[Congressional Record Volume 170, Number 184 (Wednesday, December 11, 2024)]
[Senate]
[Pages S6973-S6974]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

  SA 3316. Mr. MERKLEY (for himself and Mr. Cornyn) proposed an 
amendment to the bill S. 1351, to study and prevent child abuse in 
youth residential programs, and for other purposes; as follows:

        Strike all after the enacting clause and insert the 
     following:

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Stop Institutional Child 
     Abuse Act''.

     SEC. 2. NATIONAL ACADEMIES OF SCIENCES, ENGINEERING, AND 
                   MEDICINE STUDY.

       (a) In General.--Not later than 45 days after the date of 
     enactment of this Act, the Secretary of Health and Human 
     Services shall seek to enter into a contract with the 
     National Academies of Sciences, Engineering, and Medicine 
     (referred to in this section as the ``National Academies'') 
     to conduct a study to examine the state of youth in youth 
     residential programs and make recommendations.
       (b) Study Components.--Pursuant to the contract under 
     subsection (a), the National Academies shall, not later than 
     3 years after the date of enactment of the Stop Institutional 
     Child Abuse Act, and every 2 years thereafter for a period of 
     10 years, issue a report informed by the study conducted 
     under such subsection that includes--
       (1) identification of the nature, prevalence, severity, and 
     scope of child abuse, neglect, and deaths in youth 
     residential programs, including types of abuse and neglect, 
     causes of abuse, neglect, and deaths, and criteria used to 
     assess abuse, neglect, and deaths;
       (2) identification of all Federal and State funding sources 
     for youth residential programs;
       (3) identification of Federal data collection sources on 
     youth in youth residential programs;
       (4) identification of existing regulation of youth 
     residential programs, including alternative licensing 
     standards or licensing exemptions for youth residential 
     programs;
       (5) identification of existing standards of care of 
     national accreditation entities that provide accreditation or 
     certification of youth residential programs;
       (6) identification of existing barriers in policy for 
     blending and braiding of funding sources to serve youth in 
     community-based settings;
       (7) recommendations for coordination by agencies of data on 
     youth in youth residential programs;
       (8) recommendations for the improvement of oversight of 
     youth residential programs receiving Federal funding;

[[Page S6974]]

       (9) identification of risk assessment tools, including 
     projects that provide for the development of research-based 
     strategies for risk assessments relating to the health, 
     safety (including with respect to the use of seclusion and 
     restraints), and well-being of youth in youth residential 
     programs;
       (10) recommendations to support the development and 
     implementation of education and training resources for 
     professional and paraprofessional personnel in the fields of 
     health care, law enforcement, judiciary, social work, child 
     protection (including the prevention, identification, and 
     treatment of child abuse and neglect), education, child care, 
     and other relevant fields, and individuals such as court 
     appointed special advocates and guardians ad litem, including 
     education and training resources regarding--
       (A) the unique needs, experiences, and outcomes of youth 
     with lived experience in youth residential programs;
       (B) the enhancement of interagency communication among 
     child protective service agencies, protection and advocacy 
     systems, State licensing agencies, State Medicaid agencies, 
     and accreditation agencies;
       (C) best practices to eliminate the use of physical, 
     mechanical, and chemical restraint and seclusion, and to 
     promote the use of positive behavioral interventions and 
     supports, culturally and linguistically sensitive services, 
     mental health supports, trauma- and grief-informed care, and 
     crisis de-escalation interventions; and
       (D) the legal duties of such professional and 
     paraprofessional personnel and youth residential program 
     personnel and the responsibilities of such professionals and 
     personnel to protect the legal rights of children in youth 
     residential programs, consistent with applicable State and 
     Federal law;
       (11) recommendations to improve accessibility and 
     development of community-based alternatives to youth 
     residential programs;
       (12) recommendations for innovative programs designed to 
     provide community support and resources to at-risk youth, 
     including programs that--
       (A) support continuity of education, including removing 
     barriers to access;
       (B) provide mentorship;
       (C) support the provision of crisis intervention services 
     and in-home or outpatient mental health and substance use 
     disorder treatment; and
       (D) provide other resources to families and parents or 
     guardians that assist in preventing the need for out-of-home 
     placement of youth in youth residential programs;
       (13) recommendations relating to the development, 
     dissemination, outreach, engagement, or training associated 
     with advancing least-restrictive, evidence-based, trauma and 
     grief-informed, and developmentally and culturally competent 
     care for youth in youth residential programs and youth at 
     risk of being placed in such programs;
       (14) recommendations on best practices regarding the health 
     and safety (including reduction or elimination of use of 
     seclusion and restraints), care, and treatment of youth in 
     youth residential programs to convey to States;
       (15) recommendations to improve the coordination, 
     dissemination, and implementation of best practices regarding 
     the health and safety (including use, reduction, or 
     elimination of seclusion and restraints), care, and treatment 
     of youth in youth residential programs among child welfare 
     systems, licensing agencies, accreditation organizations, 
     other relevant monitoring and enforcement entities, State 
     child welfare agencies, State Medicaid agencies, State mental 
     and behavioral health agencies, consumers, and State 
     protection advocacy centers; and
       (16) identification of aggregate data, including process-
     oriented data such as length of stay and use of restraints, 
     and seclusion and outcome-oriented data such as discharge 
     setting and ability to be safely maintained in school and 
     community at least 12 months after discharge, including--
       (A) recommendations on how such data should be shared 
     across child-placing agencies and stakeholders, including 
     individuals receiving services, families of such individuals, 
     and advocates; and
       (B) identification of barriers to sharing information 
     across child-placing agencies.
       (c) Consultation.--In carrying out the duties described in 
     subsection (b), the National Academies shall consult with--
       (1) child advocates, including attorneys experienced in 
     working with youth overrepresented in the child welfare 
     system or the juvenile justice system;
       (2) health professionals, including mental health and 
     substance use disorder professionals, nurses, physicians, 
     social workers, and other health care providers who provide 
     services to youth who may be served by residential programs;
       (3) protection and advocacy systems;
       (4) individuals experienced in working with youth with 
     disabilities, including emotional, mental health, and 
     substance use disorders;
       (5) individuals with lived experience as children and youth 
     in youth residential programs, including individuals with 
     intellectual or developmental disabilities and individuals 
     with emotional, mental health, or substance use disorders;
       (6) representatives of State and local child protective 
     services agencies and other relevant public agencies;
       (7) parents or guardians of children and youth with 
     emotional, mental health, or substance use disorder needs;
       (8) parents of children and youth with intellectual 
     disabilities and autism;
       (9) experts on issues related to child abuse and neglect in 
     youth residential programs;
       (10) administrators of youth residential programs;
       (11) education professionals who provide services to youth 
     with complex needs in youth residential programs;
       (12) State educational agencies;
       (13) local educational agencies;
       (14) Indian Tribes and Tribal organizations;
       (15) State legislators;
       (16) State licensing agencies;
       (17) the Administration for Children and Families;
       (18) the Administration for Community Living;
       (19) the Substance Abuse and Mental Health Services 
     Administration;
       (20) the Department of Justice;
       (21) the Indian Health Service;
       (22) the Centers for Medicare & Medicaid Services;
       (23) the National Council on Disability; and
       (24) others, as appropriate.
       (d) Report Submission and Publication.--The National 
     Academies shall submit to the Secretary for dissemination to 
     relevant State agencies, and make publicly available, a 
     report on the comprehensive review conducted under subsection 
     (b), including the findings of the National Academies under 
     subsection (b);
       (e) Definitions.--In this section:
       (1) Child abuse and neglect.--The term ``child abuse and 
     neglect'' has the meaning given such term in section 3 of the 
     Child Abuse Prevention and Treatment Act (42 U.S.C. 5101 
     note).
       (2) Culturally competent.--The term ``culturally 
     competent'' has the meaning given such term in section 102 of 
     the Developmental Disabilities Assistance and Bill of Rights 
     Act of 2000 (42 U.S.C. 15002).
       (3) Indian tribe; tribal organization.--The terms ``Indian 
     Tribe'' and ``Tribal organization'' have the meanings given 
     such terms in section 4 of the Indian Self-Determination and 
     Education Assistance Act (25 U.S.C. 5304).
       (4) Protection and advocacy systems.--The term ``protection 
     and advocacy system'' means a system established by a State 
     or Indian Tribe under section 143 of the Developmental 
     Disabilities Assistance and Bill of Rights Act of 2000 (42 
     U.S.C. 15043).
       (5) State.--The term ``State'' means each of the several 
     States, the District of Columbia, the Commonwealth of Puerto 
     Rico, the Virgin Islands, Guam, American Samoa, and the 
     Commonwealth of the Northern Mariana Islands.
       (6) Youth.--The term ``youth'' means an individual who has 
     not attained the age of 22.
       (7) Youth residential program.--
       (A) In general.--The term ``youth residential program'' 
     means each location of a facility or program operated by a 
     public or private entity that, with respect to one or more 
     youth who are unrelated to the owner or operator of the 
     facility or 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) an education or therapeutic boarding school;
       (IV) a behavioral modification program;
       (V) a residential treatment center or facility;
       (VI) a qualified residential treatment program (as defined 
     in section 472(k)(4) of the Social Security Act (42 U.S.C. 
     672(k)(4)));
       (VII) a psychiatric residential treatment program that 
     meets the requirements of subpart D of part 441 of title 42, 
     Code of Federal Regulations (or any successor regulations);
       (VIII) a group home serving children and youth placed by 
     any placing authority;
       (IX) an intermediate care facility for individuals with 
     intellectual disabilities; or
       (X) any residential program that is utilized as an 
     alternative to incarceration for justice involved youth, 
     adjudicated youth, or youth deemed delinquent; and

       (ii) serves youth who have a history or diagnosis of--

       (I) an emotional, behavioral, or mental health disorder;
       (II) a substance misuse or use disorder, including alcohol 
     misuse or use disorders; or
       (III) an intellectual, developmental, physical, or sensory 
     disability.

       (B) Exclusion.--The term ``youth residential program'' does 
     not include--
       (i) a hospital licensed by a State; or
       (ii) a foster family home that--

       (I) provides 24-hour substitute care for children placed 
     away from their parents or guardians and for whom the State 
     child welfare services agency has placement and care 
     responsibility; and
       (II) is licensed and regulated by the State as a foster 
     family home.

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