[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[S. 3031 Introduced in Senate (IS)]

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114th CONGRESS
  2d Session
                                S. 3031

  To require certain standards and enforcement provisions to prevent 
    child abuse and neglect in residential programs, and for other 
                               purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              June 8, 2016

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

_______________________________________________________________________

                                 A BILL


 
  To require certain standards and enforcement provisions to prevent 
    child abuse and neglect in residential programs, 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 ``Stop Child Abuse in Residential 
Programs for Teens Act of 2016''.

SEC. 2. DEFINITIONS.

    In this Act:
            (1) Child.--The term ``child'' means an individual who has 
        not attained the age of 18.
            (2) Child abuse and neglect.--The term ``child abuse and 
        neglect'' has the meaning given such term in section 3 of the 
        Child Abuse Prevention and Treatment Act (42 U.S.C. 5101 note).
            (3) Covered program.--
                    (A) In general.--The term ``covered program'' means 
                a program (including the portion of a program at each 
                affiliated facility) that is operated by a public or 
                private entity and that, with respect to one or more 
                children who are unrelated to the owner or operator of 
                the program, purports to provide treatment or modify 
                behaviors in a residential environment, such as--
                            (i) a program with a wilderness or outdoor 
                        experience, expedition, or intervention;
                            (ii) a boot camp experience or other 
                        experience designed to simulate characteristics 
                        of basic military training or correctional 
                        regimes;
                            (iii) a therapeutic boarding school; or
                            (iv) a behavioral modification program.
                    (B) Exclusion.--The term ``covered program'' does 
                not include--
                            (i) a hospital licensed by the State; or
                            (ii) a foster family home or foster group 
                        home that provides 24-hour substitute care for 
                        children placed away from their parents or 
                        guardians and for whom the State child welfare 
                        services agency has placement and care 
                        responsibility and that is licensed and 
                        regulated by the State as a foster family home 
                        or foster group home.
            (4) Licensed clinician.--The term ``licensed clinician'' 
        means such a clinician, as defined by State law.
            (5) Mechanical restraint.--The term ``mechanical 
        restraint'' has the meaning given the term in section 595(d)(1) 
        of the Public Health Service Act (42 U.S.C. 290jj(d)(1)).
            (6) Mental health practitioner.--The term ``mental health 
        practitioner'' means such a practitioner, as defined by State 
        law.
            (7) Physical restraint.--The term ``physical restraint'' 
        means a personal restriction on an individual that immobilizes 
        or reduces the ability of the individual to move freely the 
        individual's arms, legs, torso, or head, except that such term 
        does not include voluntary physical escort (as such term is 
        defined in section 595(d)(2) of the Public Health Service Act 
        (42 U.S.C. 290jj(d)(2))).
            (8) Protection and advocacy system.--The term ``protection 
        and advocacy system'' means a system established by a State 
        under section 143 of the Developmental Disabilities Assistance 
        and Bill of Rights Act of 2000 (42 U.S.C. 15043).
            (9) Seclusion.--The term ``seclusion'' means the 
        involuntary confinement of a child alone in a room or area from 
        which the child is physically prevented from leaving.
            (10) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
            (11) Staff member.--The term ``staff member'' includes a 
        volunteer and an applicant to be a staff member.
            (12) State.--The term ``State'' has the meaning given such 
        term in section 3 of the Child Abuse Prevention and Treatment 
        Act (42 U.S.C. 5101 note).

SEC. 3. STANDARDS AND ENFORCEMENT.

    (a) Minimum Standards.--
            (1) In general.--Not later than 180 days after the date of 
        enactment of this Act, the Secretary shall require each covered 
        program in a State, in order to provide for the basic health 
        and safety of children at such a program and in order for the 
        State to remain eligible as described in section 114(b) of the 
        Child Abuse Prevention and Treatment Act (as added by section 7 
        of this Act), to meet the following minimum standards:
                    (A) Prohibition on child abuse and neglect.--Child 
                abuse and neglect shall be prohibited.
                    (B) Prohibition on certain disciplinary 
                techniques.--Disciplinary techniques or other practices 
                that involve the withholding of essential food, water, 
                clothing, shelter, or medical care necessary to 
                maintain physical health, mental health, and general 
                safety, shall be prohibited.
                    (C) Prohibition on physical or mental abuse.--Acts 
                of physical or mental abuse designed to humiliate or 
                degrade a child, or undermine a child's self-respect, 
                shall be prohibited.
                    (D) Limitation on restraints and seclusion.--
                            (i) Certain restraints and seclusion.--The 
                        use of seclusion, mechanical restraints, and 
                        physical restraints that impair breathing or 
                        communication shall be prohibited.
                            (ii) Physical restraints in emergencies.--
                        Physical restraints other than the restraints 
                        described in clause (i) may be used (if not 
                        contraindicated) only in emergency situations 
                        in which a child presents an imminent danger of 
                        harm to self or others and only after less 
                        restrictive interventions have been determined 
                        to be ineffective.
                    (E) Access to communications.--Each child at such a 
                program--
                            (i) shall have reasonable access to a 
                        telephone and means for electronic and written 
                        communications, and be informed of the child's 
                        right to such access, to maintain frequent 
                        contact with parents or guardians, including 
                        making, sending, and receiving scheduled and 
                        unscheduled calls, unrestricted written 
                        correspondence, and electronic communications, 
                        with as much privacy as possible; and
                            (ii) shall have access to current and 
                        appropriate national, State, and local hotline 
                        numbers for reporting child abuse and neglect.
                    (F) Staff-to-child ratio.--The program shall have 
                appropriate ratios of medical, clinical, and line staff 
                members to children, as determined by the Secretary, to 
                ensure child safety and the efficacy of treatment.
                    (G) Senior management.--Not less than one full-time 
                licensed clinician or mental health practitioner shall 
                be employed as a senior manager of the program.
                    (H) Licensed clinician.--Not less than one licensed 
                clinician shall be present at all times for the 
                program. The licensed clinician may be on call unless 
                having such a clinician physically present is necessary 
                to ensure safety and clinically appropriate care.
                    (I) Program policies.--The program shall have 
                policies to require--
                            (i) parents or guardians of a child 
                        attending such a program to notify, in writing, 
                        such program of any medication the child is 
                        taking;
                            (ii) a full-time licensed clinician--
                                    (I) to obtain consent from the 
                                parents or guardians of the child to 
                                make any change to the child's medical 
                                treatment, except in the case of an 
                                emergency;
                                    (II) in the case of an emergency, 
                                to notify the parents or guardians 
                                within 24 hours after any change to the 
                                child's medical treatment, to describe 
                                the change and the reason for such 
                                change; and
                                    (III) to notify the parents or 
                                guardians within 24 hours after any 
                                change to the child's prescribed 
                                medication or any occurrence of a 
                                missed dose of prescribed medication, 
                                to describe the change or occurrence 
                                and the reason for such change or 
                                occurrence; and
                            (iii) the covered program to notify parents 
                        or guardians of a child of any change to the 
                        program's treating provider team within 48 
                        hours after the change.
                    (J) Notification procedures.--The program shall 
                have procedures for notifying immediately, to the 
                maximum extent practicable, but not later than 6 hours 
                after the occurrence involved, parents or guardians of 
                a child at such a program and the appropriate 
                protection and advocacy system of any occurrence of 
                an--
                            (i) onsite investigation of a report of 
                        child abuse and neglect;
                            (ii) violation of a standard described in 
                        any of subparagraphs (A) through (D); and
                            (iii) violation of a State licensing 
                        requirement.
                    (K) Staff member disclosures.--Full disclosure, in 
                writing, of staff member qualifications and their roles 
                and responsibilities at such a program, including any 
                medical, emergency response, and mental health training 
                received by such staff members, shall be given to 
                parents or guardians of children at such a program.
                    (L) Disclosure of right of action.--Full 
                disclosure, in writing, of the private right of action 
                established under subsection (b)(3), shall be given to 
                parents or guardians of children at such a program.
                    (M) Child abuse and neglect response training.--
                Each staff member at such a program shall be required, 
                as a condition of employment, to become trained in the 
                acts and omissions that constitute child abuse and 
                neglect, State law relating to mandated reporters, and 
                procedures for reporting child abuse and neglect, in 
                the State in which the program is located, and 
                information on current and appropriate national, State, 
                and local hotline numbers for reporting child abuse and 
                neglect.
                    (N) Medical response training.--Each staff member 
                at such a program shall be required, as a condition of 
                employment, to become trained in recognizing the signs, 
                symptoms, and appropriate responses associated with 
                common medical emergencies and mental health crises, 
                including warning signs of suicide and worsening 
                symptoms of mental illness.
                    (O) Criminal history check.--
                            (i) Requirement.--Each staff member for 
                        such a program shall be required, as a 
                        condition of employment, to submit to a 
                        criminal history check, including a name-based 
                        search of the National Sex Offender Registry 
                        established pursuant to the Adam Walsh Child 
                        Protection and Safety Act of 2006 (42 U.S.C. 
                        16901 et seq.), a search of the State criminal 
                        registry or repository in the State in which 
                        the covered program is operating, and a Federal 
                        Bureau of Investigation fingerprint check. An 
                        individual shall be ineligible to serve in a 
                        position with any contact with children at a 
                        covered program if any such criminal history 
                        check reveals a conviction for a violent felony 
                        that, by virtue of its nature, proximity in 
                        time, or other factor, is likely to directly 
                        increase a child's risk of harm in the program 
                        as determined by the Secretary.
                            (ii) Appeals.--The covered program shall 
                        provide an independent process through which a 
                        staff member who is determined to be ineligible 
                        for employment as a result of a criminal 
                        history check under clause (i) shall have the 
                        right--
                                    (I) to obtain a copy of the report 
                                resulting from the check; and
                                    (II) within 10 business days after 
                                receipt of the report, to appeal, in 
                                order to dispute the accuracy of the 
                                information obtained through the check.
                    (P) Informational materials.--Full disclosure, in 
                writing, in promotional and informational materials 
                produced by a covered program, shall be given to 
                parents or guardians of children at such a program, 
                which shall include disclosure of--
                            (i) the name and location of the program, 
                        including the names of any owners and 
                        operators;
                            (ii) the number and percentage of children 
                        who terminated participation prior to 
                        completion of that program in the past 5 years, 
                        including children discharged against medical 
                        advice;
                            (iii) any past violations of the standards 
                        required under this paragraph by the program 
                        and any penalties levied against the program as 
                        a result of such violations;
                            (iv) its current status (current as of the 
                        date the materials were given to the parents or 
                        guardians) with respect to State licensing 
                        requirements;
                            (v) the number of deaths that occurred in 
                        that program during the most recent 10-year 
                        period and the cause of each death;
                            (vi) the names of owners and operators of 
                        the program that have violated State licensing 
                        requirements;
                            (vii) information on evidence-based or 
                        promising practices employed as treatment in 
                        the covered program, and information to aid 
                        parents and guardians in finding community-
                        based treatment resources; and
                            (viii) any national, State, and local 
                        telephone hotline numbers that the program made 
                        available to children and staff members to 
                        report complaints of child abuse and neglect, 
                        or a violation of this paragraph, by the 
                        program.
                    (Q) Treatment and discharge plans.--The entity 
                carrying out the covered program shall work with the 
                parents or guardians of a child of the program and the 
                child's community-based providers in the development, 
                modification, and implementation of treatment and 
                discharge plans, including a plan for community 
                reintegration and linkage to community-based providers 
                and supports.
                    (R) Prohibition on discrimination.--The entity 
                carrying out the program shall ensure that no person 
                shall, on the basis of actual or perceived race, color, 
                religion, national origin, sex, gender identity, sexual 
                orientation, or disability, be subjected to 
                discrimination in the provision of any program or 
                activity, in whole or in part, covered by this Act.
                    (S) Evidence-based practices.--The entity carrying 
                out the program shall ensure that the program employs 
                safe, evidence-based practices, and that children are 
                protected against harmful or fraudulent practices, 
                including use of isolation or of mechanical restraints 
                or physical restraints.
                    (T) Other standards.--The program shall meet any 
                other standard the Secretary determines appropriate to 
                provide for the basic health and safety of children at 
                a covered program.
            (2) Regulations.--
                    (A) Interim regulations.--Not later than 180 days 
                after the date of enactment of this Act, the Secretary 
                shall promulgate and enforce interim regulations to 
                carry out paragraph (1).
                    (B) Public comment.--The Secretary shall, for a 90-
                day period beginning on the date of the promulgation of 
                interim regulations under subparagraph (A), solicit and 
                accept public comment concerning such regulations. Such 
                public comment shall be submitted in written form.
                    (C) Final regulations.--Not later than 90 days 
                after the conclusion of the 90-day period referred to 
                in subparagraph (B), the Secretary shall promulgate and 
                enforce final regulations to carry out paragraph (1).
    (b) Monitoring and Enforcement.--
            (1) Review process.--Not later than 180 days after the date 
        of enactment of this Act, the Secretary shall implement a 
        review process for overseeing, investigating, and evaluating 
        reports, of child abuse and neglect at covered programs, that 
        are received by the Secretary from the appropriate State, in 
        accordance with paragraph (4) or (5) of section 114(b) of the 
        Child Abuse Prevention and Treatment Act, as added by section 7 
        of this Act. Such review process shall--
                    (A) include an investigation to determine if a 
                violation of the standards required under subsection 
                (a)(1) has occurred; and
                    (B) include consultation and collaboration with 
                relevant Federal and State agencies.
            (2) Civil penalties.--Not later than 180 days after the 
        date of enactment of this Act, the Secretary shall promulgate 
        regulations establishing civil penalties for violations of the 
        standards required under subsection (a)(1). The regulations 
        establishing such penalties shall incorporate the following:
                    (A) Amount.--Any owner or operator of a covered 
                program at which the Secretary has found a violation of 
                the standards required under subsection (a)(1) may be 
                assessed a civil penalty not to exceed $50,000 per 
                violation.
                    (B) Deposit to treasury.--All penalties collected 
                under this paragraph shall be deposited in the 
                appropriate account of the Treasury of the United 
                States.
            (3) Private right of action.--Any person who suffers injury 
        by reason of a violation of subsection (a)(1) may bring a civil 
        action against the alleged violator to obtain appropriate 
        compensatory damages and injunctive relief or other equitable 
        relief.
    (c) Action.--The Secretary shall establish a process to assist 
States in the oversight and enforcement of this Act, which shall 
include--
            (1) assisting States in implementing oversight mechanisms 
        to ensure compliance of covered programs in the States with the 
        standards required under subsection (a)(1);
            (2) maintaining oversight of covered programs in a State, 
        in a case in which a State has not established, within 3 years 
        after the date of the enactment of this Act, mechanisms 
        sufficient to ensure compliance of such programs with the 
        standards required under subsection (a)(1); and
            (3) encouraging the use by States of national, State, or 
        local hotline numbers for reporting child abuse and neglect and 
        any other resources the Secretary determines to be appropriate.

SEC. 4. ENFORCEMENT BY THE ATTORNEY GENERAL.

    If the Secretary determines that a violation of section 3(a)(1) has 
not been remedied through the enforcement process described in section 
3(b)(2), the Secretary shall refer such violation to the Attorney 
General for appropriate action. Regardless of whether such a referral 
has been made, the Attorney General may, sua sponte, bring an action in 
any court of competent jurisdiction seeking equitable relief or any 
other relief authorized by this Act for such violation.

SEC. 5. REPORT.

    Not later than 1 year after the date of enactment of this Act and 
annually thereafter, the Secretary of Health and Human Services, in 
coordination with the Attorney General shall submit to the Committee on 
Education and the Workforce of the House of Representatives and the 
Committee on Health, Education, Labor, and Pensions of the Senate, a 
report on the activities carried out by the Secretary and the Attorney 
General, as authorized and as required under this Act.

SEC. 6. AUTHORIZATION OF APPROPRIATIONS.

    There is authorized to be appropriated to the Secretary of Health 
and Human Services $5,000,000 for each of fiscal years 2017 through 
2021 to carry out this Act (excluding the amendment made by section 7 
of this Act).

SEC. 7. ADDITIONAL ELIGIBILITY REQUIREMENTS FOR GRANTS TO STATES TO 
              PREVENT CHILD ABUSE AND NEGLECT AT RESIDENTIAL PROGRAMS.

    (a) In General.--Title I of the Child Abuse Prevention and 
Treatment Act (42 U.S.C. 5101 et seq.) is amended by adding at the end 
the following new section:

``SEC. 114. ADDITIONAL ELIGIBILITY REQUIREMENTS FOR GRANTS TO STATES TO 
              PREVENT CHILD ABUSE AND NEGLECT AT RESIDENTIAL PROGRAMS.

    ``(a) Definitions.--In this section:
            ``(1) Child.--The term `child' means an individual who has 
        not attained the age of 18.
            ``(2) Covered program.--The term `covered program' has the 
        meaning given the term in section 2 of the Stop Child Abuse in 
        Residential Programs for Teens Act of 2016.
    ``(b) Eligibility Requirements.--To be eligible to receive a grant 
under section 106, a State shall--
            ``(1) not later than 3 years after the date of enactment of 
        this section, develop policies and procedures to prevent child 
        abuse and neglect at covered programs operating in such State, 
        including standards that meet or exceed the standards required 
        under section 3(a)(1) of the Stop Child Abuse in Residential 
        Programs for Teens Act of 2016;
            ``(2) provide a private right of action under State law for 
        any person who suffers injury by reason of a violation of the 
        standards required under paragraph (1);
            ``(3) develop policies and procedures to enforce compliance 
        with the requirements developed in accordance with paragraph 
        (1), including--
                    ``(A) establishing and monitoring health and safety 
                licensing requirements applicable to and necessary for 
                the operation of each location of such covered programs 
                in the State; and
                    ``(B) conducting unannounced site inspections at 
                each location of a covered program;
            ``(4) develop policies and procedures for timely 
        notification to the Secretary and the appropriate protection 
        and advocacy system if--
                    ``(A) the State determines there is evidence of a 
                pattern of violations of the standards required under 
                paragraph (1) at a covered program operating in the 
                State or by an owner or operator of such a program; or
                    ``(B) there is a child fatality at a covered 
                program operating in the State; and
            ``(5) annually submit to the Secretary a report that 
        includes all covered programs within the jurisdiction of the 
        State, including any violations by each program or any 
        information that the Secretary determines to be necessary for 
        enforcement of this Act.
    ``(c) Oversight.--If, within the 3-year period beginning on the 
date of enactment of this section, the Secretary determines that the 
State is not satisfying the requirements of this subsection, the 
Secretary shall provide assistance to the State to satisfy such 
requirements or withhold funding until such policies and procedures are 
established.''.
    (b) Authorization of Appropriations.--Section 112(a)(1) of the 
Child Abuse Prevention and Treatment Act (42 U.S.C. 5106h(a)(1)) is 
amended by striking ``$120,000,000'' and all that follows through the 
period and inserting ``$200,000,000 for each of fiscal years 2017 
through 2021.''.
    (c) Conforming Amendments.--
            (1) Coordination with available resources.--Section 
        103(c)(1)(D) of the Child Abuse Prevention and Treatment Act 
        (42 U.S.C. 5104(c)(1)(D)) is amended by inserting after 
        ``specific'' the following: ``(including reports of child abuse 
        and neglect occurring at covered programs (as such term is 
        defined in section 114), except that such reports shall not 
        contain any personally identifiable information relating to the 
        identity of individuals who were the victims of such child 
        abuse and neglect)''.
            (2) Further requirement.--Section 106(b)(1) of the Child 
        Abuse Prevention and Treatment Act (42 U.S.C. 5106a(b)(1)) is 
        amended by adding at the end the following new subparagraph:
                    ``(D) Further requirement.--To be eligible to 
                receive a grant under this section, a State shall 
                comply with the requirements under section 114(b) and 
                shall include in the State plan submitted pursuant to 
                subparagraph (A) a description of the activities the 
                State will carry out to comply with the requirements 
                under such section 114(b).''.
            (3) Annual state data reports.--Section 106(d) of the Child 
        Abuse Prevention and Treatment Act (42 U.S.C. 5106a(d)) is 
        amended--
                    (A) in paragraph (1), by inserting before the 
                period at the end the following: ``(including reports 
                of child abuse and neglect occurring at covered 
                programs (as such term is defined in section 114), 
                except that such reports shall not contain any 
                personally identifiable information relating to the 
                identity of individuals who were the victims of such 
                child abuse and neglect)''; and
                    (B) in paragraph (6), by inserting before the 
                period at the end the following: ``or who were in the 
                care of a covered program, as such term is defined in 
                section 114''.
    (d) Clerical Amendment.--Section 1(b) of the Child Abuse Prevention 
and Treatment Act (42 U.S.C. 5101 note) is amended by inserting after 
the item relating to section 113 the following new item:

``Sec. 114. Additional eligibility requirements for grants to States to 
                            prevent child abuse and neglect at 
                            residential programs.''.
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