II 

115TH CONGRESS 

1ST SESSION S. 774 

To address the psychological, developmental, social, and emotional needs of 

children, youth, and families who have experienced trauma, and for 

other purposes. 

IN THE SENATE OF THE UNITED STATES 

MARCH 29, 2017 

Ms. HEITKAMP (for herself, Mr. DURBIN, Mr. FRANKEN, and Mr. BOOKER) 

introduced the following bill; which was read twice and referred to the 

Committee on Health, Education, Labor, and Pensions 

A BILL 

To address the psychological, developmental, social, and emotional needs of children, youth, and families who have 

experienced trauma, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Trauma-Informed 

5 Care for Children and Families Act of 2017’’. 

6 SEC. 2. FINDINGS. 

7 Congress makes the following findings: 

8 (1) The 2007 Great Smoky Mountains Study, a 

9 representative longitudinal study of children, found 


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1 that by age 16, more than 67 percent of the children 

2 had been exposed to 1 or more traumatic events, 

3 such as child maltreatment, domestic violence, or 

4 sexual assault. 

5 (2) According to a 2009 Office of Juvenile Jus6 tice and Delinquency Prevention study of children 

7 ages 0 through 17, more than 60 percent of the chil8 dren surveyed were exposed to violence within the 

9 past year, either directly or indirectly. 

10 (3) According to the Administration for Chil11 dren and Families, the rate of substantiated reports 

12 of child maltreatment in fiscal year 2015 was 9.2 

13 per 1,000 children ages 0 through 17, with children 

14 under age 1 having the highest rate of 24.2 per 

15 1,000 children. 

16 (4) According to the Office of Juvenile Justice 

17 and Delinquency Prevention, a longitudinal study of 

18 youth detained at a juvenile detention center in Chi19 cago showed that 92.5 percent of youth had experi20 enced at least 1 trauma, and 84 percent had experi21 enced more than 1 trauma. 

22 (5) The National Intimate Partner and Sexual 

23 Violence Survey conducted by the Centers for Dis24 ease Control and Prevention revealed that nearly 1 

25 in 5 women reported having been the victim of a 


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1 rape at some time during their lives. Seventy-eight 

2 percent experienced their first rape before the age of 

3 25. 

4 (6) A 2017 study found that abuse and mal5 treatment suffered as a child was associated with 

6 post-traumatic stress disorder and opioid-related 

7 misuse as an adult, and recommended that trauma 

8 history and post-traumatic stress disorder symptom 

9 severity be addressed as part of opioid addiction 

10 treatment. 

11 (7) Findings from the Adverse Childhood Expe12 riences Study conducted by the Centers for Disease 

13 Control and Prevention have shown that adverse 

14 childhood experiences predispose children towards 

15 negative trajectories from infancy through adoles16 cence. Followup representative studies have shown 

17 the long-range impact of early trauma exposure on 

18 adult health conditions, including heart disease, 

19 asthma, and mental health. 

20 (8) According to a subsequent study conducted 

21 by the Centers for Disease Control and Prevention, 

22 adults who had been exposed to multiple adverse 

23 childhood experiences were significantly more likely 

24 to be unemployed, to be living in poverty, and not 


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1 to have graduated high school than adults who had 

2 zero adverse childhood experiences. 

3 (9) According to a 2008 finding by the Na4 tional Child Traumatic Stress Network, educators 

5 who work directly with traumatized children and 

6 adolescents are particularly vulnerable to secondary 

7 traumatic stress, experiencing burnout, fatigue, irri8 tability, and other symptoms, and can be supported 

9 through early recognition of that stress, self-care, 

10 and trauma-informed support systems. 

11 (10) Findings from a 2012 study conducted by 

12 the Centers for Disease Control and Prevention in13 cluded an estimate that the total lifetime burden of 

14 child maltreatment cases that occur each year in the 

15 United States, including medical, welfare, and crimi16 nal justice costs, is $124,000,000,000. 

17 (11) According to the Centers for Disease Con18 trol and Prevention’s National Health and Nutrition 

19 Examination Survey, only half of children ages 8 

20 through 15 with a mental disorder had received 

21 treatment for their disorder within the past year. 

22 Children with anxiety disorders such as post-trau23 matic stress disorder were the least likely to be 

24 treated, with only 32.2 percent having received 

25 treatment for a mental disorder in the past year. 


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1 (12) According to a 2014 report of the Institute 

2 of Medicine and National Research Council of the 

3 National Academies entitled ‘‘New Directions in 

4 Child Abuse and Neglect Research’’, research has 

5 shown that child abuse and neglect experiences re6 sulted in higher risk for behavioral health problems 

7 (such as depression and substance use) throughout 

8 life, but that with informed prevention approaches, 

9 child abuse and neglect can be both preventable and 

10 manageable. 

11 (13) According to a 2017 finding by the Na12 tional Child Traumatic Stress Network, of the chil13 dren served by the Network with problems in the 

14 clinical range when entering care, 83 percent showed 

15 significant improvements in post-traumatic stress 

16 disorder, behavioral problems, or traumatic stress 

17 symptoms after receiving evidence-based treatments. 

18 (14) According to a 2008 Washington State re19 port on prevention programs that assessed both cost 

20 and effectiveness, evidence-based, two-generational 

21 child trauma treatments such as Parent-Child Inter22 action Therapy return $3.64 per dollar of cost. 


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1 TITLE I—DEVELOPMENT OF 

2 BEST PRACTICES 

3 SEC. 101. TASK FORCE TO DEVELOP BEST PRACTICES FOR 

4 TRAUMA-INFORMED IDENTIFICATION, RE5 FERRAL, AND SUPPORT. 

6 (a) ESTABLISHMENT OF TASK FORCE TO IDENTIFY, 

7 EVALUATE, RECOMMEND, MAINTAIN, AND UPDATE BEST

8 PRACTICES.— 

9 (1) ESTABLISHMENT.—There is established a 

10 task force, to be known as the Interagency Task 

11 Force on Trauma-Informed Care. 

12 (2) MAIN DUTIES.—The task force shall— 

13 (A) identify, evaluate, recommend, main14 tain, and update, as described in subsection (c) 

15 and in accordance with subsection (d), a set of 

16 best practices with respect to children and 

17 youth, and their families as appropriate, who 

18 have experienced or are at risk of experiencing 

19 trauma; and 

20 (B) carry out other duties as described in 

21 subsection (c). 

22 (b) TASK FORCE COMPOSITION.— 

23 (1) COMPOSITION.—The task force shall be 

24 composed of Federal employees, consisting of the 

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1 stance Use (referred to in this section as the ‘‘As2 sistant Secretary’’, except where another Assistant 

3 Secretary is specifically named) and 1 representative 

4 of each of— 

5 (A) the National Center for Injury Preven6 tion and Control of the Centers for Disease 

7 Control and Prevention; 

8 (B) the Center for Mental Health Services 

9 of the Substance Abuse and Mental Health 

10 Services Administration; 

11 (C) the Center for Substance Abuse Pre12 vention of that Administration; 

13 (D) the Center for Substance Abuse Treat14 ment of that Administration; 

15 (E) the Center for Behavioral Health Sta16 tistics and Quality of that Administration; 

17 (F) the Maternal and Child Health Bureau 

18 of the Health Resources and Services Adminis19 tration; 

20 (G) the Center for Medicaid and CHIP 

21 Services; 

22 (H) the National Institute of Mental 

23 Health; 


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1 (I) the Eunice Kennedy Shriver National 

2 Institute of Child Health and Human Develop3 ment; 

4 (J) the National Institute on Drug Abuse; 

5 (K) the National Institute on Alcohol 

6 Abuse and Alcoholism; 

7 (L) the Administration on Children, Youth 

8 and Families of the Administration for Children 

9 and Families; 

10 (M) the Administration for Native Ameri11 cans of the Administration for Children and 

12 Families; 

13 (N) the Office of Child Care of the Admin14 istration for Children and Families; 

15 (O) the Office of Head Start of the Admin16 istration for Children and Families; 

17 (P) the Office of Refugee Resettlement of 

18 the Administration for Children and Families; 

19 (Q) the Indian Health Service of the De20 partment of Health and Human Services; 

21 (R) the Office of Minority Health of the 

22 Department of Health and Human Services; 

23 (S) the Office of the Assistant Secretary 

24 for Planning and Evaluation; 


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1 (T) the Office of Juvenile Justice and De2 linquency Prevention of the Department of Jus3 tice; 

4 (U) the Office of Community Oriented Po5 licing Services of the Department of Justice; 

6 (V) the Office on Violence Against Women 

7 of the Department of Justice; 

8 (W) the National Center for Education 

9 Evaluation and Regional Assistance of the De10 partment of Education; 

11 (X) the Office of Safe and Healthy Stu12 dents of the Department of Education; 

13 (Y) the Office of Special Education and 

14 Rehabilitative Services of the Department of 

15 Education; 

16 (Z) the Office of Indian Education of the 

17 Department of Education; 

18 (AA) the Bureau of Indian Affairs of the 

19 Department of the Interior; 

20 (BB) the Bureau of Indian Education of 

21 the Department of the Interior; 

22 (CC) the Veterans Health Administration 

23 of the Department of Veterans Affairs; 


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1 (DD) the Office of Special Needs Assist2 ance Programs of the Department of Housing 

3 and Urban Development; and 

4 (EE) such other Federal agencies as— 

5 (i) the Assistant Secretary rec6 ommends to the President; and 

7 (ii) the President determines to be ap8 propriate. 

9 (2) APPOINTMENT.— 

10 (A) IN GENERAL.—Each member of the 

11 task force, other than the Assistant Secretary, 

12 shall be appointed by the Secretary or other 

13 head of the entire Federal agency that contains 

14 the office or other unit of government that the 

15 member represents. 

16 (B) DATE OF APPOINTMENTS.—The heads 

17 of Federal agencies with appointing authority 

18 under this paragraph shall appoint the cor19 responding members of the task force not later 

20 than 6 months after the date of enactment of 

21 this Act. 

22 (3) CHAIRPERSON.—The task force shall be 

23 chaired by the Assistant Secretary. 

24 (c) TASK FORCE DUTIES.—The task force shall— 


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1 (1) not later than 1 year after the date of en2 actment of this Act, and not less often than annually 

3 thereafter— 

4 (A) identify and evaluate a set of evidence5 based, evidence-informed, and promising best 

6 practices, which may include practices already 

7 supported by offices of the Department of 

8 Health and Human Services, including the Na9 tional Mental Health and Substance Use Policy 

10 Laboratory, the Department of Justice, the De11 partment of Education, or another Federal 

12 agency, with respect to— 

13 (i) the early identification of children 

14 and youth, and their families as appro15 priate, who have experienced or are at risk 

16 of experiencing trauma; 

17 (ii) the expeditious referral of such 

18 children and youth, and their families as 

19 appropriate, that require specialized serv20 ices to the appropriate trauma-informed 

21 support (including treatment) services, in 

22 accordance with applicable privacy laws; 

23 and 

24 (iii) the implementation of trauma-in25 formed approaches and interventions in 


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1 child and youth-serving schools, organiza2 tions, homes, and other settings to foster 

3 safe, stable, and nurturing environments 

4 and relationships that prevent and mitigate 

5 the effects of trauma; 

6 (B) recommend such set of best practices, 

7 including disseminating the set, to the Depart8 ment of Health and Human Services, the De9 partment of Justice, the Department of Edu10 cation, other Federal agencies as appropriate, 

11 State, tribal, and local government agencies, in12 cluding State, local, and tribal educational 

13 agencies, and other entities (including recipients 

14 of relevant Federal grants, professional associa15 tions, health professional organizations, na16 tional and State accreditation bodies, and 

17 schools) that the Assistant Secretary deter18 mines to be appropriate, and to the general 

19 public; and 

20 (C) maintain and update, as appropriate, 

21 the set of best practices recommended under 

22 subparagraph (B); 

23 (2) not later than 2 years after the date of en24 actment of this Act— 


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1 (A) prepare an integrated task force strat2 egy report concerning how the task force and 

3 member agencies will collaborate, prioritize op4 tions for, and implement a coordinated ap5 proach to preventing trauma, and identifying 

6 and ensuring the appropriate interventions and 

7 supports for children, youth, and their families 

8 as appropriate, who have experienced or are at 

9 risk of experiencing trauma; 

10 (B) submit the report to the appropriate 

11 committees of Congress; and 

12 (C) make the report publicly available; and 

13 (3) not later than 1 year after the date of en14 actment of this Act, and as often as practicable but 

15 not less often than annually thereafter, coordinate, 

16 to the extent feasible, among the offices and other 

17 units of government represented on the task force, 

18 research, data collection, and evaluation regarding 

19 models described in subsection (d)(1)(C), identify 

20 gaps in or populations or settings not served by 

21 models described in that subsection, solicit feedback 

22 on the models, from the stakeholders described in 

23 subsection (d)(1)(B), coordinate, among the offices 

24 and other units of government represented on the 

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1 venting and mitigating trauma, and establish proce2 dures to enable the offices and units of government 

3 to share technical expertise related to preventing and 

4 mitigating trauma. 

5 (d) BEST PRACTICES.— 

6 (1) IN GENERAL.—In identifying, evaluating, 

7 recommending, maintaining, and updating the set of 

8 best practices under subsection (c), the task force 

9 shall— 

10 (A) consider findings from evidence-based, 

11 evidence-informed, and promising practice12 based models, including from institutions of 

13 higher education, community practice (including 

14 tribal experience), recognized professional asso15 ciations, and programs of the Department of 

16 Health and Human Services, the Department of 

17 Justice, the Department of Education, and 

18 other Federal agencies (including the National 

19 Mental Health and Substance Use Policy Lab20 oratory and offices in such agencies that main21 tain registries and clearinghouses of relevant 

22 models), that reflect the science of healthy 

23 child, youth, and family development, and have 

24 been developed, implemented, and evaluated to 


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1 demonstrate effectiveness or positive measur2 able outcomes; 

3 (B) engage with, and solicit and receive 

4 feedback from— 

5 (i) faculty at institutions of higher 

6 education, community practitioners associ7 ated with the community practice described 

8 in subparagraph (A), and recognized pro9 fessional associations that represent the 

10 experience and perspectives of individuals 

11 who provide services in covered settings, to 

12 obtain observations and practical rec13 ommendations on the best practices; and 

14 (ii) the public, by— 

15 (I) holding at least one public 

16 meeting to solicit recommendations 

17 and information relating to the best 

18 practices; and 

19 (II) providing notice of the meet20 ing in the Federal Register; 

21 (C) recommend models for settings in 

22 which individuals may come into contact with 

23 children and youth, and their families as appro24 priate, who have experienced or are at risk of 

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1 pitals, settings where health care providers, in2 cluding primary care and pediatric providers, 

3 provide services, preschool and early childhood 

4 education and care settings, home visiting set5 tings, after-school program facilities, child wel6 fare agency facilities, public health agency fa7 cilities, mental health treatment facilities, sub8 stance abuse treatment facilities, faith-based in9 stitutions, domestic violence centers, homeless 

10 services system facilities, refugee services sys11 tem facilities, juvenile justice system facilities, 

12 and law enforcement agency facilities; 

13 (D) recommend best practices that are evi14 dence-based, are evidence-informed, or are 

15 promising and practice-based, and that include 

16 guidelines for— 

17 (i)(I) training of front-line service 

18 providers, including teachers, providers 

19 from child- or youth-serving organizations, 

20 health care providers, individuals who are 

21 mandatory reporters of child abuse or ne22 glect, and first responders, in under23 standing and identifying early signs and 

24 risk factors of trauma in children and 


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1 youth, and their families as appropriate, 

2 including through screening processes; and 

3 (II) implementing appropriate re4 sponses; 

5 (ii) procedures or systems that— 

6 (I) are designed to quickly refer 

7 children and youth, and their families 

8 as appropriate, who have experienced 

9 or are at risk of experiencing trauma 

10 to, and ensure the children, youth, 

11 and appropriate family members re12 ceive, the appropriate trauma-in13 formed screening and support, includ14 ing treatment; or 

15 (II) use partnerships that— 

16 (aa) include local social serv17 ices organizations or clinical 

18 mental health or health care serv19 ice providers with expertise in 

20 furnishing support services (in21 cluding trauma-informed treat22 ment) to prevent or mitigate the 

23 effects of trauma; 

24 (bb) may be partnerships 

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1 ices, such as by providing serv2 ices at school-based health cen3 ters; and 

4 (cc) are designed to make 

5 such quick referrals, and ensure 

6 the receipt of screening, support, 

7 and treatment, described in sub8 clause (I); 

9 (iii) educating children and youth 

10 to— 

11 (I) understand trauma; 

12 (II) identify the signs, effects, or 

13 symptoms of trauma; and 

14 (III) build the resilience and cop15 ing skills to mitigate the effects of ex16 periencing trauma; 

17 (iv) multi-generational interventions 

18 to— 

19 (I) support, including through 

20 skills building, parents (with an ap21 propriate emphasis on fathers), foster 

22 parents, adult caregivers, and front23 line service providers described in 

24 clause (i)(I) in fostering safe, stable, 

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1 tionships that prevent and mitigate 

2 the effects of trauma for children and 

3 youth who have experienced or are at 

4 risk of experiencing trauma; 

5 (II) assist parents, foster par6 ents, and adult caregivers in learning 

7 to access resources related to such 

8 prevention and mitigation; and 

9 (III) provide tools to prevent and 

10 address caregiver or secondary trau11 ma, as appropriate; 

12 (v) community interventions for un13 derserved areas that have faced trauma 

14 through acute or long-term exposure to 

15 substantial discrimination, historical or 

16 cultural oppression, intergenerational pov17 erty, civil unrest, a high rate of violence, or 

18 a high rate of drug overdose mortality; 

19 (vi) assisting parents and guardians 

20 in understanding eligibility for and obtain21 ing certain health benefits coverage, in22 cluding coverage under a State Medicaid 

23 plan under title XIX of the Social Security 

24 Act (42 U.S.C. 1396 et seq.) of screening 

25 and treatment for children and youth, and 


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1 their families as appropriate, who have ex2 perienced or are at risk of experiencing 

3 trauma; 

4 (vii) utilizing trained nonclinical pro5 viders (such as peers through peer support 

6 models, mentors, clergy, and other commu7 nity figures), to— 

8 (I) expeditiously link children 

9 and youth, and their families as ap10 propriate, who have experienced or 

11 are at risk of experiencing trauma, to 

12 the appropriate trauma-informed 

13 screening and support (including clin14 ical treatment) services; and 

15 (II) provide ongoing care or case 

16 management services; 

17 (viii) collecting and utilizing data 

18 from screenings, referrals, or the provision 

19 of services and supports, conducted in the 

20 covered settings, to evaluate and improve 

21 processes for trauma-informed support and 

22 outcomes; 

23 (ix)(I) improving disciplinary practices 

24 in early childhood education and care set25 tings and schools, including use of positive 


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1 disciplinary strategies that are effective at 

2 reducing the incidence of punitive school 

3 disciplinary actions, including school sus4 pensions and expulsions; and 

5 (II) providing the training described 

6 in clause (i) to child care providers and to 

7 school personnel, including school resource 

8 officers, teacher assistants, administrators, 

9 and heads of charter schools; and 

10 (x) incorporating trauma-informed 

11 considerations into educational, preservice, 

12 and continuing education opportunities, for 

13 the use of health professional and edu14 cation organizations, national and State 

15 accreditation bodies for health care and 

16 education providers, health and education 

17 professional schools or accredited graduate 

18 schools, and other relevant training and 

19 educational entities; 

20 (E) recommend best practices that— 

21 (i) include practices that are cul22 turally sensitive, linguistically appropriate, 

23 age- and gender-relevant, and appropriate 

24 for lesbian, gay, bisexual, transgender, and 

25 queer populations; 


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1 (ii) can be applied across underserved 

2 geographic areas; and 

3 (iii) engage entire organizations in 

4 training and skill building related to the 

5 best practices; and 

6 (F) recommend best practices that are de7 signed not to lead to unwarranted custody loss 

8 or criminal penalties for parents or guardians 

9 in connection with children and youth who have 

10 experienced or are at risk of experiencing trau11 ma. 

12 (e) AUTHORIZATION OF APPROPRIATIONS.—To carry 

13 out this section, there are authorized to be appropriated 

14 $3,000,000 for fiscal year 2018 and $1,000,000 for each 

15 of fiscal years 2019 through 2022. 

16 (f) DEFINITIONS.—In this section: 

17 (1) COVERED RECIPIENT.—The term ‘‘covered 

18 recipient’’ means a department or other entity de19 scribed in subsection (c)(1)(B). 

20 (2) COVERED SETTING.—The term ‘‘covered 

21 setting’’ means a setting described in subsection 

22 (d)(1)(C). 


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1 SEC. 102. DONALD J. COHEN NATIONAL CHILD TRAUMATIC 

2 STRESS INITIATIVE. 

3 Section 582(f) of the Public Health Service Act (42 

4 U.S.C. 290hh–1(f)) is amended— 

5 (1) by striking ‘‘$46,887,000’’ and inserting 

6 ‘‘$66,887,000’’; and 

7 (2) by adding at the end the following: ‘‘Of the 

8 amounts appropriated under this subsection for each 

9 of fiscal years 2018 through 2022, $7,500,000 shall 

10 be allocated to the operation of the coordinating cen11 ter of the National Child Traumatic Stress Initiative 

12 for purposes of gathering and reporting data, evalu13 ating models, and providing technical assistance.’’. 

14 TITLE II—DISSEMINATION AND 

15 IMPLEMENTATION OF BEST 

16 PRACTICES 

17 SEC. 201. USE OF GRANT FUNDS FOR TRAINING IN BEST 

18 PRACTICES RELATING TO CHILD AND YOUTH 

19 TRAUMA AND COMMUNITY SUPPORT. 

20 (a) HEAD START ACT.— 

21 (1) IN GENERAL.—Section 640(a) of the Head 

22 Start Act (42 U.S.C. 9835(a)) is amended— 

23 (A) by redesignating paragraph (7) as 

24 paragraph (8); and 

25 (B) by inserting after paragraph (6) the 

26 following: 


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1 ‘‘(7) Any of the funds allocated under this sub2 section for Head Start programs (including Early 

3 Head Start programs), for training and technical as4 sistance activities, or for collaboration grants may be 

5 used to provide training for administrators and 

6 other staff of Head Start agencies in the best prac7 tices developed under section 101 of the Trauma-In8 formed Care for Children and Families Act of 

9 2017.’’. 

10 (2) CONFORMING AMENDMENTS.— 

11 (A) Section 640(a)(2)(C)(i) of the Head 

12 Start Act (42 U.S.C. 9835(a)(2)(C)(i)), in the 

13 matter preceding subclause (I), by inserting 

14 after ‘‘training and technical assistance activi15 ties’’ the following: ‘‘(such as training in the 

16 best practices developed under section 101 of 

17 the Trauma-Informed Care for Children and 

18 Families Act of 2017)’’. 

19 (B) Sections 641A(h)(1)(B) and 645(d)(3) 

20 of the Head Start Act (42 U.S.C. 

21 9836a(h)(1)(B), 9840(d)(3)) are amended by 

22 striking ‘‘640(a)(7)’’ and inserting ‘‘640(a)(8)’’. 

23 (C) Section 642B(a)(2)(B)(i) of the Head 

24 Start Act (42 U.S.C. 9837b(a)(2)(B)(i)) is 

25 amended by inserting before the semicolon the 


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1 following: ‘‘(such as by providing training for 

2 administrators and other staff of those agencies 

3 in the best practices developed under section 

4 101 of the Trauma-Informed Care for Children 

5 and Families Act of 2017)’’. 

6 (D) Section 648 of the Head Start Act (42 

7 U.S.C. 9843) is amended— 

8 (i) in subsection (a)(3)(B)(i), by in9 serting after ‘‘systems’’ the following: 

10 ‘‘(such as systems that include training in 

11 the best practices developed under section 

12 101 of the Trauma-Informed Care for 

13 Children and Families Act of 2017)’’; 

14 (ii) in subsection (b)(2)(C), by insert15 ing before the semicolon the following: 

16 ‘‘(such as training in the best practices de17 veloped under section 101 of the Trauma18 Informed Care for Children and Families 

19 Act of 2017)’’; and 

20 (iii) in subsection (d)(1)(G), by insert21 ing after ‘‘staff training’’ the following 

22 ‘‘(such as training in the best practices de23 veloped under section 101 of the Trauma24 Informed Care for Children and Families 

25 Act of 2017)’’. 


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1 (b) CHILD CARE AND DEVELOPMENT BLOCK

2 GRANT.—Section 658G(b)(1) of the Child Care and De3 velopment Block Grant Act of 1990 (42 U.S.C. 

4 9858e(b)(1)) is amended— 

5 (1) in subparagraph (G), by striking ‘‘; and’’ 

6 and inserting a semicolon; 

7 (2) in subparagraph (H), by striking the period 

8 and inserting ‘‘; and’’; and 

9 (3) by adding at the end the following: 

10 ‘‘(I) providing training in the best prac11 tices developed under section 101 of the Trau12 ma-Informed Care for Children and Families 

13 Act of 2017 for administrators of child care 

14 programs, and child care providers, that receive 

15 assistance under this subchapter.’’. 

16 (c) SOCIAL SERVICES BLOCK GRANT.—Section 

17 2002(a)(2)(B) of the Social Security Act (42 U.S.C. 

18 1397a(a)(2)(B) is amended— 

19 (1) in clause (ii), by striking ‘‘and’’ after the 

20 semicolon; 

21 (2) in clause (iii), by striking the period at the 

22 end and inserting ‘‘; and’’; and 

23 (3) by adding at the end the following new 

24 clause: 


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1 ‘‘(iv) training for providers in the best 

2 practices developed under section 101 of 

3 the Trauma-Informed Care for Children 

4 and Families Act of 2017.’’. 

5 (d) MATERNAL AND CHILD HEALTH SERVICES

6 BLOCK GRANT.—Section 504 of the Social Security Act 

7 (42 U.S.C. 704) is amended by adding at the end the fol8 lowing new subsection: 

9 ‘‘(e) A State may use a portion of the amounts de10 scribed in subsection (a) for the purpose of providing 

11 training for licensed health care providers and public 

12 health agencies in the best practices developed under sec13 tion 101 of the Trauma-Informed Care for Children and 

14 Families Act of 2017.’’. 

15 (e) MATERNAL, INFANT, AND EARLY CHILDHOOD

16 HOME VISITING (MIECHV).—Section 511(i)(2) of the 

17 Social Security Act (42 U.S.C. 711(i)(2)) is amended— 

18 (1) by redesignating subparagraphs (D) 

19 through (G) as subparagraphs (E) through (H), re20 spectively; and 

21 (2) by inserting after subparagraph (C) the fol22 lowing new subparagraph: 

23 ‘‘(D) Section 504(e) (relating to the use of 

24 funds for training in the best practices devel25 oped under section 101 of the Trauma-InVerDate Sep 11 2014 23:36 Mar 31, 2017 Jkt 069200 PO 00000 Frm 00027 Fmt 6652 Sfmt 6201 E:\BILLS\S774.IS S774

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1 formed Care for Children and Families Act of 

2 2017).’’. 

3 (f) CHILD WELFARE SERVICES.—Section 

4 422(b)(4)(B) of the Social Security Act (42 U.S.C. 

5 622(b)(4)(B)) is amended by inserting before the semi6 colon ‘‘(which may include training in the best practices 

7 developed under section 101 of the Trauma-Informed Care 

8 for Children and Families Act of 2017)’’. 

9 (g) FEDERAL PAYMENTS FOR FOSTER CARE AND

10 ADOPTION ASSISTANCE.—Section 474(a)(3)(A) of the So11 cial Security Act (42 U.S.C. 674(a)(3)(A)) is amended by 

12 inserting ‘‘, and including training in the best practices 

13 developed under section 101 of the Trauma-Informed Care 

14 for Children and Families Act of 2017’’ after ‘‘enrolled 

15 in such institutions’’. 

16 (h) HEALTHY START INITIATIVE.—Section 330H(e) 

17 of the Public Health Service Act (42 U.S.C. 254c–8(e)) 

18 is amended by adding at the end the following: 

19 ‘‘(3) TRAINING PROVIDERS IN BEST PRACTICES

20 RELATING TO TRAUMA.—Any of the funds appro21 priated under paragraph (1) may be used to provide 

22 training for providers in the best practices developed 

23 under section 101 of the Trauma-Informed Care for 

24 Children and Families Act of 2017.’’. 


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1 (i) BLOCK GRANTS FOR COMMUNITY MENTAL

2 HEALTH SERVICES.—Section 1920 of the Public Health 

3 Service Act (42 U.S.C. 300x–9) is amended by adding at 

4 the end the following: 

5 ‘‘(d) TRAINING PROVIDERS IN BEST PRACTICES RE6 LATING TO TRAUMA.—Except as specified in subsection 

7 (c), any of the funds appropriated under subsection (a) 

8 may be used to provide training for providers in the best 

9 practices developed under section 101 of the Trauma-In10 formed Care for Children and Families Act of 2017.’’. 

11 (j) BLOCK GRANTS FOR PREVENTION AND TREAT12 MENT OF SUBSTANCE ABUSE.—Section 1935 of the Pub13 lic Health Service Act (42 U.S.C. 300x–35) is amended 

14 by adding at the end the following: 

15 ‘‘(c) ALLOCATIONS FOR TRAINING PROVIDERS IN

16 BEST PRACTICES RELATING TO TRAUMA.—Any of the 

17 funds appropriated under subsection (a) may be used to 

18 provide training for providers in the best practices devel19 oped under section 101 of the Trauma-Informed Care for 

20 Children and Families Act of 2017.’’. 

21 (k) USE OF GRANT FUNDS FOR TRAINING PRO22 VIDERS IN BEST PRACTICES RELATING TO TRAUMA.— 

23 (1) SCHOOL-BASED HEALTH CENTERS.—Sec24 tion 399Z–1(l) of the Public Health Service Act (42 

25 U.S.C. 280h–5(l)) is amended by adding ‘‘Any of 


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1 the funds appropriated under this subsection may be 

2 used to provide training for providers in the best 

3 practices developed under section 101 of the Trau4 ma-Informed Care for Children and Families Act of 

5 2017.’’ after the first sentence. 

6 (2) COMMUNITY HEALTH CENTERS.—Section 

7 330(r) of the Public Health Service Act (42 U.S.C. 

8 254b(r)) is amended by adding at the end the fol9 lowing: 

10 ‘‘(5) TRAINING PROVIDERS IN BEST PRACTICES

11 RELATING TO TRAUMA.—Any of the funds appro12 priated under this subsection may be used to provide 

13 training for providers in the best practices developed 

14 under section 101 of the Trauma-Informed Care for 

15 Children and Families Act of 2017.’’. 

16 (l) SUPPORTING EFFECTIVE INSTRUCTION; LOCAL

17 USE OF FUNDS.—Section 2103(b)(3) of the Elementary 

18 and Secondary Education Act of 1965 (20 U.S.C. 

19 6613(b)(3)) is amended— 

20 (1) in subparagraph (O), by striking ‘‘and’’ 

21 after the semicolon; 

22 (2) by redesignating subparagraph (P) as sub23 paragraph (Q); and 

24 (3) by inserting after subparagraph (O) the fol25 lowing: 


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1 ‘‘(P) providing training for school per2 sonnel, including teachers, principals, other 

3 school leaders, specialized instructional support 

4 personnel, and paraprofessionals, in the best 

5 practices developed under section 101 of the 

6 Trauma-Informed Care for Children and Fami7 lies Act of 2017; and’’. 

8 (m) STUDENT SUPPORT AND ACADEMIC ENRICH9 MENT.— 

10 (1) STATE USE OF FUNDS.—Section 4104(b) of 

11 the Elementary and Secondary Education Act of 

12 1965 (20 U.S.C. 7114(b)) is amended— 

13 (A) in paragraph (2), by striking ‘‘or’’ at 

14 the end; 

15 (B) in paragraph (3) by striking the period 

16 at the end and inserting ‘‘; or’’; and 

17 (C) by adding at the end the following: 

18 ‘‘(4) providing training for teachers, adminis19 trators, school counselors, mental health profes20 sionals, and other appropriate personnel in the best 

21 practices developed under section 101 of the Trau22 ma-Informed Care for Children and Families Act of 

23 2017.’’. 


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1 (2) LOCAL USE OF FUNDS.—Paragraph (5) of 

2 section 4108 of the Elementary and Secondary Edu3 cation Act of 1965 (20 U.S.C. 7118) is amended— 

4 (A) in subparagraph (H), by striking ‘‘or’’ 

5 at the end; 

6 (B) in subparagraph (I), by striking the 

7 period at the end and inserting ‘‘; or’’; and 

8 (C) by adding at the end the following: 

9 ‘‘(J) providing training for teachers, ad10 ministrators, school counselors, mental health 

11 professionals, and other appropriate personnel 

12 in the best practices developed under section 

13 101 of the Trauma-Informed Care for Children 

14 and Families Act of 2017.’’. 

15 (n) 21ST CENTURY COMMUNITY LEARNING CEN16 TERS.— 

17 (1) STATE USE OF FUNDS.—Section 4202(c)(3) 

18 of the Elementary and Secondary Education Act of 

19 1965 (20 U.S.C. 7172(c)(3)) is amended— 

20 (A) by redesignating subparagraphs (H), 

21 (I), and (G), as subparagraphs (G), (H), and 

22 (I), respectively; and 

23 (B) by adding at the end the following: 

24 ‘‘(J) Providing training for teachers, ad25 ministrators, school counselors, mental health 


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•S 774 IS

1 professionals, and other appropriate personnel 

2 (including appropriate personnel involved with 

3 programs and activities that advance student 

4 academic achievement and support student suc5 cess during nonschool hours) in the best prac6 tices developed under section 101 of the Trau7 ma-Informed Care for Children and Families 

8 Act of 2017.’’. 

9 (2) LOCAL USE OF FUNDS.—Section 4205(a) of 

10 the Elementary and Secondary Education Act of 

11 1965 (20 U.S.C. 7175(a)) is amended— 

12 (A) in paragraph (13), by striking ‘‘and’’ 

13 at the end; 

14 (B) in paragraph (14), by striking the pe15 riod at the end and inserting ‘‘; and’’; and 

16 (C) by adding at the end the following: 

17 ‘‘(15) training for teachers, administrators, 

18 school counselors, mental health professionals, and 

19 other appropriate personnel in the best practices de20 veloped under section 101 of the Trauma-Informed 

21 Care for Children and Families Act of 2017.’’. 

22 (o) FULL-SERVICE COMMUNITY SCHOOLS.—Section 

23 4625(e) of the Elementary and Secondary Education Act 

24 of 1965 (20 U.S.C. 7275(e)) is amended— 


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1 (1) in paragraph (2), by striking ‘‘and’’ after 

2 the semicolon; 

3 (2) by redesignating paragraph (3) as para4 graph (4); and 

5 (3) by inserting after paragraph (2) the fol6 lowing: 

7 ‘‘(3) provide training for teachers, administra8 tors, school counselors, mental health professionals, 

9 and other appropriate personnel (including appro10 priate personnel involved with the full-service com11 munity school) in the best practices developed under 

12 section 101 of the Trauma-Informed Care for Chil13 dren and Families Act of 2017; and’’. 

14 (p) NATIONAL ACTIVITIES FOR SCHOOLS.—Section 

15 4631(a)(1)(B) of the Elementary and Secondary Edu16 cation Act of 1965 (20 U.S.C. 7281(a)(1)(B)) is amended 

17 by striking ‘‘or conducting a national evaluation.’’ and in18 serting ‘‘, conducting a national evaluation, or providing 

19 training for teachers, administrators, school counselors, 

20 mental health professionals, and other appropriate per21 sonnel in the best practices developed under section 101 

22 of the Trauma-Informed Care for Children and Families 

23 Act of 2017.’’. 

24 (q) IDEA.—Section 638 of the Individuals with Dis25 abilities Education Act (20 U.S.C. 1438) is amended— 


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1 (1) in paragraph (4), by striking ‘‘and’’ after 

2 the semicolon; 

3 (2) in paragraph (5), by striking the period at 

4 the end and inserting ‘‘; and’’; and 

5 (3) by adding at the end the following: 

6 ‘‘(6) to provide training for appropriate per7 sonnel who provide direct early intervention services 

8 for infants and toddlers with disabilities in the best 

9 practices developed under section 101 of the Trau10 ma-Informed Care for Children and Families Act of 

11 2017.’’. 

12 (r) SPECIAL SUPPLEMENTAL NUTRITION PROGRAM

13 FOR WOMEN, INFANTS, AND CHILDREN.—Section 17(f) 

14 of the Child Nutrition Act of 1966 (42 U.S.C. 1786(f)) 

15 is amended by adding at the end the following: 

16 ‘‘(27) BEST PRACTICES.—A State agency may 

17 use a portion of the amounts made available to the 

18 State agency under this section for the purpose of 

19 providing training for local agencies in the best prac20 tices developed under section 101 of the Trauma-In21 formed Care for Children and Families Act of 

22 2017.’’. 

23 (s) COMMUNITY SERVICES BLOCK GRANT ACT.— 

24 (1) STATE ACTIVITIES.—Section 675C(b)(1)(A) 

25 of the Community Services Block Grant Act (42 


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•S 774 IS

1 U.S.C. 9907(b)(1)(A)) is amended by inserting after 

2 ‘‘providing training’’ the following: ‘‘(which may in3 clude providing training, to the entities that are pro4 viders of services to children and youth, in the best 

5 practices developed under section 101 of the Trau6 ma-Informed Care for Children and Families Act of 

7 2017)’’. 

8 (2) NATIONAL ACTIVITIES.—Section 

9 678A(a)(1)(A) of the Community Services Block 

10 Grant Act (42 U.S.C. 9913(a)(1)(A)) is amended by 

11 inserting after ‘‘training’’ the following: ‘‘(which may 

12 include providing training, to the entities that are 

13 providers of services to children and youth, in the 

14 best practices developed under section 101 of the 

15 Trauma-Informed Care for Children and Families 

16 Act of 2017)’’. 

17 (t) RUNAWAY AND HOMELESS YOUTH ACT.—Section 

18 342 of the Runaway and Homeless Youth Act (42 U.S.C. 

19 5714–22) is amended by inserting after ‘‘technical assist20 ance and training’’ the following: ‘‘(which may include 

21 providing training, to providers of services under this title, 

22 in the best practices developed under section 101 of the 

23 Trauma-Informed Care for Children and Families Act of 

24 2017)’’. 


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1 (u) PROGRAMS OF THE OFFICE OF REFUGEE RESET2 TLEMENT.—Section 462(b)(1) of the Homeland Security 

3 Act of 2002 (6 U.S.C. 279(b)(1)) is amended— 

4 (1) in subparagraph (K), by striking ‘‘and’’ at 

5 the end; 

6 (2) in subparagraph (L), by striking the period 

7 and inserting ‘‘; and’’; and 

8 (3) by adding at the end the following: 

9 ‘‘(M) at the election of the Director, pro10 viding training, to providers responsible for the 

11 care of the unaccompanied alien children, in the 

12 best practices developed under section 101 of 

13 the Trauma-Informed Care for Children and 

14 Families Act of 2017.’’. 

15 (v) CHILD ABUSE PREVENTION AND TREATMENT.— 

16 (1) NATIONAL CLEARINGHOUSE.—Section 

17 103(b) of the Child Abuse Prevention and Treat18 ment Act (42 U.S.C. 5104) is amended— 

19 (A) in paragraph (8), by striking ‘‘and’’ at 

20 the end; 

21 (B) in paragraph (9), by striking the pe22 riod and inserting ‘‘; and’’; and 

23 (C) by adding at the end the following: 

24 ‘‘(10) disseminate information regarding the 

25 best practices developed under section 101 of the 


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•S 774 IS

1 Trauma-Informed Care for Children and Families 

2 Act of 2017 for individuals and officials described in 

3 paragraph (8).’’. 

4 (2) RESEARCH AND ASSISTANCE ACTIVITIES.— 

5 Section 104(b)(1) of that Act (42 U.S.C. 

6 5105(b)(1)) is amended by adding at the end the 

7 following: ‘‘Such assistance may include technical as8 sistance regarding the best practices developed 

9 under section 101 of the Trauma-Informed Care for 

10 Children and Families Act of 2017.’’. 

11 (3) TRAINING.—Section 105(a)(1) of that Act 

12 (42 U.S.C. 5106(a)(1)) is amended— 

13 (A) in subparagraph (L), by striking 

14 ‘‘and’’ at the end; 

15 (B) in subparagraph (M), by striking the 

16 period and inserting ‘‘; and’’; and 

17 (C) by adding at the end the following: 

18 ‘‘(D) for providing training in the best 

19 practices developed under section 101 of the 

20 Trauma-Informed Care for Children and Fami21 lies Act of 2017 to individuals and entities de22 scribed in this paragraph.’’. 

23 (4) STATE CHILD ABUSE OR NEGLECT PREVEN24 TION AND TREATMENT PROGRAMS.—Section 106(a) 

25 of that Act (42 U.S.C. 5106a(a)) is amended— 


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1 (A) in paragraph (13), by striking ‘‘or’’ at 

2 the end; 

3 (B) in paragraph (14), by striking the pe4 riod and inserting ‘‘; or’’; and 

5 (C) by adding at the end the following: 

6 ‘‘(15) providing training in the best practices 

7 developed under section 101 of the Trauma-In8 formed Care for Children and Families Act of 2017 

9 for employees of agencies or systems described in 

10 paragraph (12), (13), or (14).’’. 

11 (5) COMMUNITY-BASED GRANTS FOR THE PRE12 VENTION OF CHILD ABUSE AND NEGLECT.—Section 

13 205(b) of that Act (42 U.S.C. 5116e(b)) is amend14 ed— 

15 (A) in paragraph (5), by striking ‘‘and’’ at 

16 the end; 

17 (B) in paragraph (6), by striking the pe18 riod and inserting ‘‘; and’’; and 

19 (C) by adding at the end the following: 

20 ‘‘(7) provide training in the best practices devel21 oped under section 101 of the Trauma-Informed 

22 Care for Children and Families Act of 2017 for pro23 viders of programs, activities, or services described 

24 in this subsection.’’. 


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1 (w) GRANTS FOR JUVENILE AND FAMILY COURT

2 PERSONNEL.—Section 222(1) of the Victims of Child 

3 Abuse Act of 1990 (42 U.S.C. 13022(1)) is amended by 

4 inserting ‘‘(which may include providing training, to the 

5 entities that are providers of services to children and 

6 youth, in the best practices developed under section 101 

7 of the Trauma-Informed Care for Children and Families 

8 Act of 2017)’’ after ‘‘technical assistance and training’’. 

9 (x) GRANTS TO SUPPORT FAMILIES IN THE JUSTICE

10 SYSTEM.—Section 1301(c) of the Victims of Trafficking 

11 and Violence Protection Act of 2000 (42 U.S.C. 10420(c)) 

12 is amended by adding at the end the following: 

13 ‘‘(3) BEST PRACTICES FOR TRAUMA-INFORMED

14 CARE FOR CHILDREN AND FAMILIES.—In making 

15 grants under subsection (b), the Attorney General 

16 shall take into account the extent to which the appli17 cant is using the best practices developed under sec18 tion 101 of the Trauma-Informed Care for Children 

19 and Families Act of 2017.’’. 

20 SEC. 202. ESTABLISHMENT OF LAW ENFORCEMENT CHILD 

21 AND YOUTH TRAUMA COORDINATING CEN22 TER. 

23 (a) ESTABLISHMENT OF CENTER.— 

24 (1) IN GENERAL.—The Attorney General shall 

25 establish a National Law Enforcement Child and 


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1 Youth Trauma Coordinating Center (referred to in 

2 this section as the ‘‘Center’’) to provide assistance to 

3 State, local, and tribal law enforcement agencies in 

4 interacting with children and youth who have been 

5 exposed to violence or other trauma, and their fami6 lies as appropriate. 

7 (2) AGE RANGE.—The Center shall determine 

8 the age range of children and youth to be covered 

9 by the activities of the Center. 

10 (b) DUTIES.—The Center shall provide assistance to 

11 State, local, and tribal law enforcement agencies by— 

12 (1) disseminating information on the best prac13 tices for law enforcement officers developed under 

14 section 101, which may include best practices based 

15 on evidence-based and evidence-informed models 

16 from programs of the Department of Justice and the 

17 Office of Justice Services of the Bureau of Indian 

18 Affairs, such as— 

19 (A) models developed in partnership with 

20 national law enforcement organizations, Indian 

21 tribes, or clinical researchers; and 

22 (B) models that include— 

23 (i) trauma-informed approaches to 

24 conflict resolution, de-escalation, and crisis 

25 intervention training; 


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1 (ii) early interventions that link child 

2 and youth witnesses and victims, and their 

3 families as appropriate, to appropriate 

4 trauma-informed services; and 

5 (iii) supporting officers who experi6 ence secondary trauma; 

7 (2) providing professional training and technical 

8 assistance; and 

9 (3) awarding grants under subsection (c). 

10 (c) GRANT PROGRAM.— 

11 (1) IN GENERAL.—The Attorney General, act12 ing through the Center, may award grants to State, 

13 local, and tribal law enforcement agencies or to 

14 multi-disciplinary consortia to— 

15 (A) enhance the awareness of best prac16 tices developed under section 101 for trauma17 informed responses to children and youth who 

18 have been exposed to violence or other trauma, 

19 and their families as appropriate; and 

20 (B) provide professional training and tech21 nical assistance in implementing the best prac22 tices described in subparagraph (A). 

23 (2) APPLICATION.—Any State, local, or tribal 

24 law enforcement agency seeking a grant under this 

25 subsection shall submit an application to the AttorVerDate Sep 11 2014 23:36 Mar 31, 2017 Jkt 069200 PO 00000 Frm 00042 Fmt 6652 Sfmt 6201 E:\BILLS\S774.IS S774

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1 ney General at such time, in such manner, and con2 taining such information as the Attorney General 

3 may require. 

4 (3) USE OF FUNDS.—A grant awarded under 

5 this subsection may be used to— 

6 (A) provide training to law enforcement of7 ficers on the best practices developed under sec8 tion 101, including how to identify early signs 

9 of trauma and violence exposure when inter10 acting with children and youth; and 

11 (B) establish, operate, and evaluate a re12 ferral and partnership program with trauma-in13 formed clinical mental health, substance use, 

14 health care, or social service professionals in the 

15 community in which the law enforcement agen16 cy serves. 

17 (d) AUTHORIZATION OF APPROPRIATIONS.—There 

18 are authorized to be appropriated to the Attorney Gen19 eral— 

20 (1) $15,000,000 for each of fiscal years 2018 

21 through 2022 to award grants under subsection (c); 

22 and 

23 (2) $2,000,000 for each of fiscal years 2018 

24 through 2022 for other activities of the Center. 


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1 SEC. 203. ESTABLISHMENT OF NATIVE AMERICAN TECH2 NICAL ASSISTANCE RESOURCE CENTER. 

3 (a) DEFINITIONS.—In this section: 

4 (1) INDIAN TRIBE; TRIBAL ORGANIZATION.— 

5 The terms ‘‘Indian tribe’’ and ‘‘tribal organization’’ 

6 have the meanings given the terms in section 4 of 

7 the Indian Self-Determination and Education Assist8 ance Act (25 U.S.C. 5304). 

9 (2) INSTITUTION OF HIGHER EDUCATION.—The 

10 term ‘‘institution of higher education’’ has the 

11 meaning given the term in section 101 of the Higher 

12 Education Act of 1965 (20 U.S.C. 1001). 

13 (3) SECRETARY.—The term ‘‘Secretary’’ means 

14 the Secretary of Health and Human Services, act15 ing— 

16 (A) through the Assistant Secretary for 

17 Mental Health and Substance Use; and 

18 (B) after consultation with— 

19 (i) the Director of the Bureau of In20 dian Education of the Department of the 

21 Interior; and 

22 (ii) the Director of the Indian Health 

23 Service. 

24 (b) ESTABLISHMENT OF CENTER.—The Secretary 

25 shall establish and operate a Native American Technical 


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1 Assistance Resource Center (referred to in this section as 

2 the ‘‘Center’’) to provide assistance to Indian tribes. 

3 (c) DUTIES.—The Center shall provide assistance to 

4 the Indian tribes by— 

5 (1) providing trauma-informed technical assist6 ance to tribal organizations in implementing the best 

7 practices developed under section 101; and 

8 (2) disseminating the best practices to the trib9 al organizations, to schools that serve students from 

10 the Indian tribes, to health care entities that serve 

11 the Indian tribes, to child welfare systems that serve 

12 children and youth from the Indian tribes, to law en13 forcement agencies that serve the Indian tribes, to 

14 criminal justice and court systems that serve the In15 dian tribes, and other relevant entities. 

16 (d) GRANT PROGRAM.— 

17 (1) IN GENERAL.—The Secretary may award 

18 grants to nonprofit organizations or institutions of 

19 higher education, to operate the Center. 

20 (2) APPLICATION.—An organization or institu21 tion seeking a grant under this subsection shall sub22 mit an application to the Secretary at such time, in 

23 such manner, and containing such information as 

24 the Secretary may require. 


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1 (e) AUTHORIZATION OF APPROPRIATIONS.—There is 

2 authorized to be appropriated to the Secretary, to carry 

3 out this section, $2,000,000 for each of fiscal years 2018 

4 through 2021. 

5 SEC. 204. GRANTS TO IMPROVE TRAUMA SUPPORT SERV6 ICES AND MENTAL HEALTH CARE FOR CHIL7 DREN AND YOUTH IN EDUCATIONAL SET8 TINGS. 

9 Part A of title IV of the Elementary and Secondary 

10 Education Act of 1965 (20 U.S.C. 7101 et seq.) is amend11 ed by adding at the end the following: 

12 ‘‘Subpart 3—Grants To Improve Trauma Support 

13 Services and Mental Health Care for Children 

14 and Youth in Educational Settings 

15 ‘‘SEC. 4131. GRANTS TO IMPROVE TRAUMA SUPPORT SERV16 ICES AND MENTAL HEALTH CARE FOR CHIL17 DREN AND YOUTH IN EDUCATIONAL SET18 TINGS. 

19 ‘‘(a) GRANTS, CONTRACTS, AND COOPERATIVE

20 AGREEMENTS AUTHORIZED.—The Secretary is authorized 

21 to award grants to, or enter into contracts or cooperative 

22 agreements with, State educational agencies, local edu23 cational agencies, Indian tribes or their tribal educational 

24 agencies, a school operated by the Bureau of Indian Edu25 cation, or a Regional Corporation (as defined in section 


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•S 774 IS

1 3 of the Alaska Native Claims Settlement Act (43 U.S.C. 

2 1602)) for the purpose of increasing student access to 

3 quality trauma support services and mental health care 

4 by developing innovative programs to link local school sys5 tems with local trauma-informed support and mental 

6 health systems, including those under the Indian Health 

7 Service. 

8 ‘‘(b) DURATION.—With respect to a grant, contract, 

9 or cooperative agreement awarded or entered into under 

10 this section, the period during which payments under such 

11 grant, contract or agreement are made to the recipient 

12 may not exceed 5 years. 

13 ‘‘(c) USE OF FUNDS.—An entity that receives a 

14 grant, contract, or cooperative agreement under this sec15 tion shall use amounts made available through such grant, 

16 contract, or cooperative agreement for any of the fol17 lowing: 

18 ‘‘(1) To enhance, improve, or develop collabo19 rative efforts between school-based service systems 

20 and trauma-informed support and mental health 

21 service systems to provide, enhance, or improve pre22 vention, screening, referral, and treatment services 

23 to students. 

24 ‘‘(2) To enhance the availability of trauma sup25 port services and school-based counseling programs, 


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•S 774 IS

1 and provide appropriate referrals and interventions 

2 for students potentially in need of mental health 

3 services. 

4 ‘‘(3) To provide universal trauma screenings to 

5 identify students in need of specialized support. 

6 ‘‘(4) To implement multi-tiered positive behav7 ioral interventions and supports, or other trauma-in8 formed models of support. 

9 ‘‘(5) To provide training to teachers, teacher 

10 assistants, specialized instructional support per11 sonnel, and mental health professionals to— 

12 ‘‘(A) develop safe, stable, and nurturing 

13 learning environments that prevent and miti14 gate the effects of trauma, including through 

15 social and emotional learning; or 

16 ‘‘(B) improve school capacity to identify, 

17 refer, and provide services, as appropriate, to 

18 students in need of trauma support or behav19 ioral health services. 

20 ‘‘(6) To provide technical assistance and con21 sultation to school systems and mental health agen22 cies as well as to families participating in the pro23 gram carried out under this section. 

24 ‘‘(7) To provide linguistically appropriate and 

25 culturally competent services. 


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•S 774 IS

1 ‘‘(8) To evaluate the effectiveness of the pro2 gram carried out under this section in increasing 

3 student access to quality trauma support services 

4 and mental health care, and make recommendations 

5 to the Secretary about the sustainability of the pro6 gram. 

7 ‘‘(9) To engage and utilize expertise provided 

8 by institutions of higher education, such as a Tribal 

9 College or University, as defined in section 316(b) of 

10 the Higher Education Act of 1965. 

11 ‘‘(10) To provide trainings and implement pro12 cedures pursuant to the relevant best practices de13 veloped under section 101 of the Trauma-Informed 

14 Care for Children and Families Act of 2017. 

15 ‘‘(d) APPLICATIONS.—To be eligible to receive a 

16 grant, contract, or cooperative agreement under this sec17 tion, an entity described in subsection (a) shall submit an 

18 application to the Secretary at such time, in such manner, 

19 and containing such information as the Secretary may rea20 sonably require, such as the following: 

21 ‘‘(1) A description of the program to be funded 

22 under the grant, contract, or cooperative agreement. 

23 ‘‘(2) A description of how such program will in24 crease access to quality trauma support services and 

25 mental health care for students. 


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1 ‘‘(3) A description of how the applicant will es2 tablish trauma support services or a school-based 

3 counseling program, or both, that provide immediate 

4 prevention and mental health services to the school 

5 community as necessary. 

6 ‘‘(4) An assurance that— 

7 ‘‘(A) persons providing services under the 

8 grant, contract, or cooperative agreement are 

9 adequately trained to provide such services; 

10 ‘‘(B) the services will be provided in ac11 cordance with subsection (c); 

12 ‘‘(C) teachers, administrators, specialized 

13 instructional support personnel, parents or 

14 guardians, representatives of local Indian tribes, 

15 and other school personnel are aware of the 

16 program; and 

17 ‘‘(D) parents or guardians of students par18 ticipating in services under this section will be 

19 engaged and involved in the design and imple20 mentation of the services. 

21 ‘‘(5) An assurance that the applicant will sup22 port and integrate existing school-based services 

23 with the program in order to provide appropriate 

24 mental health services for students. 


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1 ‘‘(6) An assurance that the applicant will estab2 lish a program that will support students and the 

3 school in improving the school climate in order to 

4 support an environment conducive to learning. 

5 ‘‘(e) INTERAGENCY AGREEMENTS.— 

6 ‘‘(1) DESIGNATION OF LEAD AGENCY.—A re7 cipient of a grant, contract, or cooperative agree8 ment under this section shall designate a lead agen9 cy to direct the establishment of an interagency 

10 agreement among local educational agencies, juvenile 

11 justice authorities, mental health agencies, and other 

12 relevant entities in the State, in collaboration with 

13 local entities, such as Indian tribes. 

14 ‘‘(2) CONTENTS.—The interagency agreement 

15 shall ensure the provision of the services described 

16 in subsection (c), specifying with respect to each 

17 agency, authority, or entity— 

18 ‘‘(A) the financial responsibility for the 

19 services; 

20 ‘‘(B) the conditions and terms of responsi21 bility for the services, including quality, ac22 countability, and coordination of the services; 

23 and 

24 ‘‘(C) the conditions and terms of reim25 bursement among the agencies, authorities, or 


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1 entities that are parties to the interagency 

2 agreement, including procedures for dispute 

3 resolution. 

4 ‘‘(f) EVALUATION.—The Secretary shall evaluate 

5 each program carried out under this section and shall dis6 seminate the findings with respect to each such evaluation 

7 to appropriate public, tribal, and private entities. 

8 ‘‘(g) DISTRIBUTION OF AWARDS.—The Secretary 

9 may ensure that grants, contracts, and cooperative agree10 ments awarded or entered into under this section are equi11 tably distributed among the geographical regions of the 

12 United States and among tribal, urban, suburban, and 

13 rural populations. 

14 ‘‘(h) RULE OF CONSTRUCTION.—Nothing in this sec15 tion shall be construed— 

16 ‘‘(1) to prohibit an entity involved with a pro17 gram carried out under this section from reporting 

18 a crime that is committed by a student to appro19 priate authorities; or 

20 ‘‘(2) to prevent State and tribal law enforce21 ment and judicial authorities from exercising their 

22 responsibilities with regard to the application of 

23 Federal, tribal, and State law to crimes committed 

24 by a student. 


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1 ‘‘(i) SUPPLEMENT, NOT SUPPLANT.—Any services 

2 provided through programs carried out under this section 

3 shall supplement, and not supplant, existing mental health 

4 services, including any services required to be provided 

5 under the Individuals with Disabilities Education Act. 

6 ‘‘(j) CONSULTATION WITH INDIAN TRIBES.—In car7 rying out subsection (a), the Secretary shall, in a timely 

8 manner, meaningfully consult, engage, and cooperate with 

9 Indian tribes and their representatives to ensure notice of 

10 eligibility. 

11 ‘‘(k) AUTHORIZATION OF APPROPRIATIONS.—There 

12 is authorized to be appropriated to carry out this section 

13 $6,000,000 for the period of fiscal years 2018 through 

14 2023.’’. 

15 TITLE III—UNDERSTANDING 

16 THE SCOPE OF TRAUMA EX17 POSURE 

18 SEC. 301. CDC SURVEILLANCE AND DATA COLLECTION FOR 

19 CHILD, YOUTH, AND ADULT TRAUMA. 

20 (a) DATA COLLECTION.—The Director of the Centers 

21 for Disease Control and Prevention (referred to in this 

22 section as the ‘‘Director’’) shall authorize and encourage 

23 States to collect and report data on adverse childhood ex24 periences through the Behavioral Risk Factor Surveillance 

25 System and the Youth Risk Behavior Surveillance System. 


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1 In collecting and reporting such data, States shall use the 

2 appropriate modules developed under section 302(2)(B), 

3 in addition to other appropriate modules. 

4 (b) TIMING.—The collection of data authorized under 

5 subsection (a) may occur in fiscal year 2019 and every 

6 2 years thereafter. 

7 (c) DATA FROM TRIBAL AND RURAL AREAS.—The 

8 Director shall require that each State, in collecting data 

9 in accordance with subsection (a), ensure that, as appro10 priate, data from tribal and rural areas within such State 

11 is included by oversampling from such areas. 

12 (d) AUTHORIZATION OF APPROPRIATIONS.—To carry 

13 out this section, there are authorized to be appropriated 

14 $64,000,000 for the period of fiscal years 2019 through 

15 2021. 

16 SEC. 302. CDC ANALYSIS OF CHILD, YOUTH, AND ADULT 

17 TRAUMA. 

18 The Secretary of Health and Human Services, acting 

19 through the Director of the Centers for Disease Control 

20 and Prevention, shall— 

21 (1) conduct an analysis of— 

22 (A) the prevalence of child, youth, and 

23 adult trauma experienced in the United States, 

24 including assessments of the types of the most 

25 prominent adverse childhood experiences, and 


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1 disparities by race and ethnicity, by geographic 

2 distribution, and by socioeconomic status; 

3 (B) the public health impact of adverse 

4 childhood experiences, including the correlation 

5 of such experiences with trends in life expect6 ancy and whether the scope of such experiences 

7 constitutes a public health epidemic; 

8 (C) modules that measure and assess ad9 verse childhood experiences, for development 

10 and ultimate inclusion in the Youth Risk Be11 havior Surveillance System; and 

12 (D) outcomes modules that measure and 

13 evaluate the utilization and efficacy of trauma14 informed interventions, such as mental health 

15 services or other clinical or sub-clinical care, for 

16 ultimate inclusion in the Youth Risk Behavior 

17 Surveillance System and the Behavioral Risk 

18 Factor Surveillance System; and 

19 (2) not later than 1 year after the date of en20 actment of this Act, submit to Congress a report on 

21 the analysis under paragraph (1) that includes rec22 ommendations on— 

23 (A) what communities can do to mitigate 

24 the impact of adverse childhood experiences and 

25 how Indian tribes, social service providers, law 


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1 enforcement, health care practitioners, public 

2 health agencies, educational institutions, and 

3 other community stakeholders may collaborate 

4 to improve efforts to identify, connect to appro5 priate services, and provide treatment and sup6 port for children and youth, and their families 

7 as appropriate, who have experienced or are at 

8 risk of experiencing trauma; 

9 (B) modules for inclusion in the appro10 priate surveillance systems, as described in sub11 paragraphs (C) and (D) of paragraph (1); and 

12 (C) how the Centers for Disease Control 

13 and Prevention can utilize data collected 

14 through surveillance systems to target specific 

15 populations or geographic locations with a high 

16 incidence of measured Adverse Childhood Expe17 riences, including by considering such data 

18 when awarding grants and contracts to entities 

19 serving such populations or locations. 

20 SEC. 303. GOVERNMENT ACCOUNTABILITY STUDY ON BAR21 RIERS TO AND OPPORTUNITIES FOR TRAU22 MA-INFORMED IDENTIFICATION AND TREAT23 MENT. 

24 (a) STUDY.— 


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1 (1) IN GENERAL.—The Comptroller General 

2 shall conduct a study of the barriers to, and the op3 portunities for increasing, the early identification 

4 and treatment of children and youth, and their fami5 lies as appropriate, who have experienced or are at 

6 risk of experiencing trauma. 

7 (2) CONTENTS.—In conducting the study, the 

8 Comptroller General shall examine— 

9 (A) ways in which such identification and 

10 treatment could be facilitated in early childhood 

11 education and care settings and elementary and 

12 secondary schools, such as through improved 

13 teacher preparation, professional development, 

14 and curriculum design, and the development of 

15 the cognitive and social-emotional skills of stu16 dents; 

17 (B)(i) the extent to which State Medicaid 

18 plans use early and periodic screening, diag19 nostic, and treatment services (as defined in 

20 section 1905(r) of the Social Security Act (42 

21 U.S.C. 1396d(r)) that are provided in accord22 ance with the requirements of section 

23 1902(a)(43) of such Act (42 U.S.C. 

24 1396a(a)(43))) to provide trauma-informed 

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1 lies as appropriate, who have experienced or are 

2 at risk of experiencing trauma; 

3 (ii) barriers to increased utilization of such 

4 screening, diagnostic, and treatment services; 

5 and 

6 (iii) the impact of State Medicaid plan de7 sign and State regulatory decisions on the pro8 vision of such services; 

9 (C) the feasibility of, State experiences 

10 with, and considerations regarding, systematic 

11 collection and sharing of data that— 

12 (i) is carried out by health care pro13 viders, State, local, and tribal educational 

14 agencies, social service providers, law en15 forcement, and any other entity providing 

16 services in a covered setting (as defined in 

17 section 101(f)); 

18 (ii) relies on common data measures, 

19 fosters communication and coordination 

20 across covered settings (as so defined), and 

21 promotes shared accountability for the 

22 data; and 

23 (iii) relates to the screening, referral, 

24 and support of children and youth, and 

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1 perienced or are at risk of experiencing 

2 trauma; 

3 (D) privacy and consent issues affecting 

4 identification and treatment of children and 

5 youth who have experienced or are at risk of ex6 periencing trauma, including considerations re7 garding information collected and reported by 

8 providers and regarding parental consent; 

9 (E)(i) the comprehensive, coordinated, and 

10 multisector process through which State, local, 

11 and tribal educational agencies locate, identify, 

12 and screen infants and toddlers with disabil13 ities, and children with disabilities (including 

14 such children who are youth), under the Indi15 viduals with Disabilities Education Act (20 

16 U.S.C. 1400 et seq.); and 

17 (ii) considerations, strategies, alignment 

18 opportunities, and applicability for trauma-in19 formed models for conducting such location, 

20 identification, and screening; 

21 (F)(i) clinical child and adolescent mental 

22 health and child- and youth-serving social serv23 ice workforce capacity, including analyzing that 

24 capacity by setting, geographic distribution, and 

25 population served; and 


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1 (ii) barriers that contribute to any short2 ages in professionals in that workforce; and 

3 (G) the cost-effectiveness and success of 

4 providing services through school-based health 

5 centers as a method of— 

6 (i) addressing the needs of students 

7 who have experienced or are at risk of ex8 periencing trauma; and 

9 (ii) improving their academic achieve10 ment. 

11 (b) REPORT.—The Comptroller General shall submit 

12 a report containing the results of the study to— 

13 (1) the Committee on Appropriations, the Com14 mittee on Health, Education, Labor, and Pensions, 

15 the Committee on Finance, the Committee on Indian 

16 Affairs, and the Committee on the Judiciary of the 

17 Senate; and 

18 (2) the Committee on Appropriations, the Com19 mittee on Energy and Commerce, the Committee on 

20 Education and the Workforce, the Committee on 

21 Ways and Means, the Committee on Natural Re22 sources, and the Committee on the Judiciary of the 

23 House of Representatives. 

24 (c) DEFINITIONS.—In this section: 


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1 (1) CHILD WITH A DISABILITY.—The term 

2 ‘‘child with a disability’’ has the meaning given the 

3 term in section 602 of the Individuals with Disabil4 ities Education Act (20 U.S.C. 1401). 

5 (2) INFANT OR TODDLER WITH A DIS6 ABILITY.—The term ‘‘infant or toddler with a dis7 ability’’ has the meaning given the term in section 

8 632 of the Individuals with Disabilities Education 

9 Act (20 U.S.C. 1432). 

10 SEC. 304. NIH REPORT ON TRAUMA. 

11 The Director of the National Institutes of Health, not 

12 later than 1 year after the date of enactment of this Act, 

13 shall submit to Congress a report on the activities of the 

14 National Institutes of Health with respect to trauma (in15 cluding trauma that stems from child abuse, exposure to 

16 violence, and toxic stress) and the implications of trauma 

17 for children, youth, and adults. Such report shall in18 clude— 

19 (1) the comprehensive research agenda of the 

20 National Institutes of Health with respect to trau21 ma; 

22 (2) the capacity, expertise, and review mecha23 nisms of the National Institutes of Health with re24 spect to the evaluation and examination of research 


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1 proposals related to child trauma, including coordi2 nation across institutes and centers; 

3 (3) the relevance of trauma to other diseases, 

4 outcomes, and domains; 

5 (4) strategies to link and analyze data from 

6 multiple independent sources, including child wel7 fare, health care (including mental health care), law 

8 enforcement, and education systems, to enhance re9 search efforts and improve health outcomes; 

10 (5) the efficacy of existing interventions, includ11 ing clinical treatment methods, child- and family-fo12 cused prevention models, and community-based ap13 proaches, in mitigating the effects of experiencing 

14 trauma and improving health and societal outcomes; 

15 and 

16 (6) identification of gaps in understanding in 

17 the field of trauma and areas of greatest need for 

18 further research related to trauma. 


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1 TITLE IV—EVALUATION OF NEW 

2 INTERVENTIONS AND IM3 PROVING SERVICE DELIVERY 

4 SEC. 401. CLARIFICATION OF DEFINITION OF MEDICAID 

5 EPSDT SERVICES; DEMONSTRATION 

6 PROJECT TO TEST TRAUMA-INFORMED DE7 LIVERY OF EPSDT SERVICES. 

8 (a) CLARIFICATION OF DEFINITION OF EPSDT 

9 SERVICES.—Section 1905(r) of the Social Security Act 

10 (42 U.S.C. 1396d(r)) is amended— 

11 (1) in paragraph (1)— 

12 (A) in subparagraph (A)(ii), by inserting 

13 ‘‘(including in the immediate aftermath of expo14 sure to a traumatic event)’’ after ‘‘medically 

15 necessary’’; and 

16 (B) in subparagraph (B)(i), by inserting 

17 ‘‘and any past exposure to traumatic events’’ 

18 after ‘‘health development’’; and 

19 (2) in paragraph (5), by inserting ‘‘including 

20 any defects, illnesses, and conditions (including 

21 symptoms of a possible mental health disorder that 

22 are not sufficiently acute for a diagnosis of a clinical 

23 mental health disorder) stemming from exposure to 

24 traumatic events,’’ after ‘‘screening services,’’. 


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1 (b) TRAUMA-INFORMED DELIVERY OF EPSDT 

2 SERVICES DEMONSTRATION PROJECT.— 

3 (1) IN GENERAL.—The Secretary shall make 

4 grants to States to conduct demonstration projects 

5 under title XIX of the Social Security Act (42 

6 U.S.C. 1396 et seq.) to test innovative, trauma-in7 formed approaches for delivering early and periodic 

8 screening, diagnostic, and treatment services (as de9 fined in section 1905(r) of the Social Security Act 

10 (42 U.S.C. 1396d(r))) to eligible children. 

11 (2) SCOPE AND DURATION.— 

12 (A) SCOPE.—The Secretary shall select 10 

13 States to participate in the demonstration 

14 project. 

15 (B) SELECTION.— 

16 (i) DIVERSITY.—In selecting States to 

17 participate in the demonstration project, 

18 the Secretary shall— 

19 (I) ensure that geographically di20 verse areas, including rural and un21 derserved areas, are included; and 

22 (II) include at least 2 States in 

23 which Indian tribes or tribal organiza24 tions (as defined in section 4 of the 


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1 Indian Health Care Improvement Act 

2 (25 U.S.C. 1603)) are located. 

3 (ii) PRIORITY.—In selecting States to 

4 participate in the demonstration project, 

5 the Secretary shall give priority to States 

6 that— 

7 (I) use a value-based payment 

8 methodology for paying providers for 

9 services provided under the State 

10 Medicaid program, including services 

11 related to healthy child development; 

12 (II) use an alternative payment 

13 model under the State Medicaid pro14 gram that enables cross-sector col15 laboration, provision of trauma-in16 formed services, and supports for 

17 healthy child development; or 

18 (III) integrate information tech19 nology between child- and youth-serv20 ing sectors to improve coordination 

21 and outcomes. 

22 (C) DURATION.—The demonstration 

23 project shall begin not later than 1 year after 

24 the date of the enactment of this Act, and shall 

25 be conducted for a period of 4 years. 


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1 (3) REQUIREMENTS.—To be eligible for a grant 

2 under this subsection, a State that is participating 

3 in the demonstration project shall demonstrate that 

4 it has implemented the following measures with re5 spect to the State Medicaid program: 

6 (A) The State Medicaid program allows for 

7 the provision of early and periodic screening, di8 agnostic, and treatment services— 

9 (i) in a diverse set of settings, includ10 ing schools, hospitals, primary care set11 tings, Federally-qualified health centers (as 

12 defined in section 1905(l)(2)(B) of the So13 cial Security Act (42 U.S.C. 

14 1396d(l)(2)(B))), and tribally-operated 

15 health facilities, without undue restrictions 

16 on the settings in which providers are per17 mitted to furnish such services; and 

18 (ii) by the full scope of providers that 

19 are licensed or otherwise authorized under 

20 State law to provide the services, including 

21 trained peers through eligible peer support 

22 services, community health workers, or 

23 subclinical case managers. 

24 (B) Where necessary to improve or pro25 mote the health of an eligible child, the State 


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1 Medicaid program provides for payment for 

2 services provided to the parent of the child. 

3 (C) The State Medicaid program has pro4 cedures in place to coordinate across settings, 

5 which may include coordinating with law en6 forcement, juvenile justice agencies, schools (in7 cluding preschools and after-school programs), 

8 hospitals, primary care providers, tribally-oper9 ated health facilities, mental health and sub10 stance use treatment facilities, and child welfare 

11 providers, to ensure that eligible children who 

12 experience trauma receive the appropriate serv13 ices. 

14 (D) Where appropriate, the State Medicaid 

15 program coordinates with facilities of the In16 dian Health Service (including a hospital, nurs17 ing facility, or any other type of facility which 

18 provides services of a type otherwise covered 

19 under the program) and other tribally-operated 

20 health facilities to ensure eligible children have 

21 access to adequate qualified providers that are 

22 licensed or otherwise authorized under State 

23 law to furnish the services. 

24 (4) FUNDING.—Out of any funds in the Treas25 ury not otherwise appropriated, there is approVerDate Sep 11 2014 23:36 Mar 31, 2017 Jkt 069200 PO 00000 Frm 00067 Fmt 6652 Sfmt 6201 E:\BILLS\S774.IS S774

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1 priated $75,000,000 for the period of fiscal years 

2 2017 through 2021 to carry out this subsection. 

3 (5) DEFINITIONS.—In this subsection: 

4 (A) DEMONSTRATION PROJECT.—The term 

5 ‘‘demonstration project’’ means the demonstra6 tion project established under this subsection. 

7 (B) ELIGIBLE CHILD.—The term ‘‘eligible 

8 child’’ means an individual who is under age 21 

9 and who is enrolled in a State plan under title 

10 XIX of the Social Security Act (42 U.S.C. 1396 

11 et seq.). 

12 (C) SECRETARY.—The term ‘‘Secretary’’ 

13 means the Secretary of Health and Human 

14 Services. 

15 (D) STATE MEDICAID PROGRAM.—The 

16 term ‘‘State Medicaid program’’ means a State 

17 plan or waiver under title XIX of the Social Se18 curity Act (42 U.S.C. 1396 et seq.). 

19 SEC. 402. HEALTH PROFESSIONAL SHORTAGE AREAS. 

20 Section 332(a) of the Public Health Service Act (42 

21 U.S.C. 254e(a)) is amended— 

22 (1) in paragraph (2)(A), by inserting ‘‘(includ23 ing a community health center operated in an ele24 mentary or secondary school)’’ after ‘‘community 

25 health center’’; and 


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1 (2) in paragraph (3)— 

2 (A) by striking ‘‘, and residents’’ and in3 serting ‘‘, residents’’; and 

4 (B) by inserting ‘‘, and a population group 

5 that the Secretary determines has experienced 

6 trauma (such as through acute or long-term ex7 posure to substantial discrimination, historical 

8 or cultural oppression, intergenerational pov9 erty, civil unrest, a high rate of violence, or a 

10 high rate of drug overdose mortality)’’ before 

11 ‘‘may be’’. 

12 SEC. 403. TRAINING AND CERTIFICATION GUIDELINES FOR 

13 COMMUNITY FIGURES. 

14 The Secretary of Health and Human Services, acting 

15 through the Administrator of the Agency for Healthcare 

16 Research and Quality, shall conduct a study on, and estab17 lish guidelines for States to consider with respect to, the 

18 training and certification of community figures, including 

19 community mentors, peers with lived experiences, and 

20 faith-based leaders, to build awareness of trauma and pro21 mote linkages to community services, provide case man22 agement services, and conduct appropriate trauma-in23 formed screening for individuals who have experienced or 

24 are at risk of experiencing trauma. Such training and cer25 tification guidelines shall include recommendations for exVerDate Sep 11 2014 23:36 Mar 31, 2017 Jkt 069200 PO 00000 Frm 00069 Fmt 6652 Sfmt 6201 E:\BILLS\S774.IS S774

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1 perience, education, and supervision requirements for, and 

2 partnerships between, such trained and certified commu3 nity figures and other health care providers such that the 

4 trained and certified community figures may be reim5 bursed through the State Medicaid plan under title XIX 

6 of the Social Security Act (42 U.S.C. 1396 et seq.) for 

7 furnishing services to individuals enrolled in such plan. 

8 SEC. 404. TRAINING FOR HEALTH CARE WORKFORCE. 

9 (a) MENTAL AND BEHAVIORAL HEALTH EDUCATION

10 AND TRAINING PROGRAM.—Section 756 of the Public 

11 Health Service Act (42 U.S.C. 294e–1) is amended— 

12 (1) in subsection (a)— 

13 (A) in paragraph (1), by inserting ‘‘, trau14 ma,’’ after ‘‘focus on child and adolescent men15 tal health’’; and 

16 (B) in paragraphs (2) and (3), by inserting 

17 ‘‘trauma-informed care and’’ before ‘‘substance 

18 use disorder prevention and treatment serv19 ices’’; and 

20 (2) in subsection (d)— 

21 (A) in paragraph (1), by striking ‘‘and’’ at 

22 the end; 

23 (B) in paragraph (2), by striking the pe24 riod and inserting ‘‘; and’’; and 

25 (C) by adding at the end the following: 


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1 ‘‘(3) programs with academic study and com2 munity practice related to trauma, its impact on 

3 mental and behavioral health outcomes, and appro4 priate interventions, which may include best prac5 tices developed under section 101 of the Trauma-In6 formed Care for Children and Families Act of 

7 2017.’’. 

8 (b) TRAINING DEMONSTRATION PROGRAM.—Section 

9 760 of such Act (42 U.S.C. 294k) is amended— 

10 (1) in subsection (a)— 

11 (A) in paragraphs (1) and (2), by inserting 

12 ‘‘trauma-informed’’ after ‘‘integrate’’; and 

13 (B) in paragraph (3)(A), by inserting ‘‘, 

14 and recognize and address the impacts of expe15 riencing trauma on children, youth, and fami16 lies’’ before the semicolon; 

17 (2) in subsection (b)— 

18 (A) in paragraph (1)(A)— 

19 (i) in clause (i)(II), by inserting 

20 ‘‘trauma-informed’’ after ‘‘integrated’’; and 

21 (ii) in clause (ii)(III), by inserting 

22 ‘‘trauma-informed’’ before ‘‘treatment’’; 

23 and 

24 (B) in paragraph (2)(A), by inserting 

25 ‘‘trauma-informed’’ after ‘‘integrate’’; 


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1 (3) in subsection (c)(1)(B), by inserting ‘‘trau2 ma-informed’’ after ‘‘integrate’’; and 

3 (4) in subsection (d)— 

4 (A) in paragraph (1)— 

5 (i) in subparagraph (C), by striking 

6 ‘‘or’’ at the end; 

7 (ii) in subparagraph (D), by striking 

8 the period and inserting ‘‘; or’’; and 

9 (iii) by adding at the end the fol10 lowing: 

11 ‘‘(E) provide training with academic study 

12 and community practice related to trauma, its 

13 impact on mental health outcomes, and appro14 priate interventions, which may include best 

15 practices developed under section 101 of the 

16 Trauma-Informed Care for Children and Fami17 lies Act of 2017.’’; and 

18 (B) in paragraph (2)— 

19 (i) in subparagraph (D), by striking 

20 ‘‘or’’ at the end; 

21 (ii) in subparagraph (E), by striking 

22 the period and inserting ‘‘; or’’; and 

23 (iii) by adding at the end the fol24 lowing: 


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1 ‘‘(F) provide training with academic study 

2 and community practice related to trauma, its 

3 impact on mental health outcomes, and appro4 priate interventions, which may include best 

5 practices developed under section 101 of the 

6 Trauma-Informed Care for Children and Fami7 lies Act of 2017.’’. 

8 SEC. 405. TRAUMA-RELATED COORDINATING BODIES. 

9 Part G of title V of the Public Health Service Act 

10 (42 U.S.C. 290hh et seq.) is amended by adding at the 

11 end the following: 

12 ‘‘SEC. 583. TRAUMA-RELATED COORDINATING BODIES. 

13 ‘‘(a) GRANTS.— 

14 ‘‘(1) IN GENERAL.—The Secretary, acting 

15 through the Administrator, shall make not more 

16 than 20 grants for demonstration projects to State, 

17 local, or tribal eligible entities to act as trauma-re18 lated coordinating bodies. 

19 ‘‘(2) AMOUNT.—The Secretary shall make such 

20 a grant in an amount of not more than $4,000,000. 

21 ‘‘(3) DURATION.—The Secretary shall make 

22 such a grant for a period of 4 years. 

23 ‘‘(b) ELIGIBLE ENTITIES.— 

24 ‘‘(1) IN GENERAL.—To be eligible to receive a 

25 grant under this section, an entity shall include 1 or 


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1 more representatives of each of the categories de2 scribed in paragraph (2). 

3 ‘‘(2) COMPOSITION.—The categories referred to 

4 in paragraph (1) are— 

5 ‘‘(A) agencies, such as public health or 

6 child welfare agencies, that provide services to 

7 prevent the impact of trauma among, identify, 

8 refer for services, or support (including pro9 viding treatment for) children and youth, and 

10 their families as appropriate, that have experi11 enced or are at risk of experiencing trauma; 

12 ‘‘(B) faculty at an institution of higher 

13 education, or researchers or experts, in an area 

14 related to prevention of the impact of, identi15 fication of, referral for services for, or support 

16 (including treatment) for child and youth trau17 ma; 

18 ‘‘(C) hospitals or other health care institu19 tions, such as mental health and substance use 

20 treatment facilities; 

21 ‘‘(D) law enforcement; 

22 ‘‘(E) elementary or secondary schools, or 

23 early childhood education or care programs; 

24 ‘‘(F) community-based faith, human serv25 ices, or social services organizations, including 


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1 providers of after-school programs, home vis2 iting programs, or programs to prevent or ad3 dress the impact of violence; and 

4 ‘‘(G) the general public, including individ5 uals who have experienced trauma. 

6 ‘‘(3) QUALIFICATIONS.—In order for an entity 

7 to be eligible to receive the grant, the representatives 

8 included in the entity shall, collectively, have profes9 sional training and expertise concerning a broad 

10 range of adverse childhood experiences. 

11 ‘‘(c) APPLICATION.—To be eligible to receive a grant 

12 under this section, an entity shall submit an application 

13 to the Secretary at such time, in such manner, and con14 taining such information as the Secretary may require, in15 cluding information describing how the coordinating body 

16 will continue its activities after the end of the grant pe17 riod. 

18 ‘‘(d) PRIORITY.—In making grants under this sec19 tion, the Secretary shall give priority to entities proposing 

20 to serve communities that have faced trauma due to sub21 stantial discrimination, historical or cultural oppression, 

22 intergenerational poverty, civil unrest, a high rate of vio23 lence, or a high rate of drug overdose mortality. 


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1 ‘‘(e) USE OF FUNDS.—An entity that receives a grant 

2 under this section to act as a coordinating body shall use 

3 the grant funds— 

4 ‘‘(1) to bring together stakeholders who provide 

5 or use services in, or have expertise concerning, cov6 ered settings to identify community needs and re7 sources related to services to prevent or address the 

8 impact of trauma, and to build on any needs assess9 ments conducted by organizations or groups rep10 resented on the coordinating body; 

11 ‘‘(2)(A) to collect data, on indicators specified 

12 by the Secretary, that covers multiple covered set13 tings; and 

14 ‘‘(B) to use the data to identify unique commu15 nity challenges, gaps in services, and high-need 

16 areas, related to services to prevent or address the 

17 impact of trauma; 

18 ‘‘(3) to build awareness, skills, and leadership 

19 (including through trauma-informed training and 

20 public outreach campaigns) related to implementing 

21 the best practices developed under section 101 of the 

22 Trauma-Informed Care for Children and Families 

23 Act of 2017 (referred to in this subsection as the 

24 ‘developed best practices’); 


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1 ‘‘(4) to pool resources of the members of the or2 ganizations and groups represented on the coordi3 nating body, related to implementing the developed 

4 best practices; and 

5 ‘‘(5) to develop a strategic plan that identi6 fies— 

7 ‘‘(A) barriers to and gaps in the provision 

8 of services to prevent or address the impact of 

9 trauma; and 

10 ‘‘(B) policy goals and coordination oppor11 tunities (including coordination in applying for 

12 grants) relating to implementing the developed 

13 best practices. 

14 ‘‘(f) SUPPLEMENT NOT SUPPLANT.—Amounts made 

15 available under this section shall be used to supplement 

16 and not supplant other Federal, State, and local public 

17 funds and private funds expended to provide trauma-re18 lated coordination activities. 

19 ‘‘(g) EVALUATION.—At the end of the period for 

20 which grants are made under this section, the Secretary 

21 shall conduct an evaluation of the activities carried out 

22 under each grant under this section. In conducting the 

23 evaluation, the Secretary shall assess the outcomes of the 

24 grant activities carried out by each grant recipient. 


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1 ‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—There 

2 is authorized to be appropriated to carry out this section 

3 $80,000,000 for the period of fiscal years 2018 through 

4 2021. 

5 ‘‘(i) DEFINITION.—In this section, the term ‘covered 

6 setting’ has the meaning given the term in section 101(f) 

7 of the Trauma-Informed Care for Children and Families 

8 Act of 2017.’’. 

9 SEC. 406. EXPANSION OF PERFORMANCE PARTNERSHIP 

10 PILOT FOR CHILDREN WHO HAVE EXPERI11 ENCED OR ARE AT RISK OF EXPERIENCING 

12 TRAUMA. 

13 Section 526 of the Departments of Labor, Health and 

14 Human Services, and Education, and Related Agencies 

15 Appropriations Act, 2014 (42 U.S.C. 12301 note) is 

16 amended— 

17 (1) in subsection (a), by adding at the end the 

18 following: 

19 ‘‘(4) ‘To improve outcomes for children and 

20 youth, and their families as appropriate, who have 

21 experienced or are at risk of experiencing trauma’ 

22 means to increase the rate at which individuals who 

23 have experienced or are at risk of experiencing trau24 ma, including those who are low-income, homeless, 

25 in foster care, involved in the juvenile justice system, 


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1 unemployed, or not enrolled in or at risk of dropping 

2 out of an educational institution and live in a com3 munity that has faced acute or long-term exposure 

4 to substantial discrimination, historical oppression, 

5 intergenerational poverty, civil unrest, or a high rate 

6 of violence, achieve success in meeting educational, 

7 employment, health, developmental, community re8 entry, or other key goals.’’; 

9 (2) in subsection (b)— 

10 (A) in the subsection heading, by striking 

11 ‘‘FISCAL YEAR 2014’’ and inserting ‘‘FISCAL

12 YEARS 2018 THROUGH 2022’’; 

13 (B) by redesignating paragraphs (1) and 

14 (2) as subparagraphs (A) and (B), respectively, 

15 and by moving such subparagraphs, as so re16 designated, 2 ems to the right; 

17 (C) by striking ‘‘Federal agencies’’ and in18 serting the following: 

19 ‘‘(1) DISCONNECTED YOUTH PILOTS.—Federal 

20 agencies’’; and 

21 (D) by adding at the end the following: 

22 ‘‘(2) TRAUMA-INFORMED CARE PILOTS.—Fed23 eral agencies may use Federal discretionary funds 

24 that are made available in this Act or any Act ap25 propriating funds for any of fiscal years 2018 


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1 through 2022 to carry out up to 10 Performance 

2 Partnership Pilots. Such Pilots shall— 

3 ‘‘(A) be designed to improve outcomes for 

4 children and youth, and their families as appro5 priate, who have experienced or are at risk of 

6 experiencing trauma; and 

7 ‘‘(B) involve Federal programs targeted on 

8 children and youth, and their families as appro9 priate, who have experienced or are at risk of 

10 experiencing trauma.’’; 

11 (3) in subsection (c)(2)(A), by striking ‘‘2018’’ 

12 and inserting ‘‘2022’’; and 

13 (4) in subsection (e), by striking ‘‘2018’’ and 

14 inserting ‘‘2022’’. 

15 SEC. 407. TRAUMA-INFORMED TEACHING. 

16 (a) PARTNERSHIP GRANTS.—Section 202 of the 

17 Higher Education Act of 1965 (20 U.S.C. 1022a) is 

18 amended— 

19 (1) in subsection (b)(6)— 

20 (A) by redesignating subparagraphs (H) 

21 through (K) as subparagraphs (I) through (L), 

22 respectively; and 

23 (B) by inserting after subparagraph (G) 

24 the following: 


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1 ‘‘(H) how the partnership will prepare gen2 eral education and special education teachers to 

3 work with students who have experienced trau4 ma (including students who are involved in the 

5 foster care or juvenile justice systems or run6 away or homeless youth) and in alternative edu7 cation settings in which high populations of 

8 youth with trauma exposure may learn (includ9 ing settings for correctional education, juvenile 

10 justice, pregnant and parenting students, or 

11 youth who have re-entered school after a period 

12 of absence due to dropping out);’’; 

13 (2) in subsection (d)(1)(A)(i)— 

14 (A) in subclause (II), by striking ‘‘and’’ at 

15 the end; 

16 (B) by redesignating subclause (III) as 

17 subclause (IV); and 

18 (C) by inserting after subclause (II) the 

19 following: 

20 ‘‘(III) such teachers to adopt evi21 dence-based approaches for improving 

22 behavior (such as positive behavior 

23 interventions and supports and restor24 ative justice), supporting social and 

25 emotional learning, mitigating the efVerDate Sep 11 2014 23:36 Mar 31, 2017 Jkt 069200 PO 00000 Frm 00081 Fmt 6652 Sfmt 6201 E:\BILLS\S774.IS S774

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1 fects of trauma, improving the learn2 ing environment in the school, and for 

3 reducing the need for suspensions, ex4 pulsions, corporal punishment, refer5 rals to law enforcement, and other ac6 tions that remove students from in7 struction; and’’; and 

8 (3) in subsection (d), by adding at the end the 

9 following: 

10 ‘‘(7) TRAUMA-INFORMED PRACTICE AND WORK

11 IN ALTERNATIVE EDUCATION SETTINGS.—Devel12 oping the teaching skills of prospective and, as appli13 cable, new elementary school and secondary school 

14 teachers to adopt evidence-based trauma-informed 

15 teaching strategies— 

16 ‘‘(A) to— 

17 ‘‘(i) recognize the signs of trauma and 

18 its impact on learning; 

19 ‘‘(ii) maximize student engagement; 

20 and 

21 ‘‘(iii) minimize suspension and expul22 sion; and 

23 ‘‘(B) including programs training teachers 

24 to work with students with exposure to trau25 matic events (including students involved in the 


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1 foster care or juvenile justice systems) and in 

2 alternative academic settings for youth unable 

3 to participate in a traditional public school pro4 gram in which high populations of students 

5 with trauma exposure may learn (such as stu6 dents involved in the foster care or juvenile jus7 tice systems, pregnant and parenting students, 

8 runaway and homeless students, and other 

9 youth who have re-entered school after a period 

10 of absence due to dropping out).’’. 

11 (b) ADMINISTRATIVE PROVISIONS.—Section 

12 203(b)(2) of the Higher Education Act of 1965 (20 

13 U.S.C. 1022b(b)(2)) is amended— 

14 (1) in subparagraph (A), by striking ‘‘and’’ at 

15 the end; 

16 (2) in subparagraph (B), by striking the period 

17 at the end and inserting ‘‘; and’’; and 

18 (3) by adding at the end the following: 

19 ‘‘(C) to eligible partnerships that have a 

20 high-quality proposal for trauma training pro21 grams for general education and special edu22 cation teachers.’’. 

Æ 


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