[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[S. 380 Introduced in Senate (IS)]

113th CONGRESS
  1st Session
                                 S. 380

 To amend the Public Health Service Act to reauthorize and update the 
 National Child Traumatic Stress Initiative for grants to address the 
  problems of individuals who experience trauma and violence related 
                                stress.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           February 26, 2013

  Mrs. Murray introduced the following bill; which was read twice and 
  referred to the Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
 To amend the Public Health Service Act to reauthorize and update the 
 National Child Traumatic Stress Initiative for grants to address the 
  problems of individuals who experience trauma and violence related 
                                stress.

    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 ``Children's Recovery from Trauma 
Act''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) According to a 2002 Government Accountability Office 
        report (GAO-02-813), large numbers of children experience 
        trauma-related mental health problems, while at the same time 
        facing barriers to receiving appropriate mental health care.
            (2) According to the National Institute of Mental Health, 
        only 36 percent of youth with any mental disorder received 
        services, and only half of these youth who were severely 
        impaired by their mental disorder received any professional 
        mental health treatment. Of those with anxiety disorders 
        (including post traumatic stress disorder), only 18 percent 
        received services. Half of all lifetime cases of mental illness 
        begin by age 14, and that despite effective treatments that 
        have been developed, there are long delays, sometimes decades, 
        between first onset of symptoms and when treatment is obtained.
            (3) Findings from the Adverse Childhood Experiences Study 
        have shown that adverse childhood experiences predispose 
        children towards negative trajectories from infancy to 
        adulthood.
            (4) The 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 one or more 
        traumatic events, such as child maltreatment, domestic 
        violence, or sexual assault (Copeland et al, 2007).
            (5) According to the National Institute of Mental Health, 
        the lifetime prevalence of post-traumatic stress disorder for 
        13 to 18 year olds is 4 to 6 percent (NIMH, 2010). In 2007, the 
        National Institute of Mental Health reported that adults who 
        were abused or neglected as children have increased risk of 
        major depression, often beginning in childhood with long-
        lasting effects.
            (6) According to the Department of Defense, more than 
        700,000 children have experienced one or more parental 
        deployments. Children's reactions to a parent's deployment vary 
        by a child's developmental stage, age, and presence of any 
        preexisting psychological or behavioral problems. The mental 
        health of the parent is often a key factor affecting the 
        child's distress level. Parents reporting clinically 
        significant stress are more likely to have children identified 
        as high risk for psychological and behavioral problems.
            (7) The National Intimate Partner and Sexual Violence 
        Survey revealed that nearly 1 in 5 women reported having been 
        the victim of a rape at some time during their lives. Forty-two 
        percent experienced their first rape before the age of 18.
            (8) The National Child Traumatic Stress Network collected 
        data on 14,088 children and adolescents served by 56 Network 
        service centers across the country from 2004 to 2010, examining 
        the prevalence of exposure to a wide range of trauma types, 
        access to services, and child outcomes outcome. Nearly 80 
        percent of children referred for screening and evaluation 
        reported experiencing at least one type of traumatic event. Of 
        the 11,104 children and adolescents who reported trauma 
        exposure, 77 percent had experienced more than one type of 
        trauma and 31 percent had experienced five or more types.
            (9) The children served by the National Child Traumatic 
        Stress Network are involved with many different kinds of child-
        serving systems. Of those receiving service, 65 percent had 
        received social services and 35 percent had received school-
        based services. After treatment, significant improvements were 
        made in trauma symptoms, mental health diagnoses, and 
        behavioral problems.

SEC. 3. GRANTS TO ADDRESS THE PROBLEMS OF INDIVIDUALS WHO EXPERIENCE 
              TRAUMA AND VIOLENCE RELATED STRESS.

    Section 582 of the Public Health Service Act (42 U.S.C. 290hh-1) is 
amended to read as follows:

``SEC. 582. GRANTS TO ADDRESS THE PROBLEMS OF INDIVIDUALS WHO 
              EXPERIENCE TRAUMA AND VIOLENCE RELATED STRESS.

    ``(a) In General.--The Secretary shall award grants, contracts or 
cooperative agreements to public and nonprofit private entities, as 
well as to Indian tribes and tribal organizations, for the purpose of 
developing and maintaining programs that provide for--
            ``(1) the continued operation of the National Child 
        Traumatic Stress Initiative (referred to in this section as the 
        `NCTSI') that focus on the mental, behavioral, and biological 
        aspects of psychological trauma response; and
            ``(2) the development of knowledge with regard to evidence-
        based practices for identifying and treating mental, 
        behavioral, and biological disorders of children and youth 
        resulting from witnessing or experiencing a traumatic event.
    ``(b) Priorities.--In awarding grants, contracts or cooperative 
agreements under subsection (a)(2) (related to the development of 
knowledge on evidence-based practices for treating mental, behavioral, 
and biological disorders associated with psychological trauma), the 
Secretary shall give priority to universities, hospitals, mental health 
agencies, and other community-based child-serving programs that have 
established clinical and research experience in the field of trauma-
related mental disorders.
    ``(c) Child Outcome Data.--The NCTSI coordinating center shall 
collect, analyze, and report NCTSI-wide child outcome and process data 
for the purpose of establishing the effectiveness, implementation, and 
clinical utility of early identification and delivery of evidence-based 
treatment and services delivered to children and families served by the 
NCTSI grantees.
    ``(d) Training.--The NCTSI coordinating center shall oversee the 
continuum of interprofessional training initiatives in evidence-based 
and trauma-informed treatments, interventions, and practices offered to 
NCTSI grantees and providers in all child-serving systems.
    ``(e) Dissemination.--The NCTSI coordinating center shall 
collaborate with the Secretary in the dissemination of evidence-based 
and trauma-informed interventions, treatments, products, and other 
resources to all child-serving systems and policymakers.
    ``(f) Review.--The Secretary shall establish consensus-driven, in-
person or teleconference review of NCTSI applications by child trauma 
experts and review criteria related to expertise and experience related 
to child trauma and evidence-based practices.
    ``(g) Geographical Distribution.--The Secretary shall ensure that 
grants, contracts or cooperative agreements under subsection (a) are 
distributed equitably among the regions of the United States and among 
urban and rural areas. Notwithstanding the previous sentence, expertise 
and experience in the field of trauma-related disorders shall be 
prioritized in the awarding of such grants are required under 
subsection (b).
    ``(h) Evaluation.--The Secretary, as part of the application 
process, shall require that each applicant for a grant, contract or 
cooperative agreement under subsection (a) submit a plan for the 
rigorous evaluation of the activities funded under the grant, contract 
or agreement, including both process and outcome evaluation, and the 
submission of an evaluation at the end of the project period.
    ``(i) Duration of Awards.--With respect to a grant, contract or 
cooperative agreement under subsection (a), the period during which 
payments under such an award will be made to the recipient shall be 6 
years. Such grants, contracts or agreements may be renewed. Expertise 
and experience in the field of trauma-related disorders shall be a 
priority for new and continuing awards.
    ``(j) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $100,000,000 for fiscal year 
2014, and such sums as may be necessary for each of fiscal years 2015 
through 2024.''.
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