[House Report 110-669]
[From the U.S. Government Publishing Office]





110th Congress                                                   Report
                        HOUSE OF REPRESENTATIVES
 2d Session                                                     110-669

======================================================================



 
     STOP CHILD ABUSE IN RESIDENTIAL PROGRAMS FOR TEENS ACT OF 2008

                                _______
                                

  May 22, 2008.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

 Mr. George Miller of California, from the Committee on Education and 
                     Labor, submitted the following

                              R E P O R T

                             together with

                            ADDITIONAL VIEWS

                        [To accompany H.R. 5876]

      [Including cost estimate of the Congressional Budget Office]

  The Committee on Education and Labor, to whom was referred 
the bill (H.R. 5876) to require certain standards and 
enforcement provisions to prevent child abuse and neglect in 
residential programs, and for other purposes, having considered 
the same, report favorably thereon with an amendment and 
recommend that the bill as amended do pass.
  The amendment is as follows:
  Strike all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE.

  This Act may be cited as the ``Stop Child Abuse in Residential 
Programs for Teens Act of 2008''.

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 not operated by a 
                governmental 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;
                          (ii) a foster family home or group 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 or group home; or
                          (iii) a psychiatric residential treatment 
                        facility that is certified as meeting the 
                        requirements specified in regulations 
                        promulgated for such facilities under section 
                        1905(h)(1)(A) of the Social Security Act and 
                        that provides psychiatric services for which 
                        medical assistance is available under a State 
                        plan under title XIX of such Act.
          (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 location of a covered program that 
        individually or together with other locations has an effect on 
        interstate commerce, 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 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 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 8 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) Inspections.--The Assistant Secretary shall establish a 
        process for conducting unannounced site inspections of each 
        location of a covered program to determine compliance with the 
        standards required under subsection (a)(1). Such inspections 
        shall--
                  (A) begin not later than the date on which the 
                Assistant Secretary promulgates interim regulations 
                under subsection (a)(2)(A); and
                  (B) be conducted at each location of each covered 
                program not less often than once every two years, until 
                such time as the Assistant Secretary has determined a 
                State has appropriate health and safety licensing 
                requirements, monitoring, and enforcement of covered 
                programs in such State, as determined in accordance 
                with section 114(c) of the Child Abuse Prevention and 
                Treatment Act, as added by section 8 of this Act.
          (2) 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 8 
        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 8 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.
          (3) 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 8 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 8 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;
                          (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 8 of this Act, and who 
                        subsequently own or operate another covered 
                        program; and
                          (v) any penalties levied under subsection 
                        (b)(3), any judgments or orders issued by a 
                        court pursuant to section 5, 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 has not been remedied through the enforcement 
process described in subsection (b)(3) 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. PRIVATE RIGHT OF ACTION.

  (a) Maintenance of Action.--Any person suffering an injury-in-fact 
traceable to a violation of a regulation promulgated pursuant to 
section 3(a) may bring suit or a claim demanding relief.
  (b) Relief.--A court hearing a claim or suit under subsection (a) may 
order any appropriate equitable remedy and award damages, including 
punitive damages and reasonable attorneys' fees, for a violation of a 
regulation promulgated pursuant to section 3(a).
  (c) Limitation.--The provisions of section 7 of the Civil Rights of 
Institutionalized Persons Act (42 U.S.C. 1997e) shall not apply to any 
action brought under this Act.

SEC. 6. 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 description of the number and types of covered programs 
        inspected by the Assistant Secretary pursuant to section 
        3(b)(1);
          (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 findings from on-going reviews conducted by 
        the Assistant Secretary pursuant to section 3(b)(2);
          (4) 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 8 of this Act; and
          (5) a summary of the Secretary's oversight activities and 
        findings conducted pursuant to subsection (d) of such section 
        114.

SEC. 7. AUTHORIZATION OF APPROPRIATIONS.

  There is authorized to be appropriated to the Secretary of Health and 
Human Services $50,000,000 for each of fiscal years 2009 through 2013 
to carry out this Act (excluding the amendment made by section 8 of 
this Act).

SEC. 8. 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;
                          ``(ii) a foster family home or group 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 
                        or group home; or
                          ``(iii) a psychiatric residential treatment 
                        facility that is certified as meeting the 
                        requirements specified in regulations 
                        promulgated for such facilities under section 
                        1905(h)(1)(A) of the Social Security Act and 
                        that provides psychiatric services for which 
                        medical assistance is available under a State 
                        plan under title XIX of such Act.
          ``(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 2008;
                  ``(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) 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 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;
                  ``(C) conducting unannounced site inspections not 
                less often than once every two years at each location 
                of a covered program;
                  ``(D) creating a 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 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), 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 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 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 2008, 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 2008, 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) annually, a random sample of review 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 2008.
          ``(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 
$200,000,000 for each of fiscal years 2009 through 2013''.
  (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.''.

                               I. Purpose

    The purpose of H.R. 5876, the ``Stop Child Abuse in 
Residential Programs for Teens Act of 2008'' is to ensure the 
safety of children attending residential programs that focus on 
serving children with emotional, behavioral or mental health 
problems by requiring basic health and safety standards and 
enforcement.

                          II. Committee Action


                             110TH CONGRESS

Full Committee hearing on ``Cases of Child Neglect and Abuse at Private 
        Residential Treatment Facilities''

    On Thursday, October 10, 2007, the Committee on Education 
and Labor held a hearing in Washington, D.C. entitled ``Cases 
of Child Neglect and Abuse at Private Residential Treatment 
Facilities.'' The purpose of the hearing was to gain an 
understanding of the nature and magnitude of abuses committed 
against children at private residential programs. The hearing 
focused on ten cases of neglect and abuse that resulted in the 
death of a child, and included testimony from parents whose 
children died at abusive programs. Testifying before the full 
Committee were Greg Kutz, Managing Director, Forensic Audits 
and Special Investigations, U.S. Government Accountability 
Office; Cynthia Harvey, Mother of a child victim; Bob Bacon, 
Father of a child victim; Paul Lewis, Father of a child victim; 
Allison Pinto, Assistant Professor, Louis de la Parte Florida 
Medical Health Institute, University of South Florida; and Jan 
Moss, Executive Director, National Association of Therapeutic 
Schools and Programs.

Full Committee Hearing: ``Child Abuse and Deceptive Marketing by 
        Residential Programs for Teens''

    On Thursday, April 24, 2008, the Committee on Education and 
Labor held a hearing in Washington, D.C. entitled ``Child Abuse 
and Deceptive Marketing by Residential Programs for Teens.'' 
The purpose of the hearing was to highlight eight additional 
cases of neglect and abuse, some of which resulted in death, 
and to examine the questionable marketing practices employed by 
private residential programs and referral agencies to entice 
parents. The hearing included testimony from individuals who 
were abused, or witnessed abuse, as teenagers enrolled in 
residential programs. Further, this hearing demonstrated the 
degree to which the states and the federal government do not 
sufficiently regulate and oversee private residential programs. 
Testifying before the full Committee were Greg Kutz, Managing 
Director, Forensic Audits and Special Investigations, U.S. 
Government Accountability Office; Kathryn Whitehead, Former 
Program Participant, Mountain Mission School, Condon, Montana; 
Jon Martin-Crawford, Former Program Participant, the Family 
Foundation School, Hancock, New York; Christopher Bellonci, MD, 
Medical Director and Senior Clinical Consultant, Walker School, 
Needham, Massachusetts; and Kay Brown, Director, Education, 
Workforce and Income Security, U.S. Government Accountability 
Office.

Introduction of the ``Stop Child Abuse in Residential Programs for 
        Teens Act of 2008''

    On April 23, 2008, Representatives George Miller of 
California, Carolyn McCarthy of New York, Donald Payne, Phil 
Hare, Ruben Hinojosa, Robert C. ``Bobby'' Scott of Virginia, 
Raul M. Grijalva, Danny Davis of Illinois, Dale Kildee, Lynn 
Woolsey, and Dennis Kucinich introduced H.R. 5876, the ``Stop 
Child Abuse in Residential Programs for Teens Act of 2008.'' 
The bill sets federal health and safety standards for private 
residential programs for children under the age of eighteen and 
requires the Assistant Secretary for Children and Families of 
the Department of Health and Human Services to monitor and 
enforce the standards. The bill also amends the Child Abuse and 
Prevention Treatment Act (CAPTA) to require states to implement 
similar licensing standards for public and private residential 
programs.

Full Committee markup of H.R. 5876

    On Wednesday, May 14, 2008, the Committee on Education and 
Labor considered H.R. 5876 in legislative session, and reported 
the bill favorably, as amended, to the House of Representatives 
by a vote of 27-16. The Committee adopted the following 
amendments:
    1. An amendment in the nature of a substitute offered by 
Mr. Miller, adopted by voice vote. The amendment in the nature 
of a substitute contains minor technical changes and the 
following additions to H.R. 5876:
     Amends the Child Abuse Prevention and Treatment 
Act to require the state licensing and enforcement provisions 
included in H.R. 5876 apply to public residential programs as 
well as private programs.
     Amends the Child Abuse Prevention and Treatment 
Act to require states that are meeting the licensing and 
enforcement requirements of H.R. 5876 to develop policies and 
procedures for reporting to the appropriate protection and 
advocacy system any case of death of an individual at a covered 
program, not later than forty-eight hours after the state is 
informed of the death.
    2. An amendment offered by Mr. Rob Bishop (UT), adopted by 
voice vote. The amendment clarifies the confidential nature of 
personally identifiable information of abuse reports in state 
and federal databases.
    The Committee rejected five amendments by rollcall vote.

                        III. Summary of the Bill


Federal response

    H.R. 5876 provides immediate federal action to ensure the 
safety of children attending private residential programs that 
focus on serving children with emotional, behavioral, or mental 
health problems or disorders, or problems with alcohol or 
substance abuse. This includes programs such as therapeutic 
wilderness programs, boot camps, therapeutic boarding schools, 
and behavioral modification programs. The bill requires the 
Assistant Secretary for Children and Families of the Department 
of Health and Human Services (HHS) to oversee and enforce 
minimum standards that provide for the basic health and safety 
of children at covered programs. These standards include 
prohibitions on inappropriate and abusive practices of care 
giving, and requirements for staff training, reasonable access 
to a telephone, disclosure to parents of staff roles, 
responsibilities, and training, procedures for notification to 
parents of changes to a child's medical treatment, and 
notification to parents of violations of health and safety 
standards. The standards also require covered programs to 
include a hyperlink or URL address of an HHS website on all 
promotional and informational material. The Assistant Secretary 
must promulgate regulations and enforce interim regulations on 
these standards within 180 days after enactment of H.R. 5876.
    H.R. 5876 requires the Assistant Secretary to monitor 
compliance with and enforce these standards. The bill requires 
the Assistant Secretary to conduct unannounced site inspections 
of all covered programs at least once every two years in order 
to evaluate compliance with the federal health and safety 
standards. The bill also establishes an ongoing review process 
for investigating and evaluating reports of child abuse and 
neglect at covered programs. H.R. 5876 requires states to 
inform the Secretary within thirty days of a report of child 
abuse and neglect at a covered program and within forty-eight 
hours of a fatality at a covered program. The Assistant 
Secretary is required to investigate these reports to determine 
if a violation of the federal standards occurred. The bill 
further requires that such reviews not interfere with the 
state's investigation, be completed within sixty days, and 
include an assessment of the state's performance with respect 
to the appropriateness of response, investigation, and legal 
action against responsible parties. H.R. 5876 specifies that 
the Assistant Secretary will discontinue both the scheduled 
unannounced site inspections and the ongoing review process in 
a state meeting the licensing standards and enforcement process 
required under the bill.
    In order to enforce compliance with the federal minimum 
standards, the bill requires the Assistant Secretary to 
establish civil penalties for violations of the federal 
standards. Owner or operators of covered programs are subject 
to civil penalties of $50,000 per violation of any of the 
federal standards.
    If the Assistant Secretary determines that the 
administrative enforcement process authorized by this bill has 
not remedied a violation of a regulation promulgated under the 
bill, the Assistant Secretary must refer the ongoing violation 
to the Attorney General to take action to remedy the violation. 
While the Assistant Secretary must make a referral in certain 
circumstances, the Attorney General may commence an action to 
compel compliance with the regulations without such a referral.
    In addition to the enforcement authority granted to the 
Assistant Secretary and the Attorney General, an individual 
harmed because of a violation of a regulation promulgated 
pursuant to H.R. 5876 may commence a lawsuit to obtain relief 
for the violation. While such a suit brought for a violation of 
a regulation arises under federal law, the bill does not create 
exclusive jurisdiction in federal courts. A court that hears an 
action by an individual who claims harm or the likelihood of 
harm for a violation of a regulation may award money damages, 
including punitive damages where warranted, and attorneys' 
fees, and may fashion an appropriate equitable remedy, 
including injunctive relief. Because children participating in 
a covered program are not to be considered prisoners, the 
restrictions, limitations, and procedures called for in the 
Civil Rights of Institutionalized Persons Act, 42 U.S.C. 1997e, 
do not apply to a suit brought for a violation of a regulation 
promulgated under this bill.
    The Assistant Secretary is required to establish and 
maintain publicly available websites that include a database 
with information on each covered program and the program's 
history of violations of the federal and state standards 
required by the bill. The database must also include 
information on any fatalities to a child under the care of a 
program, as well as information on owners or operators who are 
in violation of the standards in one program and who own or 
operate another covered program. The database shall also 
include information on any penalties levied against a program 
by the Assistant Secretary and any judgments or orders issued 
by a court against a program. A website must also provide 
information on best practices for helping adolescents with 
mental health problems. The Assistant Secretary is also 
required to establish a national toll-free telephone hotline to 
receive complaints of child abuse and neglect at covered 
programs.
    Fifty million dollars are authorized annually from fiscal 
year 2009 through 2013 for the Assistant Secretary to carry out 
these activities.

State response

    H.R. 5876 amends the Child Abuse Prevention and Treatment 
Act (CAPTA) to require that states take the primary 
responsibility for licensing public and private residential 
programs that focus on serving children with emotional, 
behavioral, or mental health problems or disorders, or problems 
with alcohol or substance abuse. The bill provides states three 
years to develop policies and procedures for preventing child 
abuse and neglect at covered programs operating in the state, 
including health and safety licensing requirements necessary 
for the operation of a program. The standards must meet or 
exceed the federal standards in the bill, address the provision 
of essential food, water, clothing, shelter, and medical care 
necessary to maintain physical health, mental health, and 
general safety of children, and meet other standards.
    States are required to monitor and enforce compliance with 
the licensing requirements including, conducting unannounced 
site inspections at least once every two years, creating a 
database of reports of child abuse and neglect at covered 
programs, and implementing a policy of graduated sanctions 
against programs that are out of compliance. States must also 
develop a publicly available database of covered programs 
operating in the state, including information on reports of 
child abuse and neglect and violations of state licensing 
standards.
    Until states are adequately meeting the requirements of 
H.R. 5876, as determined by the Secretary of Health and Human 
Services, states must report instances of child abuse and 
neglect at covered programs within thirty days to the Secretary 
and to the appropriate protection and advocacy system in the 
state. These reports must be made within forty-eight hours of a 
child fatality at a covered program. Once a state is adequately 
meeting the requirements of the bill, however, states are no 
longer required to report all cases of child abuse and neglect 
at covered programs directly to the Secretary. Instead, states 
in compliance with the standards are required to make reports 
to the Secretary only in instances of a child fatality at a 
covered program and when there is evidence of a pattern of 
violations of the standards by an owner or operator. In states 
meeting the requirements, the Secretary must annually conduct a 
random sample of case reviews of child abuse and neglect at 
covered programs in order to evaluate the appropriateness of 
the response to and investigation of reports of child abuse and 
neglect. The Secretary must also conduct unannounced site 
inspections of covered programs in the state but no longer must 
visit each location once every two years. If the Secretary then 
determines the state is not adequately implementing, monitoring 
and enforcing the licensing requirements, the Secretary shall 
take additional steps.
    Authorization for Title I of CAPTA is increased to 
$200,000,000 for each of fiscal year 2009-2013.

                          IV. Committee Views


Overview

    Since the early 1990's, a wide range of state agencies and 
private companies have established hundreds of residential 
programs for teens in the United States, including wilderness 
programs, boot camps, therapeutic boarding schools, and 
behavior modification programs. The stated purpose of many of 
these programs is to provide a less restrictive alternative to 
incarceration or hospitalization for children with emotional or 
behavioral problems. A 2006 report by the Substance Abuse and 
Mental Health Services Administration (SAMHSA) identified 
seventy-one different types of residential programs across the 
country.\1\ An investigation by the Government Accountability 
Office (GAO) found private residential programs listed in 
forty-eight states.\2\
---------------------------------------------------------------------------
    \1\U.S. Department of Health and Human Services, State Regulation 
of Residential Facilities for Children with Mental Illness. DHHS Pub. 
No. (SMA) 07-4167. Rockville, Maryland: Center for Mental Health 
Services, Substance Abuse and Mental Health Services Administration, 
2006.
    \2\GAO, Residential Programs: Selected Cases of Death, Abuse, and 
Deceptive Marketing, GAO-08-713T (Washington, D.C.: April 24, 2008).
---------------------------------------------------------------------------
    Reports of child fatalities and cases of child abuse and 
neglect at residential programs are widely documented. The GAO 
testified before the Committee about inexcusable and inhumane 
treatment of children at residential programs. On April 24, 
2008, Greg Kutz, the Managing Director of Forensic Audits and 
Special Investigations at GAO testified to the Full Committee 
that ``boys at one boot camp were required to stand with bags 
over their head and a hangman's noose around their neck. The 
rope on this noose was tightened to simulate a hanging. The 
individual responsible for this told officers that this was an 
appropriate form of discipline.''\3\ GAO also testified about a 
case study in which a 15-year-old died at a private residential 
program from a severed neck artery after being held face down 
in the dirt for forty-five minutes. Another 15-year-old showed 
signs of dehydration including blurred vision, vomiting water, 
and frequent stumbling for two days before she collapsed while 
hiking. She then lay dead on the ground for another eighteen 
hours before the program's ``highly trained survival experts'' 
checked on her.\4\
---------------------------------------------------------------------------
    \3\Testimony of Greg Kutz, Managing Director of Forensic Audits and 
Special Investigations, Government Accountability Office, U.S. House of 
Representatives, Committee on Education and Labor, Child Abuse and 
Deceptive Marketing by Residential Programs for Teens, April 24, 2008.
    \4\GAO, Residential Treatment Programs: Concerns Regarding Abuse 
and Death in Certain Programs for Troubled Youth, GAO-08-146T 
(Washington, D.C.: Oct. 10, 2007).
---------------------------------------------------------------------------
    At the hearing before the Full Committee on October 10, 
2007, Bob Bacon testified about the twenty-one day calendar 
that was reconstructed by investigators and described the last 
weeks of his son's life. He stated that his son

          Aaron spent 14 of his 20 days on the trail without 
        any food whatsoever, while being forced to hike 8-10 
        miles per day. On the days he did have food it 
        consisted of undercooked lentils, lizards, scorpions, 
        trail mix, and a celebrated canned peach on the 13th. 
        On top of this, with temperatures below freezing, he 
        endured 13 of 20 nights with only a thin wool blanket, 
        plus 5 nights without warmth or protection of any kind. 
        Aaron complained of severe stomach pain and asked to 
        see a doctor as early as the third day of hiking, and 
        by the tenth day had lost all control of his bodily 
        functions; but unbelievably, as he got weaker and lost 
        nearly 20% of his body weight they repeatedly refused 
        to send him to a doctor.\5\
---------------------------------------------------------------------------
    \5\Testimony of Bob Bacon, Father of child victim, U.S. House of 
Representatives, Committee on Education and Labor, Cases of Child 
Neglect and Abuse at Private Residential Treatment Facilities, October 
10, 2008.

    Unfortunately these shocking examples of abuse and neglect 
are not isolated incidents. State reported data to the National 
Child Abuse and Neglect Data System (NCANDS) from 2005 found 
that thirty-four states reported 1,503 incidents of 
maltreatment of youth by residential facility staff.\6\ Of the 
states surveyed by GAO, twenty-eight reported at least one 
youth fatality in a residential facility in 2006. The GAO 
concluded that because of significant gaps in the data that 
states collect and report, both statistics understate the 
incidence of maltreatment and death at residential programs.\7\
---------------------------------------------------------------------------
    \6\U.S. Department of Health and Human Services, Child Maltreatment 
2005.
    \7\GAO, Residential Facilities: Improved Data and Enhanced 
Oversight Would Help Safeguard the Well-Being of Youth with Behavioral 
and Emotional Challenges, GAO-08-346 (Washington, D.C.: May 2008).
---------------------------------------------------------------------------
    Despite the fact that these programs serve some of our 
nation's most vulnerable youth, and despite the problems with 
abuse and death at residential programs, state standards and 
regulations for these types of programs vary greatly. Some 
types of residential teen programs may be monitored by state 
agencies and staffed with licensed professionals that provide 
high standards of care. However, many states have inadequate or 
nonexistent regulations and oversight to protect children in 
residential teen programs. The GAO found major gaps in the 
licensing and oversight of residential facilities, and the GAO 
reports that many types of facilities are exempt from state 
licensing requirements altogether. In addition, GAO found that 
because of the gaps in licensing, programs can choose to avoid 
standards and oversight. For example, in some states, a 
residential treatment program self-identified as a private 
boarding school would not be regulated by the state. But the 
same facility must be licensed if it self-identified as a 
residential treatment center. After concluding an investigation 
of the current status of federal and state oversight of 
residential programs, the GAO concluded that ``[w]eaknesses in 
the current federal-state regulatory structure have failed to 
safeguard the civil rights and well-being of some of the 
nation's most vulnerable youth.''\8\
---------------------------------------------------------------------------
    \8\GAO, Residential Facilities: Improved Data and Enhanced 
Oversight Would Help Safeguard the Well-Being of Youth with Behavioral 
and Emotional Challenges, GAO-08-346 (Washington, D.C.: May 2008).
---------------------------------------------------------------------------
    The Committee is also concerned that some individuals in 
the residential program industry are enticing parents and 
children by using deceptive marketing and questionable 
practices. A GAO investigation revealed a number of fraudulent 
methods and irresponsible claims used by both referral service 
agencies and residential programs.\9\ The investigators posed 
as parents of a troubled teen needing help and made calls to 
both programs and referral service agencies. The investigators 
were pitched spurious medical advice, fraudulent tax schemes, 
and inaccurate information, all apparently designed to get into 
parents' pockets. Most of the information provided in these 
calls was about how to finance the exorbitant tuition being 
charged, rather than about properly screening children and 
matching children with the appropriate programs based on the 
child's needs. Furthermore, a blatant conflict-of-interest was 
uncovered when it was revealed that a referral service owned by 
a husband consistently made referrals to a residential program 
owned by his wife. These schemes do not merely represent bad 
business practices. Greater than that, such practices directly 
or indirectly contribute to a decision making process that may 
lead to the abuse or death of a child. Parents are desperately 
looking for answers to help their struggling child, and instead 
of getting reliable accurate information, they are given self-
serving and unreliable advice. The GAO investigation 
underscores the increasing need to provide parents with 
objective information and hold the industry accountable.
---------------------------------------------------------------------------
    \9\GAO, Residential Programs: Selected Cases of Death, Abuse, and 
Deceptive Marketing, GAO-08-713T (Washington, D.C.: April 24, 2008).
---------------------------------------------------------------------------

Federal standards and oversight

    The Committee believes the safety and basic well-being of 
children in residential programs is an urgent and critical 
matter and must be dealt with accordingly. As a result of a 
loose patchwork of state regulations, we have a crisis 
situation where large numbers of children are being abused and 
even dying in residential programs. Moreover, deceptive 
marketing practices make it very difficult for parents to make 
informed and safe choices for their children. Furthermore, the 
GAO case studies suggest that local responses to incidents of 
abuse have sometimes been inadequate or inappropriate. H.R. 
5876 takes numerous steps to stop this abuse and keep children 
safe. The intent of this bill is not to limit the choices 
available to parents but instead to give parents the 
information they need to make safe choices for their children 
and to ensure that, notwithstanding the residential setting, 
children are safe from abusive and neglectful treatment.
    The Committee believes the fastest and most effective way 
to end child abuse at residential programs is to immediately 
implement federal standards and oversight of residential 
programs. This action is imperative if we are to prevent kids 
from dying or from suffering abuse and trauma that will 
undoubtedly affect them for years to come. Therefore, H.R. 5876 
provides immediate federal action in response to an urgent 
problem of abuse, and sometimes death, in private residential 
programs for teens that are loosely (if at all) regulated and 
monitored by states. Within 180 days after enactment of H.R. 
5876, the Assistant Secretary must issue regulations on minimum 
standards at private residential programs and begin unannounced 
site inspections. The standards included in H.R. 5876 are 
minimum standards of care needed to keep kids safe in 
residential programs and to provide parents with the 
information they need. The Committee believes states and 
programs should require additional and stronger standards to 
ensure children with emotional, behavioral, mental health, or 
substance abuse problems are receiving effective therapeutic 
practices. However, that was not the focus of this bill.
    The federal standard prohibiting child abuse and neglect at 
covered programs may be questioned as unnecessary or too 
obvious, because all states prohibit child abuse and neglect. 
However, the GAO case studies and testimony heard by the 
Committee raise concerns that there are instances in which 
abuse and neglect of children at residential programs has been 
ignored, dismissed, or accepted by staff and/or local 
authorities as part of acceptable therapy. The Committee 
believes that abuse and inhumane treatment of children is 
inexcusable and illegal. Therefore, H.R. 5876 explicitly 
prohibits such behavior.
    In the GAO investigation described earlier, state officials 
reported that a central cause of youth maltreatment at 
residential facilities is the improper application of seclusion 
and restraint.\10\ In fact, a large number of injuries and 
deaths at residential facilities seem to be attributable to 
improper restraint procedures. The Committee concurs with the 
current standard of practice that requires that seclusion and 
restraint be utilized only by staff trained in these 
techniques, such that these interventions are practiced safely 
and appropriately in very limited circumstances. Therefore, 
H.R. 5876 includes a standard that requires programs to limit 
the use of restraint and seclusion procedures to the methods 
described in the Public Health Service Act, 42 U.S.C. 
Sec. 300--300a-6. The Committee believes these standards will 
support ethical and safe procedures of care for children and 
greatly limit the likelihood of children dying or experiencing 
significant trauma or injury from restraint and seclusion 
procedures.
---------------------------------------------------------------------------
    \10\GAO, Residential Facilities: Improved Data and Enhanced 
Oversight Would Help Safeguard the Well-Being of Youth with Behavioral 
and Emotional Challenges, GAO-08-346 (Washington, D.C.: May 2008).
---------------------------------------------------------------------------
    H.R. 5876 also includes a standard that prohibits acts of 
physical or mental abuse designed to humiliate, degrade, or 
undermine a child's self-respect. This standard is based 
closely on Oregon's licensing regulations\11\ for residential 
programs. The Committee believes this standard is important to 
move towards the elimination of abuse and inhumane treatment of 
children at residential programs.
---------------------------------------------------------------------------
    \11\Oregon Admin. R. 413-210-0190 (2008).
---------------------------------------------------------------------------
    The federal standards also require children at covered 
programs to have reasonable access to a telephone for making 
and receiving calls with as much privacy as possible. This 
standard is based on public health laws, which the Committee 
believes exist in every state, that provide for access to 
telephones for committed patients on psychiatric inpatient 
wards. The Committee believes the isolation inherent in 
residential programs makes extending this right to children 
appropriate and necessary. It provides a safeguard and a 
lifeline for children isolated from their families. The 
Committee has heard concerns that this provision will allow 
teens the right to continue to communicate with drug dealers 
back home or have other potentially destructive outcomes. But 
the Committee is confident that the ``reasonable access'' 
requirement can be executed in an appropriate and effective 
manner.
    The federal standards also require some staff training. For 
instance, H.R. 5876 requires staff to be familiar with what 
constitutes child abuse and neglect in their state, as well as 
being familiar with the state requirements for mandated 
reporters and procedures for reporting child abuse and neglect 
in the state. This standard is not intended to alter state 
definitions of mandated reporters. After a careful review of 
state mandated reporting laws, however, the Committee believes 
that most--if not all--staff at residential programs are 
already mandated reporters of child abuse and neglect in each 
state. Yet, there is little evidence of staff at these programs 
reporting incidents of abuse and neglect. These standards are 
designed to prevent child abuse and neglect by ensuring all 
staff are aware of what constitutes abuse and of their legal 
responsibility to report abuse. The bill also requires staff at 
programs such as wilderness or boot camps to be familiar with 
the signs, symptoms, and appropriate responses associated with 
heatstroke, dehydration, and hypothermia. The GAO investigation 
revealed a number of instances where children's serious medical 
conditions were ignored by staff and attributed to ``faking 
it.''\12\ This standard is meant to provide staff with the 
ability to recognize serious medical conditions that have led 
to death at residential programs.
---------------------------------------------------------------------------
    \12\GAO, Residential Treatment Programs: Concerns Regarding Abuse 
and Death in Certain Programs for Troubled Youth, GAO-08-146T 
(Washington, D.C.: Oct. 10, 2007).
---------------------------------------------------------------------------
    H.R. 5876 includes standards to help give parents 
additional tools for making safe choices for their children. 
The bill requires programs to notify parents of violations of 
the federal and state standards and of on-site investigations 
of child abuse and neglect. The bill further requires parents 
to be notified about any changes in the child's medical 
treatment. It also requires all promotional and informational 
materials produced by a program to include a hyperlink or URL 
address of the website created by the Assistant Secretary. This 
website includes a database with information on covered 
programs, including any history of fatalities and violations of 
standards. The Committee believes this will help empower 
parents to make safe decisions for their child's treatment and 
care.
    H.R. 5876 requires monitoring and enforcement of the 
federal standards through a number of mechanisms. First, the 
Assistant Secretary is required to conduct unannounced site 
inspections of all covered programs at least once every two 
years. Second, states are required to inform the Secretary of 
reports of child abuse and neglect at covered programs. The 
Assistant Secretary is required to establish an ongoing review 
process for investigating and evaluating these reports. This 
process must include an investigation to determine if there was 
a violation of federal standards, and it must include an 
assessment of the state's response to and investigation of 
reports of child abuse and neglect at covered programs and 
appropriateness of legal action against responsible parties. 
Civil penalties for violations of the standards are also 
established.
    The Committee recognizes that strong enforcement is 
critical to the success of the minimum standards regulations. 
Unfortunately, the evidence gathered by the Committee indicates 
that some operators of covered programs habitually neglect or 
abuse children and place at risk the lives entrusted to their 
care. That is why the bill provides that where a covered 
program persists in violating the minimum standards 
regulations, the Assistant Secretary must refer the matter to 
the Attorney General. The Department of Justice, therefore, is 
empowered to bring a lawsuit to force an operator to follow the 
regulations. The Department of Justice need not wait for a 
referral, however, and is empowered to bring such a suit of its 
own volition.
    A crucial piece of the enforcement mechanism is the 
provision providing for a private right of action. An 
individual harmed by a covered program's violation of the 
regulations detailing the minimum standard promulgated under 
this bill should be made whole. In addition, injunctive or 
other equitable remedies should be available to prevent harm to 
participants in covered programs. To date, state law has not 
been sufficient to fully recompense victims of abuse, nor to 
allow courts to expeditiously enjoin harm to participants.
    Individuals harmed, or in imminent danger of being harmed, 
by a violation of the regulations promulgated under H.R. 5876 
may have a remedy under state tort law. The private right of 
action provision, however, provides for a uniform cause of 
action for a person injured because of a violation of a minimum 
standard, victims who, in many cases, are participating in a 
covered program in a state that is not their domicile. The 
Committee believes that nation-wide uniformity of the minimum 
standards together with a uniform mechanism of enforcement of 
those standards will prevent covered programs from moving from 
state-to-state, organizing and operating in states with the 
most relaxed duties of care or most restrictive tort award and 
injunctive relief.
    The private right of action provision provides covered 
programs with ample, specific notice of the violations for 
which they may be successfully sued under this provision. The 
provision only allows suits for violations of the detailed 
regulations promulgated by the Assistant Secretary under this 
bill. This provision does not allow suits for violations of the 
more general minimum standards enumerated in the bill itself. 
The private right of action established by H.R. 5876 may be 
pursued in federal court. The bill does not, however, require 
that such claims be adjudicated in federal court or create 
exclusive jurisdiction in the federal courts. The Committee 
also believes that, in this context, prevention is the most 
effective remedy and, therefore, intends that the authorization 
of punitive damages will act as a deterrent for covered 
programs that might otherwise violate the regulations required 
by this bill.
    The Committee believes that victims should be empowered to 
seek redress for any injury suffered as a result of a violation 
of this bill. Accordingly, H.R. 5876 provides for the award of 
reasonable attorneys' fees to increase the likelihood of 
securing effective counsel. By allowing the courts the 
authority to award reasonable attorneys' fees, it is the 
Committee's expectation that attorneys will be willing to take 
meritorious cases that may potentially save lives, but which, 
absent this provision, would be financially prohibitive to 
undertake.
    The Committee believes the creation of publicly available 
websites and a national hotline by H.R. 5876 are key components 
to keeping children safe. The bill requires the Assistant 
Secretary to establish a website with a database of information 
on covered programs. The Committee envisions the creation of 
this website and the information contained therein as a 
collaborative effort between the states and the Assistant 
Secretary. This website will help parents learn which programs 
have a history of abuse and which programs are providing safe 
care for children. The website will contain information that 
will assist parents to make safe choices for their children 
under very difficult circumstances. The national hotline 
created by this bill is also intended to help parents and 
children who do not know where to turn for help. Because many 
parents send their children out of state to residential 
programs, the children may be unsure of who to contact for 
assistance within the state. The hotline is designed to 
minimize this problem.

State response

    The Committee believes the federal standards and oversight 
are critical to quickly and successfully restrain child abuse 
and neglect at residential programs. However, the Committee 
also believes that ultimately states must take on the primary 
responsibility for ensuring the safety of children at these 
programs. For that reason, the bill requires that once states 
assume primary responsibility for standards and enforcement of 
residential programs, the federal involvement will greatly 
decrease.
    Contingent on receiving CAPTA funds, states are required 
under the bill to implement licensing standards as a condition 
to operate public and private residential programs focused on 
serving children with emotional, behavioral, substance abuse, 
and mental health problems. These licensing standards must meet 
or exceed the federal standards. Though the Committee believes 
these standards are critical to the safety of kids in covered 
programs, it views these standards as very minimal and strongly 
encourages states to enact stronger and more comprehensive 
standards that will facilitate the provision of effective 
services. For example, this bill does not include standards on 
staff qualifications relating to mental health services. States 
are encouraged to consider developing standards. Moreover, the 
Committee hopes states will take additional steps to help 
parents understand the differences in the types of programs 
operating in a state.
    H.R. 5876 also requires states to effectively monitor the 
minimum health and safety licensing standards. This may be 
achieved in part by conducting unannounced site inspections at 
least once every two years, implementing a policy of graduated 
sanctions for failing to meet state standards, and requiring 
the licensing application process to disclose prior 
substantiated reports of child abuse and neglect and all child 
deaths at a business previously or currently owned or operated 
by the applicant. The bill also requires states to create a 
publicly available database of information on covered programs 
and a history of problems at each program.
    Once a state has in place appropriate licensing and 
monitoring, federal involvement greatly diminishes. States 
meeting the bill's requirements are released from the 
requirement to report each incident of child abuse and neglect 
at a covered program to the Secretary. In addition, the 
requirement that the Secretary conduct unannounced site 
inspections of every program at least once every two years is 
also eliminated in a state meeting the requirements. As a 
result, the two main mechanisms for the Secretary to oversee 
the federal standards are eliminated when a state successfully 
assumes the responsibility of ensuring children's safety at 
residential programs.

                     V. Section-by-Section Analysis


Sec. 1. Short title

    Provides that the short title is the ``Stop Child Abuse in 
Residential Programs for Teens Act 2008.''

Sec. 2. Definitions

    Sets forth definitions for the terms ``Assistant 
Secretary,'' ``Child, Child Abuse and Neglect,'' ``Covered 
Program,'' ``Protection and Advocacy System,'' and ``State.''

Sec. 3. Standards and enforcement

    This section is composed of four subsections: (a) Minimum 
Standards, (b) Monitoring and Enforcement, (c) Dissemination of 
Information, and (d) Action.
    Subsection (a) provides minimum health and safety standards 
for children residing in covered programs and requires the 
Assistant Secretary for Children and Families of the Department 
of Health and Human Services to issue regulations to enforce 
those standards applicable to covered programs that have an 
affect on interstate commerce. The minimum standards prohibit 
physical and mental abuse and neglect, inappropriate and 
degrading disciplinary techniques, denying patients the 
essentials necessary to maintain physical and mental health and 
safety, denying reasonable access to outside communications, 
and the unnecessary use of seclusion and restraint. The 
subsection also requires program policies and minimal 
qualification regarding staffs' training in emergency response 
techniques and mandates abuse and neglect reporting. The 
section requires staff criminal background checks and mandates 
communication with a parent or guardian whenever there are 
proposed changes in medical treatment. Parents must also be 
informed of any investigations regarding child abuse reports 
and health and safety violations at covered programs.
    Subsection (b) requires the Assistant Secretary to conduct 
unannounced site inspections at each covered program at least 
once every two years until such time that the Secretary has 
determined that the state has established appropriate health 
and safety licensing requirements. The subsection also 
establishes guidelines for an ongoing review process for 
investigating and evaluating reports of child abuse and neglect 
at covered programs, including a determination of violations of 
standards and the appropriateness of states' investigations and 
responses. This subsection also requires the Assistant 
Secretary to promulgate regulations establishing civil 
penalties for violations of standards, not to exceed $50,000 
per violation.
    Subsection (c) requires the establishment and maintenance 
of a publicly accessible website that provides information 
regarding covered program ownership and compliance with state 
child abuse licensing requirements. It also provides for the 
development of a national child abuse and neglect toll-free 
hotline for reporting complaints and violations against covered 
programs.
    Subsection (d) requires a process by which complaints made 
to the hotline are reviewed, communicated to state and local 
law enforcement, and by which violations are investigated. 
There is also a mandate for collaboration between the national 
hotline authorized in this Act and other state, regional, and 
national hotlines.

Sec. 4. Enforcement by the Attorney General

    Authorizes the Assistant Secretary to refer to the Attorney 
General for appropriate action any violations of this Act not 
remedied through the administrative enforcement process. It 
also allows the Attorney General to file a complaint, sua 
sponte, in any court of competent jurisdiction to seek 
equitable relief.

Sec. 5. Private rights of action

    Allows suit against a covered program to seek equitable 
relief, damages (including punitive damages), or both, for harm 
caused by a violation of a regulation promulgated under this 
Act. This section also authorizes an award of attorneys' fees. 
The provisions of section 7 of the Civil Rights of 
Institutionalized Persons Act (42 U.S.C. 1997e) shall not apply 
to actions brought under this Act.

Sec. 6. Report

    Describes the annual reporting requirements of the 
Secretary of Health and Human Services, in coordination with 
the Attorney General.

Sec. 7. Authorization of appropriations

    Authorizes $50,000,000 for each fiscal year 2009 through 
2013 for activities required by the Act (excluding the 
amendment made by section 8 of this Act).

Sec. 8. Additional eligibility requirements for grants to states to 
        prevent child abuse and neglect at residential programs

    This section is divided into four subsections: (a) an 
Amendment to Title I of the Child Abuse Prevention and 
Treatment Act (CAPTA; 42 U.S.C. 5101 et seq.), (b) 
Authorization (c) Conforming Amendments, and (d) Clerical 
Amendments.
    Subsection (a) amends Title I of CAPTA by adding 
definitions of the terms ``Child,'' ``Covered Program,'' and 
``Protection and Advocacy System.'' It also provides 
eligibility requirements for receipt of grants under section 
106 of CAPTA, including the prevention of abuse and neglect in 
covered programs by creating licensing requirements that exceed 
the federal standards created in Section 3; the development of 
policies and procedures for monitoring and enforcing compliance 
with licensing requirements through a designated state agency; 
when a state is not satisfying requirements, the development of 
policies and procedures for notifying the Secretary and the 
appropriate protection and advocacy systems of child abuse and 
neglect at covered programs; if states have satisfied 
requirements, the development of policies and procedures for 
notifying the Secretary of evidence of a pattern of violations 
of standards at covered programs. The state also shall develop 
and maintain a public database with information related covered 
programs, including ownership, license, and violations. The 
Secretary shall include a process for monitoring states once 
licensing, monitoring, and enforcement requirements have been 
satisfied.
    Subsection (b) amends section 112(a)(1) of CAPTA to 
authorize $200,000,000 for each fiscal year 2009 through 2013.
    Subsection (c) amends section 103(c)(1)(D) of CAPTA to 
include ``reports of child abuse and neglect occurring at 
covered programs . . . as such term is defined in section 
114.'' Further requirements for grant eligibility include state 
compliance with section 114 of CAPTA and submission of a plan 
describing the activities the state will undertake in order to 
carry out the requirements of section 114 of CAPTA.

                     VI. Explanation of Amendments

    The Amendment in the Nature of a Substitute, as amended, is 
explained in the body of this report.

           VII. Application of Law to the Legislative Branch

    Section 102(b)(3) of Public Law 104-1, the Congressional 
Accountability Act, requires a description of the application 
of this bill to the legislative branch. H.R. 5876 provides 
federal and state standards to prevent child abuse at covered 
residential treatment facilities and programs. The bill does 
not prevent legislative branch employees' coverage under this 
legislation.

                    VIII. Unfunded Mandate Statement

    Section 423 of the Congressional Budget and Impoundment 
Control Act (as amended by Section 101(a)(2) of the Unfunded 
Mandates Reform Act, P.L. 104-4) requires a statement of 
whether the provisions of the reported bill include unfunded 
mandates. H.R. 5876 contains no intergovernmental or private-
sector mandates as defined by the Unfunded Mandates Reform Act 
(UMRA).

                         IX. Earmark Statement

    H.R. 5876 does not contain any congressional earmarks, 
limited tax benefits, or limited tariff benefits as defined in 
clauses 9(d), 9(e) or 9(f) of rule XXI of the Rules of the 
House of Representatives.

                              X. Roll Call



    XI. Statement of Oversight Findings and Recommendations of the 
                               Committee

    In compliance with clause 3(c)(1) of rule XIII and clause 
2(b)(1) of rule X of the rules of the House of Representatives, 
the Committee's oversight findings and recommendations are 
reflected in the body of this report.

            XII. New Budget Authority and CBO Cost Estimate

    With respect to the requirements of clause 3(c)(2) of rule 
XIII of the House of Representatives and section 308(a) of the 
Congressional Budget Act of 1974 and with respect to 
requirements of 3(c)(3) of rule XIII of the House of 
Representatives and section 402 of the Congressional Budget Act 
of 1974, the Committee has received the following estimate for 
H.R. 5876 from the Director of the Congressional Budget Office:

                                     U.S. Congress,
                               Congressional Budget Office,
                                      Washington, DC, May 22, 2008.
Hon. George Miller,
Chairman, Committee on Education and Labor,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for H.R. 5876, the Stop 
Child Abuse in Residential Programs for Teens Act of 2008.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Jonathan 
Morancy.
            Sincerely,
                                         Robert A. Sunshine
                                   (For Peter R. Orszag, Director).
    Enclosure.

H.R. 5876--Stop Child Abuse in Residential Programs for Teens Act of 
        2008

    Summary: H.R. 5876 would authorize the appropriation of 
$250 million per year for fiscal years 2009 through 2013 for 
child abuse prevention programs. CBO estimates that 
implementing the bill would cost $805 million over the 2009-
2013 period, assuming appropriation of the authorized amounts.
    Enacting H.R. 5876 would not affect direct spending. The 
bill would create new civil penalties, which CBO estimates 
would have an insignificant effect on revenues over the 2009-
2018 period.
    H.R. 5876 contains mandates on the private sector as 
defined in the Unfunded Mandates Reform Act (UMRA) but CBO 
estimates that the direct costs of those mandates would be 
below the annual threshold established by UMRA ($136 million in 
2008, adjusted annually for inflation).
    H.R. 5876 contains no new intergovernmental mandates as 
defined in UMRA. The bill would establish additional 
eligibility requirements for states that receive grants for the 
prevention of child abuse and neglect and for treatment 
programs, but such requirements would be incurred voluntarily.
    Estimated Cost to the Federal Government: The estimated 
budgetary impact of H.R. 5876 is shown in the following table. 
The costs of this legislation fall within budget functions 500 
(education, training, employment, and social services) and 600 
(income security).

----------------------------------------------------------------------------------------------------------------
                                                                 By fiscal year, in millions of dollars--
                                                         -------------------------------------------------------
                                                            2009     2010     2011     2012     2013   2009-2013
----------------------------------------------------------------------------------------------------------------
                                  CHANGES IN SPENDING SUBJECT TO APPROPRIATION

Grants and Other Activities:
    Authorization Level.................................      200      200      200      200      200     1,000
    Estimated Outlays...................................       11       98      142      178      193       622
Enforcement of Standards:
    Authorization Level.................................       50       50       50       50       50       250
    Estimated Outlays...................................       15       28       40       50       50       183
      Total
        Authorization Level.............................      250      250      250      250      250     1,250
        Estimated Outlays...............................       26      126      182      228      243      805
----------------------------------------------------------------------------------------------------------------
\1\ The bill would increase revenue by less than $500,000 in 2009 and over the 2009-2018 period.

    Basis of estimate: For this estimate, CBO assumes that H.R. 
5876 will be enacted near the end of fiscal year 2008, the 
amounts authorized by the bill will be appropriated by the 
beginning of each fiscal year, and outlays will follow 
historical spending patterns.
    H.R. 5876 would authorize the appropriation of $200 million 
per year for various purposes related to combating child abuse 
and neglect, including grants and research. (The current 
authorization, which provides such sums as may be necessary, 
expires at the end of fiscal year 2008.) In 2008, $64 million 
was appropriated for those activities. The bill also would 
authorize the appropriation of $50 million per year for fiscal 
years 2009 through 2013 to assist with enforcing new standards 
for certain residential treatment programs for children.
    Estimated impact on state, local, and tribal governments: 
H.R. 5876 contains no intergovernmental mandates as defined in 
UMRA. The bill would establish additional eligibility 
requirements for states that receive grants for the prevention 
of child abuse and neglect and for treatment programs. As 
conditions of assistance, those requirements would be incurred 
voluntarily.
    Estimated impact on the private sector: H.R. 5876 contains 
mandates as defined by UMRA on operators of private residential 
programs for teenagers with emotional, behavioral, or mental 
health problems or disorders, or who have problems with alcohol 
or substance abuse. The covered programs may include, among 
others, those that provide a wilderness or outdoor experience 
as well as boot-camps that simulate military training. The bill 
delineates minimum health and safety standards those programs 
must meet.
    Many states already have standards that residential 
programs for youth must meet, and some industry groups regulate 
themselves by requiring members to pledge to follow certain 
guidelines. Consequently, the additional cost of complying with 
the mandates in the bill would vary widely depending on the 
conditions under which the program currently operates. CBO 
expects that the direct cost of the mandate to private-sector 
entities would be below the annual threshold established by 
UMRA for private-sector mandates ($136 million in 2008, 
adjusted annually for inflation).
    Estimate prepared by: Federal Costs: Jonathan Morancy; 
Impact on State, Local, and Tribal Governments: Burke Doherty; 
Impact on the Private Sector: Nabeel Alsalam.
    Estimate approved by: Theresa Gullo, Deputy Assistant 
Director for Budget Analysis.

      XIII. Statement of General Performance Goals and Objectives

    In accordance with clause 3(c) of rule XIII of the House of 
Representatives, the goal of H.R. 5876 is to ensure the safety 
of children attending residential programs that focus on 
serving children with emotional, behavioral or mental health 
problems. The Committee expects the Department of Health and 
Human Services to comply with H.R. 5876 and implement the 
changes to the law in accordance with these stated goals.

                XIV. Constitutional Authority Statement

    Under clause 3(d)(1) of rule XIII of the House of 
Representatives, the Committee must include a statement citing 
the specific powers granted to Congress in the Constitution to 
enact the law proposed by H.R. 5876. The Committee believes 
that the amendments made by this bill are within Congress' 
authority under Article I, section 8, clauses 1, 3 and 18 of 
the U.S. Constitution.

                         XV. Committee Estimate

    Clause 3(d)(2) of rule XIII of the House of Representatives 
requires an estimate and a comparison of the costs that would 
be incurred in carrying out H.R. 5876. However, clause 
3(d)(3)(B) of that rule provides that this requirement does not 
apply when the Committee has included in its report a timely 
submitted cost estimate of the bill prepared by the Director of 
the Congressional Budget Office under section 402 of the 
Congressional Budget Act.

       XVI. Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (new matter is 
printed in italic and existing law in which no change is 
proposed is shown in roman):

                CHILD ABUSE PREVENTION AND TREATMENT ACT


SECTION 1. SHORT TITLE AND TABLE OF CONTENTS.

  (a) * * *
  (b) Table of Contents.--The table of contents is as follows:

                            TABLE OF CONTENTS

     * * * * * * *

                        TITLE I--GENERAL PROGRAM

     * * * * * * *
Sec. 114. Additional eligibility requirements for grants to States to 
          prevent child abuse and neglect at residential programs.

           *       *       *       *       *       *       *


TITLE I--GENERAL PROGRAM

           *       *       *       *       *       *       *


SEC. 103. NATIONAL CLEARINGHOUSE FOR INFORMATION RELATING TO CHILD 
                    ABUSE.

  (a) * * *

           *       *       *       *       *       *       *

  (c) Coordination With Available Resources.--
          (1) In general.--In establishing a national 
        clearinghouse as required by subsection (a), the 
        Secretary shall--
                  (A) * * *

           *       *       *       *       *       *       *

                  (D) through a national data collection and 
                analysis program and in consultation with 
                appropriate State and local agencies and 
                experts in the field, collect, compile, and 
                make available State child abuse and neglect 
                reporting information which, to the extent 
                practical, shall be universal and case specific 
                (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 integrated with 
                other case-based foster care and adoption data 
                collected by the Secretary;

           *       *       *       *       *       *       *


SEC. 106. GRANTS TO STATES FOR CHILD ABUSE AND NEGLECT PREVENTION AND 
                    TREATMENT PROGRAMS.

  (a) * * *
  (b) Eligibility Requirements.--
          (1) State plan.--
                  (A) * * *

           *       *       *       *       *       *       *

                  (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).

           *       *       *       *       *       *       *

  (d) Annual State Data Reports.--Each State to which a grant 
is made under this section shall annually work with the 
Secretary to provide, to the maximum extent practicable, a 
report that includes the following:
          (1) The number of children who were reported to the 
        State during the year as abused or neglected (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).

           *       *       *       *       *       *       *

          (6) Of the number of children described in paragraph 
        (5), the number of such children who were in foster 
        care or who were in the care of a covered program, as 
        such term is defined in section 114.

           *       *       *       *       *       *       *


SEC. 112. AUTHORIZATION OF APPROPRIATIONS.

  (a) In General.--
          (1) General authorization.--There are authorized to 
        be appropriated to carry out this title $120,000,000 
        for fiscal year 2004 and such sums as may be necessary 
        for each of the fiscal years 2005 through 2008, and 
        $200,000,000 for each of fiscal years 2009 through 
        2013.

           *       *       *       *       *       *       *


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;
                          (ii) a foster family home or group 
                        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 or group 
                        home; or
                          (iii) a psychiatric residential 
                        treatment facility that is certified as 
                        meeting the requirements specified in 
                        regulations promulgated for such 
                        facilities under section 1905(h)(1)(A) 
                        of the Social Security Act and that 
                        provides psychiatric services for which 
                        medical assistance is available under a 
                        State plan under title XIX of such Act.
          (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 2008;
                  (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) 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 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;
                  (C) conducting unannounced site inspections 
                not less often than once every two years at 
                each location of a covered program;
                  (D) creating a 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 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), 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 and 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 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 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 2008, 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 2008, 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) annually, a random sample of review 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 2008.
          (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.

           *       *       *       *       *       *       *


                     XVII. Committee Correspondence

    None.

                     REPUBLICAN VIEWS ON H.R. 5876

    Republican Members of the House Committee on Education and 
Labor are committed to stopping child abuse and neglect at 
residential treatment programs. We have supported the Child 
Abuse Prevention and Treatment Act (CAPTA) since the program's 
creation in 1974. CAPTA provides federal funding to states in 
support of prevention, assessment, investigation, prosecution, 
and treatment activities, and also provides grants to public 
agencies and nonprofit organizations for demonstration programs 
and projects. We have also supported the federal oversight role 
established under CAPTA in setting a minimum definition of 
child abuse and neglect and supporting research, evaluation, 
technical assistance, and data collection activities.
    Instances of child neglect, abuse, and death at residential 
treatment programs are unacceptable and must be stopped. 
However, Committee Republicans do not believe that it is 
necessary to create the proposed dual regulatory structure set 
out in H.R. 5876 in order to protect children in such programs. 
The legislation Chairman Miller introduced provides a good 
starting point for Congress to work from, but the bill as 
written is unworkable and unrealistic. It creates a highly 
duplicative process at the federal and state level, and 
mandates unachievable timelines. It is the hope of Committee 
Republicans to work with Chairman Miller and Democrats on the 
Committee to produce a bipartisan bill that addresses these 
concerns and develops the best, most effective and appropriate 
safeguards to protect young people placed in residential 
treatment programs.

   Background on the Congressional Interest in Residential Treatment 
                                Programs

    Since the early 1990s, hundreds of residential treatment 
programs--sometimes referred to as behavior modification 
facilities or boot camps--are believed to have been established 
by U.S. companies, both within the U.S. and abroad. The 
treatment methods employed by some of these programs have been 
controversial, with some allegations of severe child abuse by 
some of these programs' staff.
    While the true size of the industry is not known, it is 
widely estimated that thousands of American children are 
enrolled in juvenile and adult boot camp programs. In 2004, the 
Chicago Tribune reported that ``a trade association and other 
experts say the schools are a $1 billion to $1.2 billion 
industry that serves 10,000 to 14,000 school-age children.''
    In April 2005, Chairman Miller (then Senior Democratic 
Member) introduced H.R. 1738, legislation intended to prevent 
child abuse at residential treatment facilities in the U.S. and 
abroad. In December 2005, Chairman Miller requested a study by 
the U.S. Government Accountability Office (GAO) of residential 
treatment programs and the for-profit companies that own and 
operate these programs. The request was made in response to 
allegations of child abuse, fraud, and other violations of law 
by companies that operate these facilities.
    In October 2007, following the release of an initial GAO 
report on case studies of abuse and neglect at residential 
treatment programs, Chairman Miller convened an oversight 
hearing on the issue of wilderness therapy programs or ``boot 
camps.'' The GAO report that was the subject of the hearing 
highlighted a number of cases of abuse and neglect at private 
residential treatment programs throughout the country. In April 
2008, the Committee held a second oversight hearing on this 
issue to highlight further cases of abuse and neglect at 
residential treatment programs and to discuss the more 
comprehensive GAO report, originally requested by Chairman 
Miller, highlighting data from, and oversight of, private and 
public residential treatment programs.
    During the hearings, Committee Republicans took the 
opportunity to ask the expert witnesses whether they were aware 
of a comprehensive list of how many programs were in existence, 
by whom were they operated, and where they were located. 
Unfortunately, even the GAO, which has been investigating these 
programs for years, was unable to provide these basic facts 
during the hearings. This has been a major obstacle to the 
monitoring and regulation of residential treatment programs.

   Committee Consideration of H.R. 5876, Child Abuse in Residential 
                     Programs for Teens Act of 2008

    Less than a day before the second oversight hearing in 
April 2008, Chairman Miller introduced H.R. 5876, the Stop 
Child Abuse in Residential Programs for Teens Act of 2008, with 
ten cosponsors. The bill requires the federal government and 
states to establish systems of standards and enforcement to 
curtail instances of child neglect, abuse and death at 
privately owned and run residential treatment centers. The bill 
has two separate components.
    The first section establishes a new program, authorized at 
$50 million each year for 5 years, through which the Assistant 
Secretary for Children and Families at the U.S. Department of 
Health and Human Services (HHS) is required to create national 
standards and a federal system of review, evaluation, and 
penalties for privately owned and run residential treatment 
centers. Under the legislation, a covered program is defined as 
one that provides a residential environment and serves children 
with emotional, behavioral, or mental health problems or 
problems with alcohol or substance abuse. The bill does not 
cover hospitals accredited by a state, facilities that are 
licensed and regulated by the state as homes for children in 
foster care, or psychiatric residential treatment facilities 
covered under the Social Security Act.
    The bill establishes 14 areas in which the Assistant 
Secretary must develop federal standards, and allows for the 
creation of any other standards the Assistant Secretary deems 
necessary. The 14 standards relate to disciplinary techniques, 
conditions of employment for staff members, provision of 
emergency medical care, and disclosure on promotional and 
informational materials, among others. The Assistant Secretary 
is also required to establish a national system of monitoring 
and enforcement to begin as soon as the standards are final.
    H.R. 5876 requires the Assistant Secretary to put the 
standards in place within 180 days of the bill's enactment and 
begin the monitoring and enforcement of those standards on the 
date the standards are put in place.
    The Assistant Secretary must also conduct unannounced site 
inspections of each location at least once every two years and 
must investigate all reports of abuse and neglect. The 
Assistant Secretary is required to establish civil penalties 
for violations of the standards up to $50,000 per violation.
    In addition, the Assistant Secretary is required to create 
a public website that discloses information about each program 
relating to their compliance with the standards and state 
licensing requirements, any deaths that occurred to a child at 
a program, and any penalties levied by the state against a 
program. The Assistant Secretary must also establish a national 
toll-free telephone hotline to receive complaints of child 
abuse and neglect at covered programs.
    The bill also authorizes a private right of action for any 
person suffering an injury-in-fact as a result of the violation 
of the standards.
    The second section amends title I of CAPTA to add a section 
requiring the establishment of a state system of standards and 
enforcement of these facilities, within three years from the 
date of enactment, in order for a state to receive CAPTA 
funding. This section is authorized at $200 million (an 
increase of $95 million over current CAPTA funding levels). 
Currently every state (as well as the District of Columbia and 
the 5 territories) receives state grant funding under CAPTA. 
The state grants program was funded at just under $27 million 
in FY2008 with grant amounts ranging from over $3 million for 
California to $93,000 for Vermont.
    In this section of the bill, a covered program includes 
those covered under the federal system but adds in government 
operated entities that focus on serving children with 
emotional, behavioral, or mental health disorders or problems 
with alcohol or substance abuse.
    Under this section of the legislation, a state is required 
to develop standards that meet or exceed the federal standards 
defined in the first section of the bill. Each state is also 
required to develop policies and procedures to monitor and 
enforce compliance with the licensing requirements. If the 
state is not yet satisfying the requirements, it must develop 
policies and procedures for notifying the Secretary and the 
appropriate local child protection and advocacy system of any 
report of child abuse and neglect at a covered program 
operating in the state.
    Each state is required to develop a publicly available 
database of all covered programs operating in the state, and 
must annually submit to the Secretary a report that includes 
any violations of state licensing requirements and a 
description of state activities to monitor and enforce 
licensing requirements, including the names of programs that 
underwent a site inspection along with a summary of the 
results.
    Beginning two years after the date of the enactment of the 
bill, the Secretary must implement a process for continued 
monitoring of each state that is determined to be satisfying 
the licensing, monitoring, and enforcement requirements. The 
bill also requires a random sample of review of cases of 
reports of child abuse and neglect investigated at covered 
programs to assess the state's performance with respect to the 
appropriateness of response to reports of child abuse and 
neglect. The Secretary may also conduct unannounced site 
inspections of programs operating in the state.
    Unfortunately, there were no legislative hearings scheduled 
on H.R. 5876 before the bill was scheduled for markup by the 
Committee. As referenced above, the bill was introduced less 
than 24 hours before the second oversight hearing, which 
prevented Committee Members on either side of the aisle from 
delving into any substantive concerns with the introduced bill. 
Committee Republicans would have appreciated an opportunity to 
discuss and debate the manner in which the legislation seeks to 
stem instances of child abuse and neglect at residential 
treatment programs. It is also important to note that, if 
legislative hearings had been held, relevant stakeholders, 
including HHS, state and local governments, and nonprofit 
organizations that operate residential treatment programs would 
have had an opportunity to share their thoughts on the 
legislation with Committee Members, including whether the 
federal government has the expertise to carry out the 
provisions of the legislation and the work that states and 
organizations are currently doing to protect the well-being of 
children in their care.
    If hearings had been held on this legislation, Committee 
Republicans would have sought to discover the rationale for 
creating two parallel regulatory structures on the federal and 
state level, especially due to the fact that state and local 
governments have traditionally been responsible for regulating 
private entities and enforcing laws regarding child abuse and 
neglect. We also would have questioned why the legislation 
lacks a sunset provision for the federal regulatory structure, 
despite the majority's assurances that the bill does not 
envision a permanent federal role. While direct federal 
monitoring and evaluation of programs is not required once 
states have systems in place, the federal standards and the 
private right of action remain in place effectively maintaining 
the comprehensive federal role in the regulation of private 
programs. Committee Republicans would have asked why it is 
necessary to codify a private right of action when state laws 
clearly allow litigation. And, finally, Members should have had 
the opportunity to question why the definition of a covered 
program does not include government run programs in the federal 
regulatory structure.
    Committee Republicans believe that the underlying bill 
creates a new structure that is redundant; authorizes an HHS 
regulatory and monitoring role that would undercut our efforts 
to hold states accountable; does not cover all of the 
residential treatment programs that have committed abuse 
against children; and will have negative ramifications if 
enacted into law.

The Federal Role in Stemming Abuse and Neglect at Residential Treatment 
                        Programs Under H.R. 5876

    Committee Republicans believe that the federal government 
should assist states in preventing child abuse by insisting 
that states regulate and monitor residential treatment 
programs. We believe that stopping child abuse is a necessary 
and essential function of state and local government. Unlike 
the provisions that were included in H.R. 5876, the best way to 
address this situation is to work within current programs and 
utilize vehicles like CAPTA to require states to establish a 
system of standards and enforcement to prevent child abuse and 
neglect to stop these abuses.
    The proper federal role is one that ensures that states 
fulfill their roles and responsibilities in stopping child 
abuse in residential treatment facilities. Creating an entirely 
new bureaucracy at HHS is not the best way to stem these 
instances of abuse and neglect. The time and money that it 
would take HHS to develop a new infrastructure for inspecting 
each and every residential treatment center site could be 
better spent insisting that states live up to their 
responsibilities and helping states build their capacity to 
prevent child abuse.
    HHS expressed similar concerns about the new role and 
responsibility of the federal government established in H.R. 
5876. In a letter sent to Committee Members prior to markup, 
the Department stated:

          While ACF currently provides general funds to States 
        to improve systems that identify and address child 
        abuse and neglect and requires States that receive 
        Federal foster care funds to have licensing standards 
        for foster homes and institutions, youth who are not in 
        foster care and placed in private institutions that 
        receive no funds from ACF are outside our purview. The 
        bill requires investigations of individual child 
        fatalities as well as joint investigations of child 
        abuse and neglect at covered programs. The Federal 
        government has no oversight or rules governing child 
        abuse and neglect investigations, as each State has its 
        own process for defining and investigating child abuse 
        and neglect, including the timelines and methods for 
        responding to and completing investigations of 
        allegations. As such, any Federal investigations of 
        abuse and neglect would likely interfere and perhaps 
        conflict with a State's procedures for the same. We 
        also have concerns that ACF and the State would reach 
        different conclusions about whether abuse and neglect 
        occurred in a covered facility or the standards were 
        violated.

    Committee Republicans are also concerned that the timeframe 
requiring HHS to implement the standards and monitoring system 
within 180 days after the bill is enacted will not allow the 
Department to conduct all of the requisite work that will need 
to be completed to put in place a new federal regulatory 
structure. This includes, but is not limited to: hiring staff 
to establish and oversee the new federal regulatory system; 
training staff to establish and oversee the new federal 
regulatory system; convening experts and other stakeholders to 
develop the standards based on the 14 areas identified in the 
bill and any additional areas that HHS defines; promulgating an 
interim rule and seeking public comment on the proposed 
regulations; determining where all of the covered programs are 
located; developing and bidding contracts for the monitoring 
and evaluation of each covered program and location; hiring and 
training contractors to inspect each program and location; and 
reporting on the findings at each program and location. It is 
clear to Committee Republicans that the federal role 
established in H.R. 5876 is not only duplicative and 
unnecessary, but also unrealistic and may interfere with the 
work being done at the state level to combat abuse and neglect.
    To this end, during consideration of H.R. 5876, Committee 
Republicans supported an amendment in the nature of a 
substitute, offered by Congressman Howard P. ``Buck'' McKeon 
(R-CA), the Senior Republican on the Committee. The Republican 
substitute struck the federal regulatory and enforcement 
requirement and strengthened the state system currently 
operating under CAPTA. The substitute maintained the 
requirements for the establishment of the state standards 
included in the underlying bill and created a stronger role of 
federal oversight, which is a more appropriate role for the 
federal government to play in ending child abuse at residential 
treatment programs. The substitute also required states to have 
their systems in place in 18 months, cutting in half the 
timeline proposed in the underlying bill, and included 
government run programs in the definition of a ``covered 
program.''
    The substitute maintained the strong background check 
requirements that were a part of H.R. 5876 and struck the 
private right of action and federal sanctions put in place 
under the legislation. The federal database and national 
hotline in H.R. 5876 were also preserved in the substitute. In 
short, the Republican substitute called for a more robust state 
system of regulation and monitoring of these programs, 
bolstered by a strong federal oversight authority. 
Unfortunately, Committee Democrats rejected this common-sense 
approach.

  The Role of Trial Lawyers, Earmarks, and Victim Privacy in H.R. 5876

    Committee Republicans are concerned that H.R. 5876 opens 
the door to a new wave of litigation and lawsuit abuse. 
Currently, state and local laws provide any victim of child 
abuse and neglect with the right to sue. As such, we believe 
that a new federal private right of action is unnecessary. For 
this reason, Congresswoman Virginia Foxx (R-NC) offered an 
amendment to strike the section of the bill creating a new 
federal private right of action. While the amendment was 
rejected, Committee Republicans supported this amendment 
because state liability laws currently allow persons harmed to 
seek relief in state courts.
    Committee Republicans also supported an amendment to H.R. 
5876, offered by Congressman Tom Price (R-GA), that would have 
capped the hourly expenses of trial lawyers, in any lawsuit 
brought under the new right of action created by the bill, at 
$1,000 an hour. The underlying bill requires attorneys' fees to 
be reasonable; it was the hope of Committee Republicans that 
members on both sides of the aisle could agree in good faith 
that any fee above $1,000 an hour would be unreasonable. Our 
nation's legal system allows trial lawyers to impose 
significant costs on businesses and non-profits simply by 
filing a claim. Many organizations find it is less costly to 
settle claims even where the claims are frivolous and without 
merit. The opportunity to recoup outrageously high hourly fees 
only encourages such behavior. Throughout our history and 
indeed in many current state and federal laws, attorneys' fees 
have been capped in order to limit the potential for abusive 
lawsuits. This amendment would have placed a very reasonable, 
indeed a generous cap on fees and would help to limit that 
potential. Unfortunately, the amendment was defeated on a party 
line vote, making it impossible for Committee Members to ensure 
that victims of abuse and neglect are protected, not exploited.
    Congressman Tom Price (R-GA) offered a second amendment, 
supported by Committee Republicans, aimed at protecting 
taxpayers. Specifically, the amendment would have reduced the 
authorized spending for title I of the Child Abuse Prevention 
and Treatment Act by 1 percent, prohibited money from being 
appropriated for earmarks, and prohibited federal money from 
going to residential treatment programs in violation of the 
health and safety standards created in the bill. The slight 
reduction in the authorization level would not have affected 
the overall funding of the program, and would have allowed for 
a significant increase in current appropriations to assist 
states with their efforts to prevent abuse and establish a 
system of standards and evaluation for residential treatment 
programs. More importantly, the amendment would have prohibited 
CAPTA funding from being used for earmarks through the 
appropriations process in order to ensure that limited funds 
are distributed to each state, rather than to organizations 
with paid lobbyists or political connections. Finally, the 
amendment would have prohibited any program in violation of the 
standards and requirements set forth in this bill from 
receiving any CAPTA funding, an important provision lacking in 
the underlying bill that would deny funding to unscrupulous 
programs. Unfortunately, the amendment was defeated on a party 
line vote.
    Committee Republicans were able to secure one important 
improvement to the bill by proposing an amendment, supported by 
Committee Democrats, on the protection of victims' rights. 
Congressman Rob Bishop (R-UT) offered an amendment to H.R. 5876 
to ensure instances of abuse and neglect reported by states do 
not contain any information that is personally identifiable of 
the victim. Reports of abuse and neglect are highly 
confidential and this amendment ensures victim privacy remains 
protected and no federal requirement limits that 
confidentiality. The amendment was agreed to by voice vote.

                               Conclusion

    Committee Republicans share the commitment to protect young 
people enrolled in residential treatment programs and believe 
that even one instance of abuse, neglect, or death is too many. 
However, we believe that the most effective and appropriate way 
to protect those enrolled in these programs is to establish a 
system of federal oversight that holds states responsible for 
identification, licensure, regulation, and monitoring.
    States have historically been responsible for the direct 
regulation of child abuse and neglect, including those 
instances that occur at residential treatment programs. 
Committee Republicans believe that states should maintain this 
fundamental responsibility to protect their citizens and 
monitor the organizations operating within their borders.
                                   Buck McKeon.
                                   Tom Petri.
                                   Mark Souder.
                                   Judy Biggert.
                                   Joe Wilson.
                                   John Kline.
                                   Cathy McMorris Rodgers.
                                   Kenny Marchant.
                                   C.W. Boustany, Jr.
                                   Virginia Foxx.
                                   Rob Bishop.
                                   David Davis.
                                   Tim Walberg.

                                  
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