[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2771 Introduced in House (IH)]
<DOC>
117th CONGRESS
1st Session
H. R. 2771
To amend the Public Health Service Act to improve the health and well-
being of maltreated infants and toddlers through the implementation of
infant-toddler court teams within States, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
April 22, 2021
Ms. DeLauro (for herself, Mrs. Hayes, Mr. Cooper, Ms. Norton, Mr.
Suozzi, Mr. Rutherford, and Mr. San Nicolas) introduced the following
bill; which was referred to the Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to improve the health and well-
being of maltreated infants and toddlers through the implementation of
infant-toddler court teams within States, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Strengthening America's Families Act
of 2021''.
SEC. 2. INFANT-TODDLER COURT TEAMS FOR CHILDREN EXPERIENCING OR AT RISK
OF MALTREATMENT.
Part Q of title III of the Public Health Service Act (42 U.S.C.
280h et seq.) is amended by adding at the end the following:
``SEC. 330Z-3. INFANT-TODDLER COURT TEAMS FOR CHILDREN EXPERIENCING OR
AT RISK OF MALTREATMENT.
``(a) Continuation and Expansion of Infant-Toddler Court Program.--
``(1) Continuation and expansion of program.--The
Secretary, acting through the Administrator of the Health
Resources and Services Administration--
``(A) shall continue in effect the Infant-Toddler
Court Program; and
``(B) may, beginning with fiscal year 2022, carry
out such program on a national basis.
``(2) Infant-toddler court program defined.--For purposes
of paragraph (1), the term `Infant-Toddler Court Program'
refers to the program carried out pursuant to section 501(a)(2)
of the Social Security Act that is designed--
``(A) to support research-based infant-toddler
court teams for purposes of changing child welfare
practices to improve well-being for infants, toddlers,
and their families, including efforts to build on, and
continue the work of, sites established through the
Quality Improvement Center for Research-Based Infant-
Toddler Court Teams initiative funded by the
Administration for Children and Families; and
``(B) to provide training and technical assistance
in support of infant-toddler court teams' efforts
across the United States.
``(b) Grants to States for Implementation of Infant-Toddler Court
Teams.--
``(1) In general.--The Secretary of Health and Human
Services, acting through the Administrator of the Health
Resources and Services Administration, may make grants to
States for purposes of seeding the establishment of, or
stabilizing and enhancing existing, infant-toddler court teams
for children experiencing or at risk of maltreatment.
``(2) Use of funds.--A State receiving a grant under this
subsection may only use funds received through the grant to--
``(A) designate a State lead agency as a focal
point for statewide planning administration and
coordination--
``(i) to identify sites and leadership for,
and establish, enhance, or stabilize, local
community infant-toddler court teams; and
``(ii) to promote collaboration among State
and local systems that address the needs of--
``(I) infants and toddlers and
their families within the child welfare
system; and
``(II) individuals in need of
preventive family strengthening
services to facilitate the provision of
local services;
``(B) provide funding to the sites identified under
subparagraph (A)(i) to establish, enhance, or stabilize
local community infant-toddler court teams that meet
the criteria specified in paragraph (8); and
``(C) ensure that local community court team
projects--
``(i) provide for improved communication
and coordination among the courts, child
welfare agencies, and related child-serving
organizations--
``(I) to share information and
expedite appropriate high-quality
services for young children and their
families in the child welfare system;
and
``(II) to prevent recurrence of
maltreatment, promote timely
permanency, and provide a community
structure to help prevent entry into
the child welfare system;
``(ii) protect young children in the child
welfare system and at risk of entering the
child welfare system from further maltreatment
and developmental harm and address the damage
already done; and
``(iii) identify and address the structural
issues in the child welfare system that are
harmful to infants and toddler development and
impede the ability to strengthen and stabilize
families.
``(3) Term of grant.--A grant under this subsection shall
be for a term of not less than 3 years and may be renewed for a
single term not to exceed 8 years.
``(4) Application process.--
``(A) In general.--A State seeking a grant under
this subsection shall submit an application to the
Secretary at such time, in such manner, and containing
such information as the Secretary may require,
including--
``(i) the information specified in
paragraph (5); and
``(ii) a plan for the establishment or
enhancement and ongoing support of local
community infant-toddler court teams in the
State.
``(B) Lead state agency.--The Governor of a State
submitting an application under subparagraph (A) shall
designate an appropriate State lead agency, such as the
State Court Improvement Program or the State agency
that administers child welfare services, with the
ability to carry out the activities specified in
paragraph (2).
``(5) Application contents.--The information specified in
this paragraph is--
``(A) a description of how the State lead agency
designated pursuant to paragraph (4)(B) will implement
infant-toddler court team projects that meet the
criteria specified in paragraph (2)(C) and the
communities in which local community infant-toddler
court teams will be established, enhanced, or
stabilized;
``(B) an assurance that the State lead agency will
consult with representatives of State agencies
providing services to infants, toddlers, and families,
the State and local judiciary, and local communities
and stakeholders, to develop a comprehensive plan for
implementing infant-toddler court teams in the State,
that includes a plan for determining how the court team
structure and approach will inform and support building
a family strengthening continuum, which may include
using the infant-toddler court team structure in
implementing prevention and family services and
programs under section 471(e) of the Social Security
Act (42 U.S.C. 671(e)); and
``(C) a certification that any infant-toddler court
team established, enhanced, or implemented using funds
received through the grant meet the criteria specified
in paragraph (8).
``(6) Continuum requirements.--The continuum referred to in
paragraph (5)(B) shall--
``(A) seek to ensure that children and their
families, particularly families with histories of
trauma and adversity, receive effective, timely
services that strengthen protective factors;
``(B) begin as early as possible before families
encounter the child welfare system--
``(i) to provide comprehensive supportive
community services to families with very young
children in need of such services; and
``(ii) to emphasize the social determinants
of health to strengthen families and prevent
abuse and neglect;
``(C) for young children with substantiated cases
of maltreatment, including those whose families have
been placed in an alternative or differential response
program, include a comprehensive approach to
stabilizing and strengthening families and preventing
children from being placed in foster care that provides
services and supports focused on in-home parent
education and specialized programs that address the
risk factors for removal of infants and toddlers from
the home; and
``(D) use the community structure combined with the
judicial oversight within the infant-toddler court team
to improve outcomes for infants and toddlers who have
been placed in foster care and their families through
working with communities to ensure that--
``(i) parents receive intensive services
and supports, including mental health and
substance use disorder treatment, to increase
the likelihood of reunification; and
``(ii) young children receive intensive
interventions that will address their
developmental needs and heal the trauma of
abuse, neglect, domestic violence, and
separation from their caregiver and family.
``(7) Conditions.--A State selected to receive a grant
under this subsection, shall, as a condition on receipt of such
grant--
``(A) agree to work with the National Infant-
Toddler Court Team Resource Center established under
subsection (c) to design or enhance and implement local
infant-toddler court teams, including supporting data
collection and continuous quality improvement;
``(B) provide information to the National Infant-
Toddler Court Team Resource Center on the plan
developed pursuant to paragraph (5)(B), including the
development of a continuum of family strengthening
services that meets the conditions specified in
paragraph (6);
``(C) commit to building sustainability into the
State lead agency function and the plan referred to in
subparagraph (B); and
``(D) ensure that any infant-toddler court team
established, enhanced, or implemented using funds
received through the grant meets the criteria specified
in paragraph (8).
``(8) Local community infant-toddler court team criteria.--
The criteria specified in this paragraph with respect to a
local community infant-toddler court team established,
enhanced, or implemented using funds received through the grant
are that the team--
``(A) organizes and promotes collaboration, with
leadership from judges and the heads of child welfare
agencies, among community stakeholders and service
providers to address the needs of families with infants
and toddlers, through implementing trauma-informed
practices for infants and toddlers and their families
in the child welfare system and for creating a
community structure that can provide a continuum of
services;
``(B) works to strengthen families to prevent
foster care placement, promote timely permanency,
prevent recurrence of maltreatment, and promote
positive early development;
``(C) is coordinated through a local community
coordinator;
``(D) is composed of community stakeholders that
include legal and child welfare professionals involved
with families of infants and toddlers and community
service providers that--
``(i) have experience solving problems and
filling gaps at the community systems level,
including with respect to evidence-based
interventions appropriate for infants and
toddlers and their families;
``(ii) receive training on the science of
early childhood development, the impact of
trauma, and the implications for child welfare
and family strengthening practice;
``(iii) work to build a community structure
for strengthening families across sectors,
including work support, education, health
(including mental health), and social supports;
``(iv) undergo a period of preparation and
training before taking families into the
infant-toddler court program;
``(v) provide a team of professionals that
provides support to an individual family to
ensure the needs of individual children within
such family and such family as a whole are met;
``(vi) focus on infants and toddlers under
the court's jurisdiction or under in-home
supervision; and
``(vii) as resources and team structure
permit, work with families of infants and
toddlers outside the child welfare system to
provide preventive services to strengthen
families of young children and avoid child
welfare involvement;
``(E) supports parents' strengths and needs in a
compassionate, respectful, holistic, and individualized
way;
``(F) prevents children from entering and
reentering the child welfare system;
``(G) addresses community service gaps and
disparities using evidence-based strategies;
``(H) commits to working toward sustainability for
the infant-toddler court team program;
``(I) removes barriers to racial equity and social
justice, and prevents disparate outcomes for racial and
ethnic minorities, Tribes, and lesbian, gay, bisexual,
transgender, and queer individuals;
``(J) integrates family support services to meet
family needs in a comprehensive way, including--
``(i) developmentally appropriate evidence-
based interventions for very young children and
their families, including developmental
screening, early intervention services, high-
quality early care and learning programs such
as Early Head Start, and multigenerational
mental health treatment focused on the child-
caregiver relationship; and
``(ii) assessments of parents' needs,
including past trauma, high-quality health
services, including mental health services, for
parents, including prenatal and postnatal care,
screening for depression, well-woman care,
mental health treatment, and evidence-based
substance use disorder treatment;
``(K) infuses a trauma-informed approach in the
delivery of family support services that supports
children, families, and professionals across systems of
care;
``(L) provides for a continuum of parenting
interventions and mental health and substances use
prevention and treatment services consistent with
paragraph (7);
``(M) uses continuous quality improvement
practices, including collecting project data elements
established by the National Infant-Toddler Court Team
Resource Center under subsection (c) for case
management and assessing progress; and
``(N) where placement of an infant or toddler in
foster care is necessary, uses--
``(i) concurrent planning upon removal and
limits the number of placements;
``(ii) mentoring and coparenting between
birth and foster parents and kin caregivers and
supports;
``(iii) preremoval conferences and monthly
family team meetings to ensure support for
family and child from the beginning as well as
timely action and services to address child and
family needs; and
``(iv) frequent, quality family time
interaction or visitation in settings where
families normally interact and coaches to
support parent-child interactions.
``(c) National Infant-Toddler Court Team Resource Center Grant.--
``(1) Grant authorized.--The Secretary shall award to an
eligible entity a grant to establish a national center to carry
out the activities specified in paragraph (3) to serve as a
resource for infant-toddler court teams (to be known as and
referred to in this section as the `National Infant-Toddler
Court Team Resource Center'). The term of a grant under this
subsection shall be for not less than 3 years, renewable for up
to 8 years.
``(2) Eligible entities.--An entity is eligible to receive
a grant under this subsection if the entity is a national early
childhood development organization with--
``(A) recognized experience as a training
organization in infant-toddler development, infant-
early childhood mental health, and other related
topics;
``(B) experience working in collaboration with, and
providing training to, court officials, child welfare
agencies, attorneys, guardians, court-appointed special
advocates, and other individuals and community
organizations providing services to infants and
toddlers in the child welfare system, including--
``(i) specific expertise in educating
judges, attorneys, child welfare staff, and
community service providers about the impacts
of child maltreatment and trauma on early
development and family functioning; and
``(ii) experience in incorporating the
expertise described in clause (i) into the
court and child-family service systems to
promote change in the way courts and
communities address cases involving maltreated
infants and toddlers and support other families
with infants and toddlers in need of family
strengthening services;
``(C) the capacity to carry out the activities of
the National Infant-Toddler Court Team Resource Center;
``(D) a proven ability to provide training and
technical assistance, collect data and support its use
for continuous quality improvement and evaluation, and
other tasks; and
``(E) a demonstrated ability to bring the
collective impact of other national organizations
together to address the needs of infants and toddlers
that touch the child welfare system or are in need of
preventive services to strengthen families and avoid
the child welfare system.
``(3) Activities of national infant-toddler court team
resource center.--The National Infant-Toddler Court Team
Resource Center shall carry out the following activities:
``(A) Provide technical assistance to States and
communities with infant-toddler court teams receiving
funding under subsection (a) established through the
Infant-Toddler Court Program, or through other means in
building the systemic team structure to identify and
address the needs of at-risk children and families
before maltreatment occurs.
``(B) Provide technical assistance and training to
States and local jurisdictions--
``(i) in selecting sites, coordinating
systems, planning, and implementing, enhancing,
or stabilizing evidence-based infant-toddler
court teams, including embedding a child
development approach to promote the healthy
development and mitigate trauma of infants and
toddlers experiencing or at risk of
experiencing maltreatment and their families,
so that such court teams meet the criteria
specified in subsection (b)(7); and
``(ii) in determining how to use the court
team community structure to inform and support
the continuum of family strengthening services
described in paragraph (6).
``(C) Develop materials to guide judges in the
decision-making process regarding infants and toddlers,
and train members of local infant-toddler court teams
and others in the community regarding the appropriate
care of infants and toddlers, including the importance
of--
``(i) understanding early brain
development, the impact of abuse and neglect
and placement in foster care, and the need for
preventing such occurrences;
``(ii) the social determinants of health;
``(iii) placement stability and caregiver
continuity for very young children;
``(iv) supporting the parent-child
relationship;
``(v) comprehensive services for children
and parents to reduce the recurrence of abuse
and neglect;
``(vi) comprehensive services to monitor
and improve the health, development, and well-
being of infants and toddlers in foster care or
in in-home placements;
``(vii) for children placed in foster care,
timely permanent placement frequent parent-
child visitation, and concurrent planning; and
``(viii) implementing a comprehensive
service delivery plan addressing the needs of
children and parents at the proximate time of a
child's removal from the care of the child's
biological parents.
``(D) Provide information to States, communities,
and courts around the United States seeking to adopt an
infant-toddler court team approach grounded in the
science of early childhood development, including
information related to--
``(i) the incorporation of knowledge about
infant and toddler development into the
resolution of cases by judges with jurisdiction
over children in foster care and by child
welfare agencies overseeing children under in-
home supervision; and
``(ii) methods to change State and local
government systems to better address the needs
of infants and toddlers in the child welfare
system and their families.
``(E) Coordinate and facilitate peer learning
opportunities for judges, community coordinators, and
other personnel through communities of practice,
learning communities, conferences, and other means.
``(F) Ensure local infant-toddler court teams
collect and report data specified under subparagraph
(H) and provide technical assistance in--
``(i) ensuring quality data collection and
reporting; and
``(ii) using the data collected for case
and site monitoring, to establish a continuous
quality improvement process to identify areas
that need strengthening, to develop a plan for
such improvements, and to monitor progress.
``(G) Provide technical assistance to States and
communities--
``(i) in evidence-based methods to change
policies and practices to better address the
needs of infants and toddlers experiencing
maltreatment and their families as well as
infants, toddlers, and families in need of
services to strengthen families and prevent the
likelihood of entry into the child welfare
system; and
``(ii) through onsite implementation
assistance to local infant-toddler court teams
tailored to the needs of each unique
jurisdiction, using a process of assessing and
building on community strengths.
``(H) Define key metrics and collect data from
local infant-toddler court teams related to the
operation and outcomes of the projects supported by
States receiving a grant under subsection (b) and other
existing infant-toddler court team sites on elements
that include--
``(i) data on child and parent demographics
and relevant family history;
``(ii) adult health care services,
including prenatal and postnatal care,
depression screening, mental health services,
substance use treatment, and well-woman care;
``(iii) child services, including
multigenerational mental health treatment
focused on the relationship, developmental
screening, early intervention services, well-
child care and medical homes, and early
childhood education;
``(iv) family engagement activities, such
as family team meetings and court hearings;
``(v) family well-being, including health
equity and health insurance;
``(vi) court practices, such as frequency
of hearings, family team meetings, and
stakeholder meetings; and
``(vii) foster care practices that support
development and stable relationships, including
placement type, visitation frequency, and
permanency outcomes and timeliness, with an
emphasis on reunification.
``(I) Compile such data annually and report to the
Secretary together with information from State planning
processes reported under subsection (b)(7)(B).
``(J) In developing data elements under
subparagraph (H), consult with the organization awarded
a contract under paragraph (4).
``(4) Evaluation.--The National Infant-Toddler Court Team
Resource Center shall enter into a contract with an
organization experienced in conducting a child welfare national
evaluation over the course of the grant period of the
effectiveness of local evidence-based infant-toddler court
teams supported by States receiving a grant under subsection
(b) as well as other infant-toddler court team sites that may
participate in such evaluation in--
``(A) linking children and families to appropriate
services and supports that prevent foster care
placements, expedite permanency where placements occur,
and strengthen families in improving family well-being
and support for positive child development;
``(B) preventing, or reducing the recurrence of,
abuse and neglect;
``(C) promoting access to timely, high-quality
primary health care and oral health care in a medical
home for children and parents;
``(D) promoting quality parent education,
mentoring, and coaching to strengthen parenting skills;
``(E) promoting timely assessment, referral to, and
receipt of, mental health treatment and substance use
treatment for parents of infants and toddlers;
``(F) promoting timely permanent placements of
maltreated infants and toddlers; and
``(G) reducing costs through system improvements.
``(d) Definitions.--In this section:
``(1) The term `child welfare system' includes all services
and supports provided through a State's child welfare system.
``(2) The term `State' means each State of the United
States, the District of Columbia, each territory or possession
of the United States, and each federally recognized Indian
Tribe (as defined in section 4 of the Indian Self-Determination
and Education Assistance Act (25 U.S.C. 5304)).
``(e) Authorization of Appropriations.--
``(1) In general.--There are authorized to be appropriated
to carry out this section, $25,000,000 for each of fiscal years
2022, 2023, 2024, and 2025.
``(2) Reservation of funds.--Of the amounts made available
under paragraph (1) for a fiscal year, the Secretary shall
reserve--
``(A) in the case of a fiscal year in which the
amount made available under paragraph (1) does not
exceed $15,000,000, not less than $5,000,000 for the
National Infant-Toddler Court Team Resource Center
established pursuant to subsection (c); and
``(B) in the case of a fiscal year in which the
amount made available under paragraph (1) equals or
exceeds $15,000,000 but does not exceed $25,000,000,
not less than $7,000,000 for such Center.''.
SEC. 3. REPORTS TO CONGRESS.
Not later than 3 years after the date of the enactment of this Act,
and not later than 5 years after such date of enactment, the Secretary
shall submit to Congress a report addressing the implementation and
effectiveness of the infant-toddler court teams pursuant to section
330Z-3 of the Public Health Service Act, as added by section 2,
including--
(1) a compilation of the data on local community infant-
toddler court teams included in the annual report from the
National Infant-Toddler Court Team Resource Center established
pursuant to such section; and
(2) interim or final results from the national evaluation
of infant-toddler court teams conducted under such section.
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