[Congressional Record (Bound Edition), Volume 162 (2016), Part 4]
[House]
[Pages 5686-5692]
[From the U.S. Government Publishing Office, www.gpo.gov]




                INFANT PLAN OF SAFE CARE IMPROVEMENT ACT

  Mr. BARLETTA. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 4843) to amend the Child Abuse Prevention and Treatment Act 
to require certain monitoring and oversight, and for other purposes, as 
amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 4843

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

[[Page 5687]]



     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Infant Plan of Safe Care 
     Improvement Act''.

     SEC. 2. BEST PRACTICES FOR DEVELOPMENT OF PLANS OF SAFE CARE.

       Section 103(b) of the Child Abuse Prevention and Treatment 
     Act (42 U.S.C. 5104(b)) is amended--
       (1) by redesignating paragraphs (5) through (8) as 
     paragraphs (6) through (9), respectively; and
       (2) by inserting after paragraph (4), the following:
       ``(5) maintain and disseminate information about the 
     requirements of section 106(b)(2)(B)(iii) and best practices 
     relating to the development of plans of safe care as 
     described in such section for infants born and identified as 
     being affected by illegal substance abuse or withdrawal 
     symptoms, or a Fetal Alcohol Spectrum Disorder;''.

     SEC. 3. STATE PLANS.

       Section 106(b)(2)(B)(iii) of the Child Abuse Prevention and 
     Treatment Act (42 U.S.C. 5106a(b)(2)(B)(iii)) is amended by 
     inserting before the semicolon at the end the following: ``to 
     ensure the safety and well-being of such infant following 
     release from the care of healthcare providers, including 
     through--''

       ``(I) addressing the health and substance use disorder 
     treatment needs of the infant and affected family or 
     caregiver; and
       ``(II) the development and implementation by the State of 
     monitoring systems regarding the implementation of such plans 
     to determine whether and in what manner local entities are 
     providing, in accordance with State requirements, referrals 
     to and delivery of appropriate services for the infant and 
     affected family or caregiver''.

     SEC. 4. DATA REPORTS.

       (a) In General.--Section 106(d) of the Child Abuse 
     Prevention and Treatment Act (42 U.S.C. 5106a(d)) is amended 
     by adding at the end of the following:
       ``(17)(A) The number of infants identified under subsection 
     (b)(2)(B)(ii).
       ``(B) The number of infants for whom a plan of safe care 
     was developed under subsection (b)(2)(B)(iii).
       ``(C) The number of infants for whom a referral was made 
     for appropriate services, including services for the affected 
     family or caregiver, under subsection (b)(2)(B)(iii).''.
       (b) Redesignation.--Effective on May 29, 2017, section 
     106(d) of the Child Abuse Prevention and Treatment Act (42 
     U.S.C. 5106a(d)) is amended by redesignating paragraph (17) 
     (as added by subsection (a)) as paragraph (18).

     SEC. 5. MONITORING AND OVERSIGHT.

       (a) Amendment.--Title I of the Child Abuse Prevention and 
     Treatment Act (42 U.S.C. 5101 et seq.) is further amended by 
     adding at the end the following:

     ``SEC. 114. MONITORING AND OVERSIGHT.

       ``The Secretary shall conduct monitoring to ensure that 
     each State that receives a grant under section 106 is in 
     compliance with the requirements of section 106(b), which--
       ``(1) shall--
       ``(A) be in addition to the review of the State plan upon 
     its submission under section 106(b)(1)(A); and
       ``(B) include monitoring of State policies and procedures 
     required under clauses (ii) and (iii) of section 
     106(b)(2)(B); and
       ``(2) may include--
       ``(A) a comparison of activities carried out by the State 
     to comply with the requirements of section 106(b) with the 
     State plan most recently approved under section 432 of the 
     Social Security Act;
       ``(B) a review of information available on the Website of 
     the State relating to its compliance with the requirements of 
     section 106(b);
       ``(C) site visits, as may be necessary to carry out such 
     monitoring; and
       ``(D) a review of information available in the State's 
     Annual Progress and Services Report most recently submitted 
     under section 1357.16 of title 45, Code of Federal 
     Regulations (or successor regulations).''.
       (b) Table of Contents.--The table of contents in 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:

``Sec. 114. Monitoring and oversight.''.

     SEC. 6. RULE OF CONSTRUCTION.

       Nothing in this Act, or the amendments made by this Act, 
     shall be construed to authorize the Secretary of Health and 
     Human Services or any other officer of the Federal Government 
     to add new requirements to section 106(b) of the Child Abuse 
     Prevention and Treatment Act (42 U.S.C. 5106a(b)), as amended 
     by this Act.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Pennsylvania (Mr. Barletta) and the gentlewoman from Massachusetts (Ms. 
Clark) each will control 20 minutes.
  The Chair recognizes the gentleman from Pennsylvania.


                             General Leave

  Mr. BARLETTA. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their remarks 
and include extraneous materials on H.R. 4843.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Pennsylvania?
  There was no objection.
  Mr. BARLETTA. Mr. Speaker, I yield myself such time as I may consume.
  I rise today in strong support of H.R. 4843, the Infant Plan of Safe 
Care Improvement Act.
  Every 25 minutes in America, a baby is born suffering from opiate 
withdrawal. It is an eye-opening statistic. The more you consider what 
it really means, the more tragic it becomes.
  Every 25 minutes a child enters the world having already been exposed 
to drugs. Every 25 minutes a newborn has to pay the price for something 
that he or she was defenseless against. Every 25 minutes another infant 
becomes a victim of the national opiate crisis.
  These are the victims this bill will help protect. Federal policies, 
including the Child Abuse Prevention and Treatment Act, or CAPTA, have 
long supported State efforts to identify, assess, and treat children 
who are victims of abuse and neglect.
  The law provides States with resources to improve their child 
protective services systems if they assure the Department of Health and 
Human Services that they have put in place certain child welfare 
policies, for example, requiring healthcare providers to notify child 
protective service agencies when a child is born with prenatal illegal 
substance exposure and requiring the development of something known as 
a safe care plan to keep these newborns and their caregivers healthy 
and safe.
  Last year a Reuters investigation examined the care that infants 
receive when they are born to parents struggling with opiate addiction. 
The investigation detailed the heartbreaking consequences those infants 
had to endure, consequences like suffering through the physical pain of 
withdrawal and, in the most shocking cases, terrible deaths.
  It is hard to imagine that stories like these could be any more 
tragic. Unfortunately, they are because they should have and, in many 
cases, could have been prevented. As Reuters revealed, HHS is providing 
Federal funds to States that do not have the necessary child welfare 
policies in place.
  In short, the law is not being properly followed and enforced and 
some of our most vulnerable children and families are slipping through 
the cracks.
  That is why Representative Clark and I worked with a number of our 
colleagues on both sides of the aisle and introduced the legislation 
before us today. The bill requires HHS to better ensure States are 
meeting their legal responsibilities when it comes to preventing and 
responding to child abuse and neglect.
  Through a number of commonsense measures, it strengthens protections 
for infants born with illegal substance exposure, improves 
accountability related to the care of infants and their families, and 
ensures States will have the best practices for developing plans to 
keep infants and their caregivers healthy and safe.
  As the House works this week to fight the opiate epidemic that is 
destroying communities and lives across the country, these are 
commonsense reforms that we all should embrace. By working together and 
advancing this legislation, we can help ensure these children, their 
mothers, and their families have the help they need and the care that 
they deserve.
  I urge my colleagues to support this bipartisan legislation.
  I reserve the balance of my time.
  Ms. CLARK of Massachusetts. Mr. Speaker, I yield myself such time as 
I may consume.
  I am pleased to join with Representative Barletta to introduce this 
important bill to help the most vulnerable victims of the opioid 
epidemic.
  In every corner of our country, the opioid crisis is having a 
devastating effect. In Massachusetts, last year 1,379 people succumbed 
to fatal overdoses. Nationwide, drug overdoses are the leading cause of 
accidental death and we lose 129 people a day to fatal drug overdoses. 
This epidemic doesn't see race, gender, income, or political ideology 
and does not spare newborns and infants.
  We know that every 25 minutes a baby is born suffering from opioid 
withdrawal symptoms. This is a condition known as neonatal abstinence 
syndrome. While there is no silver bullet

[[Page 5688]]

to address this crisis in our country, this bill takes important steps 
to help.
  This bill, the Infant Plan of Safe Care Improvement Act, strengthens 
and updates the care plans required by the Child Abuse Prevention and 
Treatment Act of 1974, also known as CAPTA.
  CAPTA itself is up for reauthorization. This is just one portion of 
that important legislation where timely reauthorization will protect 
children in many different and difficult situations.
  This legislation will help infants by ensuring that States have 
access to the best practices for establishing safe care plans for 
newborns with prenatal substance exposure.
  It will also improve accountability by collecting data on the 
incidence of babies born exposed to drugs and the care that is provided 
to them and their families.
  Perhaps most importantly, it will prevent tragedies by ensuring that 
babies and their moms and their families have the supports they need to 
be healthy and to build a future. We know that children have the best 
opportunity to thrive when their parents and caregivers are at the 
center of care.
  I am grateful to the partnership with Representative Barletta and 
glad that we are taking this important step with this bill to ensure 
that the whole family is healthy and successful and supported.
  I urge my colleagues to support this bill.
  I reserve the balance of my time.
  Mr. BARLETTA. Mr. Speaker, I yield 2 minutes to the gentleman from 
Minnesota (Mr. Kline), the chairman of the Education and the Workforce 
Committee.
  Mr. KLINE. Mr. Speaker, I thank Mr. Barletta for yielding the time 
and for his leadership on this issue.
  Mr. Speaker, I rise today in strong support of the Infant Plan of 
Safe Care Improvement Act. Like many of the bills the House has slated 
to consider this week, this legislation will help address the growing 
opioid epidemic that has swept across America, focusing specifically on 
the most vulnerable among us.
  This crisis has led to a number of painful consequences for 
individuals and families across the country. But few are as tragic as 
those suffered by infants born to parents struggling with an opioid 
addiction.
  As is often the case with addiction, the parents' struggle affects 
those around them, including their newborns. In fact, according to a 
recent Reuters investigation mentioned earlier by Mr. Barletta, more 
than 130,000 babies born in the United States in the last decade 
entered the world addicted to drugs.
  This report described the pain suffered by newborns going through 
withdrawal and told the stories of infants who actually lost their 
lives because of a terrible addiction. Many of the stories are too 
disturbing to even mention. But perhaps even more disturbing than the 
details is the fact that these deaths should have been prevented.
  Current policies, including the Child Abuse Prevention and Treatment 
Act, are meant to prevent these tragedies from ever happening. The law 
is simple. If a State wants to receive Federal funding, then the State 
has to provide some basic assurances about their child welfare 
policies. The Department of Health and Human Services has a 
responsibility to ensure those policies are actually in place.
  As we now know all too well, this important Federal law is not being 
properly followed and enforced. Earlier this year I sent a letter to 
the Department of Health and Human Services to better understand how it 
works with States to ensure they are meeting current child welfare 
requirements.
  Not surprisingly, the Department passed the buck and suggested recent 
changes to the law somehow absolved them from their enforcement 
responsibilities, a disappointing response, to say the least.
  Fortunately, thanks to the work of Mr. Barletta and Ms. Clark, we are 
here today to consider our response to this preventable problem: the 
bill before us today. I appreciate their leadership in developing a 
bipartisan bill that will require the Department to do its job and 
assist States in their efforts to prevent and respond to child abuse 
and neglect.
  I urge my colleagues to support this important legislation and to 
help ensure the most vulnerable victims of the opioid epidemic receive 
the help and care they desperately need.
  Ms. CLARK of Massachusetts. Mr. Speaker, I yield 3 minutes to the 
gentleman from Virginia (Mr. Scott).
  Mr. SCOTT of Virginia. Mr. Speaker, I rise in support of H.R. 4843, 
the Infant Plan of Safe Care Improvement Act.
  Mr. Speaker, one of our highest national priorities should be to 
ensure that children have early quality opportunities to remove 
barriers to success in future life. But children born dependent on 
addictive substances face severe obstacles to overcome, and we know 
that many of these obstacles can be removed.
  The Child Abuse Prevention and Treatment Act, CAPTA, is meant to 
support infants born addicted to these illegal substances. 
Unfortunately, nearly every State fails to follow the CAPTA 
requirements, which work to ensure that children born of these 
circumstances have a plan of safe care that will help them grow up 
healthy.
  H.R. 4843 is a strong positive first step to safeguard the well-being 
of our Nation's most vulnerable children. It will strengthen an 
infant's plan of safe care. It will help families and caregivers give 
the guidance and support they need in order to provide a nurturing 
environment for these children.
  I welcome this bipartisan agreement to amend CAPTA as part of the 
comprehensive efforts to intervene and treat those affected by 
substance abuse. I therefore urge my colleagues to support H.R. 4843.
  Ms. CLARK of Massachusetts. Mr. Speaker, I want to thank the 
gentleman from Virginia (Mr. Scott) for his leadership on this issue 
and so many involving the welfare and health of our children.
  I reserve the balance of my time.
  Mr. BARLETTA. Mr. Speaker, in response to an inquiry from the 
Education and the Workforce Committee Chairman Kline and Chairman 
Rokita of the Subcommittee on Early Childhood, Elementary, and 
Secondary Education, HHS indicated that it would request additional 
information from States regarding their child protective services 
notification processes and plans of safe care policies. HHS has started 
this process.
  I include in the Record the HHS Children's Bureau Program Instruction 
requesting this additional information.

              U.S. Department of Health and Human Services


             Administration on Children, Youth and Families

       1. Log No: ACYF-CB-PI-16-03
       2. Issuance Date: April 13, 2016
       3. Originating Office: Children's Bureau
       4. Key Words: Title IV-B Child and Family Services Plan; 
     Annual Progress and Services Report; Child Abuse Prevention 
     and Treatment Act State Plan; Chafee Foster Care Independence 
     Program; Education and Training Vouchers Program


                          PROGRAM INSTRUCTION

       To: State Agencies, Territories, and Insular Areas 
     Administering or Supervising the Administration of Title IV-
     B, subparts 1 and 2, and Title IV-E of the Social Security 
     Act (the Act); Organization Designated by the Governor to 
     Apply for Child Abuse and Neglect Prevention and Treatment 
     Programs State Grant Funds; State Independent Living and 
     Education and Training Voucher Coordinators.
       Subject: June 30, 2016, submission of: (1) the second 
     Annual Progress and Services Report (APSR) to the 2015-2019 
     Child and Family Services Plan (CFSP) for the Stephanie Tubbs 
     Jones Child Welfare Services (CWS), the Promoting Safe and 
     Stable Families (PSSF) and Monthly Caseworker Visit Grant 
     programs; and the Chafee Foster Care Independence Program 
     (CFCIP) and the Education and Training Vouchers (ETV) 
     Program; (2) the Child Abuse Prevention and Treatment Act 
     (CAPTA) State Plan update; and (3) the CFS-101, Part I, 
     Annual Budget Request, Part II, Annual Summary of Child and 
     Family Services, and Part III, Annual Expenditure Report-
     Title IV-B, subparts 1 and 2, CFCIP, and ETV.
       Legal and Related References: Title IV-B, subparts 1 and 2, 
     sections 421-425, 428, 430-438, and title IV-E, section 477 
     of the Act; sections 106 and 108 of CAPTA (42 U.S.C. 5106a. 
     and 5106d.), as amended by Public Law (P.L.) 111-320, the 
     CAPTA Reauthorization Act of 2010; the Indian Child Welfare 
     Act. (ICWA) of 1978 (P.L. 95-608); the Indian Self-
     Determination and Education Assistance Act (P.L. 93-

[[Page 5689]]

     638); 45 CFR Parts 1355 and 1357; The Fostering Connections 
     to Success and Increasing Adoptions Act of 2008 (P.L. 110-
     351); the Patient Protection and Affordable Care Act (P.L. 
     111-148); the Child and Family Services Improvement and 
     Innovation Act of 2011 (P.L. 112-34); the Preventing Sex 
     Trafficking and Strengthening Families Act (P.L. 113-183); 
     and the Justice for Victims of Trafficking Act of 2015 (P.L. 
     114-22).
       Purpose: This Program Instruction (PI) provides guidance to 
     states, territories, and insular areas (hereafter ``states,'' 
     unless otherwise noted) on actions they are required to take 
     to receive their allotments for federal fiscal year (FY) 2017 
     (subject to the availability of appropriations) authorized 
     under title IV-B, subparts 1 and 2, section 106 of CAPTA, 
     CFCIP and ETV programs.
       This PI summarizes the actions required in completion and 
     submission of (1) the second APSR to the 2015-2019 CFSP, (2) 
     the CAPTA Update, and (3) the CFS-101, Parts I, II, and III.
       A separate PI addresses requirements for tribes, tribal 
     consortia, and tribal organizations applying for funding 
     under these programs.
       We note that the title IV-B programs (subparts 1 and 2) are 
     required to be reauthorized periodically by the Congress. The 
     Child and Family Services Improvement and Innovation Act, 
     signed into law on September 30, 2011, last reauthorized 
     funding for these programs for five years through FY 2016. 
     The guidance provided in this PI assumes that the programs 
     will be extended without significant changes. Should new 
     legislation be enacted that would affect the steps that 
     states must take to receive funding for FY 2017, additional 
     guidance will be provided.


          INFORMATION: Organization of the Program Instruction

       Section A. Background
       Section B. Continued Integration of the Child and Family 
     Services Review Process with the CFSP/APSR
       Section C. Requirements for 2017 APSR (Due June 30, 2016)
       Section D. CAPTA State Plan Requirements and Update
       Section E. Chafee Foster Care Independence Program
       Section F. Updates to Targeted Plans within the 2015-2019 
     CFSP
       Section G. Statistical and Supporting Information
       Section H. Financial Information
       Section I. Instructions for the Submission of the 2017 APSR 
     for States, Puerto Rico, and the District of Columbia
       Section J. Submittal Rule for Insular Areas
       Attachments


Section D. Child Abuse Prevention and Treatment Act (CAPTA) State Plan 
                        Requirements and Update

       States submitted a plan for the CAPTA State Grant on June 
     30, 2011. Once approved by CB, the CAPTA State Plan remains 
     in effect for the duration of the state's participation in 
     the CAPTA State Grant program. However, section 108(e) of 
     CAPTA requires states receiving a CAPTA State Grant to submit 
     an annual report describing its use of the grant. To 
     facilitate coordination between the CAPTA State Plan and the 
     title IV-B plan, as required by section 106(b)(2)(A) of 
     CAPTA, CB requires that the annual report describing use of 
     CAPTA funds be submitted with the APSR. In addition, CB 
     encourages states to use CAPTA State Grant funds in a manner 
     that aligns with and supports their overall goals for the 
     delivery and improvement of child welfare services, as they 
     continue to implement their 2015-2019 CFSP and APSR goals.


                In the State's 2017 Annual CAPTA Report

       Describe substantive changes, if any, to state law or 
     regulations, including laws and regulations relating to the 
     prevention of child abuse and neglect, that could affect the 
     state's eligibility for the CAPTA State Grant (section 
     106(b)(1)(C)(i) of CAPTA). The state must also include an 
     explanation from the State Attorney General as to why the 
     change would, or would not, affect eligibility. (Note: States 
     do not have to notify ACF of statutory changes or submit them 
     for review if they are not substantive and would not affect 
     eligibility.)
       Describe any significant changes from the state's 
     previously approved CAPTA plan in how the state proposes to 
     use funds to support the 14 program areas enumerated in
     section 106(a) of CAPTA. (See section 106(b)(1)(C)(ii) of 
     CAPTA).
       Describe how CAPTA State Grant funds were used, alone or in 
     combination with other federal funds, in support of the 
     state's approved CAPTA plan to meet the purposes of the 
     program since the state submitted its last update on June 30, 
     2015 (section 108(e) of CAPTA).
       Submit a copy of the annual report(s) from the citizen 
     review panels and a copy of the state agency's most recent 
     response(s) to the panels and state and local child 
     protective services agencies, as required by section 
     106(c)(6) of CAPTA.
       Update on Services to Substance-Exposed Newborns
       In addition to the information outlined above, CB requests 
     an update from states on implementation of CAPTA provisions 
     relating to substance-exposed newborns. Sections 
     106(b)(2)(B)(ii) and (iii) of CAPTA require states to have a 
     statewide program relating to child abuse and neglect that 
     includes:
       --policies and procedures (including appropriate referrals 
     to child protection service systems and for other appropriate 
     services) to address the needs of infants born with and 
     identified as being affected by illegal substance abuse or 
     withdrawal symptoms resulting from prenatal drug exposure, or 
     a Fetal Alcohol Spectrum Disorder, including a requirement 
     that health care providers involved in the delivery or care 
     of such infants notify the child protective services system 
     of the occurrence of such condition of such infants, except 
     that such notification shall not be construed to--
       I. establish a definition under Federal law of what 
     constitutes child abuse or neglect; or
       II. require prosecution for any illegal action.
       --the development of a plan of safe care for the infant 
     born and identified as being affected by illegal substance 
     abuse or withdrawal symptoms or Fetal Alcohol Spectrum 
     Disorder.
       The most recent national data on child abuse and neglect 
     from the National Child Abuse and Neglect Data System 
     (NCANDS) showed increases in FY 2014 compared to FY 2013 in 
     the number of children referred to CPS, the number of 
     children who received a CPS investigation or alternative 
     response and the number of children who were determined to be 
     victims of child abuse and neglect. While increases 
     nationally were relatively small, some states saw increases 
     of 15 percent or more in the number of children determined to 
     be victims. Nationally, states reported to NCANDS that more 
     than one-quarter (27.4%) of victims were younger than 3 years 
     and that the victimization rate was highest for children 
     younger than 1 year (24.4 per 1,000 children in the 
     population of the same age).
       State commentary and data on risk factors associated with 
     reports of abuse and neglect indicate that caretaker alcohol 
     and drug abuse are significant factors associated with 
     reports of child abuse and neglect. For states reporting to 
     NCANDS, 9.2 percent of victims and 3.8 percent of nonvictims 
     were reported with the alcohol abuse caregiver risk factor 
     and 26.0 percent of victims and 8.2 percent of nonvictims 
     were reported with the drug abuse caregiver risk factor. 
     Beyond reports to NCANDS, increasing public attention is 
     being paid to the significant effect of opioid addiction on 
     individuals, families and communities.
       In light of these trends, states are requested to provide 
     an update on their implementation of these provisions of 
     CAPTA.


                    In the 2017 CAPTA Annual Report

       Describe the policies and procedures the state has in place 
     to address the needs of infants born with and identified as 
     being affected by illegal substance abuse or withdrawal 
     symptoms resulting from prenatal drug exposure, or a Fetal 
     Alcohol Spectrum Disorder, including a requirement that 
     health care providers involved in the delivery or care of 
     such infants notify the child protective services system of 
     the occurrence of such condition of such infants (section 
     106(b)(2)(B)(ii) of CAPTA). We note that such notification 
     should occur in any instance in which an infant is 
     demonstrating withdrawal symptoms due to prenatal drug 
     exposure, whether the drugs were obtained legally or 
     illegally.
       Describe the state's policies and procedures for developing 
     a plan of safe care for infants born and identified as being 
     affected by illegal substance abuse or withdrawal symptoms or 
     Fetal Alcohol Spectrum Disorder (section 106(b)(2)(B)(iii)). 
     Describe which agency or entity is responsible for developing 
     a plan of safe care, how it is monitored and how follow-up is 
     conducted to ensure the safety of these infants.
       Describe any technical assistance the state needs to 
     improve practice and implementation in these areas, including 
     how to support mothers and families, as well as infants, 
     through a plan of safe care.
       Amendments to CAPTA made by P.L. 114-22, the Justice for 
     Victims of Trafficking Act of 2015:
       As noted in Section A of this PI, the Justice for Victims 
     of Trafficking Act of 2015 included amendments to CAPTA that 
     become effective on May 29, 2017.
       The law amended CAPTA's definition of ``child abuse and 
     neglect'' and ``sexual abuse'' by adding a special rule that 
     a child shall be considered a victim of `child abuse and 
     neglect' and of `sexual abuse' if the child is identified, by 
     a state or local agency employee of the state or locality 
     involved, as being a victim of sex trafficking or severe 
     forms of trafficking (as defined in sections 103(9)(A) and 
     (10) of the Trafficking Victims Protection Act (TVPA)).
       --As defined in section 103(10) of TVPA, ``sex 
     trafficking'' means the recruitment, harboring, 
     transportation, provision, obtaining, patronizing, or 
     soliciting of a person for the purpose of a commercial sex 
     act.
       --As defined in section 103(9)(A) of TVPA, ``severe forms 
     of trafficking in persons'' means sex trafficking in which a 
     commercial sex act is induced by force, fraud, or coercion, 
     or in which the person induced to perform such act has not 
     attained 18 years of age.

[[Page 5690]]

       The amendments also specify that, notwithstanding the 
     general definition of a ``child'' in CAPTA, a state may opt 
     to apply the sex trafficking portion of the definition of 
     ``child abuse and neglect'' and ``sexual abuse'' to a person 
     who has not attained age 24.
       In addition to expanding the definitions of child abuse and 
     neglect and sexual abuse applicable to the CAPTA State Grant, 
     the law added new requirements to the list of assurances a 
     state must provide to receive a CAPTA State Grant. Each state 
     will now need to provide an assurance that the state has in 
     effect and is operating a statewide program, relating to 
     child abuse and neglect that includes:
       --provisions and procedures regarding identifying and 
     assessing all reports involving known or suspected child sex 
     trafficking victims (as defined in section 103(10) of the 
     Trafficking Victims Protection Act of 2000 (TVPA) (22 U.S.C. 
     7102)); and
       --provisions and procedures for training CPS workers about 
     identifying, assessing and providing comprehensive services 
     to children who are sex trafficking victims, including 
     efforts to coordinate with state law enforcement, juvenile 
     justice, and social service agencies such as runaway and 
     homeless youth shelters.
       Finally, the amendments add to the list of data elements a 
     state must annually report, to the maximum extent 
     practicable, as a condition of receiving their CAPTA State 
     Grant. Beginning with submission of FY 2018 data, the CB 
     expects to ask states to report the number of children who 
     are victims of sex trafficking. The CB anticipates collecting 
     this information through NCANDS. Additional information on 
     NCANDS data reporting will be provided separately from this 
     PI.


                    In the 2017 CAPTA Annual Report

       Describe the steps that the state is taking or will need to 
     take to address the amendments to CAPTA relating to sex 
     trafficking in order to implement those provisions by May 29, 
     2017.
       Provide an assessment of the changes the state will need to 
     make to its laws, policies or procedures to ensure that 
     victims of sex trafficking, as defined in sections 103(9)(A) 
     and (10) of the TVPA, are considered victims of child abuse 
     and neglect and sexual abuse. We note that it is likely that 
     some states will need to make changes to state laws to come 
     into compliance. Indicate whether the state is electing to 
     apply the sex trafficking portion of the definition of 
     ``child abuse and neglect'' and ``sexual abuse'' to persons 
     who are over age 18 but have not yet attained age 24.
       Provide an update on the state's progress and planned 
     activities in the coming year to develop provisions and 
     procedures regarding identifying and assessing all reports 
     involving known or suspected child sex trafficking victims.
       Provide an update on the state's progress and planned 
     activities in the coming year to develop provisions and 
     procedures for training CPS workers about identifying, 
     assessing and providing comprehensive services to children 
     who are sex trafficking victims, including efforts to 
     coordinate with state law enforcement, juvenile justice, and 
     social service agencies such as runaway and homeless youth 
     shelters.
       In addition, no later than May 29, 2017, states must submit 
     the new CAPTA assurances relating to sex trafficking. These 
     assurances are to be provided in the form of a certification 
     signed by the State's Governor (see Attachment F). The signed 
     assurance may be returned with the 2017 CAPTA Annual Report 
     submitted with the APSR due June 30, 2016, if the state is 
     ready to submit them by that time. If not, the state may 
     submit the certification at a later date, but no later than 
     May 29, 2017.
       If the state anticipates it will be unable to submit these 
     assurances by May 29, 2017, provide an explanation as to why 
     that is the case.
       Identify any technical assistance needs the state has 
     identified relating to implementation of the amendments to 
     CAPTA made by the Justice for Victims of Trafficking Act of 
     2015.
       States must include all required information indicated 
     above in their 2017 CAPTA Annual Report to be submitted as 
     part of the 2017 APSR. Missing or incomplete information will 
     result in the withholding of CAPTA funds until such time as 
     approval can be granted by CB. Please note that compliance 
     with the eligibility requirements for a CAPTA State Grant 
     program is a prerequisite for eligibility to receive funding 
     under the Children's Justice Act State Grant Program, 
     authorized by section 107(a) of CAPTA.
       Finally, to facilitate ongoing communication between CB and 
     states on issues relating to CAPTA and child abuse and 
     neglect, please submit the name, address, and email for the 
     state CAPTA coordinator (also known as the State Liaison 
     Officer) or where this information can be found on the 
     state's website.
  Mr. BARLETTA. Mr. Speaker, I yield 2 minutes to the gentleman from 
Pennsylvania (Mr. Thompson).
  Mr. THOMPSON of Pennsylvania. Mr. Speaker, I rise in support of H.R. 
4843, the Infant Plan of Safe Care Improvement Act. Introduced by my 
colleague and friend, Mr. Barletta, this bill takes steps to strengthen 
protections for our Nation's most precious and vulnerable population: 
infants and children.
  In Pennsylvania alone, nearly 8,000 infants were diagnosed with 
neonatal abstinence syndrome between 2010 and 2014, and that number is 
increasing every day.

                              {time}  1545

  Neonatal abstinence syndrome, or NAS, is defined by the National 
Institutes of Health as a set of problems that occurs in a newborn who 
was exposed to addictive opiate drugs while in the mother's womb. 
Infants experiencing NAS can endure fevers, rapid breathing, seizures, 
and even death.
  While States are currently required to certify to the Department of 
Health and Human Services that they have developed a safe care plan for 
infants born under these conditions, it has come to light that HHS does 
not independently verify State plans unless there is a specific reason 
to do so.
  My cosponsorship of this bill is a direct assertion of my belief that 
our Nation's infants deserve more from legislators, Federal agencies, 
and the administration. This valuable legislation will help clarify the 
intent of safe care plans, provide States with best practices for 
keeping infants safe, and improve accountability across the board.
  Mr. Speaker, every district in every State in the United States has 
been affected by what has been referred to as a substance abuse 
epidemic. While there is hope in the fact that the House is taking up 
more than a dozen opioid bills this week, we must not lose sight of the 
long road ahead of us.
  I urge my colleagues to support H.R. 4843 and join the fight to 
defend our Nation's children.
  Ms. CLARK of Massachusetts. Mr. Speaker, I reserve the balance of my 
time.
  Mr. BARLETTA. Mr. Speaker, I yield 1 minute to the gentleman from 
Georgia (Mr. Carter).
  Mr. CARTER of Georgia. I thank the gentleman for yielding.
  Mr. Speaker, I rise in support of H.R. 4843, the Infant Plan of Safe 
Care Improvement Act, because when newborn infants are tragically 
affected by illegal substance abuse, they deserve the best possible 
care and treatment.
  The Child Abuse Prevention and Treatment Act, which was enacted in 
1974, set the groundwork for Federal coordination in addressing the 
issues of neglect and child abuse that is present in our country. H.R. 
4843 builds on that by updating and improving existing laws to ensure 
that States are utilizing Federal dollars in a safe and effective way 
in providing care for children who suffer from illegal substance abuse, 
withdrawal symptoms, or fetal alcohol spectrum disorders.
  Under this bill, infants who are born with having had exposure to 
illegal substances will have strengthened protections through improved 
safe care plans and best practices. As a lifelong pharmacist and 
healthcare professional, I have seen firsthand families as they 
struggle to provide the care that is needed by infants who suffer from 
these conditions.
  I commend Congressman Barletta and the Committee on Education and the 
Workforce for their leadership on this important legislation, and I 
encourage my colleagues to support this bill so we can care for 
precious newborn infants across the country.
  Ms. CLARK of Massachusetts. Mr. Speaker, I reserve the balance of my 
time.
  Mr. BARLETTA. Mr. Speaker, I yield 2 minutes to the gentleman from 
Michigan (Mr. Walberg).
  Mr. WALBERG. I thank Mr. Barletta for what he is doing here today.
  Mr. Speaker, I rise as a proud original cosponsor of H.R. 4843, the 
Infant Plan of Safe Care Improvement Act, which takes important steps 
in protecting our most vulnerable citizens from the damaging effects of 
addiction.
  As communities in Michigan and around the country fight against the 
growing opioid epidemic, it is important for stakeholders at all levels 
to

[[Page 5691]]

work together to reverse the trends of addiction and find solutions for 
the families who are swept up by this public health crisis. Tragically, 
we know that, every 25 minutes, a baby is born in our country having 
been exposed to drugs and suffering from opioid withdrawal.
  A Federal law is already in place to help ensure these newborns have 
the necessary protections and care once they are born, but the system 
is still failing some of our most defenseless children and their 
families. Recent investigations have uncovered the failure of the 
Department of Health and Human Services to effectively monitor the 
implementation of State-level plans to prevent child abuse and neglect, 
and some States are still receiving taxpayer dollars despite their not 
following the laws that are in place to ensure the safe care of 
newborns.
  The bill we are considering today would require HHS to review and 
confirm that States are properly following and enforcing the policies 
that are outlined in Federal law to protect infants who are affected by 
drug dependency. It also strengthens protections for infants who have 
been exposed to illegal substances, and it ensures best practices are 
disseminated to States for developing plans to keep infants and their 
caregivers safe.
  Mr. Speaker, we must do better to provide these babies and their 
mothers with the help they need.
  I thank my colleagues, Representatives Barletta and Clark, for their 
leadership in crafting this bipartisan bill, and I encourage all of my 
colleagues to vote in support.
  Ms. CLARK of Massachusetts. Mr. Speaker, I yield myself the balance 
of my time.
  Again, many thanks to the gentleman from Pennsylvania for his 
partnership and his leadership on this issue.
  Mr. Speaker, I am particularly proud that this legislation takes a 
comprehensive look at not only protecting our newborns and infants but 
at putting the supports in place to ensure that their mothers and 
fathers and grandparents and families have the services they need and 
deserve to have the best outcomes for these babies and children and 
their family units. I am very pleased that this bill is before us 
today, and I urge my colleagues to support this bill.
  Mr. Speaker, I yield back the balance of my time.
  Mr. BARLETTA. Mr. Speaker, I yield myself the remainder of my time.
  In closing, I reiterate the purpose and the importance of this 
legislation. No government, Federal or State, should be allowed to 
skirt its responsibilities on the taxpayers' dime, especially when 
those responsibilities involve the health and safety of children. We 
have seen what can happen when they do, and none of us should be okay 
with allowing those kinds of consequences to continue. Making sure they 
don't is a responsibility that we all share.
  In the end, this bill is not about pointing fingers or about placing 
blame. It is about the kids who need help, not only the infants who are 
affected by the opioid crisis, but all of the victims of child abuse 
and neglect. This bill is about ensuring that we work together to 
strengthen the protections for our country's most vulnerable children 
and their families.
  I urge my colleagues to support this legislation.
  Mr. Speaker, I yield back the balance of my time.
  Ms. JACKSON LEE. Mr. Speaker, I rise in support of H.R. 4843, the 
``Improving Safe Care for the Prevention of Infant Abuse and Neglect 
Act,'' approved by the Education and the Workforce Committee.
  In the past decade and a half, the growth in the number of physicians 
prescribing opioids to help patients deal with pain from surgeries, 
dental work and chronic conditions has resulted in an increasing number 
of patients becoming dependent on the powerful and highly addictive 
painkillers--with patients not only abusing the use of those 
painkillers but often turning to heroin once their opioid prescription 
ended.
  The Centers for Disease Control and Prevention reports that nearly 
259 million opioid prescriptions were written in 2012, more than enough 
for every adult in the United States, and it is estimated that in 2013 
nearly 4.5 million people in the United States without a valid medical 
need were using prescription painkillers.
  The Health and Human Services Department estimates that the number of 
unintentional overdose deaths from prescription painkillers almost 
quadrupled between 1999 and 2013 and that abuse of prescription opioids 
now kills nearly 30,000 Americans each year.
  The ``Child Abuse Prevention and Treatment Act'' (CAPTA; PL 93-247) 
was enacted in 1974 to coordinate federal and state efforts to prevent 
and respond to child abuse and neglect.
  The law provides states with federal funds to improve their child 
protective services systems; however, to receive the funds, states are 
supposed to implement certain child welfare policies.
  CAPTA was amended in 2003 by the ``Keeping Children and Families Safe 
Act,'' (PL 108-36) that requires health care providers to notify child 
protective services agencies when a child is born with prenatal 
substance exposure or addiction.
  The protective services agencies are supposed to develop a ``safe 
care plan'' to protect the babies.
  The law explicitly states that it is meant to protect drug-dependent 
newborns and not to punish mothers who are dealing with addiction.
  In December 2015, Reuters published the first in a series of articles 
documenting the failure of health care providers and state child 
protective services to help these infants.
  Based on information from 2013, the latest year for which data are 
available, there were 27,000 cases of drug-dependent babies born that 
year, up from 5,000 in 2003 when CAPTA's notification requirements were 
enacted.
  However, more than 30 states do not require doctors to report cases 
of infants born with addictions.
  Some states have interpreted the law to mean that only addiction to 
illegal substances need be reported.
  This means that if the mother is taking prescribed drugs, even if the 
infant is born with an addiction, they do not require that the 
addiction be reported.
  In addition, even in states where infants born with drug dependencies 
must be reported to child protective services agencies, these agencies 
often take no steps toward developing a safe care plan for these 
infants.
  As a result, infants die because of neglect or abuse in their homes.
  Reuters identified 110 fatalities since 2010 of babies and toddlers 
whose mother used opioids during pregnancy and who later died from 
causes that could have been prevented.
  I recognize that infant mortality is at unprecedentedly high rates in 
our nation.
  Seeking to right the same wrongs as H.R. 4843, the ``Improving Safe 
Care for the Prevention of Infant Abuse and Neglect Act,'' I introduced 
the ``Stop Infant Mortality and Recidivism Reduction Act of 2016,'' or 
the ``SIMARRA Act,'' which will help the Federal Bureau of Prisons to 
improve the effectiveness and efficiency of the Federal prison system 
for pregnant offenders, by establishing a pilot program of critical-
stage, developmental nurseries in Federal prisons for children born to 
inmates.
  It is time that our nation recognizes a long-persistent need to break 
the cycle of generational, institutional incarceration amongst mothers 
serving time for non-violent crimes and the children they birth behind 
prison bars.
  H.R. 5130, the ``SIMARRA Act of 2016,'' gives those infants born to 
incarcerated mothers a chance to succeed in life.
  ``SIMARRA'' is not merely yet another second chance program, 
demanding leniency from the criminal justice system.
  Instead, H.R. 5130 asks our national criminal justice system what it 
can do for those young Americans born and relegated to a life of nearly 
impossible odds of survival.
  ``SIMARRA'' provides that first chance--a first chance for American 
infants--that many of their mothers, born themselves to mothers behind 
bars, never received.
  H.R. 4843 requires the Health and Human Services Department (HHS) to 
review and confirm that states have enacted and implemented the child 
protection policies required by the Child Abuse and Treatment Act, 
including the requirement that addicted newborns are cared for.
  Specifically, in order to receive a grant for its child protective 
services system, a state must certify that it has a law or statewide 
program for child abuse and neglect that includes a safe care plan for 
an infant born with substance addiction after the infant is released 
from the care of health care providers.
  HHS must monitor the compliance of each state that receives a grant.

[[Page 5692]]

  Under the measure, states must also develop and implement monitoring 
systems to follow the safe care plans and determine whether local 
entities are providing referrals to, and delivery of, appropriate 
services for the infant and the affected family or caregiver.
  States must include in their annual data reports the total number of 
affected infants for whom a safe care plan was developed and for whom 
there were referrals to appropriate services, including services for 
the affected family or caregiver.
  The bill requires HHS to maintain and disseminate information 
regarding the requirements and best practices relating to the 
development of safe care plans for infants born with substance 
addiction.
  H.R. 4843, the ``Improving Safe Care for the Prevention of Infant 
Abuse and Neglect Act,'' is a valuable piece of legislation that I 
encourage my colleagues to support.
  Additionally, I urge my colleagues to join me in sponsoring and 
supporting all legislation targeting the improvement of care for the 
prevention of infant abuse and neglect, such as H.R. 5130, the ``Stop 
Infant Mortality and Recidivism Reduction Act of 2016'' or the 
``SIMARRA Act.''
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Pennsylvania (Mr. Barletta) that the House suspend the 
rules and pass the bill, H.R. 4843, as amended.
  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. BARLETTA. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, further 
proceedings on this motion will be postponed.

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