[Congressional Record Volume 170, Number 187 (Tuesday, December 17, 2024)]
[House]
[Pages H7278-H7281]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
STOP INSTITUTIONAL CHILD ABUSE ACT
Mr. GUTHRIE. Mr. Speaker, I move to suspend the rules and pass the
bill (S. 1351) to study and prevent child abuse in youth residential
programs, and for other purposes.
The Clerk read the title of the bill.
The text of the bill is as follows:
S. 1351
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 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;
(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,
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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.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Kentucky (Mr. Guthrie) and the gentlewoman from Washington (Ms.
Schrier) each will control 20 minutes.
The Chair recognizes the gentleman from Kentucky.
Mr. GUTHRIE. I yield myself such time as I may consume.
Mr. Speaker, I rise in support of S. 1351, the Stop Institutional
Child Abuse Act.
In 2022, there were approximately 34,000 children and adolescents
placed in these youth residential treatment programs. These programs
play a pivotal role in helping young people navigate mental health and
behavioral health challenges. Unfortunately, there have been many
instances of youth being mistreated in certain residential treatment
programs. This is unacceptable.
S. 1351 will require the National Academies of Sciences, Engineering,
and Medicine to conduct a study examining the state of youth
residential programs. It also requires recommendations on how to
improve oversight, disseminate education and training resources, and
enhance interagency coordination, among others.
Every residential treatment program should be a secure place for
children to
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heal. Parents and guardians deserve transparency.
Mr. Speaker, I encourage my colleagues to support this bill, and I
reserve the balance of my time.
Ms. SCHRIER. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I rise in support of S. 1351, the Stop Institutional
Child Abuse Act. This legislation, sponsored by Representatives Khanna
and Carter in the House, would direct the National Academies of
Sciences, Engineering, and Medicine to conduct a study on youth
residential treatment programs.
These programs offer a variety of services to adolescents, teens, and
young adults with emotional, mental health, or substance use disorder
needs.
Residential treatment can play a pivotal role in helping young people
navigate serious behavioral and emotional challenges, but too often
these programs only harm these children, subjecting them to abuse and
neglect.
Young people deserve to be safe and properly cared for and to receive
treatment in the least restrictive environment that meets their needs.
Youth residential treatment programs need proper oversight to ensure
that young people are protected against abuse and neglect. This
legislation would provide greater transparency around the prevalence of
abuse in youth residential treatment programs, as well as
recommendations to improve the implementation of best practices
regarding the health and the safety of young people in these systems.
In carrying out the study, this legislation would require the
National Academies of Science, Engineering, and Medicine to consult
with a wide range of stakeholders. This would include health
professionals, individuals who have lived in youth residential
programs, parents, child abuse experts, program administrators, and
State and Federal agencies, among others.
I hope my colleagues will join me in this effort to strengthen
accountability and transparency in youth residential treatment
programs.
Mr. Speaker, I encourage all of my colleagues to vote ``yes'' on S.
1351, and I reserve the balance of my time.
Mr. GUTHRIE. Mr. Speaker, I yield 5 minutes to the gentleman from
Georgia (Mr. Carter), my good friend.
Mr. CARTER of Georgia. Mr. Speaker, I thank the gentleman for
yielding.
Mr. Speaker, I rise today in strong support of the Stop Institutional
Child Abuse Act, which I am proud to lead with Senator Merkley and
Representative Khanna.
Before I begin, I will start by thanking Paris Hilton for her hard
work, her bravery, and her vulnerability in sharing her story about
abuse at the hands of a youth residential treatment facility. This
truly was a courageous act on her part.
Mr. Speaker, Paris is already making a difference, and I applaud her
for using her voice to advance such a critical cause.
When Paris first met with me last Congress and shared her story about
being in institutional care as a child, I will be quite honest, I was
horrified. I believe the words out of my mouth were: This sounds like
it is being run by the cartel.
{time} 1745
Let me tell you, everything that I have heard since that meeting--
from policy experts, advocates, and survivors--has confirmed this
terrifying truth. One child, just one child experiencing abuse, is too
many.
Thousands of children are being funneled into seemingly safe
institutional care facilities only to be dehumanized and abused in a
crisis, one that I am so glad there is bipartisan and bicameral support
to address.
There are as many as 200,000 minors in youth residential programs or
facilities across the country. At their best, youth residential
programs provide counseling, treatment, and care for struggling teens
and children. At their worst, they subject innocent children to
physical, emotional, and sexual abuse, which has led to
hospitalizations, prolonged trauma, and even death.
Disgustingly, far too many of these centers are operating at their
worst.
The Stop Institutional Child Abuse Act, which I am proud to be the
Republican lead of in the House of Representatives, would increase
transparency and accountability for these programs so that parents and
children alike have an accurate understanding of the practices, goals,
and ethics of these centers.
It will also help to establish best practices for health, safety,
care, and treatment so that there is a Federal standard for how
institutionalized youth are treated. This will also give parents the
information they need to make an informed decision about whether
institutional care is the best option for their child.
Mr. Speaker, I am not trying to intervene on State rights here. Yes,
they are regulated by the States, and I want to be clear to my
colleagues that the States will continue to regulate them. This simply
calls for more transparency, responsibility, and accountability. It
gives parents the opportunity to see if these centers truly are using
seclusion or physical restraints. It does not intend to interfere with
the States regulating these facilities.
As you know, I am a healthcare professional, and we abide by the
Hippocratic oath, do no harm. It is time institutional care facilities
were held to that same standard.
There are a lot of good facilities out there, there is no question
about that, but there are some bad ones. That is what we are trying to
identify here. Every profession has bad actors.
I am a pharmacist, the second most well-respected profession in
America. We have bad actors, just like every profession does. That is
what we are trying to identify here.
It is time that institutional care facilities were held to the same
standards of the Hippocratic oath, do no harm.
This bill has already passed the Senate, and I thank Speaker Johnson,
Leader Scalise, and many others for bringing this bill before the House
here today. We have the votes, and it is time to get this done.
Who would vote against this? We all want our children safe. This is
simply calling for more accountability and more transparency. This is
simply calling for best practices. This is an attempt to identify bad
actors.
The children in these facilities can't wait another Congress for
change. Sunlight is the best disinfectant there is, and we are going to
light the institutional care industry up with transparency and
oversight because our children deserve it.
I commend Senator Merkley and Representative Khanna for working on
this issue, and I urge my colleagues to support this bill.
Ms. SCHRIER. Mr. Speaker, I yield 5 minutes to the gentleman from
California (Mr. Khanna), to whom I am so grateful for sponsoring this
legislation with Mr. Carter.
Mr. KHANNA. Mr. Speaker, I thank Representative Schrier for her
leadership, Representative Carter for working across the aisle, and the
leadership for bringing this bill on the floor for a vote.
I join Representative Carter in thanking Paris Hilton and her
husband, Carter, both up in the gallery as we speak. They really helped
drive this and start this.
I had coffee with Carter 4 years ago, and we were talking about
technology in my district. At the end of it, he says, ``By the way, I
am married to Paris Hilton,'' like you just drop that at the end of a
conversation.
I said: Paris Hilton. Okay. That is interesting.
Then he said: There is this issue I want to talk about.
I thought: Here we go. Here is some celebrity issue, and the person
will fly in, do PR, and leave.
I said: Carter, what is it?
He talked about the institutional facilities, these congregate care
facilities and the thousands of American kids who go there hoping to
get assistance, hoping to get support, and instead face sexual abuse,
horrific discipline, conditions where they aren't given enough food.
He said: You know, Paris went through that.
I was immediately struck by his vulnerability in sharing that. Then I
met Paris, I met her mother, and I saw the emotion that she had. I also
met so many survivors who told their stories. Representative Carter
knows this. Paris and Carter, her husband, and these survivors came to
our offices again and again for years because they
[[Page H7281]]
wanted to do something with these experiences to make it better for
America's children.
We are often so polarized in this Chamber. We disagree sometimes on,
it seems like, everything. As we approach Christmas and approach these
holidays, I think we can feel good that when it comes to America's
children, we put them first. We did something right. We did something
to help the American people, and we did that because of the commitment
and leadership that Paris and so many survivors have shown.
I feel good today about being a Member of Congress, working with
Representative Carter, and proud of being part of this institution. I
appreciate the leadership for allowing this bill to come. I hope it
will pass unanimously.
Mr. GUTHRIE. Mr. Speaker, I have no further speakers, and I am
prepared to close. I reserve the balance of my time.
The SPEAKER pro tempore. The Chair reminds Members that the rules do
not allow references to persons in the gallery.
Ms. SCHRIER. Mr. Speaker, I yield myself the balance of my time to
close.
As a pediatrician, I reiterate my support for S. 1351, the Stop
Institutional Child Abuse Act.
This is so important, as we have already heard through these stories,
and we want to make sure that when our adolescents and young adults are
sent off for care, they receive the best care and not abuse.
Mr. Speaker, I encourage my colleagues to vote for this bill, and I
yield back the balance of my time.
Mr. GUTHRIE. Mr. Speaker, I yield myself the balance of my time to
close.
Mr. Speaker, I want to close by saying that there has been quite a
bit of hard work put into this bill and quite a bit of persistence.
Without referring to anybody in the gallery, I know there are people
here who have worked really, really hard to get to where we are now.
Mr. Speaker, I support this bill, and I encourage all of my
colleagues to vote ``yes.'' I yield back the balance of my time.
The SPEAKER pro tempore. The question is on the motion offered by the
gentleman from Kentucky (Mr. Guthrie) that the House suspend the rules
and pass the bill, S. 1351.
The question was taken.
The SPEAKER pro tempore. In the opinion of the Chair, two-thirds
being in the affirmative, the ayes have it.
Mr. GUTHRIE. Mr. Speaker, on that I demand the yeas and nays.
The yeas and nays were ordered.
The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, further
proceedings on this motion will be postponed.
____________________