II 

118TH CONGRESS 

1ST SESSION S. 1351 

To study and prevent child abuse in youth residential programs, and for 

other purposes. 

IN THE SENATE OF THE UNITED STATES 

APRIL 27, 2023 

Mr. MERKLEY (for himself, Mr. CORNYN, Mr. LUJA ́N, Mr. TUBERVILLE, Mr. 

MURPHY, and Ms. COLLINS) introduced the following bill; which was read 

twice and referred to the Committee on Health, Education, Labor, and 

Pensions 

A BILL 

To study and prevent child abuse in youth residential 

programs, 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 ‘‘Stop Institutional 

5 Child Abuse Act’’. 


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1 SEC. 2. IMPROVING NATIONAL DATA COLLECTION AND RE2 PORTING FOR YOUTH IN YOUTH RESIDEN3 TIAL PROGRAMS. 

4 Title V of the Public Health Service Act (42 U.S.C. 

5 290aa et seq.) is amended by inserting after part I (42 

6 U.S.C. 290jj et seq.) the following: 

7 ‘‘PART J—IMPROVING NATIONAL DATA COLLEC8 TION AND REPORTING FOR YOUTH IN YOUTH 

9 RESIDENTIAL PROGRAMS 

10 ‘‘SEC. 596. FEDERAL WORK GROUP ON YOUTH RESIDENTIAL 

11 PROGRAMS. 

12 ‘‘(a) IN GENERAL.—The Secretary shall establish the 

13 Federal Work Group on Youth Residential Programs (re14 ferred to in this section as the ‘Work Group’) to improve 

15 the dissemination and implementation of best practices re16 garding the health and safety (including with respect to 

17 the use of seclusion and restraints), care, treatment, and 

18 appropriate placement of youth in youth residential pro19 grams. 

20 ‘‘(b) COMPOSITION.— 

21 ‘‘(1) IN GENERAL.—The Secretary shall appoint 

22 9 representatives to the Work Group from the Ad23 ministration for Children and Families, the Adminis24 tration for Community Living, the Substance Abuse 

25 and Mental Health Services Administration, the De26 partment of Education, the Department of Justice, 


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1 the Indian Health Service, and the Centers for 

2 Medicare & Medicaid Services. 

3 ‘‘(2) OTHER FEDERAL AGENCIES.—The Work 

4 Group may include representatives from other Fed5 eral agencies, as the Secretary determines appro6 priate, appointed by the head of the relevant agency. 

7 ‘‘(c) CONSULTATION.—In carrying out the duties de8 scribed in subsection (d), the Work Group shall consult 

9 with— 

10 ‘‘(1) child advocates, including attorneys experi11 enced in working with youth overrepresented in the 

12 child welfare system or the juvenile justice system; 

13 ‘‘(2) health professionals, including mental 

14 health and substance use disorder professionals, 

15 nurses, physicians, social workers and other health 

16 care providers who provide services to youth who 

17 may be served by residential programs; 

18 ‘‘(3) protection and advocacy systems; 

19 ‘‘(4) individuals experienced in working with 

20 youth with disabilities, including emotional, mental 

21 health, and substance use disorders; 

22 ‘‘(5) individuals with lived experience as chil23 dren and youth in youth residential programs, in24 cluding individuals with intellectual or developmental 


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1 disabilities and individuals with emotional, mental 

2 health, or substance use disorders; 

3 ‘‘(6) representatives of State and local child 

4 protective services agencies and other relevant public 

5 agencies; 

6 ‘‘(7) parents or guardians of children and youth 

7 with emotional, mental health, or substance use dis8 order needs; 

9 ‘‘(8) experts on issues related to child abuse 

10 and neglect in youth residential programs; 

11 ‘‘(9) administrators of youth residential pro12 grams; 

13 ‘‘(10) education professionals who provide serv14 ices to youth in youth residential programs; 

15 ‘‘(11) Indian Tribes and Tribal organizations; 

16 ‘‘(12) State legislators; 

17 ‘‘(13) State licensing agencies; and 

18 ‘‘(14) others, as appropriate. 

19 ‘‘(d) DUTIES.—The Work Group shall— 

20 ‘‘(1) develop and publish recommendations re21 garding a national database that aggregates data, 

22 including process-oriented data such as length of 

23 stay and use of restraints, and seclusion and out24 come-oriented data such as discharge setting and 


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1 ability to be safety maintained in school and commu2 nity at least 6-months after discharge; 

3 ‘‘(2) beginning not later than 2 years after the 

4 date of enactment of the Stop Institutional Child 

5 Abuse Act, and every 2 years thereafter, submit to 

6 the Secretary and the Committee on Health, Edu7 cation, Labor, and Pensions and the Committee on 

8 Finance of the Senate, and the Committee on Edu9 cation and the Workforce, the Committee on Energy 

10 and Commerce, and the Committee on Ways and 

11 Means of the House of Representatives, a report 

12 containing policy recommendations designed to— 

13 ‘‘(A) improve the coordination of the dis14 semination and implementation of best practices 

15 regarding the health and safety (including use 

16 of seclusion and restraints), care, treatment, 

17 and appropriate placement of youth in youth 

18 residential programs; 

19 ‘‘(B) promote the coordination of the dis20 semination and implementation of best practices 

21 regarding the care and treatment of youth in 

22 youth residential programs among State child 

23 welfare agencies, State Medicaid agencies, and 

24 State mental and behavioral health agencies; 

25 and 


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1 ‘‘(C) promote the adoption and implemen2 tation of best practices regarding the care and 

3 treatment of youth in youth residential pro4 grams among child welfare systems, licensing 

5 agencies, accreditation organizations, and other 

6 relevant monitoring and enforcement entities; 

7 ‘‘(3) develop and utilize risk assessment tools, 

8 including projects that provide for the development 

9 of research-based strategies for risk assessments re10 lating to the health, safety (including with respect to 

11 the use of seclusion and restraints), and well-being 

12 of youth in youth residential programs; 

13 ‘‘(4) support the development and implementa14 tion of education and training resources for profes15 sional and paraprofessional personnel in the fields of 

16 health care, law enforcement, judiciary, social work, 

17 child protection (including the prevention, identifica18 tion, and treatment of child abuse and neglect), edu19 cation, child care, and other relevant fields, and indi20 viduals such as court appointed special advocates 

21 and guardians ad litem, including education and 

22 training resources regarding— 

23 ‘‘(A) the unique needs, experiences, and 

24 outcomes of youth overrepresented in youth res25 idential programs; 


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1 ‘‘(B) the enhancement of interagency com2 munication among child protective service agen3 cies, protection and advocacy systems, State li4 censing agencies, State Medicaid agencies, and 

5 accreditation agencies; 

6 ‘‘(C) best practices to eliminate the usage 

7 of physical, mechanical, and chemical restraint 

8 and seclusion, and to promote the use of posi9 tive behavioral interventions and supports, cul10 turally and linguistically sensitive services, men11 tal health supports, trauma- and grief-informed 

12 care, and crisis de-escalation interventions; and 

13 ‘‘(D) the legal duties of such professional 

14 and paraprofessional personnel and youth resi15 dential program personnel and the responsibil16 ities of such professionals and personnel to pro17 tect the legal rights of children in youth resi18 dential programs, consistent with applicable 

19 State and Federal law; 

20 ‘‘(5) improve accessibility and development of 

21 community-based alternatives to youth residential 

22 programs; 

23 ‘‘(6) provide recommendations for innovative 

24 programs designed to provide community support 


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1 and resources to at-risk youth, including programs 

2 that— 

3 ‘‘(A) support continuity of education, in4 cluding removing barriers to access; 

5 ‘‘(B) provide mentorship; 

6 ‘‘(C) support the provision of crisis inter7 vention services and in-home or outpatient men8 tal health and substance use disorder treat9 ment; and 

10 ‘‘(D) provide other resources to families 

11 and parents or guardians that assist in pre12 venting the need for out-of-home placement of 

13 youth in youth residential programs; 

14 ‘‘(7) perform other activities, such as activities 

15 relating to development, dissemination, outreach, en16 gagement, or training associated with advancing 

17 least-restrictive, evidence-based, trauma and grief-in18 formed, and developmentally and culturally com19 petent care for youth in youth residential programs 

20 and youth at risk of being placed in such programs; 

21 and 

22 ‘‘(8) provide recommendations on best practices 

23 to convey Work Group recommendations to States. 

24 ‘‘SEC. 596A. DEFINITIONS. 

25 ‘‘In this part: 


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1 ‘‘(1) CHILD ABUSE OR NEGLECT.—The term 

2 ‘child abuse or neglect’ has the meaning given such 

3 term in section 3 of the Child Abuse Prevention and 

4 Treatment Act. 

5 ‘‘(2) CULTURALLY COMPETENT.—The term 

6 ‘culturally competent’ has the meaning given such 

7 term in section 102 of the Developmental Disabil8 ities Assistance and Bill of Rights Act of 2000. 

9 ‘‘(3) INDIAN TRIBE; TRIBAL ORGANIZATION.— 

10 The terms ‘Indian Tribe’ and ‘Tribal organization’ 

11 have the meanings given such terms in section 4 of 

12 the Indian Self-Determination and Education Assist13 ance Act. 

14 ‘‘(4) PROTECTION AND ADVOCACY SYSTEMS.— 

15 The term ‘protection and advocacy system’ means a 

16 system established by a State or Indian Tribe under 

17 section 143 of the Developmental Disabilities Assist18 ance and Bill of Rights Act of 2000. 

19 ‘‘(5) STATE.—The term ‘State’ means each of 

20 the several States, the District of Columbia, the 

21 Commonwealth of Puerto Rico, the Virgin Islands, 

22 Guam, American Samoa, and the Commonwealth of 

23 the Northern Mariana Islands. 

24 ‘‘(6) YOUTH.—The term ‘youth’ means an indi25 vidual who has not attained the age of 22. 


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1 ‘‘(7) YOUTH RESIDENTIAL PROGRAM.— 

2 ‘‘(A) IN GENERAL.—The term ‘youth resi3 dential program’ means each location of a facil4 ity or program operated by a public or private 

5 entity that, with respect to one or more youth 

6 who are unrelated to the owner or operator of 

7 the facility or program— 

8 ‘‘(i) provides a residential environ9 ment, such as— 

10 ‘‘(I) a program with a wilderness 

11 or outdoor experience, expedition, or 

12 intervention; 

13 ‘‘(II) a boot camp experience or 

14 other experience designed to simulate 

15 characteristics of basic military train16 ing or correctional regimes; 

17 ‘‘(III) an education or thera18 peutic boarding school; 

19 ‘‘(IV) a behavioral modification 

20 program; 

21 ‘‘(V) a residential treatment cen22 ter or facility; 

23 ‘‘(VI) a qualified residential 

24 treatment program (as defined in secVerDate Sep 11 2014 03:13 May 06, 2023 Jkt 039200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S1351.IS S1351

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1 tion 472(k)(4) of the Social Security 

2 Act); 

3 ‘‘(VII) a psychiatric residential 

4 treatment program that meets the re5 quirements of subpart D of part 441 

6 of title 42, Code of Federal Regula7 tions (or any successor regulations); 

8 ‘‘(VIII) a group home serving 

9 children and youth placed by any 

10 placing authority; 

11 ‘‘(IX) an intermediate care facil12 ity for individuals with intellectual 

13 disabilities; or 

14 ‘‘(X) any residential program 

15 that is utilized as an alternative to in16 carceration for justice involved youth, 

17 adjudicated youth, or youth deemed 

18 delinquent; and 

19 ‘‘(ii) serves youth who have a history 

20 or diagnosis of— 

21 ‘‘(I) an emotional, behavioral, or 

22 mental health disorder; 

23 ‘‘(II) a substance misuse or use 

24 disorder, including alcohol misuse or 

25 use disorders; or 


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1 ‘‘(III) an intellectual, develop2 mental, physical, or sensory disability. 

3 ‘‘(B) EXCLUSION.—The term ‘youth resi4 dential program’ does not include— 

5 ‘‘(i) a hospital licensed by the State; 

6 or 

7 ‘‘(ii) a foster family home that pro8 vides 24-hour substitute care for children 

9 placed away from their parents or guard10 ians and for whom the State child welfare 

11 services agency has placement and care re12 sponsibility and that is licensed and regu13 lated by the State as a foster family 

14 home.’’. 

15 SEC. 3. NATIONAL ACADEMIES OF SCIENCES, ENGINEER16 ING, AND MEDICINE STUDY. 

17 (a) IN GENERAL.—Not later than 45 days after the 

18 date of enactment of this Act, the Secretary of Health and 

19 Human Services shall seek to enter into a contract with 

20 the National Academies of Sciences, Engineering, and 

21 Medicine (referred to in this section as the ‘‘National 

22 Academies’’) to conduct a study to examine the state of 

23 youth in youth residential programs and make rec24 ommendations. 


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1 (b) STUDY COMPONENTS.—Pursuant to the contract 

2 under subsection (a), the National Academies shall, not 

3 later than 3 years after the date of enactment of the Stop 

4 Institutional Child Abuse Act, issue a report informed by 

5 the study conducted under such subsection that includes— 

6 (1) identification of all Federal and State fund7 ing sources for youth residential programs; 

8 (2) identification of Federal data collection 

9 sources on youth in youth residential programs; 

10 (3) identification of existing Federal and State 

11 regulation of youth residential programs, including 

12 alternative licensing standards or licensing exemp13 tions for youth residential programs; 

14 (4) identification of existing standards of care 

15 of national accreditation entities that provide accred16 itation or certification of youth residential programs; 

17 (5) identification of existing barriers in Federal 

18 and State policy for blending and braiding of Fed19 eral and State funding sources to serve youth in 

20 community-based settings; 

21 (6) recommendations for coordination by Fed22 eral and State agencies of data on youth in youth 

23 residential programs; and 


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1 (7) recommendations for the improvement of 

2 Federal and State oversight of youth residential pro3 grams receiving Federal funding. 

4 (c) DEFINITION.—In this section, the term ‘‘youth 

5 residential program’’ has the meaning given such term in 

6 section 596A of the Public Health Service Act, as added 

7 by section 2. 

Æ 


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