[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[S. 2696 Introduced in Senate (IS)]

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115th CONGRESS
  2d Session
                                S. 2696

To provide grants to States to improve and coordinate their response to 
ensure the safety, permanency, and well-being of children at high risk 
                         for abuse and neglect.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             April 18, 2018

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

_______________________________________________________________________

                                 A BILL


 
To provide grants to States to improve and coordinate their response to 
ensure the safety, permanency, and well-being of children at high risk 
                         for abuse and neglect.

    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 ``Supporting Infant Plans of Safe Care 
Implementation Act''.

SEC. 2. PLANS OF SAFE CARE.

    (a) In General.--Title I of the Child Abuse Prevention and 
Treatment Act (42 U.S.C. 5101 et seq.) is amended by inserting after 
section 107 the following:

``SEC. 107A. GRANTS TO STATES TO IMPROVE AND COORDINATE THEIR RESPONSE 
              TO ENSURE THE SAFETY, PERMANENCY, AND WELL-BEING OF 
              INFANTS AFFECTED BY SUBSTANCE USE.

    ``(a) Program Authorized.--The Secretary shall make grants to 
States for the purpose of assisting child welfare agencies, social 
services agencies, substance use disorder treatment agencies, public 
health agencies, and maternal and child health agencies to facilitate 
collaboration in developing, updating, and implementing plans of safe 
care described in section 106(b)(2)(B)(iii).
    ``(b) Distribution of Funds.--
            ``(1) Reservations.--Of the amounts appropriated under 
        subsection (h), the Secretary shall reserve--
                    ``(A) no more than 3 percent for the purposes 
                described in subsection (g); and
                    ``(B) up to 2 percent for grants to Indian Tribes 
                and tribal organizations for purposes consistent with 
                this section, as the Secretary determines appropriate.
            ``(2) Allotments to states and territories.--The Secretary 
        shall allot the amount appropriated under subsection (h) that 
        remains after application of paragraph (1) on a competitive 
        basis to States that apply for such a grant.
    ``(c) Application.--A State desiring a grant under this section 
shall submit an application to the Secretary at such time and in such 
manner as the Secretary may require. Such application shall include--
            ``(1) a description of--
                    ``(A) the impact of substance use disorder in such 
                State, including with respect to the substance or class 
                of substances with the highest incidence of abuse in 
                the previous year in such State, including--
                            ``(i) the prevalence of substance use 
                        disorder in such State;
                            ``(ii) the aggregate rate of births in the 
                        State of infants with prenatal substance 
                        exposure (as determined by hospitals, insurance 
                        claims, claims submitted to the State Medicaid 
                        program, or other records), if available; and
                            ``(iii) the number of infants identified, 
                        for whom a plan of safe care was developed, and 
                        for whom a referral was made for appropriate 
                        services, as reported under section 106(d)(18);
                    ``(B) the challenges the State faces in developing 
                and implementing plans of safe care in accordance with 
                section 106(b)(2)(B)(iii);
                    ``(C) the State's lead agency for the grant program 
                and how that agency will coordinate with relevant State 
                entities and programs, including the child welfare 
                agency, the substance use disorder treatment agency, 
                and the public health agency, programs funded by the 
                Residential Treatment for Pregnant and Postpartum Women 
                grant program of the Substance Abuse and Mental Health 
                Services Administration, the State Medicaid program, 
                the maternal, infant, and early childhood home visiting 
                program under section 511 of the Social Security Act, 
                the State judicial system, and other agencies, as 
                determined by the Secretary;
                    ``(D) how the State will monitor local 
                implementation of plans of safe care, in accordance 
                with section 106(b)(2)(B)(iii)(II);
                    ``(E) how the State meets the requirements of 
                section 1927 of the Public Health Service Act (42 
                U.S.C. 300x-27);
                    ``(F) how the State plans to utilize funding 
                authorized under part E, of title IV of the Social 
                Security Act (42 U.S.C. 670 et seq.) to assist in 
                carrying out any plan of safe care, including such 
                funding authorized under section 471(e) of such Act (as 
                in effect on October 1, 2018) for mental health and 
                substance abuse prevention and treatment services and 
                in-home parent skill-based programs and funding 
                authorized under such section 472(j) (as in effect on 
                October 1, 2018) for children with a parent in a 
                licensed residential family-based treatment facility 
                for substance abuse; and
                    ``(G) an assessment of the treatment and other 
                services and programs available in the State, to 
                effectively carry out any plan of safe care developed, 
                including identification of needed treatment, other 
                services and programs to ensure the well-being of young 
                children and their families affected by substance use 
                disorder;
            ``(2) a description of how the State plans to use funds for 
        activities described in subsection (d) for the purposes of 
        ensuring State compliance with requirements under clauses (ii) 
        and (iii) of section 106(b)(2)(B); and
            ``(3) an assurance that the State will--
                    ``(A) comply with this Act and parts B and E of 
                title IV of the Social Security Act (42 U.S.C. 621 et 
                seq.; 670 et seq.); and
                    ``(B) comply with requirements to refer a child 
                identified as substance-exposed to early intervention 
                services as required pursuant to a grant under part C 
                of the Individuals with Disabilities Education Act (20 
                U.S.C. 1431 et seq.).
    ``(d) Uses of Funds.--Funds awarded to a State under this section 
may be used for the following activities, which may be carried out by 
the State directly, or through grants or subgrants, contracts, or 
cooperative agreements:
            ``(1) Improving State and local systems with respect to the 
        development and implementation of plans of safe care, which--
                    ``(A) shall include parent and caregiver 
                engagement, as required under section 
                106(b)(2)(B)(iii)(I), regarding available treatment and 
                service options, which may include resources available 
                for pregnant, perinatal, and postnatal women; and
                    ``(B) may include activities such as--
                            ``(i) developing policies, procedures, or 
                        protocols for the administration of evidence-
                        based and validated screening tools for infants 
                        who may be affected by substance use withdrawal 
                        symptoms or a fetal alcohol spectrum disorder 
                        and pregnant, perinatal, and postnatal women 
                        whose infants may be affected by substance use 
                        withdrawal symptoms or a fetal alcohol spectrum 
                        disorder;
                            ``(ii) improving assessments used to 
                        determine the needs of the infant and family;
                            ``(iii) improving ongoing case management 
                        services; and
                            ``(iv) improving access to treatment 
                        services, which may be prior to the pregnant 
                        woman's due date.
            ``(2) Developing policies, procedures, or protocols in 
        consultation and coordination with health professionals, public 
        and private health facilities, and substance use disorder 
        treatment agencies to ensure that--
                    ``(A) appropriate notification to child protective 
                services is made in a timely manner;
                    ``(B) a plan of safe care is in place, where 
                needed, before the infant is discharged from the birth 
                or health care facility; and
                    ``(C) such health and related agency professionals 
                are trained on how to follow such protocols and are 
                aware of the supports that may be provided under a plan 
                of safe care.
            ``(3) Training health professionals and health system 
        leaders, child welfare workers, substance use disorder 
        treatment agencies, and other related professionals such as 
        home visiting agency staff and law enforcement in relevant 
        topics including--
                    ``(A) State mandatory reporting laws and the 
                referral and notification process;
                    ``(B) the co-occurrence of pregnancy and substance 
                use disorder;
                    ``(C) the clinical guidance about treating 
                substance use disorder in pregnant and postpartum 
                women; and
                    ``(D) appropriate screening and interventions for 
                infants affected by substance use disorder, withdrawal 
                symptoms, or a fetal alcohol spectrum disorder and the 
                requirements under section 106(b)(2)(B)(iii).
            ``(4) Establishing partnerships, agreements, or memoranda 
        of understanding between the lead agency and health 
        professionals, health facilities, child welfare professionals, 
        substance use disorder and mental health disorder treatment 
        programs, and maternal and child health and early intervention 
        professionals, including home visiting providers, peer recovery 
        specialists, and housing agencies to facilitate the 
        implementation of, and compliance with section 106(b)(2) and 
        paragraph (2) of this subsection, in areas which may include--
                    ``(A) developing a comprehensive, multi-
                disciplinary assessment and intervention process for 
                infants and their families who are affected by 
                substance use disorder, withdrawal symptoms, or a fetal 
                alcohol spectrum disorder, that takes into account the 
                unique needs of each family and addresses differences 
                between legal, medically supervised substance use, and 
                substance use disorder;
                    ``(B) ensuring that treatment approaches for 
                serving infants, pregnant women, and perinatal and 
                postnatal women whose infants may be affected by 
                substance use, withdrawal symptoms, or a fetal alcohol 
                spectrum disorder, are designed to, where appropriate, 
                keep infants with their mothers during both inpatient 
                and outpatient treatment; and
                    ``(C) increasing access to appropriate evidence-
                based medication assisted treatment services for 
                substance use disorders approved by the Food and Drug 
                Administration and behavioral therapy, as appropriate, 
                and counseling services.
            ``(5) Developing and updating systems of technology for 
        improved data collection and monitoring under section 
        106(b)(2)(B)(iii), including existing electronic medical 
        records, to measure the outcomes achieved through the plans of 
        safe care, including monitoring systems to meet the 
        requirements of this Act and submission of performance 
        measures.
    ``(e) Reporting.--Each State that receives funds under this 
section, for each year such funds are received, shall submit a report 
to the Secretary, disaggregated by geographic location, economic 
status, and major racial and ethnic groups as determined by the State, 
on the following:
            ``(1) The number of the infants identified under section 
        106(b)(2)(B)(ii) who experienced removal due to parental 
        substance use concerns who are reunified with parents, and the 
        length of time between such removal and reunification.
            ``(2) The number of the infants identified under section 
        106(b)(2)(B)(ii) who experienced substantiated reports of child 
        abuse or neglect, received differential response while in the 
        care of their birth parents or within 1 year after a 
        reunification has occurred.
            ``(3) The number of the infants identified under section 
        106(b)(2)(B)(ii) who experienced a return to out-of-home care 
        within one year after reunification.
    ``(f) Secretary's Report to Congress.--The Secretary shall submit 
an annual report to the Committee on Health, Education, Labor, and 
Pensions and the Committee on Appropriations of the Senate and the 
Committee on Education and the Workforce and the Committee on 
Appropriations of the House of Representatives that includes the 
information described in subsection (e) and recommendations or 
observations on the challenges, successes, and lessons derived from 
implementation of the grant program.
    ``(g) Reservation of Funds.--The Secretary shall use the amount 
reserved under subsection (b)(1)(A) for the purposes of--
            ``(1) providing technical assistance, including programs of 
        in-depth technical assistance, to additional States, 
        territories, and Indian tribes in accordance with the 
        substance-exposed infant initiative developed by the National 
        Center on Substance Abuse and Child Welfare;
            ``(2) issuing guidance on the requirements of this Act with 
        respect to infants born with and identified as being affected 
        by substance abuse or withdrawal symptoms or fetal alcohol 
        spectrum disorder, as described in clauses (ii) and (iii) of 
        section 106(b)(2)(B), including by--
                    ``(A) clarifying key terms; and
                    ``(B) disseminating best practices on 
                implementation of plans of safe care, on such topics as 
                differential response, collaboration and coordination, 
                and identification and delivery of services, for 
                different populations;
            ``(3) supporting State efforts to develop information 
        technology systems to manage plans of safe care; and
            ``(4) preparing the Secretary's report to Congress 
        described in subsection (f).
    ``(h) Authorization of Appropriations.--To carry out the program 
under this section, there are authorized to be appropriated $60,000,000 
for each of fiscal years 2018 through 2024.''.
    (b) Definition.--Section 3 of the Child Abuse Prevention and 
Treatment Act (42 U.S.C. 5101 note) is amended--
            (1) in paragraph (7), by striking ``; and'' and inserting a 
        semicolon;
            (2) by redesignating paragraph (8) as paragraph (9); and
            (3) by inserting after paragraph (7) the following:
            ``(8) the term `substance use disorder' means the abuse of 
        alcohol or other drugs; and''.
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