[Congressional Record (Bound Edition), Volume 155 (2009), Part 4]
[House]
[Pages 4394-4400]
[From the U.S. Government Publishing Office, www.gpo.gov]




     STOP CHILD ABUSE IN RESIDENTIAL PROGRAMS FOR TEENS ACT OF 2009

  Mrs. McCARTHY of New York. Mr. Speaker, I move to suspend the rules 
and pass the bill (H.R. 911) to require certain standards and 
enforcement provisions to prevent child abuse and neglect in 
residential programs, and for other purposes.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                                H.R. 911

       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 2009''.

     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 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; or
       (ii) a foster family home that 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 that is licensed and 
     regulated by the State as a foster family home.
       (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 covered program, 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

[[Page 4395]]

     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 immediately, to the maximum 
     extent practicable, but not later than within 48 hours, 
     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 7 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) 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 7 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 7 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.
       (2) 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 contain, 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 7 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 7 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, and including the cause of 
     each such death;
       (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 7 of this 
     Act, and who subsequently own or operate another covered 
     program; and
       (v) any penalties levied under subsection (b)(2) 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

[[Page 4396]]

     has not been remedied through the enforcement process 
     described in subsection (b)(2) 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. 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 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;
       (3) 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 7 of this Act;
       (4) a summary of the Secretary's oversight activities and 
     findings conducted pursuant to subsection (d) of such section 
     114; and
       (5) a description of the activities undertaken by the 
     national toll-free telephone hotline established pursuant to 
     section 3(c)(2).

     SEC. 6. AUTHORIZATION OF APPROPRIATIONS.

       There is authorized to be appropriated to the Secretary of 
     Health and Human Services $15,000,000 for each of fiscal 
     years 2010 through 2014 to carry out this Act (excluding the 
     amendment made by section 7 of this Act and section 8 of this 
     Act).

     SEC. 7. 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; or
       ``(ii) a foster family 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.
       ``(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 2009;
       ``(B) the provision of essential food, water, clothing, 
     shelter, and medical care necessary to 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) establishing 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 substantiated 
     reports of child abuse and neglect may remain confidential 
     and all 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 non-public 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 
     substantiated 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 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), 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 
     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

[[Page 4397]]

     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 non-public 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 2009, 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 2009, 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) an annual review by the Secretary 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 2009.
       ``(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 $235,000,000 for each of fiscal 
     years 2010 through 2014''.
       (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.''.

     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 SPEAKER pro tempore. Pursuant to the rule, the gentlewoman from 
New York (Mrs. McCarthy) and the gentleman from California (Mr. McKeon) 
each will control 20 minutes.
  The Chair recognizes the gentlewoman from New York.


                             General Leave

  Mrs. McCARTHY of New York. Mr. Speaker, I request 5 legislative days 
during which time Members may revise and extend their remarks and 
insert extraneous material on H.R. 911 into the Record.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from New York?
  There was no objection.
  Mrs. McCARTHY of New York. I yield myself such time as I may consume.
  Mr. Speaker, I rise today in support of H.R. 911, the Stop Child 
Abuse in Residential Programs for Teens Act of 2009. I want to thank 
Chairman Miller and the committee staff for working with me on this 
important legislation, and for Mr. Miller's personal leadership on this 
over the years. I would also like to thank Mr. Platts and Mr. McKeon 
for all of the work that they have done on this important issue.
  Over the years, far too many children have been abused in residential 
treatment facilities that were billed as places where parents could 
send their kids to help them overcome behavioral problems. What's even 
more disturbing is that, in many cases, children have died in the care 
of these facilities.
  When we started working on this issue 2 years ago in committee, I 
became outraged over the testimony that we heard. In fact, the 
Government Accountability Office reportedly found thousands of cases of 
abuse and neglect at residential programs for teens. We heard gruesome 
accounts of abuse that occurred in residential treatment facilities.
  These facilities often used highly deceptive marketing practices to 
bill themselves as safe and effective places for troubled teenagers to 
get the help that they need so they could get on with their life. 
Brochures would claim, for example, that counselors are highly trained 
survival experts, but as we heard from the GAO, these so-called highly 
trained survival experts did not recognize the signs of dehydration in 
a 15-year-old girl when she began complaining of blurred version, 
stumbling, and vomiting 3 days into a hike. After the fifth day, she 
died. And she lay there dead in the road for almost 18 hours because 
the survival experts were not equipped with a radio.

[[Page 4398]]

  In other examples, we heard of abuses that included staff members 
forcing children to remain in so-called stress positions for hours at a 
time and to undergo extreme physical exertion without food, water, or 
rest. We even heard of a child that died as a result of being denied 
medically prescribed medication that could have saved his life.
  Parents are sold a bill of goods about these facilities, are enticed 
by advertising schemes portraying these programs as safe with 
professional staff in highly qualified environments for their children.
  I want to say, also, there are many good places that children go to, 
but these are the ones that obviously need to be regulated. When 
parents send their children to these facilities, they are often at the 
end of their ropes and see few, if any, alternatives.
  We heard testimony from parents of children who died while in the 
care of residential treatment facilities. These parents thought they 
were doing the right thing by sending their children. They did research 
on where to send their children. Unfortunately, the information they 
were provided with was misleading. The GAO's investigation work has 
shown that a number of programs had deceptive marketing practices to 
appeal to parents and even uncovered deception, fraud, and conflicts of 
interests.
  Corruption and deception has been a hallmark of many aspects of the 
system surrounding residential treatment centers. In fact, I recently 
read with disgust that two judges were charged after it was found that 
they sent their children to facilities in which they, themselves, had 
financial interests.
  This is the height of corruption, and its impact is felt by the most 
vulnerable among us: children in trouble.
  This bill will create necessary national standards on some very basic 
human rights. For example, we say that child abuse and neglect is 
prohibited. This should be common sense. We say that acts which 
humiliate a child are prohibited. This should be common sense. We say 
that staff must not deny children food and water. This should be common 
sense.
  Another important provision is geared to help parents find good 
residential treatment facilities. We created a national Web site which 
will contain data on residential facilities and require programs to 
include information on their Web site in their marketing materials.
  Finally, we will give money to States to help them create their own 
licensing procedures and a public database on programs.
  This legislation is desperately needed to prevent anymore children 
from dying unnecessarily.
  I urge my colleagues to support H.R. 911.
  I reserve the balance of my time.
  Mr. McKEON. Mr. Speaker, residential treatment programs are 
unfamiliar to most of us. Sometimes referred to as ``wilderness 
therapy'' or ``teen boot camps,'' these programs serve a small number 
of extremely troubled youth.
  While many teens and their families have benefited from residential 
treatment programs, those success stories have been overshadowed by 
instances of abuse, neglect, and worst of all, the loss of life.
  The Education and Labor Committee has been investigating cases of 
abuse and neglect at these facilities for the last several years, and 
the result of that effort is the bill before us today.
  No one in this Chamber condones abuse, neglect, or mistreatment of 
the young people enrolled in these programs. And we all want to find 
the best way to ensure that abuse is prevented and prosecuted if it 
does occur.
  Because this issue is nonpartisan, we've been able to work together 
to find commonsense solutions. The bill before us today is not perfect, 
but it has improved at every step of the process.
  I do wish the bill had been considered under a rule so Members--and 
particularly new Members who were not here in the last Congress when we 
debated this issue--would have had an opportunity to offer amendments. 
Unfortunately, that process has been cut short by considering this bill 
under suspension of the rules.
  On a bill of this importance, I believe that regular order is 
necessary. There are complex issues that we have not yet resolved. For 
instance, we had a rigorous debate during the committee markup about 
how to balance parental rights with necessary treatment. Members on 
this side of the aisle, myself included, believe that more needs to be 
done to ensure that parents are fully informed of and involved with 
medical decisions made at these facilities. I hope that we can work on 
this issue as the bill moves forward and ensure that parental rights 
are protected.
  Mr. Speaker, this bill attempts to address a serious problem. 
Chairman Miller and Congresswoman McCarthy deserve credit for drawing 
attention to these intolerable instances of abuse and for attempting to 
find a solution. I supported this bill in committee, and I continue to 
do so today. But I am disappointed that the process has been short-
circuited. We have another opportunity to work together as this bill 
moves to the other Chamber, and I look forward to doing so.
  I reserve the balance of my time.
  Mrs. McCARTHY of New York. Mr. Speaker, I yield myself as much time 
as I may consume.
  I thank Mr. McKeon for all of the work he did on the committee in 
working with us to bring this bill to the floor. I know that there are 
those that are expressing concern about the process. We have had 
several debates on this particular bill. It did pass last year 
overwhelmingly. We also had the markup last week where amendments were 
added.
  But additionally, certainly I want to stress the bipartisan process 
in developing this legislation as an example to be followed to get the 
best product.
  One of the best things that we need to understand is that we have 
many pressing needs that are coming through the Education Committee and 
many other committees. So this bill had been passed, and I support the 
bill, and I know Mr. McKeon supports the bill. Obviously, we never, 
never have a perfect bill, but the bottom line is we're putting forth 
procedures that will save children's lives. And I think that is the 
most important thing.
  So I certainly encourage Members to vote for this piece of 
legislation.
  With that, I reserve the balance of my time.
  Mr. McKEON. Mr. Speaker, I am prepared to close, and I yield myself 
the balance of my time.
  With this bill, we're trying to do the right thing, but we're doing 
it the wrong way. Through an open process marked by bipartisanship, we 
made considerable improvements to this bill. Unfortunately, flaws 
remain, including a failure to fully protect the rights of parents.
  If this bill had been brought under regular order--we addressed this 
issue, but by rushing it to the floor under a suspension of the rules, 
we've been left with an imperfect, even incomplete product. I trust we 
will not make that same mistake again, and I look forward to addressing 
this issue as the bill moves forward.
  I believe we need to protect the young people in these programs, and 
that's why I will vote ``yes'' today. But I do so with reservations 
because I believe this bill could have been much stronger and 
eventually, I believe it will be made stronger.

                              {time}  1630

  Mr. Speaker, I yield back the balance of my time.
  Mrs. McCARTHY of New York. I yield myself as much time as I may 
consume.
  I know there was a great debate in the committee during the markup 
and many amendments were brought up. And I also know that there were 
some Members that had wanted to insert certain language as far as for 
parents and their rights as far as medication. What we did know is that 
all States have different levels on what the law is for the parents to 
handle that kind of a situation. Many of us felt that it would have 
been too complicated to try to debate that on every single State.
  The practices of many of these residential treatment facilities are 
shocking and outrageous. It is nearly impossible to believe that in the 
United

[[Page 4399]]

States of America there are facilities that would employ child abuse as 
a teaching technique. This behavior goes beyond cruelty; children have 
died. The abuse has not only been carried out on children, who are 
defenseless in these circumstances, the abuse has also been carried out 
against parents who, through their best intentions, were trying to do 
everything they could to bring that child back into a natural setting.
  There is a fundamental right in this country against abuse. That's 
why it is absolutely crucial that we make sure that children are kept 
safe when they are in these facilities by setting minimum safety 
standards. How can anyone oppose the setting of standards that assure 
the safety and well-being of children? How can anyone oppose stopping 
child abuse?
  The bill before us today reflects a bipartisan compromise on 
legislation that we nearly finished last year. It passed the House by a 
bipartisan vote of 318-103, but unfortunately the Senate did not act. 
The legislation is supported by the American Association of Children's 
Residential Centers, the American Bar Association, the American Academy 
of Pediatrics, the American Psychological Association, the Child 
Welfare League of America, Children's Defense Fund, Easter Seals, 
Mental Health America, the National Child Abuse Coalition, and many 
other organizations.
  I urge my colleagues to support this important legislation and end 
these practices once and for all.
  Mr. ROE of Tennessee. Mr. Speaker, I urge support for H.R. 911 
because I think, on balance, this bill will help states prevent further 
negligence at some ``boot-camp'' style facilities. Most programs, like 
the First Freewill Baptist Ministries in my district, do a lot to help 
troubled teens turn their lives around, but a few bad apples risk 
ruining their reputation. This legislation will ask states to 
strengthen their own oversight of these programs, but will not give the 
Federal government oversight.
  While I will support the legislation, I am still concerned that this 
bill goes too far in taking away parents' rights to decide how their 
child will be medicated, and I hope the Chairman will work to improve 
this section before this bill becomes law.
  As written, the legislation will allow residential programs for teens 
to change a child's prescriptions without parental consent. Many of 
these programs are quick to use psychotropic drugs to calm mood swings 
in these teens, and in some cases, the medicating may be warranted. I 
believe, however, that parents should always be given the right to help 
decide on best treatment options for their children, even if it is just 
to grant the facility a waiver to provide treatment. No parent should 
have no say in how their child is medicated, but as it is currently 
written, that would be the result of this bill.
  So I hope we can improve this aspect of the bill, but again, I will 
support this legislation today to move the process forward.
  Ms. JACKSON-LEE of Texas. Mr. Speaker, I rise today in strong support 
of H.R. 911, the ``Stop Child Abuse in Residential Programs for Teen 
Acts of 2009.
  Mr. Speaker, I urge my colleagues to support H.R. 911 and address the 
tragic circumstances that face some of out Nation's youth on a daily 
basis and to underscore our commitment to preventing child abuse and 
neglect so that all children can live in safety and security. I would 
first like to thank my distinguished colleague, Representative George 
Miller of California, for introducing this important piece of 
legislation.
  Mr. Speaker, H.R. 911 seeks to implement an ongoing review process 
for investigating and evaluating reports of child abuse and neglect; 
establish public websites with information about each covered program, 
as well as a national toll-free telephone hotline to receive 
complaints; establish civil penalties for violations of standards; and 
establish a process to ensure that complaints received by the hotline 
are promptly reviewed by persons with appropriate expertise. 
Furthermore, this bill amends the Child Abuse Prevention and Treatment 
Act to establish additional eligibility requirements for grants to 
states to prevent child abuse and neglect at residential programs.
  There are no greater crimes that an individual can commit than the 
crimes of child molestation and child abuse. The perpetrators of these 
crimes rob children of their innocence. Moreover, victims of child 
molestation are profoundly affected for the rest of their lives. As 
elected officials, we have an obligation to condemn this violence, work 
for stronger enforcement of the law and provide adequate funding for 
programs to assist children who may have experienced such abuse.
  At least 1 in 5 adult women and 1 in 10 adult men report having been 
sexually abused as children. In Texas, there were more than 111,000 
investigations of child abuse and neglect by the Child Protective 
Services in Texas, and of those cases 7,650 were sexual abuse.
  The sexual victimization of children is great in magnitude and 
largely either unrecognized or underreported. Statistics show that 1 in 
5 girls and 1 in 10 boys are sexually exploited before they reach 
adulthood. However it is believed that less than 35 percent of the 
incidents are reported to authorities.
  It is estimated that approximately one-third of abused and neglected 
children grow up to victimize their own children. Child abuse and 
neglect can have long-term economical and societal costs. Community-
based services to overburdened families are far less costly than the 
emotional and physical damage inflicted on children. These community-
based services also outweigh potential costs of child protective 
services, law enforcement, courts, foster care, health care, and the 
treatment of adults recovering from child abuse. The annual estimated 
cost to the United States for not preventing child abuse and neglect is 
approximately $104,000,000,000, according to a 2008 report by Prevent 
Child Abuse America.
  Tens of thousands of American children and teens each year are placed 
into residential treatment programs. Many have been abused, neglected, 
and worse, some have died at the hands of those who were supposed to be 
there to care for them. Unscrupulous programs often hire unqualified, 
untrained, uncaring, misinformed, and often mean-spirited staff who do 
not have the qualifications to care for them. The number of children 
placed in residential treatment centers is growing exponentially. These 
modern-day orphanages now house more than 50,000 children nationwide. 
Once placed, these kids may have no meaningful contact with their 
families or friends for up to two years. Despite many documented cases 
of neglect and physical and sexual abuse, monitoring is inadequate to 
ensure that children are safe, healthy and receiving proper services in 
residential treatment centers.
  It will take more than just stronger enforcement of the law to 
prevent child molestation and other forms of child abuse. In order to 
end this serious epidemic that has plagued America, all segments of the 
community such as parents, educators, religious leaders, and community 
leaders must create a nurturing environment for children to develop 
within. The children must know that they are loved and the children 
deserve to be protected from violence and sexual abuse.
  I express my support for the Stop Child Abuse in Residential Programs 
for Teens Act of 2009. I believe we should increase public awareness of 
child abuse and neglect prevention and should continue to work to 
reduce the incidence of child abuse and neglect. We should recognize 
that child abuse and neglect prevention programs reduce child 
maltreatment, strengthen families, reduce mental illness, deter 
criminal behavior, and contribute to children's positive emotional, 
academic, social and cognitive development, but we need more.
  Mr. MATHESON. Mr. Speaker, I have always worked to protect children. 
The recent press reports of abuse, neglect, and tragically death, in 
some residential therapy programs for youth is very concerning to me. 
Over the years, many treatment centers have been established across the 
Nation, including Utah. As a result, Utah has worked hard to license 
and regulate residential treatment programs over the past several years 
and our state meets many of the standards set forth in the legislation 
passed by the House of Representatives.
  It is my understanding that some states have not developed as 
stringent requirements as Utah and that leads to a patchwork of 
regulations where kids can fall through the cracks. 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. I am supportive 
of provisions in this bill which seek to support good actors and 
encourage those who are not to become so. I also feel that steps taken 
by Utah could be an example for other states implementing new 
requirements.
  I was able to include language in the legislation which requested HHS 
study 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.
  Mrs. BACHMANN. Mr. Speaker, as a mother and a former foster mother to 
23 troubled

[[Page 4400]]

teens, I strongly believe in the important 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 wellbeing 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. And, let's be clear: As adult as 
today's teens like to appear, they are still very much children in need 
of adult guidance. Critical decisions regarding the administration of 
prescription medications should only be made by a qualified medical 
doctor with the express consent of a parent or legal guardian.
  Consider contraception, for example. Contraceptives can cause serious 
medical problems like blood clots and migraine headaches. Even worse, 
they can be dispensed in certain combinations to prevent implantation 
of new baby, a form of abortion that many parents and young girls find 
morally reprehensible. This ``morning after pill'' can also be used to 
hide evidence of sexual abuse, one of the very forms of abuse that this 
legislation is seeking to prevent.
  Unfortunately, H.R. 911 would not only allow residential treatment 
facilities to change a child's prescription medication without the 
consent of her or his parent or legal guardian, but without even 
consulting them. Committee Republicans offered language to require 
consent before such a change in prescription medication, but it was 
defeated during committee consideration, almost by party line. The 
right of consent is a necessary component of any decision affecting the 
life of a child, and should be explicitly stated in this legislation.
  Mr. Speaker, the parents and guardians that have raised and cared for 
these children know and understand their children and their medical 
histories best. Without language requiring consent prior to any change 
in prescription medication, the potential positive impact of this 
legislation is lost, and so is the important role of the parent in the 
life of his or her child.
  I urge my colleagues to oppose this bill.
  Mrs. MALONEY. Mr. Speaker, I am pleased to support the Stop Child 
Abuse in Residential Programs for Teens Act, which would require 
standards and enforcement provisions to prevent child abuse and neglect 
in residential programs for teens with behavioral, emotional, mental 
health, or substance abuse problems.
  When families struggle with a troubled teen, many eventually look to 
private or public residential programs for help. Parents deserve to 
know that their child will be safe and in good hands. However, in some 
states residential facilities are subject to state law or regulation, 
but in other states they are not. Because of the resulting loose 
patchwork of state oversight and lack of accountability, at some 
programs, young people have been subject to abuse and neglect. In a 
small number of cases, this abuse and neglect has led to the death of a 
child.
  The Stop Child Abuse in Residential Programs for Teens Act sets new 
national standards to prohibit abuse and neglect and increases 
transparency to help parents make safer choices for their children. The 
bill also holds teen residential programs accountable for violating the 
law and asks states to step in to protect teens in these programs.
  We have an obligation to keep teens safe, especially when they and 
their families are battling behavioral, emotional, mental health, or 
substance abuse problems. I hope that this legislation will support 
families in their pursuit of the health and well-being of their 
children.
  Mrs. McCARTHY of New York. Mr. Speaker, I yield back the balance of 
my time.
  The SPEAKER pro tempore (Mr. Clay). The question is on the motion 
offered by the gentlewoman from New York (Mrs. McCarthy) that the House 
suspend the rules and pass the bill, H.R. 911.
  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. McKEON. 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 and the 
Chair's prior announcement, further proceedings on this motion will be 
postponed.

                          ____________________