II 

118TH CONGRESS 

1ST SESSION S. 3333 

To enhance pre- and post-adoption support services, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

NOVEMBER 15, 2023 

Ms. KLOBUCHAR (for herself and Mr. CRAMER) introduced the following bill; 

which was read twice and referred to the Committee on Finance 

A BILL 

To enhance pre- and post-adoption support services, 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 ‘‘Supporting Adopted 

5 Children and Families Act’’. 

6 SEC. 2. ADOPTION SUPPORT SERVICES. 

7 (a) ENSURING THE WELL-BEING OF ADOPTED CHIL8 DREN AND THEIR ADOPTIVE FAMILIES.—Section 421 of 

9 the Social Security Act (42 U.S.C. 621) is amended— 

10 (1) in paragraph (4), by striking ‘‘and’’ at the 

11 end; 


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1 (2) by redesignating paragraph (5) as para2 graph (6); and 

3 (3) by inserting after paragraph (4) the fol4 lowing new paragraph: 

5 ‘‘(5) ensuring the well-being of adopted children 

6 and their adoptive families and promoting efforts to 

7 prevent such children from entering the foster care 

8 system through the provision of pre- and post-adop9 tion support services; and’’. 

10 (b) PRE- AND POST-ADOPTION SUPPORT SERV11 ICES.—Paragraph (8) of section 431(a) of such Act (42 

12 U.S.C. 629a(a)) is amended to read as follows: 

13 ‘‘(8) ADOPTION PROMOTION AND SUPPORT

14 SERVICES.— 

15 ‘‘(A) IN GENERAL.—The term ‘adoption 

16 promotion and support services’ means services 

17 and activities designed to encourage more adop18 tions out of the foster care system and support 

19 domestic adoptions and adoptions from other 

20 countries, consistent with promoting the best 

21 interests of adopted children and their adoptive 

22 families. Such services and activities may in23 clude pre- and post-adoption support services, 

24 as described in subparagraph (B), that are deVerDate Sep 11 2014 20:08 Nov 21, 2023 Jkt 049200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S3333.IS S3333

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1 signed to support adopted children and their 

2 adoptive families. 

3 ‘‘(B) PRE- AND POST-ADOPTION SUPPORT

4 SERVICES.—The term ‘pre- and post-adoption 

5 support services’ means the following: 

6 ‘‘(i) Pre-adoption support services, 

7 which may include— 

8 ‘‘(I) direct services, including 

9 training, educational support, coun10 seling, and other services for adoptive 

11 parents and families that address 

12 caregiver interests and concerns re13 garding common behavioral issues, 

14 such as— 

15 ‘‘(aa) issues relating to emo16 tional, behavioral, or develop17 mental health needs; 

18 ‘‘(bb) issues relating to at19 tachment, identity, abandonment, 

20 cultural differences, grief, loss, 

21 and trauma; and 

22 ‘‘(cc) issues resulting from 

23 birth defects due to fetal alcohol 

24 syndrome or any other substance 


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1 abuse-related developmental dis2 order; 

3 ‘‘(II) the provision of educational 

4 resources for adoptive parents regard5 ing the geographic, ethnic, and cul6 tural background of the adopted child; 

7 ‘‘(III) peer-to-peer mentoring and 

8 support groups that permit a newly 

9 adoptive parent to communicate and 

10 learn from more experienced adoptive 

11 parents, including programs that en12 hance communication between adop13 tive parents with children of similar 

14 geographic, ethnic, or cultural back15 grounds; and 

16 ‘‘(IV) the provision of informa17 tional resources for adoptive parents, 

18 including— 

19 ‘‘(aa) resources available 

20 through Federal and State agen21 cies, including information re22 garding benefits for children with 

23 a medical condition or a physical, 

24 mental, or emotional disability; 


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1 ‘‘(bb) newsletters, websites, 

2 and other informational resources 

3 regarding adoption-related serv4 ices; 

5 ‘‘(cc) the establishment of 

6 lending libraries containing infor7 mation and resources for adop8 tive parents; and 

9 ‘‘(dd) conferences, discus10 sion groups, and seminars that 

11 are available to adoptive parents 

12 and other relevant stakeholders. 

13 ‘‘(ii) Post-adoption support services, 

14 which may include— 

15 ‘‘(I) continued provision to adop16 tive parents of pre-adoption support 

17 services described in clause (i); 

18 ‘‘(II) the provision of accessible 

19 and reliable respite services for adop20 tive parents; 

21 ‘‘(III) direct services and coun22 seling for adopted children, including, 

23 as appropriate— 

24 ‘‘(aa) support services for an 

25 adopted child with emotional, beVerDate Sep 11 2014 20:08 Nov 21, 2023 Jkt 049200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S3333.IS S3333

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1 havioral, or developmental health 

2 needs; 

3 ‘‘(bb) support services that 

4 address issues relating to attach5 ment, identity, abandonment, cul6 tural differences, grief, and loss; 

7 and 

8 ‘‘(cc) treatment services that 

9 are specialized for adopted chil10 dren, including psychiatric resi11 dential services, outpatient men12 tal health services, social skills 

13 training, intensive in-home super14 vision services, recreational ther15 apy, suicide prevention, and sub16 stance abuse treatment; 

17 ‘‘(IV) peer-to-peer mentoring and 

18 support groups that allow adopted 

19 children to communicate and socialize 

20 with other adopted children, including 

21 programs that provide for communica22 tion between adopted children from 

23 similar geographic, ethnic, or cultural 

24 backgrounds; and 


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1 ‘‘(V) crisis and family preserva2 tion services, including crisis coun3 seling and a 24-hour emergency hot4 line for adoptive parents.’’. 

5 SEC. 3. FUNDING FOR ADOPTION PROMOTION AND SUP6 PORT SERVICES. 

7 Paragraph (8) of section 473(a) of the Social Secu8 rity Act (42 U.S.C. 673(a)) is amended to read as follows: 

9 ‘‘(8) With respect to the amount of savings (if 

10 any) in State expenditures under this part resulting 

11 from the application of paragraph (2)(A)(ii) to all 

12 applicable children for a fiscal year, a State shall— 

13 ‘‘(A) spend a significant portion of such 

14 amount to provide pre- and post-adoption sup15 port services (as defined in section 

16 431(a)(8)(B)); 

17 ‘‘(B) spend the remainder of such amount 

18 to provide to children or families any other 

19 services that may be provided under this part 

20 or part B; and 

21 ‘‘(C) on an annual basis, submit to the 

22 Secretary a report that provides a detailed ac23 count of any services that were funded pursuant 

24 to this paragraph.’’. 


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1 SEC. 4. FEDERAL GRANT PROGRAM FOR POST-ADOPTION 

2 AND POST-LEGAL GUARDIANSHIP MENTAL 

3 HEALTH SERVICES. 

4 (a) FUNDING.—Section 436 of the Social Security 

5 Act (42 U.S.C. 629f) is amended— 

6 (1) in subsection (a), by striking 

7 ‘‘$345,000,000 for each of fiscal years 2017 through 

8 2023’’ and inserting ‘‘$365,000,000 for each of fis9 cal years 2024 through 2028’’; and 

10 (2) in subsection (b), by adding at the end the 

11 following new paragraph: 

12 ‘‘(6) POST-ADOPTION AND POST-LEGAL GUARD13 IANSHIP MENTAL HEALTH SERVICES.—The Sec14 retary shall reserve $20,000,000 for grants under 

15 section 437(h).’’. 

16 (b) GRANT PROGRAM.—Section 437 of the Social Se17 curity Act (42 U.S.C. 629g) is amended by adding at the 

18 end the following new subsection: 

19 ‘‘(h) POST-ADOPTION AND POST-LEGAL GUARDIAN20 SHIP MENTAL HEALTH SERVICE PROGRAMS.— 

21 ‘‘(1) IN GENERAL.—From the amounts reserved 

22 for each of fiscal years 2024 through 2028 under 

23 section 436(b)(6), the Secretary shall award grants 

24 or cooperative agreements under this subsection to 

25 eligible entities to— 


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1 ‘‘(A) develop and implement statewide or 

2 tribal post-adoption and post-legal guardianship 

3 mental health service programs for all children 

4 who are adopted or placed in legal guardianship 

5 and their families; 

6 ‘‘(B) support public organizations and pri7 vate nonprofit organizations actively involved in 

8 statewide or tribal post-adoption and post-legal 

9 guardianship mental health service programs; 

10 ‘‘(C) collect and analyze data on State11 sponsored statewide or tribal post-adoption and 

12 post-legal guardianship mental health service 

13 programs that can be used to monitor the effec14 tiveness of such services and for research, tech15 nical assistance, and policy development; 

16 ‘‘(D) develop and provide adoption and 

17 legal guardianship competent educational and 

18 training opportunities concerning the mental 

19 health needs of children who are adopted or 

20 placed in legal guardianship, and their families, 

21 for use by teachers, social workers, and other 

22 community mental health service providers; 

23 ‘‘(E) develop and provide materials for po24 tential adoptive parents and legal guardians, 

25 both for children who already reside in the 


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1 United States at the time of adoption or place2 ment in legal guardianship and for those who at 

3 such time reside in other countries, describing 

4 the possible need for post-adoption and post5 legal guardianship mental health services and 

6 available resources; 

7 ‘‘(F) develop and provide respite care serv8 ices for adoptive and legal guardian families; 

9 and 

10 ‘‘(G) support research on, and development 

11 of, promising practices (as defined in section 

12 471(e)(4)(C)(iii)) for post-adoption and post13 legal guardianship mental health services. 

14 ‘‘(2) ELIGIBLE ENTITY DEFINED.— 

15 ‘‘(A) IN GENERAL.—In this subsection, the 

16 term ‘eligible entity’ means— 

17 ‘‘(i) a State; 

18 ‘‘(ii) a public organization or private 

19 nonprofit organization designated by a 

20 State to develop or direct the State-spon21 sored statewide post-adoption and post22 legal guardianship mental health service 

23 program under a grant under this sub24 section; and 


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1 ‘‘(iii) a federally recognized Indian 

2 tribe or tribal organization (as defined in 

3 the Indian Self-Determination and Edu4 cation Assistance Act) or an urban Indian 

5 organization (as defined in the Indian 

6 Health Care Improvement Act) that is ac7 tively involved in the development and con8 tinuation of a post-adoption and post-legal 

9 guardianship mental health service pro10 gram. 

11 ‘‘(B) LIMITATION.—In carrying out this 

12 subsection, the Secretary shall ensure that each 

13 State is awarded only 1 grant or cooperative 

14 agreement under this subsection. For purposes 

15 of the preceding sentence, a State shall be con16 sidered to have been awarded a grant or cooper17 ative agreement if the eligible entity involved is 

18 the State or an entity designated by the State 

19 under subparagraph (A)(ii). Nothing in this 

20 subparagraph shall be construed to apply to en21 tities described in subparagraph (A)(iii). 

22 ‘‘(3) PREFERENCE.—In providing assistance 

23 under a grant or cooperative agreement under this 

24 subsection, the Secretary shall give preference to— 


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1 ‘‘(A) eligible entities that have dem2 onstrated success in increasing the level of 

3 adoption and legal guardianship competency 

4 among mental health providers, adoption and 

5 legal guardianship lawyers, social workers, case 

6 workers, adoptive parents, and legal guardians; 

7 and 

8 ‘‘(B) eligible entities that plan to partner 

9 with their State mental health agency in car10 rying out the activities for which the grant or 

11 cooperative agreement is made. 

12 ‘‘(4) REQUIREMENT FOR DIRECT SERVICES.— 

13 Not less than 85 percent of funds received under a 

14 grant or cooperative agreement under this sub15 section shall be used to provide direct services, of 

16 which not less than 5 percent shall be used for ac17 tivities authorized under paragraph (1)(C). 

18 ‘‘(5) COORDINATION AND COLLABORATION.— 

19 ‘‘(A) IN GENERAL.—In carrying out this 

20 subsection, the Secretary shall collaborate with 

21 relevant Federal agencies and adoption and 

22 legal guardianship-related working groups to 

23 promote interaction between domestic foster 

24 care agencies and private adoption agencies in 

25 other countries. 


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1 ‘‘(B) CONSULTATION.—In carrying out 

2 this subsection, the Secretary shall consult 

3 with— 

4 ‘‘(i) State and social service agencies 

5 engaged in the placement of children for 

6 adoption, domestically or from other coun7 tries; 

8 ‘‘(ii) local and national organizations 

9 that serve foster and adopted youth and 

10 youth placed in legal guardianship; 

11 ‘‘(iii) health and education specialists 

12 who focus on adoption, legal guardianship, 

13 and foster care medicine; 

14 ‘‘(iv) youth who have been in foster 

15 care, adopted, or in legal guardianship, do16 mestically or from other countries, includ17 ing youth who have experienced adoption 

18 or guardianship disruptions or dissolutions; 

19 ‘‘(v) families and friends of youth who 

20 have been in foster care, adopted, or in 

21 legal guardianship, domestically or from 

22 other countries, including foster and adop23 tive parents and legal guardians; and 

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1 rience, and relevant attributes needed to 

2 serve children who are adopted or placed in 

3 legal guardianship and their families. 

4 ‘‘(C) POLICY DEVELOPMENT.—In carrying 

5 out this subsection, the Secretary shall— 

6 ‘‘(i) coordinate and collaborate on pol7 icy development with relevant Department 

8 of Health and Human Services agencies 

9 and adoption and legal guardianship-re10 lated working groups; and 

11 ‘‘(ii) consult on policy development at 

12 the Federal level with those in the private 

13 sector engaged in the recruitment of foster 

14 and adoptive parents and legal guardians, 

15 the placement of children in foster care, 

16 for adoption, and in legal guardianship, 

17 and the provision of post-adoption and 

18 post-legal guardianship services. 

19 ‘‘(6) EVALUATION AND REPORT.— 

20 ‘‘(A) EVALUATIONS BY ELIGIBLE ENTI21 TIES.—Not later than 18 months after receipt 

22 of a grant or cooperative agreement under this 

23 subsection, an eligible entity shall submit to the 

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1 ness of the activities carried out under the 

2 grant or agreement. 

3 ‘‘(B) REPORT.—Not later than 2 years 

4 after the date of enactment of this subsection, 

5 the Secretary shall submit to the appropriate 

6 committees of Congress a report concerning the 

7 results of— 

8 ‘‘(i) the evaluations conducted under 

9 subparagraph (A); and 

10 ‘‘(ii) an evaluation conducted by the 

11 Secretary to analyze the effectiveness and 

12 efficacy of the activities conducted with 

13 grants, collaborations, and consultations 

14 under this subsection. 

15 ‘‘(7) ADDITIONAL DEFINITIONS.—In this sub16 section: 

17 ‘‘(A) ADOPTED CHILD.—The term ‘adopt18 ed child’ means an individual who is under 21 

19 years of age and was adopted from foster care 

20 or placed in legal guardianship through a pri21 vate placement agency, or from another coun22 try. 

23 ‘‘(B) ADOPTION AND LEGAL GUARDIAN24 SHIP COMPETENCY.—The term ‘adoption and 


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1 legal guardianship competency’ means an un2 derstanding of— 

3 ‘‘(i) the nature of adoption and legal 

4 guardianship as a form of family formation 

5 and the different types of adoption and 

6 legal guardianship; 

7 ‘‘(ii) relevant emotional and physical 

8 issues involved in the adoption or legal 

9 guardianship process, including issues re10 lating to separation, loss, attachment, 

11 abuse, trauma, and neglect; 

12 ‘‘(iii) common developmental chal13 lenges associated with adoption and legal 

14 guardianship; 

15 ‘‘(iv) the characteristics and skills 

16 that allow for successful adoptive and legal 

17 guardianship families; 

18 ‘‘(v) proper sensitivity with respect to 

19 the different geographic, ethnic, or cultural 

20 backgrounds of children who are adopted 

21 or placed in legal guardianship and their 

22 families; and 

23 ‘‘(vi) the necessary skills for effec24 tively advocating on behalf of birth and 

25 adoptive and legal guardian families. 


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1 ‘‘(C) POST-ADOPTION AND POST-LEGAL

2 GUARDIANSHIP MENTAL HEALTH SERVICES.— 

3 The term ‘post-adoption and post-legal guard4 ianship mental health services’ includes— 

5 ‘‘(i) adoption and legal guardianship 

6 competent mental health direct services, in7 cluding training, educational support, 

8 counseling, and other services for adoptive 

9 and legal guardian parents and families 

10 that address caregiver interests and con11 cerns regarding child behavioral issues that 

12 are common among children who are 

13 adopted, placed in legal guardianship, or 

14 placed in foster care, including, as appro15 priate— 

16 ‘‘(I) caring for a child who is 

17 adopted or placed in legal guardian18 ship and has emotional, behavioral, or 

19 developmental health needs; and 

20 ‘‘(II) providing for the emotional 

21 needs of a child who is adopted or 

22 placed in legal guardianship, including 

23 issues relating to attachment, identity, 

24 abandonment, cultural differences, 

25 grief, loss, and trauma; 


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1 ‘‘(ii) peer-to-peer mentoring and sup2 port groups that permit a newly adoptive 

3 parent or legal guardian to communicate 

4 and learn from more experienced adoptive 

5 parents or legal guardians; 

6 ‘‘(iii) the provision of informational 

7 resources and available services for adop8 tive parents or legal guardians; 

9 ‘‘(iv) direct services, including coun10 seling, peer-to-peer mentoring and support 

11 groups, and other services for children who 

12 are adopted or placed in legal guardianship 

13 that address common behavioral and ad14 justment issues, including, as appro15 priate— 

16 ‘‘(I) support services for a child 

17 who is adopted or placed in legal 

18 guardianship with emotional, behav19 ioral, or developmental health needs; 

20 ‘‘(II) support services that ad21 dress the emotional needs of a child 

22 who is adopted or placed in legal 

23 guardianship, including issues relating 

24 to attachment, identity, abandonment, 


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1 cultural differences, grief, loss, and 

2 trauma; and 

3 ‘‘(III) treatment services that are 

4 specialized for children who are adopt5 ed or placed in legal guardianship, in6 cluding psychiatric residential serv7 ices, outpatient mental health services, 

8 social skills training, intensive in9 home supervision services, recreational 

10 therapy, suicide prevention, and sub11 stance abuse treatment; 

12 ‘‘(v) peer-to-peer mentoring and sup13 port groups that allow children who are 

14 adopted or placed in legal guardianship 

15 communicate and socialize with other such 

16 children; and 

17 ‘‘(vi) crisis intervention and family 

18 preservation services.’’. 

19 SEC. 5. DATA COLLECTION ON ADOPTION DISRUPTION AND 

20 DISSOLUTION. 

21 (a) IN GENERAL.—Section 479 of the Social Security 

22 Act (42 U.S.C. 679) is amended by adding at the end the 

23 following new subsection: 

24 ‘‘(e)(1) Not later than 12 months after the date of 

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1 lies Act, the Secretary shall, as part of the data collection 

2 system established under this section, promulgate final 

3 regulations providing for the collection and analysis of in4 formation regarding children who enter into State custody 

5 as a result of the disruption of a placement for adoption 

6 or the dissolution of an adoption, which shall require 

7 States to collect and report— 

8 ‘‘(A) information on children who are adopted 

9 within the United States or from other countries and 

10 who enter into State custody as a result of the dis11 ruption of a placement for adoption or the dissolu12 tion of an adoption, including— 

13 ‘‘(i) the number of children who enter into 

14 State custody as a result of— 

15 ‘‘(I) the disruption of placement for 

16 adoption; or 

17 ‘‘(II) the dissolution of an adoption; 

18 and 

19 ‘‘(ii) for each child identified under clause 

20 (i)— 

21 ‘‘(I) as applicable, the country of birth 

22 for any child who was not born in the 

23 United States; 

24 ‘‘(II) the length of the adoption place25 ment prior to disruption or dissolution; 


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1 ‘‘(III) the age of the child at the time 

2 of the disruption or dissolution; 

3 ‘‘(IV) the reason for the disruption or 

4 dissolution; and 

5 ‘‘(V) the agencies who handled the 

6 placement for adoption; and 

7 ‘‘(B) such other information as determined ap8 propriate by the Secretary. 

9 ‘‘(2) The information described in paragraph (1) 

10 shall be used— 

11 ‘‘(A) to consolidate and expand the collection of 

12 information on adoption disruption and dissolution; 

13 ‘‘(B) to improve research and data collection 

14 systems in order to more accurately determine and 

15 measure the rates, outcomes, and causes of adoption 

16 disruption and dissolution; 

17 ‘‘(C) to identify pre- and post-adoption support 

18 services (including services described in section 

19 431(a)(8)(B)) that result in lower rates of disrup20 tion and dissolution of adoptions; 

21 ‘‘(D) to develop an understanding of the rela22 tionship between the rate of incidence of adoption 

23 disruptions and dissolutions and the support services 

24 that are provided to adoptive families in order to 

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1 gies, programs, and support services that help to 

2 prevent adoption disruption and dissolution; and 

3 ‘‘(E) to develop and enhance training and edu4 cational services regarding strategies for prevention 

5 of adoption disruption and dissolution. 

6 ‘‘(3)(A) Not later than 6 months after the date of 

7 enactment of the Supporting Adopted Children and Fami8 lies Act, the Secretary shall, subject to subparagraph (B), 

9 establish an advisory committee to study methods to effec10 tively collect data regarding disruption and dissolution of 

11 adoptions that are not included in the data collection sys12 tem established under this section, including— 

13 ‘‘(i) data on children whose adoptions are dis14 rupted or dissolved but do not enter into State cus15 tody as a result of such disruption or dissolution; 

16 ‘‘(ii) data on adoption displacements, whereby 

17 an adopted child is temporarily placed out of the 

18 home of an adoptive parent in order to receive med19 ical, mental health, behavioral, or other forms of 

20 treatment; and 

21 ‘‘(iii) such other data as determined appropriate 

22 by the Secretary. 

23 ‘‘(B) The membership and organization of the advi24 sory committee described in subparagraph (A) shall be de25 termined by the Secretary and shall include— 


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1 ‘‘(i) State and child welfare agencies that are 

2 engaged in the placement of children for adoption 

3 domestically or from other countries; 

4 ‘‘(ii) local and national organizations that serve 

5 adopted children and children in foster care; and 

6 ‘‘(iii) members of State and local judiciary and 

7 court staff. 

8 ‘‘(C) Not later than 12 months after establishment 

9 of the advisory committee described in subparagraph (A), 

10 the Secretary shall submit to the appropriate committees 

11 of Congress a report containing recommendations of the 

12 advisory committee for improvement of the data collection 

13 system established under this section.’’. 

14 (b) ANNUAL REPORT.—Section 479A(a) of the Social 

15 Security Act (42 U.S.C. 679b(a)) is amended— 

16 (1) in paragraph (6)(C), by striking ‘‘and’’ 

17 after the semicolon; 

18 (2) in paragraph (7), by striking the period at 

19 the end and inserting ‘‘; and’’; and 

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

21 paragraph: 

22 ‘‘(8) include in the report submitted pursuant 

23 to paragraph (5) for fiscal year 2024 or any suc24 ceeding fiscal year, national and State-by-State data 

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1 tions of adoptions, as collected pursuant to section 

2 479(e)(1).’’. 

Æ 


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