[Congressional Record Volume 154, Number 105 (Tuesday, June 24, 2008)]
[House]
[Pages H5953-H5962]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
STOP CHILD ABUSE IN RESIDENTIAL PROGRAMS FOR TEENS ACT OF 2008
The Committee resumed its sitting.
Mr. GEORGE MILLER of California. Madam Chairman, I yield 3 minutes to
the gentlewoman from New York (Mrs. McCarthy) who's been very, very
involved in the drafting of this legislation and also in other matters
before our committee to keep children safe in whatever setting they're
in.
Mrs. McCARTHY of New York. Madam Chairman, I want to start by saying
congratulations to Chairman Miller on this important day and thank him
for his strong leadership over the many years that this has been an
issue for him.
I also want to thank Chairman Miller and the committee staff for
working with me on this important legislation. When we started working
on this issue in the committee, I became outraged over the testimony we
heard. You see, children are dying.
I cannot forget the testimony of Bob Bacon, father of Aaron Bacon.
Bob and his wife Sally were seeking the best alternative for their son,
Aaron, who was struggling. They talked with therapists, counselors,
pastors, and doctors, and were referred by friends to a particular
program. They read, and I quote, in their very compelling brochure,
spoke with the office on the phone, and met with the owners for a
personal interview and chose this particular program for their son.
They felt that the owners were caring people who had experience in
counseling kids who were struggling with drugs and peer pressure.
He continued on in his testimony to our committee: ``Of course, being
normal, trusting, and honest people ourselves, we assumed we were being
told the truth.'' They were not.
I will never forget the pain in the father's eyes when he told us
that he regretted being talked into using the program's escort service,
and here is why: At 5 a.m., Bob's son, Aaron, was taken from his bed
under the threat of physical force if he resisted. Aaron was not
permitted to speak to Bob or Sally, his mother, or father. His parents
managed to hug him and tell him that it was for the best. The van
backed out of the driveway, and Bob told us the pleading eyes of his
son which begged them not to send him away haunt them today. They never
spoke again.
Aaron died in the wilderness with the program's staff claiming he was
faking the entire time. Aaron begged to be seen by a doctor. The
criminal investigation illuminated 21 days, 21 days of physical and
psychological abuse and neglect that Aaron experienced. There is no
excuse for this.
This and many other stories are the cause of my outrage, and we
should all
[[Page H5954]]
be outraged. There were many stories and testimony from parents that
came to our committee and talked to us, but here is the bottom line.
There are some good residential programs out there that are for the
treatment of our young people that have problems. But the majority, I
have to say, they go from State to State to State. When they close down
in one State, they open up in another State, and they use their same
abusive practices.
This is America. These are our most vulnerable children. And yes, as
far as I'm concerned, it is a Federal duty to protect these children
because these camps do go from State to State. And we should at least
be able to give the parents the tools that they need to make sure that
their children are getting the treatment and the care that they were
promised.
I hope that this bill passes. I hope that those in Congress
understand because only because we never know if that's going to happen
to one of our children in our families or our grandchildren, and we
want to make sure that we have the information that is out there to
make sure that our children get the treatment that they need.
Chairman Miller, I thank you for bringing this forward. I hope this
goes forward. I hope we can protect the children of this country. I
hope that we can set standards for the many camps around this country
that unfortunately do not do what they say to help the children.
Mr. McKEON. Madam Chairman, I yield 3 minutes no the gentleman from
Pennsylvania (Mr. Tim Murphy).
Mr. TIM MURPHY of Pennsylvania. Madam Chairman, I thank the gentleman
from California for yielding, and I thank the House for taking up this
important bill.
In my 25-plus years of practicing as a child psychologist, I have
treated many of the types of children that we're talking about today:
young men and women, young boys and girls, who oftentimes
characteristically really have reached the point in living with their
family where the family has lost all ability to control these children.
As one group of parents told me when I was working them once in a
group, the mother said, You know, it's like walking on eggshells when
you're around my son. Another mother said, No, it's like walking on
glass. You have to be so careful. You never know when you're going to
have harm.
And so it is. I know so many of them move me so much when I wrote my
book about these children called ``The Angry Child.'' I recognized what
many of their characteristics are: They have difficulty solving
problems; they tend to blame other people for their problems; their
primary emotional reaction to difficulty is anger; they believe that
anger is a source of power for them, and they have a great deal of
destructive self-talk. It is so very, very difficult to change these
children.
And thus it is important that we have residential treatment programs
available as an option because these parents have certainly gone
through the whole gamut of possible treatment options through
psychotherapy, counseling, sometimes hospitalizations, medication, et
cetera. And they're so moved by their love and affection and hope for
their child they're willing to try anything. But we have to make sure
that ``anything'' does not involve situations that can lead to more
harm and abuse.
One of the reasons this bill is so important is because parents have
to know at a time when they feel they can no longer trust their child
to control themselves and they no longer can trust their own ability to
parent, they have to trust someone. And sound, residential treatment
programs that are there with proper staff properly trained in therapy,
not there to physically abuse or harm the child, of which a majority of
these programs are good programs, but parents have to know there is
something they can trust.
It is so terribly, terribly heartbreaking to work with these families
and work with these children and know that they have destroyed a
family. Their threats of violence, the risk for drug and alcohol abuse,
their attacking other children, all just on this side of law so they
don't end up in jail.
Parents are desperately trying to help them. I'm pleased this
legislation is taking some steps to help restore some sense of trust
for parents to know that the child can get some treatment to know the
risks of harm are eliminated for them.
But still we have to recognize we must keep options open for these
families who no longer know how to handle their very, very angry and
difficult child.
Mr. GEORGE MILLER of California. Madam Chairman, I yield 3 minutes to
the gentleman from New Jersey (Mr. Rothman).
Mr. ROTHMAN. I thank our distinguished chairman.
Madam Chairman, I rise in support of the manager's amendment to the
Stop Child Abuse in Residential Programs for Teens Act.
I want to begin by thanking our distinguished Chairman Miller and his
wonderful staff, as well as the ranking member and his outstanding
staff, for putting together this bipartisan bill and for working with
me to incorporate two provisions into this manager's amendment that
will strengthen accountability measures in the bill.
Specifically, my provisions direct programs such as these to notify
parents of any reports of abuse as soon as possible but absolutely no
later than 48 hours after the incident.
Parents have the right to know when their child is in danger, and
this amendment ensures that parents are informed expeditiously of any
reports of child abuse or neglect. This amendment would also strengthen
accountability in this way: The bill creates a publicly searchable Web
site that will contain information on these facilities such as death,
reports of abuse, and violations of safety standards. My provisions
require the Web site to disclose the cause of death.
This will help parents to make informed decisions about which
residential facilities are safely caring for children as well as which
have poor records on incidents of abuse and/or death.
It is a terrifying yet documented fact that such severe abuse occurs
in these programs. The Government Accountability Office reports that
precipitated this bill found that more than 1,600 cases of alleged
abuse in 33 States occurred in 2005 alone. These alarming occurrences
of cruelty and neglect must end, and this bill will establish new
national safety standards and guidelines for private therapy facilities
to reduce, if not eliminate, these incidents.
Again, I would like to thank Chairman Miller and his outstanding
staff for all of his help in including my thoughts on this measure. I
thank again the ranking member and his staff for making this a very
important bipartisan measure that deserves the support of all of our
colleagues.
Mr. McKEON. Madam Chairman, I reserve my time.
Mr. GEORGE MILLER of California. If the Chair might advise us of how
much time we have remaining.
The CHAIRMAN. The gentleman from California (Mr. George Miller) has 9
minutes. The gentleman from California (Mr. McKeon) has 14 minutes.
Mr. GEORGE MILLER of California. If the gentleman has no further
speakers, I would be happy to yield back the general debate time.
Mr. McKEON. Madam Chairman, I yield myself the balance of my time.
I plan to support passage of H.R. 5876 today not because it's perfect
but because Members on both sides of the aisle have acted in good faith
to develop a package of reform that will help to protect the young
people enrolled in residential treatment facilities.
I thank Chairman Miller. I think that he knows that this is not the
bill I would have written, and some concerns do remain, but he's made
compromises and I have made compromises, and together we're working to
develop a seamless system of oversight to ensure the teens in these
programs, some of our most vulnerable young people, will be kept safe.
I plan to continue working with the chairman in the coming months to
improve the bill, avert unintended consequences, and ultimately achieve
our goal of putting an end to the stories of abuse, neglect, and even
death that have put a black mark on some of these programs.
I look forward to working more closely with the programs themselves
as this legislation moves forward. I believe there are best practices
out there that can be identified and replicated, and I take the
expertise of these programs will be invaluable as we develop
[[Page H5955]]
programs that do not undercut their ability to treat troubled youth.
I'm also eager to work more closely with the States, some of whom are
doing an excellent job of licensing and regulating these programs.
Unfortunately, not all States are rising to the task, which is what
this bill hopes to change.
So let me close by simply thanking Chairman Miller by shining a
spotlight on this issue and offering my assurances that I will continue
to work with you to stop child abuse in residential programs for teens.
I yield back the balance of my time.
Mr. GEORGE MILLER of California. I want to thank the gentleman from
California (Mr. McKeon) for all of his assistance, for his remarks, and
we all recognize that this is a bill that is a work in progress. I
think certainly at this stage we have it about right, but we will
continue those discussions. Again, I thank him for his assistance.
Ms. JACKSON-LEE of Texas. Madam Speaker, I rise today in strong
support of H.R. 5876, ``Stop the Child Abuse in Residential Programs
for Teens.'' I would like to thank my colleagues on the Committee on
Education and Labor for bringing this very important legislation to the
floor.
On Capitol Hill we often debate matters that can address varying
viewpoints. I believe that this legislation can only be looked at from
two angles--right and wrong.
They are everybody's children, and nobody's children. They are the
forgotten children in the Texas foster care and residential care
system. Black, White, Hispanic, and Asian--they all need the love of a
mother, the nurturing of a family, and the support of their community.
Some of them find homes with caring foster parents or in treatment
centers with experienced and caring providers. And some do not.
This legislation allows us to keep our children safe with:
New national standards for private and public residential programs--
Prohibit programs from physically, mentally, or sexually abusing
children in their care;
Prohibit programs from denying children essential water, food,
clothing, shelter, or medical care--whether as a form of punishment or
for any other reason;
Require that programs only physically restrain children if it is
necessary for their safety or the safety of others, and to do so in a
way that is consistent with existing federal law on the use of
restraints;
Require programs to provide children with reasonable access to a
telephone and inform children of their right to use the phone;
Require programs to train staff in understanding what constitutes
child abuse and neglect and how to report it; and
Require programs to have plans in place to provide emergency medical
care.
Prevent deceptive marketing by residential programs for teens--
Require programs to disclose to parents the qualifications, roles,
and responsibilities of all current staff members;
Require programs to notify parents of substantiated reports of child
abuse or violations of health and safety laws; and
Require programs to include a link or web address for the website of
the U.S. Department of Health and Human Services, which will carry
information on residential programs.
Hold teen residential programs accountable for violating the law--
Require states to inform the U.S. Department of Health and Human
Services of reports of child abuse and neglect at covered programs and
require HHS to conduct investigations of such programs to determine if
a violation of the national standards has occurred; and
Give HHS the authority to assess civil penalties of up to $50,000
against programs for every violation of the law.
Ask States to step in to protect teens in residential programs--
Three years after enactment, the legislation would provide certain
Federal grant money to States only if they development their own
licensing standards, that are at least strong as national standards,
for public and private residential programs for teens and implement a
monitoring and enforcement system, including conducting unannounced
site inspections of all programs at least once every 2 years. The
Department of Health and Human Services would continue to inspect
programs where a child fatality has occurred or where a pattern of
violations has emerged.
This legislation seeks to protect the unprotected--our children--from
abuse, neglect and exploitation. Many of these children are not safe,
and their futures are uncertain. The groups serving children and
adolescents with mental health or substance use conditions need better
regulation. The youth boot camps and other ``alternative placement
facilities'' should be forced to provide greater transparency as to the
policies and practices of their programs.
This legislation is a welcomed and needed response to numerous
studies documenting the ineffectiveness of these programs and, in
several instances, the tragic deaths as a result of child abuse and
neglect as reported by the GAO in October 2007. Too many families
struggle mightily in nearly every state to find placements, when
appropriate, for their children that will address their complex mental
health needs.
These facilities flourish, in part, because parents lack the
necessary information about the operation and practices of these
programs. The promise of help cannot be allowed to obscure the fact
that these kinds of program are not science-based and have not been
forthcoming about the incidence of neglect or abuse.
This addresses the challenges facing many families. It seeks relief
from these risks by (1) establishing standards for these programs that
are consistent with current child protection laws; (2) ensuring that
personnel is qualified; (3) shifting these programs to be family-
centered, as well as culturally and developmentally appropriate; (4)
creating mechanisms for the monitoring and enforcement of these goals;
(5) calling for greater transparency and accessibility to the
compliance of these standards; and (6) providing grants to states for
the prevention of child abuse and neglect and for the treatment of
children's mental health or substance use conditions.
Additionally, the annual report to Congress is an effective tool in
ensuring that these critical issues emerge from the shadows and see the
light of day. I share the vision and commitment of Chairman Miller and
the Education and Labor Committee in protecting our youth from such
predators.
I urge my colleagues to vote for our children, vote for our families,
and vote for H.R. 5876.
Mr. DAVIS of Illinois. Madam Chairman, I rise today to emphasize the
need for standards and enforcement provisions that prevent and respond
to allegations of child abuse and neglect at residential treatment
facilities. These facilities include both public and private programs
that serve teens with emotional, behavioral, and mental health
problems; wilderness camps, boot camps, therapeutic boarding schools,
and behavior modification facilities are all programs that serve this
purpose. The Stop Child Abuse in Residential Programs for Teens Act,
H.R. 5876, would require accountability and transparency from these
programs. I strongly support this bill, which would help protect these
vulnerable teens entrusted to their care.
Residential programs are meant to provide help and support to
teenagers. However, in October 2007, the Government Accountability
Office found numerous allegations of abuse, some of which led to death,
connected to these programs between 1990 and 2007. Accounts of physical
and sexual abuse have been publicized, although with difficulty given
that these programs are not accountable to a Federal agency or other
entity. It is unacceptable for Government to facilitate this secrecy.
Parents trust that residential facilities will keep their child safe
and care for their children properly; however, it is often found that
this is not the case. I am proud that we are taking steps to implement
Federal guidelines for treatment and care for these vulnerable youth.
H.R. 5876 works to end this abuse by enforcing national standards
that provide for the basic health and safety of children, along with
disseminating information about programs that will help ensure
compliance. The bill requires States to inform the Department of Health
and Human Services of incidences of child abuse, neglect, and
fatalities at covered programs; it also requires HHS to investigate any
allegations and will be authorized to financially penalize programs for
these offenses. A Web site will summarize information on programs and
any problems they have had, including whether the problems occurred
under the same management but different program names. In addition,
there will be a toll-free hotline to report child abuse and neglect at
covered programs. I encourage Congress to fully support H.R. 5876 and,
in turn, support the teens that it has been created to protect.
Mr. MATHESON, Madam Chairman, during my 8 years representing Utah's
Second District, I have always worked to protect children. The press
reports of abuse, neglect, and tragic deaths in some residential
therapy programs for youth are very concerning to me. Over the years,
many treatment centers have been established across the Nation,
including in my home State of Utah. As a result, Utah has worked hard
to license and regulate residential treatment programs over the past
several years and my State meets many of the standards set forth in the
legislation before us. It is my understanding that some States have not
developed stringent requirements and that leads to a patchwork of
regulations where kids can fall through the cracks.
I'd like to thank Chairman Miller for working with me to include
language in the manager's amendment requesting that HHS study
[[Page H5956]]
the outcomes of individuals in these types of programs through a
longitudinal study. I feel this data is extremely useful to better
understand the outcomes of individuals in these programs and the
progress made towards the goals of the treatment programs to fully
rehabilitate troubled youth and teens. I want to thank the chairman and
ranking member of the committee for their leadership and efforts to
establish a more standardized process for overseeing residential
treatment centers for children. I believe a uniform set of standards
makes sense, especially when it comes to meeting the needs of the most
troubled children and their families. Those centers that service
families well should not fear uniform standards because they will
naturally comply. However, those who say the standards are burdensome
fail to recognize that we all must perform at the highest possible
standard to ensure the safety of all children. These measures seek to
support good actors and encourage those who are not to become so.
Mr. GEORGE MILLER of Califonia. I yield back the balance of my time.
The CHAIRMAN. All time for general debate has expired.
Pursuant to the rule, the amendment in the nature of a substitute
printed in the bill shall be considered as an original bill for the
purpose of amendment under the 5-minute rule and shall be considered
read.
The text of the committee amendment is as follows:
H.R. 5876
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 2008''.
SEC. 2. DEFINITIONS.
In this Act:
(1) Assistant secretary.--The term ``Assistant Secretary''
means the Assistant Secretary for Children and Families of
the Department of Health and Human Services.
(2) Child.--The term ``child'' means an individual who has
not attained the age of 18.
(3) Child abuse and neglect.--The term ``child abuse and
neglect'' has the meaning given such term in section 111 of
the Child Abuse Prevention and Treatment Act (42 U.S.C.
5106g).
(4) Covered program.--
(A) In general.--The term ``covered program'' means each
location of a program not operated by a governmental entity
that, with respect to one or more children who are unrelated
to the owner or operator of the program--
(i) provides 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; and
(ii) operates with a focus on serving children with--
(I) emotional, behavioral, or mental health problems or
disorders; or
(II) problems with alcohol or substance abuse.
(B) Exclusion.--The term ``covered program'' does not
include--
(i) a hospital licensed by the State;
(ii) a foster family home or group home that provides 24-
hour substitute care for children place 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 group home; or
(iii) a psychiatric residential treatment facility that is
certified as meeting the requirements specified in
regulations promulgated for such facilities under section
1905(h)(1)(A) of the Social Security Act and that provides
psychiatric services for which medical assistance is
available under a State plan under title XIX of such Act.
(5) Protection and advocacy system.--The term ``protection
and advocacy system'' means a protection and advocacy system
established under section 143 of the Developmental
Disabilities Assistance and Bill of Rights Act of 2000 (42
U.S.C. 15043).
(6) State.--The term ``State'' has the meaning given such
term in section 111 of the Child Abuse Prevention and
Treatment Act.
SEC. 3. STANDARDS AND ENFORCEMENT.
(a) Minimum Standards.--
(1) In general.--Not later than 180 days after the date of
the enactment of this Act, the Assistant Secretary for
Children and Families of the Department of Health and Human
Services shall require each location of a covered program
that individually or together with other locations has an
effect on interstate commerce, in order to provide for the
basic health and safety of children at such a program, to
meet the following minimum standards:
(A) Child abuse and neglect shall be prohibited.
(B) 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) The protection and promotion of the right of each child
at such a program to be free from physical and mechanical
restraints and seclusion (as such terms are defined in
section 595 of the Public Health Service Act (42 U.S.C.
290jj)) to the same extent and in the same manner as a non-
medical, community-based facility for children and youth is
required to protect and promote the right of its residents to
be free from such restraints and seclusion under such section
595, including the prohibitions and limitations described in
subsection (b)(3) of such section.
(D) Acts of physical or mental abuse designed to humiliate,
degrade, or undermine a child's self-respect shall be
prohibited.
(E) Each child at such a program shall have reasonable
access to a telephone, and be informed of their right to such
access, for making and receiving phone calls with as much
privacy as possible, and shall have access to the appropriate
State or local child abuse reporting hotline number, and the
national hotline number referred to in subsection (c)(2).
(F) Each staff member, including volunteers, at such a
program shall be required, as a condition of employment, to
become familiar with what constitutes child abuse and
neglect, as defined by State law.
(G) Each staff member, including volunteers, at such a
program shall be required, as a condition of employment, to
become familiar with the requirements, including with State
law relating to mandated reporters, and procedures for
reporting child abuse and neglect in the State in which such
a program is located.
(H) Full disclosure, in writing, of staff qualifications
and their roles and responsibilities at such program,
including medical, emergency response, and mental health
training, to parents or legal guardians of children at such a
program, including providing information on any staff
changes, including changes to any staff member's
qualifications, roles, or responsibilities, not later than 10
days after such changes occur.
(I) Each staff member at a covered program described in
subclause (I) or (II) of section 2(4)(A)(i) shall be
required, as a condition of employment, to be familiar with
the signs, symptoms, and appropriate responses associated
with heatstroke, dehydration, and hypothermia.
(J) Each staff member, including volunteers, 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 (Public
Law 109-248; 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 record check
reveals a felony conviction for child abuse or neglect,
spousal abuse, a crime against children (including child
pornography), or a crime involving violence, including rape,
sexual assault, or homicide, but not including other physical
assault or battery.
(K) Policies and procedures for the provision of emergency
medical care, including policies for staff protocols for
implementing emergency responses.
(L) All promotional and informational materials produced by
such a program shall include a hyperlink to or the URL
address of the website created by the Assistant Secretary
pursuant to subsection (c)(1)(A).
(M) Policies to require parents or legal guardians of a
child attending such a program--
(i) to notify, in writing, such program of any medication
the child is taking;
(ii) to be notified within 24 hours of any changes to the
child's medical treatment and the reason for such change; and
(iii) to be notified within 24 hours of any missed dosage
of prescribed medication.
(N) Procedures for notifying parents or legal guardians
with children at such a program of any--
(i) on-site investigation of a report of child abuse and
neglect;
(ii) violation of the health and safety standards described
in this paragraph; and
(iii) violation of State licensing standards developed
pursuant to section 114(b)(1) of the Child Abuse Prevention
and Treatment Act, as added by section 8 of this Act.
(O) Other standards the Assistant Secretary determines
appropriate to provide for the basic health and safety of
children at such a program.
(2) Regulations.--
(A) Interim regulations.--Not later than 180 days after the
date of the enactment of this Act, the Assistant Secretary
shall promulgate and enforce interim regulations to carry out
paragraph (1).
(B) Public comment.--The Assistant Secretary shall, for a
90-day period beginning on the date of the promulgation of
interim regulations under subparagraph (A) of this paragraph,
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) of this paragraph, the Assistant Secretary shall
promulgate and enforce final regulations to carry out
paragraph (1).
(b) Monitoring and Enforcement.--
(1) Inspections.--The Assistant Secretary shall establish a
process for conducting unannounced site inspections of each
location of a covered program to determine compliance with
the standards required under subsection (a)(1). Such
inspections shall--
(A) begin not later than the date on which the Assistant
Secretary promulgates interim regulations under subsection
(a)(2)(A); and
(B) be conducted at each location of each covered program
not less often than once every two years, until such time as
the Assistant Secretary has determined a State has
appropriate health
[[Page H5957]]
and safety licensing requirements, monitoring, and
enforcement of covered programs in such State, as determined
in accordance with section 114(c) of the Child Abuse
Prevention and Treatment Act, as added by section 8 of this
Act.
(2) On-going review process.--Not later than 180 days after
the date of the enactment of this Act, the Assistant
Secretary shall implement an on-going review process for
investigating and evaluating reports of child abuse and
neglect at covered programs received by the Assistant
Secretary from the appropriate State, in accordance with
section 114(b)(3) of the Child Abuse Prevention and Treatment
Act, as added by section 8 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;
(B) include an assessment of the State's performance with
respect to appropriateness of response to and investigation
of reports of child abuse and neglect at covered programs and
appropriateness of legal action against responsible parties
in such cases;
(C) be completed not later than 60 days after receipt by
the Assistant Secretary of such a report;
(D) not interfere with an investigation by the State or a
subdivision thereof; and
(E) be implemented in each State in which a covered program
operates until such time as each such State has satisfied the
requirements under section 114(c) of the Child Abuse
Prevention and Treatment Act, as added by section 8 of this
Act, as determined by the Assistant Secretary, or two years
has elapsed from the date that such review process is
implemented, whichever is later.
(3) Civil penalties.--Not later than 180 days after the
date of the enactment of this Act, the Assistant 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) Any owner or operator of a covered program at which the
Assistant 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) All penalties collected under this subsection shall be
deposited in the appropriate account of the Treasury of the
United States.
(c) Dissemination of Information.--The Assistant Secretary
shall establish, maintain, and disseminate information about
the following:
(1) Websites made available to the public that contains, at
a minimum, the following:
(A) The name and each location of each covered program, and
the name of each owner and operator of each such program,
operating in each State, and information regarding--
(i) each such program's history of violations of--
(I) regulations promulgated pursuant to subsection (a); and
(II) section 114(b)(1) of the Child Abuse Prevention and
Treatment Act, as added by section 8 of this Act;
(ii) each such program's current status with the State
licensing requirements under section 114(b)(1) of the Child
Abuse Prevention and Treatment Act, as added by section 8 of
this Act;
(iii) any deaths that occurred to a child while under the
care of such a program, including any such deaths that
occurred in the five year period immediately preceding the
date of the enactment of this Act;
(iv) owners or operators of a covered program that was
found to be in violation of the standards required under
subsection (a)(1), or a violation of the licensing standards
developed pursuant to section 114(b)(1) of the Child Abuse
Prevention and Treatment Act, as added by section 8 of this
Act, and who subsequently own or operate another covered
program; and
(v) any penalties levied under subsection (b)(3), any
judgments or orders issued by a court pursuant to section 5,
and any other penalties levied by the State, against each
such program.
(B) Information on best practices for helping adolescents
with mental health disorders, conditions, behavioral
challenges, or alcohol or substance abuse, including
information to help families access effective resources in
their communities.
(2) A national toll-free telephone hotline to receive
complaints of child abuse and neglect at covered programs and
violations of the standards required under subsection (a)(1).
(d) Action.--The Assistant Secretary shall establish a
process to--
(1) ensure complaints of child abuse and neglect received
by the hotline established pursuant to subsection (c)(2) are
promptly reviewed by persons with expertise in evaluating
such types of complaints;
(2) immediately notify the State, appropriate local law
enforcement, and the appropriate protection and advocacy
system of any credible complaint of child abuse and neglect
at a covered program received by the hotline;
(3) investigate any such credible complaint not later than
30 days after receiving such complaint to determine if a
violation of the standards required under subsection (a)(1)
has occurred; and
(4) ensure the collaboration and cooperation of the hotline
established pursuant to subsection (c)(2) with other
appropriate National, State, and regional hotlines, and, as
appropriate and practicable, with other hotlines that might
receive calls about child abuse and neglect at covered
programs.
SEC. 4. ENFORCEMENT BY THE ATTORNEY GENERAL.
If the Assistant Secretary determines that a violation of
subsection (a)(1) of section 3 has not been remedied through
the enforcement process described in subsection (b)(3) of
such section, the Assistant 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, file a complaint in any
court of competent jurisdiction seeking equitable relief or
any other relief authorized by this Act for such violation.
SEC. 5. PRIVATE RIGHT OF ACTION.
(a) Maintenance of Action.--Any person suffering an injury-
in-fact traceable to a violation of a regulation promulgated
pursuant to section 3(a) may bring suit or a claim demanding
relief.
(b) Relief.--A court hearing a claim or suit under
subsection (a) may order any appropriate equitable remedy and
award damages, including punitive damages and reasonable
attorneys' fees, for a violation of a regulation promulgated
pursuant to section 3(a).
(c) Limitation.--The provisions of section 7 of the Civil
Rights of Institutionalized Persons Act (42 U.S.C. 1997e)
shall not apply to any action brought under this Act.
SEC. 6. REPORT.
Not later than one year after the date of the 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 Labor 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 Assistant Secretary and the
Attorney General under this Act, including--
(1) a description of the number and types of covered
programs inspected by the Assistant Secretary pursuant to
section 3(b)(1);
(2) a description of types of violations of health and
safety standards found by the Assistant Secretary and any
penalties assessed;
(3) a summary of findings from on-going reviews conducted
by the Assistant Secretary pursuant to section 3(b)(2);
(4) a summary of State progress in meeting the requirements
of this Act, including the requirements under section 114 of
the Child Abuse Prevention and Treatment Act, as added by
section 8 of this Act; and
(5) a summary of the Secretary's oversight activities and
findings conducted pursuant to subsection (d) of such section
114.
SEC. 7. AUTHORIZATION OF APPROPRIATIONS.
There is authorized to be appropriated to the Secretary of
Health and Human Services $50,000,000 for each of fiscal
years 2009 through 2013 to carry out this Act (excluding the
amendment made by section 8 of this Act).
SEC. 8. 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.--
``(A) In general.--The term `covered program' means each
location of a program operated by a public or private entity
that, with respect to one or more children who are unrelated
to the owner or operator of the program--
``(i) provides 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; and
``(ii) operates with a focus on serving children with--
``(I) emotional, behavioral, or mental health problems or
disorders; or
``(II) problems with alcohol or substance abuse.
``(B) Exclusion.--The term `covered program' does not
include--
``(i) a hospital licensed by the State;
``(ii) a foster family home or group home that provides 24-
hour substitute care for children place 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 group home; or
``(iii) a psychiatric residential treatment facility that
is certified as meeting the requirements specified in
regulations promulgated for such facilities under section
1905(h)(1)(A) of the Social Security Act and that provides
psychiatric services for which medical assistance is
available under a State plan under title XIX of such Act.
``(3) Protection and advocacy system.--The term `protection
and advocacy system' means a protection and advocacy system
established under section 143 of the Developmental
Disabilities Assistance and Bill of Rights Act of 2000 (42
U.S.C. 15043).
``(b) Eligibility Requirements.--To be eligible to receive
a grant under section 106, a State shall--
``(1) not later than three years after the date of the
enactment of this section, develop policies and procedures to
prevent child abuse and neglect at covered programs operating
in such State, including having in effect health and safety
licensing requirements applicable to and necessary for the
operation of each location of such covered programs that
include, at a minimum--
``(A) 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 2008;
``(B) the provision of essential food, water, clothing,
shelter, and medical care necessary to
[[Page H5958]]
maintain physical health, mental health, and general safety
of children at such programs;
``(C) policies for emergency medical care preparedness and
response, including minimum staff training and qualifications
for such responses; and
``(D) notification to appropriate staff at covered programs
if their position of employment meets the definition of
mandated reporter, as defined by the State;
``(2) develop policies and procedures to monitor and
enforce compliance with the licensing requirements developed
in accordance with paragraph (1), including--
``(A) designating an agency to be responsible, in
collaboration and consultation with State agencies providing
human services (including child protective services, and
services to children with emotional, psychological,
developmental, or behavioral dysfunctions, impairments,
disorders, or alcohol or substance abuse), State law
enforcement officials, the appropriate protection and
advocacy system, and courts of competent jurisdiction, for
monitoring and enforcing such compliance;
``(B) a State licensing application process through which
any individual seeking to operate a covered program would be
required to disclose all previous substantiated reports of
child abuse and neglect and all child deaths at any
businesses previously or currently owned or operated by such
individual, 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;
``(C) conducting unannounced site inspections not less
often than once every two years at each location of a covered
program;
``(D) creating a database, to be integrated with the annual
State data reports required under section 106(d), of reports
of child abuse and neglect at covered programs operating in
the State, 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
``(E) implementing a policy of graduated sanctions,
including fines and suspension and revocation of licences,
against covered programs operating in the State that are out
of compliance with such health and safety licensing
requirements;
``(3) if the State is not yet satisfying the requirements
of this subsection, in accordance with a determination made
pursuant to subsection (c), develop policies and procedures
for notifying the Secretary and the appropriate protection
and advocacy system of any report of child abuse and neglect
at a covered program operating in the State not later than 30
days after the appropriate State entity, or subdivision
thereof, determines such report should be investigated and
not later than 48 hours in the event of a fatality;
``(4) if the Secretary determines that the State is
satisfying the requirements of this subsection, in accordance
with a determination made pursuant to subsection (c), develop
policies and procedures for notifying the Secretary 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;
``(5) develop policies and procedures for establishing and
maintaining a publicly available database of all covered
programs operating in the State, including the name and each
location of each such program and the name of the owner and
operator of each such program, information on reports of
child abuse and neglect at such programs (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), violations of
standards required under paragraph (1), and all penalties
levied against such programs;
``(6) annually submit to the Secretary a report that
includes--
``(A) the name and each location of all covered programs,
including the names of the owners and operators of such
programs, operating in the State, and any violations of State
licensing requirements developed pursuant to subsection
(b)(1); and
``(B) a description of State activities to monitor and
enforce such State licensing requirements, including the
names of owners and operators of each covered program that
underwent a site inspection by the State, and a summary of
the results and any actions taken; and
``(7) if the Secretary determines that the State is
satisfying the requirements of this subsection, in accordance
with a determination made pursuant to subsection (c), develop
and policies and procedures to report to the appropriate
protection and advocacy system any case of the death of an
individual under the control or supervision of a covered
program not later than 48 hours after the State is informed
of such death.
``(c) Secretarial Determination.--The Secretary shall not
determine that a State's licensing requirements, monitoring,
and enforcement of covered programs operating in the State
satisfy the requirements of this subsection (b) unless--
``(1) the State implements licensing requirements for such
covered programs that meet or exceed the standards required
under subsection (b)(1);
``(2) the State designates an agency to be responsible for
monitoring and enforcing compliance with such licensing
requirements;
``(3) the State conducts unannounced site inspections of
each location of such covered programs not less often than
once every two years;
``(4) the State creates a database of such covered
programs, to include information on reports of child abuse
and neglect at such programs (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);
``(5) the State implements a policy of graduated sanctions,
including fines and suspension and revocation of licenses
against such covered programs that are out of compliance with
the health and safety licensing requirements under subsection
(b)(1); and
``(6) after a review of assessments conducted under section
3(b)(2)(B) of the Stop Child Abuse in Residential Programs
for Teens Act of 2008, the Secretary determines the State is
appropriately investigating and responding to allegations of
child abuse and neglect at such covered programs.
``(d) Oversight.--
``(1) In general.--Beginning two years after the date of
the enactment of the Stop Child Abuse in Residential Programs
for Teens Act of 2008, the Secretary shall implement a
process for continued monitoring of each State that is
determined to be satisfying the licensing, monitoring, and
enforcement requirements of subsection (b), in accordance
with a determination made pursuant to subsection (c), with
respect to the performance of each such State regarding--
``(A) preventing child abuse and neglect at covered
programs operating in each such State; and
``(B) enforcing the licensing standards described in
subsection (b)(1).
``(2) Evaluations.--The process required under paragraph
(1) shall include in each State, at a minimum--
``(A) an investigation not later than 60 days after receipt
by the Secretary of a report from a State, or a subdivision
thereof, of child abuse and neglect at a covered program
operating in the State, and submission of findings to
appropriate law enforcement or other local entity where
necessary, if the report indicates--
``(i) a child fatality at such program; or
``(ii) there is evidence of a pattern of violations of the
standards required under subsection (b)(1) at such program or
by an owner or operator of such program;
``(B) annually, a random sample of review of cases of
reports of child abuse and neglect investigated at covered
programs operating in the State to assess the State's
performance with respect to the appropriateness of response
to and investigation of reports of child abuse and neglect at
covered programs and the appropriateness of legal actions
taken against responsible parties in such cases; and
``(C) unannounced site inspections of covered programs
operating in the State to monitor compliance with the
standards required under section 3(a) of the Stop Child Abuse
in Residential Programs for Teens Act of 2008.
``(3) Enforcement.--If the Secretary determines, pursuant
to an evaluation under this subsection, that a State is not
adequately implementing, monitoring, and enforcing the
licensing requirements of subsection (b)(1), the Secretary
shall require, for a period of not less than one year, that--
``(A) the State shall inform the Secretary of each instance
there is a report to be investigated of child abuse and
neglect at a covered program operating in the State; and
``(B) the Secretary and the appropriate local agency shall
jointly investigate such report.''.
(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 inserting before the period at the
end the following: ``, and $200,000,000 for each of fiscal
years 2009 through 2013''.
(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 (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), as such term is
defined in section 114)''.
(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:
``(C) 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 (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), as such term is
defined in section 114)''; 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.''.
[[Page H5959]]
The CHAIRMAN. No amendment to the committee amendment is in order
except those printed in House Report 110-717. Each amendment may be
offered only in the order printed in the report; by a Member designated
in the report; shall be considered read; shall be debatable for the
time specified in the report, equally divided and controlled by the
proponent and an opponent of the amendment; shall not be subject to an
amendment; and shall not be subject to a demand for division of the
question.
{time} 1645
Amendment No. 1 Offered by Mr. George Miller of California
The CHAIRMAN. It is now in order to consider amendment No. 1 printed
in House Report 110-717.
Mr. GEORGE MILLER of California. Madam Chairman, I have an amendment
at the desk, the manager's amendment.
The CHAIRMAN. The Clerk will designate the amendment.
The text of the amendment is as follows:
Amendment No. 1 offered by Mr. George Miller of California:
Page 2, line 20, strike ``not''.
Page 2, line 21, strike ``governmental'' and insert
``public or private''.
Page 3, line 20, insert ``or'' after the semicolon.
Page 3, beginning line 21, strike ``or group home''.
Page 3, line 23, strike ``place'' and insert ``placed''.
Page 4, line 3, strike ``or group home; or'' and insert a
period.
Page 4, strike lines 4 through 11.
Page 9, line 4, after ``program'' insert ``immediately, to
the maximum extent practicable, but not later than within 48
hours''.
Page 9, line 13, strike ``section 8'' and insert ``section
7''.
Page 10, strike line 13 through page 11, line 4.
Page 11, line 5, strike ``(2)'' and insert ``(1)''.
Page 11, line 13, strike ``section 8'' and insert ``section
7''.
Page 12, line 10, strike ``section 8'' and insert ``section
7''.
Page 12, line 15, strike ``(3)'' and insert ``(2)''.
Page 13, line 10, strike ``contains'' and insert
``contain''.
Page 13, line 21, strike ``section 8'' and insert ``section
7''.
Page 14, beginning line 1, strike ``section 8'' and insert
``section 7''.
Page 14, line 8, before the semicolon insert ``, and
including the cause of each such death''.
Page 14, line 15, strike ``section 8'' and insert ``section
7''.
Page 14, beginning line 19, strike ``(b)(3), any judgments
or orders issued by a court pursuant to section 5,'' and
insert ``(b)(2)''.
Page 16, line 8, strike ``(b)(3)'' and insert ``(b)(2)''.
Page 16, strike line 14 through page 17, line 2.
Page 17, line 3, strike ``6'' and insert ``5''.
Page 17, strike lines 13 through 21 and insert the
following:
(1) a summary of findings from on-going reviews conducted
by the Assistant Secretary pursuant to section 3(b)(1),
including a description of the number and types of covered
programs investigated by the Assistant Secretary pursuant to
such section;
(2) a description of types of violations of health and
safety standards found by the Assistant Secretary and any
penalties assessed;
Page 17, line 22, strike ``(4)'' and insert ``(3)''.
Page 17, line 25, strike ``section 8'' and insert ``section
7''.
Page 17, line 25, strike ``and'' at the end.
Page 18, line 1, strike ``(5)'' and insert ``(4)''.
Page 18, line 3, strike the period and insert ``; and''.
Page 18, after line 3, insert the following:
(5) a description of the activities undertaken by the
national toll-free telephone hotline established pursuant to
section 3(c)(2).
Page 18, line 4, strike ``7'' and insert ``6''.
Page 18, line 6, strike ``$50,000,000'' and insert
``$15,000,000''.
Page 18, line 8, strike ``section 8'' and insert ``section
7''.
Page 18, line 8, after ``of this Act'' insert ``and section
8 of this Act''.
Page 18, line 9, strike ``8'' and insert ``7''.
Page 19, line 25, insert ``or'' after the semicolon.
Page 20, beginning line 1, strike ``or group home''.
Page 20, line 8, strike ``or group home; or'' and insert a
period.
Page 20, strike lines 9 through 16.
Page 22, line 14, insert ``establishing'' after ``(B)''.
Page 22, line 20, strike ``that such'' and insert ``that
substantiated reports of child abuse and neglect may remain
confidential and all''.
Page 23, line 4, insert ``non-public'' before ``database''.
Page 24, line 21, insert ``substantiated'' before
``child''.
Page 24, line 25, insert ``and that such database shall
include and provide the definition of `substantiated' used in
compiling the data in cases that have not been finally
adjudicated'' after ``neglect''.
Page 25, line 20, strike ``develop and'' and insert
``develop''.
Page 26, line 15, insert ``non-public'' before
``database''.
Page 28, line 14, strike ``annually, a random sample of
review'' and insert ``an annual review by the Secretary''.
Page 29, line 19, strike ``$200,000,000'' and insert
``$235,000,000''.
At the end of the bill, add the following new section:
SEC. 8. STUDY AND REPORT ON OUTCOMES IN COVERED PROGRAMS.
(a) Study.--The Secretary of Health and Human Services
shall conduct a study, in consultation with relevant agencies
and experts, to examine the outcomes for children in both
private and public covered programs under this Act
encompassing a broad representation of treatment facilities
and geographic regions.
(b) Report.--The Secretary shall submit to the Committee on
Education and Labor of the House of Representatives and the
Committee on Health, Education, Labor, and Pensions of the
Senate a report that contains the results of the study
conducted under subsection (a).
The CHAIRMAN. Pursuant to House Resolution 1276, the gentleman from
California (Mr. George Miller) and a Member opposed each will control
10 minutes.
The Chair recognizes the gentleman from California.
Mr. GEORGE MILLER of California. Madam Chairman, I yield myself 5
minutes.
I rise in strong support of this manager's amendment, and I offer
this manager's amendment on behalf of myself and Congressman McKeon,
who worked with us on this amendment to improve the legislation.
It is the intent, as you have just heard from the debate on this
legislation, to ensure that children are safe no matter what settings
they are in. And this amendment further refines the legislation to
improve the legislation.
The main changes that are offered in this amendment--and Mr. McKeon
pushed for these changes and recognized the need for them--one is to
broaden the Federal oversight to include public residential programs as
well as private ones. It strikes the right provided under this Act for
families to sue in Federal court for violations of the national
standards. And it strikes the requirement that the Health and Human
Services conduct site inspections of all covered programs at least
every 2 years.
It was my belief that we continue and are able to maintain the intent
and the purposes of this Act to make sure that children are safe in
these varied settings, as we heard from Mr. Murphy of Pennsylvania,
children who are very difficult to handle in many instances and parents
who have run out of the capacity to deal with these children seeking to
have this care.
I believe that the manager's amendment further refines the
legislation, strikes a better balance in the bill, and I want to again
thank Mr. McKeon.
I reserve the balance of my time on the manager's amendment.
Mr. McKEON. I claim the time in opposition to the amendment, Madam
Chairman, although I am not opposed.
The CHAIRMAN. Without objection, the gentleman from California is
recognized for 10 minutes.
There was no objection.
Mr. McKEON. Madam Chairman, I yield myself such time as I may
consume.
After the devastating stories we heard of children dying at
residential treatment facilities, every member of our committee
wondered how this could have happened and what could have been done to
prevent it. And being in Washington, it's easy to assume the answer
lies here with the Federal Government.
But, Madam Chairman, we know the answer is not always the Federal
Government. In fact, States may be better equipped to regulate,
monitor, and enforce the safety protections that are needed for these
programs. We can ensure stronger protections by resisting the urge to
consolidate all responsibility inside the Beltway.
When this bill was brought before the committee, the Department of
Health and Human Services said the following:
``The Federal Government has no oversight or rules governing child
abuse and neglect investigations, as each State has its own process for
defining and investigating child abuse and neglect, including the
timeliness
[[Page H5960]]
and methods for responding to and completing investigations of
allegations. As such, any Federal investigations of abuse and neglect
would likely interfere and perhaps conflict with a State's procedures
for the same.''
The Miller-McKeon substitute will go a long way toward addressing
this issue, and I want to once again thank Chairman Miller for his
willingness to consider our concerns. Some danger still remains that
the specific requirements of this bill could conflict with State child
protection laws, and I look forward to working in a bipartisan basis to
resolve that issue as this bill moves forward.
There was also a practical problem with the top-down Federal
regulation in the bill as it was drafted. It would have been virtually
impossible for HHS to build up a new regulatory infrastructure and have
the capacity to begin visiting each and every one of these programs in
the time allotted. It is far more practical for the States, many of
which are already licensing and regulating these programs, to take on
that responsibility. This substitute ensures that States will do so.
The bill, as originally drafted, also included a new private right of
action to sue in Federal court, something that I think would have
provided a much greater benefit to trial lawyers than victimized youth.
I'm pleased this provision has been removed. Victims of abuse still
have the right to remedies in court, but our emphasis now is on
protection and prevention instead of litigation.
And so, Madam Chairman, because of this substitute, the bill we will
vote on later today is a considerable improvement over what was
introduced. While it is still not perfect, I plan to support it and
continue working with the Chairman to create strong protections for the
young people enrolled in these programs.
I reserve the balance of my time.
Mr. GEORGE MILLER of California. I reserve the balance of my time.
Mr. McKEON. Madam Chairman, I yield 3 minutes to the gentleman from
Pennsylvania (Mr. Platts).
Mr. PLATTS. I appreciate the ranking member for yielding.
I rise in strong support of H.R. 5876, the Stop Child Abuse in
Residential Programs for Teens Act. This legislation will create and
enforce safety standards for residential treatment facilities that
serve to rehabilitate troubled youth.
While many residential treatment facilities for teens, such as boot
camps and substance abuse treatment programs, provide effective
rehabilitation services for troubled youth, it is the few bad actors
that bring us here today. Families send their teens to residential
treatment facilities many times after all other options have been
exhausted. Though many of these programs involve extreme physical
activities as part of their treatment plans, no child should be forced
to endure suffocation, dehydration, or other types of physical abuse
that surfaced during hearings that the Committee on Education and Labor
held earlier this year.
While I supported the original bill, I believe that this manager's
amendment makes the bill even stronger, and I thank Chairman Miller and
Ranking Member McKeon for working together on this very important
issue.
The substitute places the responsibility of monitoring and
enforcement of these safety standards in the hands of each State
government, rather than officials here in Washington. In addition, the
manager's amendment would ensure that all facilities that provide
treatment to children, public or private, are subject to safety
standards.
I want to stress that not all residential treatment facilities are
abusive or bad actors--in fact, quite the opposite. Through the process
of considering this legislation, I have heard from many facilities
which are proud of the positive impacts that they have had on the lives
of teens. I've also heard from graduates from these programs who
believe that they owe their lives to a treatment facility.
This bill, the Stop Child Abuse in Residential Programs for Teens
Act, aims to ensure that all programs are working in good faith to
achieve these goals and do not use violence or intimidation under the
guise of treatment.
Again, I'd like to thank Chairman Miller and Ranking Member McKeon
for working together to improve this important piece of legislation. I
urge my colleagues to support the manager's amendment and ultimately to
support H.R. 5876, legislation that is critically important to the
safety of our Nation's children.
Mr. GEORGE MILLER of California. I have no further requests for time
if the gentleman would yield back.
Mr. McKEON. I yield back the balance of my time.
Mr. GEORGE MILLER of California. I yield back the balance of my time.
The CHAIRMAN. The question is on the amendment offered by the
gentleman from California (Mr. George Miller).
The question was taken; and the Chairman announced that the ayes
appeared to have it.
Mr. GEORGE MILLER of California. Madam Chairman, I demand a recorded
vote.
The CHAIRMAN. Pursuant to clause 6 of rule XVIII, further proceedings
on the amendment offered by the gentleman from California will be
postponed.
It is now in order to consider amendment No. 2 printed in House
Report 110-717.
Pursuant to clause 6 of rule XVIII, the unfinished business is the
demand for a recorded vote on amendment No. 1 printed in House Report
110-717 offered by the gentleman from California (Mr. George Miller) on
which further proceedings were postponed and on which the ayes
prevailed by voice vote.
The Clerk will redesignate the amendment.
The Clerk redesignated the amendment.
Recorded Vote
The CHAIRMAN. A recorded vote has been demanded.
A recorded vote was ordered.
The vote was taken by electronic device, and there were--ayes 422,
noes 0, not voting 17, as follows:
[Roll No. 444]
AYES--422
Abercrombie
Ackerman
Aderholt
Akin
Alexander
Allen
Altmire
Andrews
Arcuri
Baca
Bachmann
Bachus
Baird
Baldwin
Barrett (SC)
Barrow
Bartlett (MD)
Barton (TX)
Bean
Becerra
Berkley
Berman
Berry
Biggert
Bilirakis
Bishop (GA)
Bishop (NY)
Bishop (UT)
Blackburn
Blumenauer
Blunt
Boehner
Bonner
Bono Mack
Boozman
Bordallo
Boren
Boswell
Boucher
Boustany
Boyd (FL)
Boyda (KS)
Brady (PA)
Brady (TX)
Braley (IA)
Broun (GA)
Brown (SC)
Brown, Corrine
Brown-Waite, Ginny
Buchanan
Burgess
Burton (IN)
Butterfield
Buyer
Calvert
Camp (MI)
Campbell (CA)
Cantor
Capito
Capps
Capuano
Cardoza
Carnahan
Carney
Carson
Carter
Castle
Castor
Cazayoux
Chabot
Chandler
Childers
Clarke
Clay
Cleaver
Clyburn
Coble
Cohen
Cole (OK)
Conaway
Conyers
Cooper
Costa
Costello
Courtney
Cramer
Crenshaw
Crowley
Cubin
Cuellar
Culberson
Cummings
Davis (AL)
Davis (CA)
Davis (KY)
Davis, David
Davis, Lincoln
Davis, Tom
Deal (GA)
DeFazio
DeGette
Delahunt
DeLauro
Dent
Diaz-Balart, L.
Diaz-Balart, M.
Dicks
Dingell
Doggett
Donnelly
Doolittle
Doyle
Drake
Dreier
Duncan
Edwards (MD)
Edwards (TX)
Ehlers
Ellison
Ellsworth
Emanuel
Emerson
Engel
English (PA)
Eshoo
Etheridge
Everett
Faleomavaega
Fallin
Farr
Fattah
Feeney
Ferguson
Filner
Flake
Forbes
Fortenberry
Fossella
Foster
Foxx
Frank (MA)
Franks (AZ)
Frelinghuysen
Gallegly
Garrett (NJ)
Gerlach
Giffords
Gilchrest
Gillibrand
Gingrey
Gohmert
Gonzalez
Goode
Goodlatte
Gordon
Granger
Graves
Green, Al
Green, Gene
Grijalva
Gutierrez
Hall (NY)
Hall (TX)
Hare
Harman
Hastings (FL)
Hastings (WA)
Hayes
Heller
Hensarling
Herger
Herseth Sandlin
Higgins
Hill
Hinchey
Hinojosa
Hirono
Hobson
Hodes
Hoekstra
Holden
Holt
Honda
Hooley
Hoyer
Hulshof
Inglis (SC)
Inslee
Israel
Issa
Jackson (IL)
Jackson-Lee (TX)
Jefferson
Johnson (GA)
Johnson (IL)
Johnson, Sam
Jones (NC)
Jones (OH)
Jordan
Kagen
Kanjorski
Kaptur
Keller
Kennedy
Kildee
Kilpatrick
Kind
King (IA)
King (NY)
Kingston
Kirk
Klein (FL)
Kline (MN)
Knollenberg
Kucinich
Kuhl (NY)
LaHood
Lamborn
Lampson
Langevin
Larsen (WA)
Larson (CT)
Latham
LaTourette
Latta
Lee
Levin
Lewis (CA)
Lewis (GA)
Lewis (KY)
Linder
Lipinski
LoBiondo
Loebsack
Lofgren, Zoe
Lowey
Lucas
Lungren, Daniel E.
Lynch
Mack
Mahoney (FL)
Maloney (NY)
Manzullo
[[Page H5961]]
Marchant
Marshall
Matheson
Matsui
McCarthy (CA)
McCarthy (NY)
McCaul (TX)
McCollum (MN)
McCotter
McCrery
McDermott
McGovern
McHenry
McHugh
McIntyre
McKeon
McMorris Rodgers
McNerney
McNulty
Meek (FL)
Meeks (NY)
Melancon
Mica
Michaud
Miller (FL)
Miller (MI)
Miller (NC)
Miller, Gary
Miller, George
Mitchell
Mollohan
Moore (KS)
Moore (WI)
Moran (KS)
Moran (VA)
Murphy (CT)
Murphy, Patrick
Murphy, Tim
Murtha
Musgrave
Myrick
Nadler
Napolitano
Neal (MA)
Neugebauer
Norton
Nunes
Oberstar
Obey
Olver
Ortiz
Pallone
Pascrell
Pastor
Paul
Payne
Pearce
Perlmutter
Peterson (MN)
Peterson (PA)
Petri
Pickering
Pitts
Platts
Poe
Pomeroy
Porter
Price (GA)
Price (NC)
Putnam
Radanovich
Rahall
Ramstad
Rangel
Regula
Rehberg
Reichert
Renzi
Reyes
Reynolds
Richardson
Rodriguez
Rogers (AL)
Rogers (KY)
Rogers (MI)
Rohrabacher
Ros-Lehtinen
Roskam
Ross
Rothman
Roybal-Allard
Royce
Ruppersberger
Ryan (OH)
Ryan (WI)
Salazar
Sali
Sanchez, Linda T.
Sarbanes
Saxton
Scalise
Schakowsky
Schiff
Schmidt
Schwartz
Scott (GA)
Scott (VA)
Sensenbrenner
Serrano
Sessions
Sestak
Shadegg
Shays
Shea-Porter
Sherman
Shimkus
Shuler
Shuster
Simpson
Sires
Skelton
Slaughter
Smith (NE)
Smith (NJ)
Smith (TX)
Smith (WA)
Solis
Souder
Space
Spratt
Stark
Stearns
Stupak
Sullivan
Sutton
Tancredo
Tanner
Tauscher
Taylor
Terry
Thompson (CA)
Thompson (MS)
Thornberry
Tiahrt
Tiberi
Tierney
Towns
Tsongas
Turner
Udall (CO)
Udall (NM)
Upton
Van Hollen
Visclosky
Walberg
Walden (OR)
Walsh (NY)
Walz (MN)
Wamp
Wasserman Schultz
Waters
Watson
Watt
Waxman
Weiner
Welch (VT)
Weller
Westmoreland
Whitfield (KY)
Wilson (NM)
Wilson (OH)
Wilson (SC)
Wittman (VA)
Wolf
Woolsey
Wu
Yarmuth
Young (AK)
Young (FL)
NOT VOTING--17
Bilbray
Cannon
Christensen
Davis (IL)
Fortuno
Hunter
Johnson, E. B.
Markey
Pence
Pryce (OH)
Rush
Sanchez, Loretta
Snyder
Speier
Velazquez
Weldon (FL)
Wexler
{time} 1720
Messrs. CANTOR, BAIRD, and POE changed their vote from ``no'' to
``aye.''
So the amendment was agreed to.
The result of the vote was announced as above recorded.
Ms. EDDIE BERNICE JOHNSON of Texas. Madam Chairman, on rollcall No.
444, I was delayed due to traffic--fundraising for DCCC. Had I been
present, I would have voted ``aye.''
The CHAIRMAN. The question is on the committee amendment in the
nature of a substitute, as amended.
The committee amendment in the nature of a substitute, as amended,
was agreed to.
The CHAIRMAN. Under the rule, the Committee rises.
Accordingly, the Committee rose; and the Speaker pro tempore (Mr.
Serrano) having assumed the chair, Ms. McCollum of Minnesota, Chairman
of the Committee of the Whole House on the state of the Union, reported
that that Committee, having had under consideration the bill (H.R.
5876) to require certain standards and enforcement provisions to
prevent child abuse and neglect in residential programs, and for other
purposes, pursuant to House Resolution 1276, she reported the bill back
to the House with an amendment adopted by the Committee of the Whole.
The SPEAKER pro tempore. Under the rule, the previous question is
ordered.
Is a separate vote demanded on any amendment to the amendment
reported from the Committee of the Whole? If not, the question is on
the amendment.
The amendment was agreed to.
The SPEAKER pro tempore. The question is on the engrossment and third
reading of the bill.
The bill was ordered to be engrossed and read a third time, and was
read the third time.
Motion to Recommit Offered by Mrs. Bachmann
Mrs. BACHMANN. Mr. Speaker, I offer a motion to recommit.
The SPEAKER pro tempore. Is the gentlewoman opposed to the bill?
Mrs. BACHMANN. I am, Mr. Speaker, in its present form.
The SPEAKER pro tempore. The Clerk will report the motion to
recommit.
The Clerk read as follows:
Mrs. Bachmann moves to recommit the bill H.R. 5876 to the
Committee on Education and Labor with instructions to report
the same back to the House promptly in the form to which
perfected at the time of this motion, with the following
amendment: On page 9, beginning on line 3, insert the
following new subparagraph (and redesignate subsequent
subparagraphs accordingly):
(N) Policies to require the consent of parents or legal
guardians of a child, before any prescription medication
(including contraception) not previously disclosed in writing
pursuant to subparagraph (M)(i) by such parents or legal
guardians, may be dispensed to such child.
The SPEAKER pro tempore. The gentlewoman from Minnesota is recognized
for 5 minutes.
Mrs. BACHMANN. Mr. Speaker, today I rise to offer a motion which will
ensure that parents of children in residential treatment facilities
have control over any medication being prescribed to their child. While
the bill as currently written would require a parent or a legal
guardian to disclose to the facility any prescription drugs that their
child is currently taking, the facility would not be required to
receive parental consent for the child to be issued a prescription for
any new medications.
As a mother and also as a foster mother, I strongly believe in the
importance of the role of the parent or the legal guardian in a child's
life. This is especially true, Mr. Speaker, when it comes to matters as
serious as the health and well-being of a child.
Prescription drugs, such as medication to treat psychiatric
conditions, can have a major impact on the mind and the body of an
adult, let alone on the young mind and the young body of a child. Such
a critical decision should only be made by a qualified medical doctor
with the expressed consent of a parent or legal guardian. This is only
common sense, Mr. Speaker.
Mr. Speaker, the bill before us today would allow residential
treatment facilities to impose their will on children without affording
those children the protection and guidance of their closest family.
Whether the parent, whose intimate relationship and familiarity with
their child is critical in choosing a treatment path, feels that it is
in their child's best interest or not, any medication could be
prescribed. For example, in its present form, this bill would allow a
treatment facility to prescribe contraception to a child, who when
properly informed and guided by a parent may have chosen to carry the
baby to term, either raising it as their own or contacting an adoption
agency, not terminating its life.
The purpose of this amendment is to protect children who are in a
very vulnerable situation away from their families in a residential
treatment facility where they are supposed to be receiving help for a
very difficult problem. The parents and the guardians who have raised
and cared for these children, who know and understand their children
and their medical histories best, should know about any new or changed
medications to exercise their role as primary medical decision makers
for their children. The right of consent should be explicitly stated in
this legislation meant to protect these vulnerable youth.
{time} 1730
Mr. Speaker, one thing that I saw firsthand as a foster mother, there
were too many children of color, minority children, who were overly
prescribed for prescription drugs at a younger and younger age. This is
a very disturbing issue and expressly underscores why parents or their
guardians should have a say to actually give consent whether these
children are given prescription drugs.
That being said, my motion, Mr. Speaker, does not infringe in any way
on the role of the medical facility at a treatment facility. The
expertise of the staff and the physicians would still be fully utilized
in the diagnosis and, upon parental consent, the dispensing of
prescription medication.
Moreover, my motion would not require parental notification for
nonprescription drugs. A child in a residential treatment facility
would not be hindered in obtaining any over-the-counter medication,
such as aspirin. Only prescription drugs, which can have such far-
reaching effects on a patient, would be applicable to the terms of this
motion.
The prescription drugs often used in these facilities, especially the
mental
[[Page H5962]]
health drugs, have very serious, and sometimes fatal side effects. This
is no laughing matter, Mr. Speaker. These side effects for children,
for children, Mr. Speaker, include suicide, homicide, psychosis, heart
problems, tics, movement disorders, diabetes, even obesity.
Mr. Speaker, a parent is one of the most powerful influences in a
child's life. I think this body agrees on that. In the case of a child
in a residential treatment facility, with a very small voice and no
ability to protect himself or herself, it is imperative that a parent
or a legal guardian be given proper authority over the course of the
treatment recommended by the treatment facility.
Mrs. BACHMANN. Mr. Speaker, today I rise to offer a motion which will
ensure that parents of children in residential treatment facilities
have control over any medication being prescribed to their child. While
the bill, as currently written, would require a parent or legal
guardian to disclose to the facility any prescription drugs their child
is currently taking, the facility would not be required to receive
parental consent for the child to be issued a prescription for any new
medication.
This issue is very real for me. As a mother and a foster mother who
has cared for children in similar situations, I strongly believe in the
importance of the role of the parent or legal guardian in a child's
life. This is especially true when it comes to matters as serious as
the health and well-being of that child. Prescription drugs, such as
medication to treat psychiatric conditions can have a major impact on
the mind and body of an adult, let alone the young mind and body of a
child. Our professionals deal with this on a regular basis in mental
health facilities all across the nation. Especially tragic is the
statistically high number of children of color who are placed on
prescription psychotropic drugs, often with severe misgivings from
parents or guardians. Such a critical decision should only be made by a
qualified medical doctor and only after the expressed consent of a
parent or legal guardian is given.
Mr. Speaker, the bill before us today would allow staff in
residential treatment facilities to impose their will on children,
without affording those children the protection and guidance of their
closest family. Whether the parent, whose intimate relationship and
familiarity with their child is critical in choosing a treatment path,
feels it is in their child's best interest or not, any medication could
be prescribed.
That is a historic leap in loss of parental rights over their
children. Parents remain legally and financially liable for their
children's mental and physical welfare yet this bill has government
stripping parents of their right to consent to medical treatment via
prescription drugs for their children. This bill says parents are good
enough to pay the bill, but they can't be trusted to make decisions
regarding their child's health. That is insulting, demeaning, and
wrong.
The purpose of this amendment is to protect children who are in a
very vulnerable situation away from their families in a residential
treatment facility where they are supposed to be receiving help for
very difficult problems. The parents and guardians that have raised and
cared for these children, who know and understand their children and
their medical histories best, should know about any new or changed
medications to exercise their role as primary medical decision makers
for their offspring. The right of consent should be explicitly stated
in this legislation meant to protect these vulnerable youth.
That being said, this motion does not infringe on the role of the
medical faculty at a treatment facility. The expertise of the staff and
physicians would still be fully utilized in the diagnosis, and upon
parental consent, the dispensing of prescription medication. Moreover,
this motion would not require parental notification for non-
prescription medication. A child in a residential treatment facility
would not be hindered in obtaining any over-the-counter (OTC)
medication such as aspirin. Only prescription drugs, which can have
such far-reaching effects on the patient, would be applicable to the
terms of this motion.
The prescription drugs often used in these facilities, especially the
mental health drugs, have extremely serious, and sometimes fatal side
effects. These include suicide, homicide, psychosis, heart problems,
tics and movement disorders, diabetes and obesity.
Mr. Speaker, Members understand, a parent is one of the most powerful
influences in a child's life. In the case of a child in a residential
treatment facility, it is imperative that his or her parent or legal
guardian be given proper authority over the course of treatment
recommended by the treatment facility.
I believe this is an important addition to this bill and I urge my
colleages to support the addition of this language.
The SPEAKER pro tempore. Pursuant to section 2 of House Resolution
1276, further proceedings on this bill are postponed.
____________________