[Congressional Record (Bound Edition), Volume 155 (2009), Part 12]
[Senate]
[Pages 16902-16906]
[From the U.S. Government Publishing Office, www.gpo.gov]




          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Mr. MARTINEZ (for himself, Mr. Casey, Mr. Ensign, and Mr. 
        Udall of Colorado):
  S. 1401. A bill to provide for the award of a gold medal on behalf of 
Congress to Arnold Palmer in recongition of his service to the Nation 
in promoting excellence and good sportsmanship in golf; to the 
Committee on Banking, Housing, and Urban Affairs.
  Mr. CASEY. Mr. President, today, I honor one of the great sports 
legends of all time, Arnold Palmer. Not only is Arnold Palmer a world-
class athlete, he is a generous philanthropist and devoted husband, 
father, and grandfather.
  This son of Latrobe, PA, changed the game of golf, both how it is 
played and how it is appreciated, forever.
  Mr. Palmer learned how to play golf when he was merely 4 years old, 
playing with clubs his father had cut down for him at Latrobe Country 
Club. His talent emerged visibly at an early age, and he was soon able 
to outplay children far older than him. He began to caddy when he was 
11 years old and later held almost every job at the country club. In 
his late teens, he also served as a member of the U.S. Coast Guard.
  His seven major career victories make Mr. Palmer one of the greatest 
golfers of all time. He won the Masters Tournament four times in 1958, 
1960, 1962, and 1964; the U.S. Open in 1960 and the British Open in 
1961 and 1962. He twice represented the United States in the Ryder Cup 
Match, including serving as captain of the victorious american team in 
1963.
  In 1997, he successfully battled prostate cancer and is a champion of 
programs supporting cancer research and early detection. In addition to 
the numerous charities he supports, Mr. Palmer led a fundraising drive 
creating the Arnold Palmer Hospital for Children in Orlando and the 
Latrobe Area Hospital Charitable Foundation. Mr. Palmer has led by 
example in kindness, good sportsmanship, and generosity.
  Today, along with my colleagues, I ask Congress to award Mr. Palmer a 
gold medal in recognition of his service to the Nation in promoting 
excellence and good sportsmanship in golf.
                                 ______
                                 
      By Mr. MERKLEY (for himself and Mr. Alexander):
  S. 1402. A bill to amend the Internal Revenue Code of 1986 to 
increase the amount allowed as a deduction for start-up expenditures; 
to the Committee on Finance.
  Mr. MERKLEY. Mr. President, I rise today to discuss legislation that 
will make it significantly easier for small businesses to open their 
doors. Providing a helping hand to small businesses is important at any 
time, but never more so than now, when so many Americans are out of 
work.
  Small businesses are the engines of our economy. By some estimates, 
they employ approximately half the private workforce, and, in rural 
America, comprise nine out of ten businesses. In my home State of 
Oregon, many of the rural counties have unemployment rates 
approaching--or even surpassing--20 percent. Clearly, small businesses 
are going to be instrumental in turning things around.
  Furthermore, small businesses are innovators--they produce 13 times 
more patents per employee than large firms. Right now, the U.S. needs 
this kind of innovation more than ever.
  Our economy cannot thrive if small businesses are not doing well.
  Unfortunately, it can be very difficult for small businesses to 
succeed. Start-up expenses are often prohibitive and it can take a few 
years before business owners begin to see a profit. There are 
administrative systems to create, employees to hire, a client base to 
build and supplies to purchase. This adds up to a lot of expenses. A 
Gallup poll showed that the average small business incurs $10,000 in 
expenses during that first year. However, if a business can last 4 
years, it is much more likely to survive in the long term. We need to 
do more to help these businesses get through this difficult period.
  Today, I am joining with my colleague from Tennessee, Senator 
Alexander, to introduce legislation that will help small businesses 
through their first year. The Small Business Jump Start Act of 2009 
lessens the tax burden on new small businesses by doubling the 
deduction they can take for start-up expenses to $10,000. The Act also 
widens the pool of businesses eligible to take the full amount of the 
deduction in their first year of business. The Small Business Jump 
Start Act gives these new businesses a boost that first year, and for 
some, will eliminate the tax complications of amortizing start-up 
expenses. The Small Business Jump Start Act of 2009 is supported by the 
U.S. Chamber of Commerce, the National Federation of Independent 
Businesses, the National Association of the Self-Employed, and the 
National Association of Small Businesses.
  I will highlight one Oregon small business that the Jump Start Act 
could have helped. Jack and Giovanina Giaccarini moved to Grants Pass, 
Oregon after Hurricane Katrina came through their town in Mississippi. 
It was their dream to start a business installing systems to help 
quadriplegics and disabled veterans maneuver around their homes. The 
first year of their business was tough--finding start-up capital was 
difficult and purchasing just one system to use for demonstrations cost 
$10,000. They struggled. Now they are in their third year of business 
and finally making a profit. Having a Jump Start in that first year 
would have made a significant difference early on.

[[Page 16903]]

  This bill will go a long way for new small businesses looking to open 
their doors and employ people in their communities. Colleagues, in 
order to help America's small businesses and the economies of rural 
America, I urge you to support the Small Business Jump Start Act of 
2009. It is time to reach out a helping hand to entrepreneurs and 
assist them in starting that new business now, to jump start our 
economy and create new jobs across America.
  Mr. President, I ask unanimous consent that the text of the bill and 
letters of support be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                S. 1402

       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 ``Small Business Jump Start 
     Act of 2009''.

     SEC. 2. INCREASE IN AMOUNT ALLOWED AS DEDUCTION FOR START-UP 
                   EXPENDITURES.

       (a) In General.--Subsection (b) of section 195 of the 
     Internal Revenue Code of 1986 is amended by adding at the end 
     the following new paragraph:
       ``(3) Special rule for taxable years beginning in 2009, 
     2010, or 2011.--In the case of a taxable year beginning in 
     2009, 2010, or 2011, paragraph (1)(A)(ii) shall be applied--
       ``(A) by substituting `$10,000' for `$5,000', and
       ``(B) by substituting `$60,000' for `$50,000'.''.
       (b) Effective Date.--The amendments made by this section 
     shall apply to amounts paid or incurred in taxable years 
     beginning after the date of the enactment of this Act.
                                  ____

         Chamber of Commerce of the United States of America,
                                    Washington, DC, June 26, 2009.
     Hon. Jeff Merkley,
     U.S. Senate,
     Washington, DC.
       Dear Senator Merkley: As a longstanding advocate of tax 
     relief for small businesses, the U.S. Chamber of Commerce 
     applauds your leadership on introducing the ``Small Business 
     Jump Start Act of 2009.'' This bill would increase the small 
     business start-up expense deduction from $5,000 to $10,000 
     and increase the threshold for the deductions phase-out from 
     $50,000 to $60,000.
       A robust small business community is a vital component to 
     America's economic recovery. Allowing small business owners 
     the opportunity to expense additional start-up costs up front 
     would foster more entrepreneurial activity and further 
     encourage the important role of small business as the job 
     producers in our economy.
       The U.S. Chamber of Commerce is the world's largest 
     business federation, representing more than three million 
     businesses and organizations of every size, sector, and 
     region. More than 96 percent of the Chamber's members are 
     small businesses and organizations with 100 or fewer 
     employees. On behalf of these small employers, the Chamber 
     strongly supports your efforts to encourage investment and 
     growth in America's 27 million small enterprises and looks 
     forward to working with you to pass this important 
     legislation.
           Sincerely,

                                              R. Bruce Josten,

                                         Executive Vice President,

Government Affairs.
                                  ____


                                              National Association


                                        for the Self-Employed,

                                     Washington, DC, July 7, 2009.
     Hon. Jeff Merkley,
     U.S. Senate,
     Washington, DC.
       Dear Senator Merkley: On behalf of the National Association 
     for the Self-Employed (NASE) and our 250,000 member 
     businesses, I am pleased to announce our support for the 
     Small Business Jump Start Act of 2009. We strongly believe 
     that in this uncertain economic time it is more important 
     than ever to assist our nation's budding entrepreneurs.
       By increasing the start up business expenses deduction, the 
     Small Business Jump Start Act will greatly assist start up 
     ventures at the most critical time--their first year of 
     business--and give them the financial boost they need to 
     succeed.
       The NASE believes that entrepreneurs have been pillars of 
     innovation and job creation, fueling much of what is great 
     about America. Legislation that supports and invests in these 
     enterprises is in the best interests of our economy and our 
     nation. We feel that the Small Business Jump Start Act of 
     2009 will encourage many individuals who have been 
     considering entrepreneurship, to take the next steps to open 
     their small business and in turn, help create jobs in this 
     tough economy.
       If you have any questions or comments, please contact 
     Kristie Arslan, NASE's executive director. We are looking 
     forward to working with you and your staff to gain passage of 
     this legislation.
       Thank you for your leadership on this important small 
     business issue.
           Sincerely,
                                                    Robert Hughes,
     President.
                                  ____

                                               National Federation


                                      of Independent Business,

                                      Nashville, TN, July 7, 2009.
     Hon. Jeff Merkley,
     Russell Senate Office Building,
     Washington, DC.
       Dear Senator Merkley: On behalf of the National Federation 
     of Independent Business (NFIB), the nation's leading small 
     business advocacy organization, I want to thank you for 
     introducing the Small Business Jump Start Act, a bill to 
     increase the start-up deduction for new small businesses from 
     $5,000 to $10,000.
       While a typical business can deduct its ordinary business 
     expenses in the year the expenses are paid, a start-up 
     business is limited as to how much and when it can deduct 
     start-up expenses. Start-up business expenses are the costs 
     associated with formation of a business made prior to the 
     actual opening of the business. Most new small businesses 
     face significant start-up costs, including advertising, 
     obtaining licenses, permits and fees, paying rent, hiring 
     business and financial consultants and providing employee 
     training. Under this bill, expenses connected with setting up 
     or investing in the creation of a new business are deductible 
     up to $10,000 in the first year of the business.
       During a time of economic uncertainty, this legislation 
     provides a significant incentive for entrepreneurs--as well 
     as many people who have recently lost their jobs--to start 
     their own business. By increasing the start-up cost 
     deduction, small business owners will be able to put money 
     back into their business sooner, creating greater 
     opportunities for job creation and investment in local 
     economies.
       Thank you again for introducing this bill to help America's 
     small businesses. I look forward to working with you on this 
     issue as the 111th Congress continues.
           Sincerely,

                                                Susan Eckerly,

                                            Senior Vice President,
     Federal Public Policy.
                                  ____

                                                    National small


                                         Business Association,

                                                     July 7, 2009.
     Hon. Jeff Merkley,
     U.S. Senate, Russell Senate Office Building, Washington, DC.
       Dear Senator Merkley: On behalf of the National Small 
     Business Association, I would like to thank you for your 
     leadership in crafting the Small Business Jump Start Act of 
     2009. As the nation's oldest nonpartisan small business 
     advocacy group, NSBA reaches more than 150,000 small 
     businesses nation-wide, and our members have highlighted tax 
     relief as a top priority for the 111th Congress.
       Small business is one of the primary catalysts of both job 
     growth and innovation in our national economy. In fact, 
     according to the Small Business Administration since the mid-
     1990s, small businesses have created 60 to 80 percent of the 
     net new jobs annually.
       However, over the past year, small businesses have 
     experienced marked economic challenges. Between skyrocketing 
     gas prices, a weak real estate market and the credit crunch, 
     today's slow economy is having a noticeable effect on our 
     entrepreneurs. This new reality is coupled with the fact that 
     the first year of a small business is often difficult and 
     expensive. New employer establishments face challenges 
     keeping up with growing first year demands--building a client 
     base, hiring employees, creating new products and services, 
     and often opening a facility.
       Yet, small businesses that make it past the first four 
     years have a better chance of surviving long-term and this is 
     why your legislation is so crucial. It will boost the federal 
     tax deduction for small business start-up costs and broaden 
     the pool of businesses eligible for the deduction.
       Start-up businesses are currently eligible for a $5,000 tax 
     deduction if they spend $50,000 or less to open their doors. 
     The legislation proposed by you would boost the deduction to 
     $10,000 and also expand eligibility to companies that spend 
     up to $60,000 on start-up costs. The deduction would be 
     phased out dollar-for-dollar for expenditures above $60,000. 
     A business that spends $61,000 in start-up costs, for 
     example, could deduct $9,000 under the proposed legislation 
     and take the remaining $1,000 deduction over 15 years, just 
     as in current law.
       Small businesses are the lifeblood of all communities, and 
     this bill supports them by providing the financial assistance 
     they need to achieve success. The Small Business Jump Start 
     Act of 2009 will give small businesses the necessary 
     financial boost in their first year which will encourage 
     investments that create jobs and economic growth. NSBA 
     supports this measure, and commends you for working to bring 
     this legislation to the Senate floor.
           Sincerely,
                                                   Todd McCracken,
                                                        President.

[[Page 16904]]


                                 ______
                                 
      By Mr. INOUYE:
  S. 1404. A bill to implement demonstration projects at federally 
qualified community health centers to promote universal access to 
family-centered, evidence-based behavioral health interventions that 
prevent child maltreatment and promote family well-being by addressing 
parenting practices and skills for families from diverse socioeconomic, 
cultural, racial, ethnic, and other backgrounds, and for other 
purposes; to the Committee on Health, Education, Labor, and Pensions.
  Mr. INOUYE. Mr. President, today I introduce the Supporting Child 
Maltreatment Prevention Efforts in Community Health Centers Act of 
2009. I am introducing this bill on behalf of the American 
Psychological Association and the National Association of Community 
Health Centers. This much-needed legislation would help address a 
critical problem in our country, the abuse and neglect of millions of 
children. Today, I am introducing legislation that will help address 
this preventable tragedy.
  Unfortunately, child maltreatment continues to be a serious public 
health problem in our country that affects millions of children and 
their families. Child abuse and neglect can take many forms, including 
neglect of children's medical needs, physical or psychological 
maltreatment, sexual abuse, and multiple types of maltreatment.
  In 2007 alone, an estimated 5.8 million were allegedly victims of 
maltreatment, 3.2 million referrals were made to Child Protective 
Services agencies, and 794,000 children were determined to be victims 
of abuse and neglect. During that same year, 1,760 children died as a 
result of abuse or neglect, most of them younger than 4-years old.
  Nearly 80 percent of the perpetrators of child maltreatment were 
parents, and approximately seven percent were other relatives. 
Therefore, child maltreatment is a tragedy that impacts millions of 
children in their own families. Considering that not all maltreatment 
is reported to the authorities, the actual numbers are estimated to be 
higher.
  Focusing on prevention will help save billions of dollars that are 
currently spent annually--due to victimization and injuries--with 
hospitalization, visits to ER, out-of-home placements, CPS services, 
investigations, incarceration of abusers, services to address mental 
health issues, and other related costs.
  At the same time, we know that community health centers represent a 
unique resource for many families who depend on their services to 
obtain much-needed health and mental health care. Community Health 
Centers, CHCs, served 16 million individuals in 2007, most of them 
poor, uninsured, and at-risk for child maltreatment. In fact, one in 
five low-income children in the U.S. receives health care at a CHC. 
Furthermore, the centers provide comprehensive primary care services 
that set up the stage for an integrated care model.
  Given this evidence, the American Psychological Association, APA, 
convened a group of experts to review the best available science to 
identify and recommend public health strategies to prevent child 
maltreatment within the context of behavioral health integration at 
community health centers. For decades, the APA and its members have 
been at the forefront of child maltreatment prevention efforts in 
research, development of interventions, and evaluation. The findings of 
this report provided the seed to develop this critical legislation on 
behalf of children and families in our country.
  Among its provisions, this important legislation supports the 
implementation of demonstration projects at federally qualified health 
centers to promote universal access to a family-centered integrated and 
voluntary services model, evidence-based behavioral health 
interventions that prevent child maltreatment and promote family well-
being by addressing parenting practices and skills for families from 
diverse socioeconomic, cultural, racial, ethnic, and other backgrounds. 
The bill would also support program evaluation outcomes, technical 
assistance, project coordination, and the design and implementation of 
a cross-site evaluation plan.
  I have been committed to the support of psychology contributions to 
children and families and the vital role of community health centers 
for decades. This bill will help address the critical need to help and 
protect our nation's children by giving their parents and caregivers 
the tools and skills they need to be become the best parents and 
caregivers they can be and to, ultimately, help prevent child abuse and 
neglect.
  It is my hope that the science-based recommendations utilized in the 
development of this legislation will serve as a useful resource to 
inform current health care reform legislative efforts.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 1404

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Supporting Child 
     Maltreatment Prevention Efforts in Community Health Centers 
     Act of 2009''.

     SEC. 2. FINDINGS AND PURPOSES.

       (a) Findings.--Congress finds as follows:
       (1) Child abuse and neglect are serious public health 
     problems in this country. During 2007, approximately 
     3,200,000 referrals, involving the alleged maltreatment of 
     approximately 5,800,000 children, were sent to child 
     protective services agencies.
       (2) The most recent data show 794,000 substantiated cases 
     of child abuse and neglect in 2007, and child maltreatment-
     related deaths rose 15.5 percent in 2007. Approximately 1,760 
     children in the United States, nearly \3/4\ of whom were 
     under 4 years of age, died as a result of abuse or neglect.
       (3) Early childhood experiences may have lifelong effects. 
     Severe and chronic childhood stress, including from 
     maltreatment and exposure to violence, is associated with 
     persistent effects and can lead to enduring health, behavior, 
     and learning problems.
       (4) Child maltreatment has--
       (A) psychological and behavioral consequences such as 
     depression, anxiety, suicide, aggressive behavior, 
     delinquency, posttraumatic stress disorder, and criminal 
     behavior;
       (B) health consequences, including injuries and death, 
     chronic obstructive pulmonary disease, smoking, heart 
     disease, liver disease, and drug use; and
       (C) developmental consequences that can compromise brain 
     development and learning.
       (5) Child maltreatment has significant financial 
     consequences, including the short-term costs associated with 
     case handling by child protective services and 
     investigations, hospitalization or emergency room visits for 
     medical treatment of injuries, out-of-home placement 
     alternatives, services to address mental health and substance 
     abuse problems, loss of productivity, and poor physical 
     health requiring multiple treatments.
       (6) Child maltreatment can be prevented. Given that parents 
     and caregivers are responsible for the majority of the abuse 
     and neglect, caregiver-focused strategies and interventions 
     that address parenting skills and parental risk factors such 
     as depression, substance abuse, and intimate partner 
     violence, as well as strategies and interventions that 
     promote family well-being are critical. Parenting practices 
     are amenable to change, given reasonable efforts, and the 
     building of safe, stable, nurturing parent-child 
     relationships is a scientifically proven strategy for the 
     prevention of child maltreatment.
       (7) Prevention of child maltreatment should have a focus on 
     primary prevention (before any maltreatment), emphasizing 
     community-centered and population-based strategies.
       (8) Prevention of child maltreatment should focus on 
     promoting healthy parent-child relationships and an 
     environment that provides safe, stable, nurturing 
     relationships for children.
       (9) Primary health care is an existing and widely-accessed 
     system in which a range of prevention strategies can be 
     implemented, and there is growing evidence that primary 
     health care settings are promising venues in which to conduct 
     child maltreatment prevention and behavioral health promotion 
     programs.
       (10) Community health centers (referred to in this Act as 
     ``CHCs'') serve more than 18,000,000 individuals in the 
     United States annually, including individuals who are poor, 
     uninsured, hard-to-reach, and at-risk for child maltreatment.
       (11) One in 5 low-income children in the United States 
     receives health care at a CHC.
       (12) CHCs are an existing network of neighborhood health 
     clinics widely and regularly accessed by families in need 
     that can serve as a fitting venue for child maltreatment 
     prevention initiatives.

[[Page 16905]]

       (13) In the last decade, behavioral issues have had an 
     expanding presence in the portfolio of services of CHCs. 
     Seventy percent of CHCs have some, if minimal, on-site mental 
     health and substance abuse services. When demand exceeds 
     capacity or on-site services do not exist, CHCs refer 
     individuals to off-site options.
       (14) The integration of behavioral health services in 
     primary care settings is a promising framework. Evaluation 
     results of integrated care have shown--
       (A) improvement in service utilization, such as shorter 
     waiting time and fewer sessions to complete treatment;
       (B) reduction in the stigma related to mental health 
     services; and
       (C) improvement in access to services.
       (b) Purposes.--The purposes of this Act are as follows:
       (1) To fund the implementation of a minimum of 10 
     demonstration projects of evidence-based and promising 
     parenting programs at federally qualified health centers.
       (2) To provide universal access to a family-centered 
     integrated and voluntary services model that prevents child 
     maltreatment and promotes family well-being and which may 
     include:
       (A) implementation of evidence-based preventive parenting 
     skills training programs at health centers or permanent or 
     temporary residences of caregivers to strengthen the capacity 
     of parents to care for their children's health and well-being 
     and promote their own ability to create safe, stable, 
     nurturing family environments that protect children and youth 
     from abuse and neglect and its consequences and support 
     children's optimal social, emotional, physical, and academic 
     development;
       (B) screening to identify parental risk factors such as 
     depression, substance abuse, and intimate partner violence 
     that are associated with the likelihood that parents will 
     abuse or neglect their children, and to further develop 
     screening methods and instruments; and
       (C) linkage with, and referral to, on-site individualized 
     quality mental health services provided by trained mental 
     health professionals for parents and caregivers screening 
     positive for child maltreatment risk factors to help them 
     overcome the impediments to effective parenting and change 
     their behaviors toward child rearing and parenting.
       (3) To coordinate the design and implementation of an 
     evaluation plan to assess the impact and feasibility of 
     integrated services model implementation at each federally 
     qualified health center participating in the demonstration 
     project for health outcomes, cost effectiveness, patient 
     satisfaction, program local adaptation, reduction of child 
     maltreatment and injuries, and improvement of parenting 
     behaviors and family functioning.
       (4) To implement critical system factors for successful 
     implementation of the integrated services model to prevent 
     child maltreatment. Such factors include training of a 
     culturally- and linguistically-competent workforce, use of 
     best available technology, establishment of cooperation among 
     FQHCs participating in the demonstration project, and 
     building internal and external buy-in and support for the 
     project.
       (5) To coordinate the design and implementation of the 
     cross-site system-wide evaluation plan to assess the impact 
     and feasibility of an integrated services model on the 
     reduction of child maltreatment and injuries, to increase a 
     family's access to services, to evaluate the effectiveness of 
     the response of FQHCs organizational systems to the model 
     implemented, and to identify lessons learned and outline 
     recommendations for system-wide areas for improvement and 
     changes.

     SEC. 3. DEFINITIONS.

       In this Act:
       (1) Federally qualified health center or fqhc.--The term 
     ``federally qualified health center'' or ``FQHC'' means an 
     entity receiving a grant under section 330 of the Public 
     Health Service Act (42 U.S.C. 254b).
       (2) Caregivers.--The term ``caregiver'' means an adult who 
     is the primary caregiver, including biological, adoptive, or 
     foster parents, grandparents or other relatives, and non-
     custodial parents who have an ongoing relationship, and 
     provides physical care for, 1 or more children under the age 
     of 10. Caregivers may be individuals who were born in, or 
     outside of, the United States and individuals whose main 
     language is not English, including American Indians and 
     Alaska Natives. Caregivers may be heterosexual or homosexual, 
     and may have learning, physical, and other disabilities.
       (3) Center-based evidence-based preventive parenting skills 
     program.--The term ``center-based evidence-based preventative 
     parenting skills program'' means research-based and proven, 
     promising interventions provided and located at a health 
     center that--
       (A) have the potential for broad impact across multiple 
     types of maltreatment, including physical and psychological 
     abuse and neglect;
       (B) are associated with effective parent behaviors and 
     parenting practices and with reducing child behavior 
     problems;
       (C) may be expected to reduce child maltreatment rates; and
       (D) may be implemented at the FQHCs.
       (4) Home visitation program.--The term ``home visitation 
     program'' means an evidence-based program in which trained 
     professionals visit a caregiver in the permanent or temporary 
     residence of the caregiver, and provide a combination of 
     information, support, or training regarding child 
     development, parenting skills, and health-related issues.
       (5) Mental health services.--The term ``mental health 
     services'' means psychotherapeutic interventions offered at 
     health centers, or off-site locations in partnership with 
     health centers, by mental health professionals to caregivers 
     that screen for or are referred for child maltreatment.
       (6) Screening.--The term ``screening'' means a form of 
     triage, using valid, culturally-sensitive tools such as 
     scales or questionnaires applied universally by trained 
     professionals to identify caregivers who are at-risk for 
     maltreating or neglecting children. Screening assesses 
     parental risks for child maltreatment such as depression, 
     substance abuse, and intimate partner violence.

     SEC. 4. GRANTS FOR DEMONSTRATION PROJECTS ON INTEGRATED 
                   FAMILY-CENTERED PREVENTIVE SERVICES.

       (a) Demonstration Project Grants.--The Secretary of Health 
     and Human Services, acting through the Director of the 
     National Center for Injury Prevention and Control of the 
     Centers for Disease Control and Prevention, shall award 
     competitive grants to eligible federally qualified health 
     centers to fund a minimum of 10 demonstration projects to 
     promote--
       (1) universal access to family-centered, evidence-based 
     interventions in the FQHCs that prevent child maltreatment by 
     addressing parenting practices and skills; and
       (2) behavioral health and family well-being for families 
     from diverse socioeconomic, cultural, racial, and ethnic 
     backgrounds, including addressing issues related to sexual 
     orientation and individuals with disabilities.
       (b) Eligibility.--To be eligible to receive a grant under 
     subsection (a), an entity shall--
       (1) be a federally qualified community health center; and
       (2) submit to the Secretary an application at such time, in 
     such manner, and containing such information as the Secretary 
     may require.
       (c) Use of Grant Funds.--A federally qualified health 
     center receiving a grant under subsection (a) may use such 
     funds to--
       (1) conduct a needs assessment for the demonstration 
     project, including the need for proposed integrated services, 
     the number of caregivers involved, an organizational 
     assessment, workforce capacity and needs, and technological 
     needs;
       (2) use available technologies to collect, organize, and 
     provide access to health and mental health information of 
     patients, and to provide referrals, train staff, monitor 
     service delivery and outcomes, and create networking 
     opportunities for on-site providers and others in the 
     community;
       (3) adapt and implement evidence-based parenting skills 
     training programs for caregivers from all backgrounds who use 
     the health center for health care and child well-visits, 
     through on-site programs or programs operated at permanent or 
     temporary residences and administered, supervised, and 
     monitored by trained professionals employed by the FQHC;
       (4) adapt instruments and screen caregivers for child 
     maltreatment risk factors such as depression, substance 
     abuse, and intimate partner violence, provided that such 
     screening is conducted by trained professionals employed by 
     the FQHC;
       (5) provide access to mental health services to caregivers 
     screened positive for child maltreatment risk factors, which 
     may include services offered at the health centers or at off-
     site locations in partnership with the health centers, and 
     which shall be conducted by mental health professionals;
       (6) promote models of integrated care that involve 
     behavioral health specialists and primary care providers 
     working collaboratively in integrated teams to deliver 
     services that prevent child maltreatment and promote family 
     well-being;
       (7) develop public education campaigns to increase 
     community awareness of the integrated services offered by the 
     health centers; and
       (8) evaluate patient satisfaction, project cost 
     effectiveness, results of the integrated services model, and 
     effectiveness of evidence-based parenting programs in 
     improving parenting practices and reducing child abuse and 
     neglect.
       (d) Duration of Grant.--A grant under subsection (a) shall 
     be awarded for a period not to exceed 5 years.
       (e) Technical Assistance and Project Coordination.--
       (1) In general.--The Secretary shall award a contract to 1 
     or more eligible entities to provide--
       (A) technical assistance and project coordination for the 
     recipients of grants under subsection (a);
       (B) training for health care professionals, including 
     mental health care professionals, at FQHCs that receive 
     grants under subsection (a); and
       (C) cross-site evaluation of the demonstration projects 
     under subsection (a).
       (2) Eligible entities.--To be eligible to receive a 
     contract under this section, an entity shall--

[[Page 16906]]

       (A) be--
       (i) an institution of higher education (as defined in 
     section 101 of the Higher Education Act of 1965 (20 U.S.C. 
     1001));
       (ii) a nonprofit organization that qualifies for tax exempt 
     status under section 501(c)(3) of the Internal Revenue Code 
     of 1986; or
       (iii) such national and professional organizations and 
     community-based organizations as the Secretary determines 
     appropriate;
       (B) have expertise in parent-child relationships, parenting 
     programs, prevention of child maltreatment, the integration 
     of behavioral health in primary and community health center 
     settings, and coordinating multi-sites projects;
       (C) demonstrate a defined or proposed collaboration with 
     purveyors of evidence-based child maltreatment prevention 
     interventions; and
       (D) submit to the Secretary an application that includes--
       (i) an outline of a technical assistance and coordination 
     plan and timeline;
       (ii) a description of activities, services, and strategies 
     to be used to reach out and work with the FQHCs and others 
     involved in the demonstration projects under subsection (a); 
     and
       (iii) a description of the evaluation methods and 
     strategies the entity plans to use, and an outline of the 
     progress and final reports required under subsection (f)(2).
       (3) Priority.--In awarding contracts under this subsection, 
     the Secretary shall give priority to eligible entities whose 
     applications under paragraph (2)(D) demonstrate that the 
     evaluation design of such eligible entity uses strong 
     experimental designs that capture a range of health and 
     behavioral outcomes and include feasibility evaluation of the 
     integrated health-behavioral health services model. Such 
     evaluation designs should provide evaluation results that 
     identify lessons learned and generate recommendations for 
     improvements and changes.
       (4) Authorized activities.--Each recipient of a contract 
     under this subsection shall use such award to provide 
     technical assistance to the FQHCs receiving a grant under 
     subsection (a) and to provide coordination and cross-site 
     evaluation of such demonstration projects to the Secretary. 
     Such technical assistance and coordination and cross-site 
     evaluation may include--
       (A) establishing and implementing uniform tracking and 
     monitoring systems across FQHCs participating in the 
     demonstration project, using the best available, highest 
     level of technological tools;
       (B) developing and implementing a cross-site, multi-level 
     evaluation plan using rigorous research and evaluation 
     designs to evaluate the demonstration projects across FQHCs;
       (C) ensuring that, in implementing the evidence-based 
     parenting training programs, each such FQHC follows 
     standardized manuals and protocols, and ensuring 
     effectiveness of the integrated services of each FQHC in 
     promoting positive stable, nurturing parent-child 
     relationships and preventing child maltreatment and injuries;
       (D) ensuring an effective and feasible evaluation of the 
     outcomes of the demonstration projects, including an 
     assessment of--
       (i) improvement of parent knowledge of child social, 
     emotional, cognitive development;
       (ii) improvement of parent-child relationships;
       (iii) parental use of positive discipline methods and 
     effective communication skills;
       (iv) health outcomes for children;
       (v) reduction of incidence of child maltreatment;
       (vi) cost-effectiveness of the demonstration projects;
       (vii) implementation that follows standardized manuals and 
     protocols;
       (viii) the interdisciplinary collaborative model;
       (ix) cultural sensitivity and local adaptation of the 
     projects;
       (x) any increase in access to services; and
       (xi) further improvements and changes needed at the FQHCs;
       (E) establishing and coordinating the implementation of a 
     workforce development and training plan to ensure that 
     professionals working at the health centers, including 
     physicians, nurses, nurse practitioners, psychologists, 
     social workers, physician's assistants, clinical pharmacists, 
     and others, are trained to participate in interdisciplinary 
     teams and work collaboratively to provide culturally-
     competent and linguistically-sensitive integrated services to 
     all caregivers coming to such center, with a focus on the 
     development and strengthening of--
       (i) knowledge of the public health model, child 
     development, family functioning, the problem of child 
     maltreatment, and methods of prevention;
       (ii) core attitudes, including the belief that child 
     maltreatment is preventable, professionals have a role in 
     prevention, families are partners in preventing maltreatment, 
     and evaluation is a critical element of interventions;
       (iii) ability to conduct screenings, implement evidence-
     based parenting programs, provide mental health services, and 
     collaborate with evaluation efforts;
       (iv) ability to manage the site project, participate in 
     interdisciplinary teams, work on integrated efforts, and 
     master technology for best results;
       (v) the knowledge, skills, and attitude to work with 
     individuals from diverse cultural, racial, ethnic, and other 
     backgrounds; and
       (vi) an understanding of cross-field culture and language 
     to effectively participate in interdisciplinary teams and 
     collaborate in integrated activities;
       (F) educating and involving the governing boards of FQHCs 
     participating in the demonstration projects in the integrated 
     service efforts;
       (G) promoting partnerships with State and local 
     institutions of higher education, community networks, and 
     professional associations for staff training and recruitment;
       (H) promoting collaboration and networking among FQHCs 
     participating in the demonstration projects; and
       (I) establishing and coordinating child maltreatment 
     prevention collaboratives across FQHCs participating in the 
     demonstration projects and helping such FQHCs partner with 
     local departments of child welfare and community mental 
     health centers.
       (5) Advisory groups.--
       (A) In general.--Each recipient of a contract under this 
     subsection shall establish an advisory group. Each such 
     advisory group shall provide feedback and input to the 
     contract recipient to ensure such recipient's effectiveness 
     in providing quality services.
       (B) Membership.--Each such advisory group shall be composed 
     of representatives of--
       (i) national organizations representing community health 
     centers;
       (ii) national professional organizations representing 
     professionals from various fields, including pediatrics, 
     nursing, psychology, and social work; and
       (iii) government agencies with relevant expertise, as 
     determined by the Director of the National Center for Injury 
     Prevention and Control of the Centers for Disease Control and 
     Prevention.
       (f) Evaluation and Reporting.--
       (1) Demonstration project reporting.--
       (A) Annual progress evaluation and financial reporting.--
     For the duration of the grant under subsection (a), each FQHC 
     shall submit to the Secretary an annual progress evaluation 
     and financial reporting indicating activities conducted and 
     the progress of the health center toward achievement of 
     established outcomes, including cost effectiveness, patient 
     satisfaction, program local adaptation, reduction of child 
     maltreatment and injuries, and improvement of parenting 
     behaviors and family functioning.
       (B) Final report.--At the end of the grant period, each 
     FQHC shall submit a final report with evaluation data 
     analysis and conclusions related to the outcomes of the 
     demonstration project.
       (2) Technical assistance reporting.--
       (A) Annual progress and financial report.--For the duration 
     of the contract under subsection (e), each technical 
     assistance provider shall submit to the Secretary an annual 
     progress and financial report indicating activities conducted 
     under such contract.
       (B) Final report.--At the end of the contract period, each 
     recipient of a technical assistance contract under subsection 
     (e) shall submit to the Secretary a final report that 
     includes--
       (i) an analysis of comparative data related to 
     effectiveness and feasibility of projects implemented at the 
     FQHCs, workforce training, and achievement of outcomes at the 
     FQHCs;
       (ii) overall recommendations for system improvement and 
     changes that would allow the demonstration projects to be 
     expanded;
       (iii) an outline of the project results; and
       (iv) a plan that outlines opportunities and vehicles for 
     the dissemination of cross-site evalution results, findings, 
     and recommendations.
       (g) Authorization of Appropriations.--
       (1) In general.--To carry out the demonstration project 
     grant program described in subsection (a), there are 
     authorized to be appropriated $10,000,000 for fiscal year 
     2010, and such sums as may be necessary for each of fiscal 
     years 2011 through 2014.
       (2) Technical assistance.--The Secretary shall reserve not 
     less than 10 percent of the amounts appropriated under 
     paragraph (1) to carry out the technical assistance program 
     described in subsection (e).

                          ____________________