategies, alignment
opportunities, and applicability for trauma-informed
models for conducting such location, identification,
and screening;
(F)(i) clinical child and adolescent mental health
and child- and youth-serving social service workforce
capacity, including analyzing that capacity by setting,
geographic distribution, and population served; and
(ii) barriers that contribute to any shortages in
professionals in that workforce; and
(G) the cost-effectiveness and success of providing
services through school-based health centers as a
method of--
(i) addressing the needs of students who
have experienced or are at risk of experiencing
trauma; and
(ii) improving their academic achievement.
(b) Report.--The Comptroller General shall submit a report
containing the results of the study to--
(1) the Committee on Appropriations, the Committee on
Health, Education, Labor, and Pensions, the Committee on
Finance, the Committee on Indian Affairs, and the Committee on
the Judiciary of the Senate; and
(2) the Committee on Appropriations, the Committee on
Energy and Commerce, the Committee on Education and the
Workforce, the Committee on Ways and Means, the Committee on
Natural Resources, and the Committee on the Judiciary of the
House of Representatives.
(c) Definitions.--In this section:
(1) Child with a disability.--The term ``child with a
disability'' has the meaning given the term in section 602 of
the Individuals with Disabilities Education Act (20 U.S.C.
1401).
(2) Infant or toddler with a disability.--The term ``infant
or toddler with a disability'' has the meaning given the term
in section 632 of the Individuals with Disabilities Education
Act (20 U.S.C. 1432).
SEC. 304. NIH REPORT ON TRAUMA.
The Director of the National Institutes of Health, not later than 1
year after the date of enactment of this Act, shall submit to Congress
a report on the activities of the National Institutes of Health with
respect to trauma (including trauma that stems from child abuse,
exposure to violence, and toxic stress) and the implications of trauma
for children, youth, and adults. Such report shall include--
(1) the comprehensive research agenda of the National
Institutes of Health with respect to trauma;
(2) the capacity, expertise, and review mechanisms of the
National Institutes of Health with respect to the evaluation
and examination of research proposals related to child trauma,
including coordination across institutes and centers;
(3) the relevance of trauma to other diseases, outcomes,
and domains;
(4) strategies to link and analyze data from multiple
independent sources, including child welfare, health care
(including mental health care), law enforcement, and education
systems, to enhance research efforts and improve health
outcomes;
(5) the efficacy of existing interventions, including
clinical treatment methods, child- and family-focused
prevention models, and community-based approaches, in
mitigating the effects of experiencing trauma and improving
health and societal outcomes; and
(6) identification of gaps in understanding in the field of
trauma and areas of greatest need for further research related
to trauma.
TITLE IV--EVALUATION OF NEW INTERVENTIONS AND IMPROVING SERVICE
DELIVERY
SEC. 401. CLARIFICATION OF DEFINITION OF MEDICAID EPSDT SERVICES;
DEMONSTRATION PROJECT TO TEST TRAUMA-INFORMED DELIVERY OF
EPSDT SERVICES.
(a) Clarification of Definition of EPSDT Services.--Section 1905(r)
of the Social Security Act (42 U.S.C. 1396d(r)) is amended--
(1) in paragraph (1)--
(A) in subparagraph (A)(ii), by inserting
``(including in the immediate aftermath of exposure to
a traumatic event)'' after ``medically necessary''; and
(B) in subparagraph (B)(i), by inserting ``and any
past exposure to traumatic events'' after ``health
development''; and
(2) in paragraph (5), by inserting ``including any defects,
illnesses, and conditions (including symptoms of a possible
mental health disorder that are not sufficiently acute for a
diagnosis of a clinical mental health disorder) stemming from
exposure to traumatic events,'' after ``screening services,''.
(b) Trauma-Informed Delivery of EPSDT Services Demonstration
Project.--
(1) In general.--The Secretary shall make grants to States
to conduct demonstration projects under title XIX of the Social
Security Act (42 U.S.C. 1396 et seq.) to test innovative,
trauma-informed approaches for delivering early and periodic
screening, diagnostic, and treatment services (as defined in
section 1905(r) of the Social Security Act (42 U.S.C.
1396d(r))) to eligible children.
(2) Scope and duration.--
(A) Scope.--The Secretary shall select 10 States to
participate in the demonstration project.
(B) Selection.--
(i) Diversity.--In selecting States to
participate in the demonstration project, the
Secretary shall--
(I) ensure that geographically
diverse areas, including rural and
underserved areas, are included; and
(II) include at least 2 States in
which Indian tribes or tribal
organizations (as defined in section 4
of the Indian Health Care Improvement
Act (25 U.S.C. 1603)) are located.
(ii) Priority.--In selecting States to
participate in the demonstration project, the
Secretary shall give priority to States that--
(I) use a value-based payment
methodology for paying providers for
services provided under the State
Medicaid program, including services
related to healthy child development;
(II) use an alternative payment
model under the State Medicaid program
that enables cross-sector
collaboration, provision of trauma-
informed services, and supports for
healthy child development; or
(III) integrate information
technology between child- and youth-
serving sectors to improve coordination
and outcomes.
(C) Duration.--The demonstration project shall
begin not later than 1 year after the date of the
enactment of this Act, and shall be conducted for a
period of 4 years.
(3) Requirements.--To be eligible for a grant under this
subsection, a State that is participating in the demonstration
project shall demonstrate that it has implemented the following
measures with respect to the State Medicaid program:
(A) The State Medicaid program allows for the
provision of early and periodic screening, diagnostic,
and treatment services--
(i) in a diverse set of settings, including
schools, hospitals, primary care settings,
Federally-qualified health centers (as defined
in section 1905(l)(2)(B) of the Social Security
Act (42 U.S.C. 1396d(l)(2)(B))), and tribally-
operated health facilities, without undue
restrictions on the settings in which providers
are permitted to furnish such services; and
(ii) by the full scope of providers that
are licensed or otherwise authorized under
State law to provide the services, including
trained peers through eligible peer support
services, community health workers, or
subclinical case managers.
(B) Where necessary to improve or promote the
health of an eligible child, the State Medicaid program
provides for payment for services provided to the
parent of the child.
(C) The State Medicaid program has procedures in
place to coordinate across settings, which may include
coordinating with law enforcement, juvenile justice
agencies, schools (including preschools and after-
school programs), hospitals, primary care providers,
tribally-operated health facilities, mental health and
substance use treatment facilities, and child welfare
providers, to ensure that eligible children who
experience trauma receive the appropriate services.
(D) Where appropriate, the State Medicaid program
coordinates with facilities of the Indian Health
Service (including a hospital, nursing facility, or any
other type of facility which provides services of a
type otherwise covered under the program) and other
tribally-operated health facilities to ensure eligible
children have access to adequate qualified providers
that are licensed or otherwise authorized under State
law to furnish the services.
(4) Funding.--Out of any funds in the Treasury not
otherwise appropriated, there is appropriated $75,000,000 for
the period of fiscal years 2017 through 2021 to carry out this
subsection.
(5) Definitions.--In this subsection:
(A) Demonstration project.--The term
``demonstration project'' means the demonstration
project established under this subsection.
(B) Eligible child.--The term ``eligible child''
means an individual who is under age 21 and who is
enrolled in a State plan under title XIX of the Social
Security Act (42 U.S.C. 1396 et seq.).
(C) Secretary.--The term ``Secretary'' means the
Secretary of Health and Human Services.
(D) State medicaid program.--The term ``State
Medicaid program'' means a State plan or waiver under
title XIX of the Social Security Act (42 U.S.C. 1396 et
seq.).
SEC. 402. HEALTH PROFESSIONAL SHORTAGE AREAS.
Section 332(a) of the Public Health Service Act (42 U.S.C. 254e(a))
is amended--
(1) in paragraph (2)(A), by inserting ``(including a
community health center operated in an elementary or secondary
school)'' after ``community health center''; and
(2) in paragraph (3)--
(A) by striking ``, and residents'' and inserting
``, residents''; and
(B) by inserting ``, and a population group that
the Secretary determines has experienced trauma (such
as through acute or long-term exposure to substantial
discrimination, historical or cultural oppression,
intergenerational poverty, civil unrest, a high rate of
violence, or a high rate of drug overdose mortality)''
before ``may be''.
SEC. 403. TRAINING AND CERTIFICATION GUIDELINES FOR COMMUNITY FIGURES.
The Secretary of Health and Human Services, acting through the
Administrator of the Agency for Healthcare Research and Quality, shall
conduct a study on, and establish guidelines for States to consider
with respect to, the training and certification of community figures,
including community mentors, peers with lived experiences, and faith-
based leaders, to build awareness of trauma and promote linkages to
community services, provide case management services, and conduct
appropriate trauma-informed screening for individuals who have
experienced or are at risk of experiencing trauma. Such training and
certification guidelines shall include recommendations for experience,
education, and supervision requirements for, and partnerships between,
such trained and certified community figures and other health care
providers such that the trained and certified community figures may be
reimbursed through the State Medicaid plan under title XIX of the
Social Security Act (42 U.S.C. 1396 et seq.) for furnishing services to
individuals enrolled in such plan.
SEC. 404. TRAINING FOR HEALTH CARE WORKFORCE.
(a) Mental and Behavioral Health Education and Training Program.--
Section 756 of the Public Health Service Act (42 U.S.C. 294e-1) is
amended--
(1) in subsection (a)--
(A) in paragraph (1), by inserting ``, trauma,''
after ``focus on child and adolescent mental health'';
and
(B) in paragraphs (2) and (3), by inserting
``trauma-informed care and'' before ``substance use
disorder prevention and treatment services''; and
(2) in subsection (d)--
(A) in paragraph (1), by striking ``and'' at the
end;
(B) in paragraph (2), by striking the period and
inserting ``; and''; and
(C) by adding at the end the following:
``(3) programs with academic study and community practice
related to trauma, its impact on mental and behavioral health
outcomes, and appropriate interventions, which may include best
practices developed under section 101 of the Trauma-Informed
Care for Children and Families Act of 2017.''.
(b) Training Demonstration Program.--Section 760 of such Act (42
U.S.C. 294k) is amended--
(1) in subsection (a)--
(A) in paragraphs (1) and (2), by inserting
``trauma-informed'' after ``integrate''; and
(B) in paragraph (3)(A), by inserting ``, and
recognize and address the impacts of experiencing
trauma on children, youth, and families'' before the
semicolon;
(2) in subsection (b)--
(A) in paragraph (1)(A)--
(i) in clause (i)(II), by inserting
``trauma-informed'' after ``integrated''; and
(ii) in clause (ii)(III), by inserting
``trauma-informed'' before ``treatment''; and
(B) in paragraph (2)(A), by inserting ``trauma-
informed'' after ``integrate'';
(3) in subsection (c)(1)(B), by inserting ``trauma-
informed'' after ``integrate''; and
(4) in subsection (d)--
(A) in paragraph (1)--
(i) in subparagraph (C), by striking ``or''
at the end;
(ii) in subparagraph (D), by striking the
period and inserting ``; or''; and
(iii) by adding at the end the following:
``(E) provide training with academic study and
community practice related to trauma, its impact on
mental health outcomes, and appropriate interventions,
which may include best practices developed under
section 101 of the Trauma-Informed Care for Children
and Families Act of 2017.''; and
(B) in paragraph (2)--
(i) in subparagraph (D), by striking ``or''
at the end;
(ii) in subparagraph (E), by striking the
period and inserting ``; or''; and
(iii) by adding at the end the following:
``(F) provide training with academic study and
community practice related to trauma, its impact on
mental health outcomes, and appropriate interventions,
which may include best practices developed under
section 101 of the Trauma-Informed Care for Children
and Families Act of 2017.''.
SEC. 405. TRAUMA-RELATED COORDINATING BODIES.
Part G of title V of the Public Health Service Act (42 U.S.C. 290hh
et seq.) is amended by adding at the end the following:
``SEC. 583. TRAUMA-RELATED COORDINATING BODIES.
``(a) Grants.--
``(1) In general.--The Secretary, acting through the
Administrator, shall make not more than 20 grants for
demonstration projects to State, local, or tribal eligible
entities to act as trauma-related coordinating bodies.
``(2) Amount.--The Secretary shall make such a grant in an
amount of not more than $4,000,000.
``(3) Duration.--The Secretary shall make such a grant for
a period of 4 years.
``(b) Eligible Entities.--
``(1) In general.--To be eligible to receive a grant under
this section, an entity shall include 1 or more representatives
of each of the categories described in paragraph (2).
``(2) Composition.--The categories referred to in paragraph
(1) are--
``(A) agencies, such as public health or child
welfare agencies, that provide services to prevent the
impact of trauma among, identify, refer for services,
or support (including providing treatment for) children
and youth, and their families as appropriate, that have
experienced or are at risk of experiencing trauma;
``(B) faculty at an institution of higher
education, or researchers or experts, in an area
related to prevention of the impact of, identification
of, referral for services for, or support (including
treatment) for child and youth trauma;
``(C) hospitals or other health care institutions,
such as mental health and substance use treatment
facilities;
``(D) law enforcement;
``(E) elementary or secondary schools, or early
childhood education or care programs;
``(F) community-based faith, human services, or
social services organizations, including providers of
after-school programs, home visiting programs, or
programs to prevent or address the impact of violence;
and
``(G) the general public, including individuals who
have experienced trauma.
``(3) Qualifications.--In order for an entity to be
eligible to receive the grant, the representatives included in
the entity shall, collectively, have professional training and
expertise concerning a broad range of adverse childhood
experiences.
``(c) Application.--To be eligible to receive a grant under this
section, an entity shall submit an application to the Secretary at such
time, in such manner, and containing such information as the Secretary
may require, including information describing how the coordinating body
will continue its activities after the end of the grant period.
``(d) Priority.--In making grants under this section, the Secretary
shall give priority to entities proposing to serve communities that
have faced trauma due to substantial discrimination, historical or
cultural oppression, intergenerational poverty, civil unrest, a high
rate of violence, or a high rate of drug overdose mortality.
``(e) Use of Funds.--An entity that receives a grant under this
section to act as a coordinating body shall use the grant funds--
``(1) to bring together stakeholders who provide or use
services in, or have expertise concerning, covered settings to
identify community needs and resources related to services to
prevent or address the impact of trauma, and to build on any
needs assessments conducted by organizations or groups
represented on the coordinating body;
``(2)(A) to collect data, on indicators specified by the
Secretary, that covers multiple covered settings; and
``(B) to use the data to identify unique community
challenges, gaps in services, and high-need areas, related to
services to prevent or address the impact of trauma;
``(3) to build awareness, skills, and leadership (including
through trauma-informed training and public outreach campaigns)
related to implementing the best practices developed under
section 101 of the Trauma-Informed Care for Children and
Families Act of 2017 (referred to in this subsection as the
`developed best practices');
``(4) to pool resources of the members of the organizations
and groups represented on the coordinating body, related to
implementing the developed best practices; and
``(5) to develop a strategic plan that identifies--
``(A) barriers to and gaps in the provision of
services to prevent or address the impact of trauma;
and
``(B) policy goals and coordination opportunities
(including coordination in applying for grants)
relating to implementing the developed best practices.
``(f) Supplement Not Supplant.--Amounts made available under this
section shall be used to supplement and not supplant other Federal,
State, and local public funds and private funds expended to provide
trauma-related coordination activities.
``(g) Evaluation.--At the end of the period for which grants are
made under this section, the Secretary shall conduct an evaluation of
the activities carried out under each grant under this section. In
conducting the evaluation, the Secretary shall assess the outcomes of
the grant activities carried out by each grant recipient.
``(h) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $80,000,000 for the period of
fiscal years 2018 through 2021.
``(i) Definition.--In this section, the term `covered setting' has
the meaning given the term in section 101(f) of the Trauma-Informed
Care for Children and Families Act of 2017.''.
SEC. 406. EXPANSION OF PERFORMANCE PARTNERSHIP PILOT FOR CHILDREN WHO
HAVE EXPERIENCED OR ARE AT RISK OF EXPERIENCING TRAUMA.
Section 526 of the Departments of Labor, Health and Human Services,
and Education, and Related Agencies Appropriations Act, 2014 (42 U.S.C.
12301 note) is amended--
(1) in subsection (a), by adding at the end the following:
``(4) `To improve outcomes for children and youth, and
their families as appropriate, who have experienced or are at
risk of experiencing trauma' means to increase the rate at
which individuals who have experienced or are at risk of
experiencing trauma, including those who are low-income,
homeless, in foster care, involved in the juvenile justice
system, unemployed, or not enrolled in or at risk of dropping
out of an educational institution and live 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, achieve
success in meeting educational, employment, health,
developmental, community reentry, or other key goals.'';
(2) in subsection (b)--
(A) in the subsection heading, by striking ``Fiscal
Year 2014'' and inserting ``Fiscal Years 2018 Through
2022'';
(B) by redesignating paragraphs (1) and (2) as
subparagraphs (A) and (B), respectively, and by moving
such subparagraphs, as so redesignated, 2 ems to the
right;
(C) by striking ``Federal agencies'' and inserting
the following:
``(1) Disconnected youth pilots.--Federal agencies''; and
(D) by adding at the end the following:
``(2) Trauma-informed care pilots.--Federal agencies may
use Federal discretionary funds that are made available in this
Act or any Act appropriating funds for any of fiscal years 2018
through 2022 to carry out up to 10 Performance Partnership
Pilots. Such Pilots shall--
``(A) be designed to improve outcomes for children
and youth, and their families as appropriate, who have
experienced or are at risk of experiencing trauma; and
``(B) involve Federal programs targeted on children
and youth, and their families as appropriate, who have
experienced or are at risk of experiencing trauma.'';
(3) in subsection (c)(2)(A), by striking ``2018'' and
inserting ``2022''; and
(4) in subsection (e), by striking ``2018'' and inserting
``2022''.
SEC. 407. TRAUMA-INFORMED TEACHING.
(a) Partnership Grants.--Section 202 of the Higher Education Act of
1965 (20 U.S.C. 1022a) is amended--
(1) in subsection (b)(6)--
(A) by redesignating subparagraphs (H) through (K)
as subparagraphs (I) through (L), respectively; and
(B) by inserting after subparagraph (G) the
following:
``(H) how the partnership will prepare general
education and special education teachers to work with
students who have experienced trauma (including
students who are involved in the foster care or
juvenile justice systems or runaway or homeless youth)
and in alternative education settings in which high
populations of youth with trauma exposure may learn
(including settings for correctional education,
juvenile justice, pregnant and parenting students, or
youth who have re-entered school after a period of
absence due to dropping out);'';
(2) in subsection (d)(1)(A)(i)--
(A) in subclause (II), by striking ``and'' at the
end;
(B) by redesignating subclause (III) as subclause
(IV); and
(C) by inserting after subclause (II) the
following:
``(III) such teachers to adopt
evidence-based approaches for improving
behavior (such as positive behavior
interventions and supports and
restorative justice), supporting social
and emotional learning, mitigating the
effects of trauma, improving the
learning environment in the school, and
for reducing the need for suspensions,
expulsions, corporal punishment,
referrals to law enforcement, and other
actions that remove students from
instruction; and''; and
(3) in subsection (d), by adding at the end the following:
``(7) Trauma-informed practice and work in alternative
education settings.--Developing the teaching skills of
prospective and, as applicable, new elementary school and
secondary school teachers to adopt evidence-based trauma-
informed teaching strategies--
``(A) to--
``(i) recognize the signs of trauma and its
impact on learning;
``(ii) maximize student engagement; and
``(iii) minimize suspension and expulsion;
and
``(B) including programs training teachers to work
with students with exposure to traumatic events
(including students involved in the foster care or
juvenile justice systems) and in alternative academic
settings for youth unable to participate in a
traditional public school program in which high
populations of students with trauma exposure may learn
(such as students involved in the foster care or
juvenile justice systems, pregnant and parenting
students, runaway and homeless students, and other
youth who have re-entered school after a period of
absence due to dropping out).''.
(b) Administrative Provisions.--Section 203(b)(2) of the Higher
Education Act of 1965 (20 U.S.C. 1022b(b)(2)) is amended--
(1) in subparagraph (A), by striking ``and'' at the end;
(2) in subparagraph (B), by striking the period at the end
and inserting ``; and''; and
(3) by adding at the end the following:
``(C) to eligible partnerships that have a high-
quality proposal for trauma training programs for
general education and special education teachers.''.
<all>
Introduced in Senate
Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
Llama 3.2 · runs locally in your browser
Ask anything about this bill. The AI reads the full text to answer.
Enter to send · Shift+Enter for new line