IB 

Union Calendar No. 424 

116TH CONGRESS 

2D SESSION H. R. 2271 

[Report No. 116–524] 

To amend the Public Health Service Act to improve the health of children 

and help better understand and enhance awareness about unexpected 

sudden death in early life. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 10, 2019 

Ms. MOORE (for herself, Mr. COLE, Ms. HERRERA BEUTLER, Mr. 

GOTTHEIMER, Ms. CLARKE of New York, Mrs. RODGERS of Washington, 

Ms. WASSERMAN SCHULTZ, Mr. GRIJALVA, Mr. KHANNA, Ms. NORTON, 

Mr. KING of New York, Ms. MCCOLLUM, Mr. CARTWRIGHT, and Ms. 

DELBENE) introduced the following bill; which was referred to the Committee on Energy and Commerce 

SEPTEMBER 21, 2020 

Additional sponsors: Mr. RYAN, Ms. SEWELL of Alabama, Mr. FITZPATRICK, 

Ms. DELAURO, Mr. HECK, Mr. WITTMAN, Mrs. WATSON COLEMAN, Ms. 

FUDGE, Mr. NEGUSE, Mr. LAWSON of Florida, Mr. PAYNE, Mr. THOMPSON of Mississippi, Mr. RICHMOND, Mr. CLEAVER, Mr. CLYBURN, Mr. 

GREEN of Texas, Mrs. DEMINGS, Ms. PRESSLEY, Ms. KELLY of Illinois, 

Ms. JOHNSON of Texas, Ms. BASS, Ms. WILSON of Florida, Mr. EVANS, 

Mr. JOHNSON of Georgia, Mrs. LAWRENCE, Ms. JACKSON LEE, Mr. 

MEEKS, Mr. KIND, Mr. HASTINGS, Ms. ROYBAL-ALLARD, Mr. DANNY K. 

DAVIS of Illinois, Mr. RASKIN, Ms. BLUNT ROCHESTER, Mr. KENNEDY, 

Mr. CASE, Mr. COHEN, Mr. HARDER of California, Mr. LIPINSKI, Mr. 

GARCI ́A of Illinois, Mr. MCGOVERN, Mr. LYNCH, Mr. PETERSON, Ms. 

PINGREE, Mr. MICHAEL F. DOYLE of Pennsylvania, Ms. SCHRIER, Ms. 

SHERRILL, Ms. SPANBERGER, Mr. COOPER, Mr. RUSH, Ms. CRAIG, Mr. 

UPTON, Mr. GUTHRIE, Ms. KUSTER of New Hampshire, Mrs. AXNE, Mr. 

SWALWELL of California, Mr. YOUNG, Mr. COX of California, Mr. SOTO, 

Mr. CONNOLLY, and Mr. BURGESS


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SEPTEMBER 21, 2020 

Reported with an amendment, committed to the Committee of the Whole 

House on the State of the Union, and ordered to be printed 

[Strike out all after the enacting clause and insert the part printed in italic] 

[For text of introduced bill, see copy of bill as introduced on April 10, 2019] 

A BILL 

To amend the Public Health Service Act to improve the 

health of children and help better understand and enhance awareness about unexpected sudden death in early 

life. 


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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 ‘‘Scarlett’s Sunshine on 

5 Sudden Unexpected Death Act’’. 

6 SEC. 2. ADDRESSING SUDDEN UNEXPECTED INFANT DEATH 

7 AND SUDDEN UNEXPECTED DEATH IN CHILD8 HOOD. 

9 Part B of title XI of the Public Health Service Act 

10 (42 U.S.C. 241 et seq.) is amended— 

11 (1) in the part heading, by striking ‘‘SUDDEN

12 INFANT DEATH SYNDROME’’ and inserting ‘‘SUDDEN

13 UNEXPECTED INFANT DEATH, SUDDEN INFANT

14 DEATH SYNDROME, AND SUDDEN UNEXPECTED

15 DEATH IN CHILDHOOD’’; and 

16 (2) by inserting before section 1122 the following: 

17 ‘‘SEC. 1121. ADDRESSING SUDDEN UNEXPECTED INFANT 

18 DEATH AND SUDDEN UNEXPECTED DEATH IN 

19 CHILDHOOD. 

20 ‘‘(a) IN GENERAL.—The Secretary may develop, sup21 port, or maintain programs or activities to address sudden 

22 unexpected infant death and sudden unexpected death in 

23 childhood, including by— 

24 ‘‘(1) continuing to support the Sudden Unex25 pected Infant Death and Sudden Death in the Young 


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1 Case Registry of the Centers for Disease Control and 

2 Prevention and other fatality case reporting systems 

3 that include data pertaining to sudden unexpected in4 fant death and sudden unexpected death in childhood, 

5 as appropriate, including such systems supported by 

6 the Health Resources and Services Administration, in 

7 order to— 

8 ‘‘(A) increase the number of States and ju9 risdictions participating in such systems; or 

10 ‘‘(B) improve the utility of such systems, 

11 which may include— 

12 ‘‘(i) making summary data available 

13 to the public in a timely manner on the 

14 internet website of the Department of 

15 Health and Human Services, in a manner 

16 that, at a minimum, protects personal pri17 vacy to the extent required by applicable 

18 Federal and State law; and 

19 ‘‘(ii) making the data submitted to 

20 such systems available to researchers, in a 

21 manner that, at a minimum, protects per22 sonal privacy to the extent required by ap23 plicable Federal and State law; and 


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1 ‘‘(2) awarding grants or cooperative agreements 

2 to States, Indian Tribes, and Tribal organizations for 

3 purposes of— 

4 ‘‘(A) supporting fetal and infant mortality 

5 and child death review programs for sudden un6 expected infant death and sudden unexpected 

7 death in childhood, including by establishing 

8 such programs at the local level; 

9 ‘‘(B) improving data collection related to 

10 sudden unexpected infant death and sudden un11 expected death in childhood, including by— 

12 ‘‘(i) improving the completion of death 

13 scene investigations and comprehensive au14 topsies that include a review of clinical his15 tory and circumstances of death with ap16 propriate ancillary testing; and 

17 ‘‘(ii) training medical examiners, coro18 ners, death scene investigators, law enforce19 ment personnel, emergency medical techni20 cians, paramedics, emergency department 

21 personnel, and others who perform death 

22 scene investigations with respect to the 

23 deaths of infants and children, as appro24 priate; 


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1 ‘‘(C) identifying, developing, and imple2 menting best practices to reduce or prevent sud3 den unexpected infant death and sudden unex4 pected death in childhood, including practices to 

5 reduce sleep-related infant deaths; 

6 ‘‘(D) increasing the voluntary inclusion, in 

7 fatality case reporting systems established for the 

8 purpose of conducting research on sudden unex9 pected infant death and sudden unexpected death 

10 in childhood, of samples of tissues or genetic ma11 terials from autopsies that have been collected 

12 pursuant to Federal or State law; or 

13 ‘‘(E) disseminating information and mate14 rials to health care professionals and the public 

15 on risk factors that contribute to sudden unex16 pected infant death and sudden unexpected death 

17 in childhood, which may include information on 

18 risk factors that contribute to sleep-related sud19 den unexpected infant death or sudden unex20 pected death in childhood. 

21 ‘‘(b) APPLICATION.—To be eligible to receive a grant 

22 or cooperative agreement under subsection (a)(2), a State, 

23 Indian Tribe, or Tribal organization shall submit to the 

24 Secretary an application at such time, in such manner, and 

25 containing such information as the Secretary may require, 


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1 including information on how such State will ensure activi2 ties conducted under this section are coordinated with other 

3 federally-funded programs to reduce infant mortality, as 

4 appropriate. 

5 ‘‘(c) TECHNICAL ASSISTANCE.—The Secretary shall 

6 provide technical assistance to States, Tribes, and Tribal 

7 organizations receiving a grant or cooperative agreement 

8 under subsection (a)(2) for purposes of carrying out activi9 ties funded through the grant or cooperative agreement. 

10 ‘‘(d) REPORTING FORMS.— 

11 ‘‘(1) IN GENERAL.—The Secretary shall, as ap12 propriate, encourage the use of sudden unexpected in13 fant death and sudden unexpected death in childhood 

14 reporting forms developed in collaboration with the 

15 Centers for Disease Control and Prevention to im16 prove the quality of data submitted to the Sudden 

17 Unexpected Infant Death and Sudden Death in the 

18 Young Case Registry, and other fatality case report19 ing systems that include data pertaining to sudden 

20 unexpected infant death and sudden unexpected death 

21 in childhood. 

22 ‘‘(2) UPDATE OF FORMS.—The Secretary shall 

23 assess whether updates are needed to the sudden unex24 pected infant death investigation reporting form used 

25 by the Centers for Disease Control and Prevention in 


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1 order to improve the use of such form with other fa2 tality case reporting systems supported by the De3 partment of Health and Human Services, and shall 

4 make such updates as appropriate. 

5 ‘‘(e) SUPPORT SERVICES.— 

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

7 through the Administrator, shall award grants to na8 tional organizations, State and local health depart9 ments, community-based organizations, and nonprofit 

10 organizations for the provision of support services to 

11 families who have had a child die of sudden unex12 pected infant death or sudden unexpected death in 

13 childhood. 

14 ‘‘(2) APPLICATION.—To be eligible to receive a 

15 grant under subsection (1), an entity shall submit to 

16 the Secretary an application at such time, in such 

17 manner, and containing such information as the Sec18 retary may require. 

19 ‘‘(3) USE OF FUNDS.—Amounts received under a 

20 grant awarded under paragraph (1) may be used— 

21 ‘‘(A) to provide grief counseling, education, 

22 home visits, 24-hour hotlines, or information, re23 sources, and referrals; 

24 ‘‘(B) to ensure access to grief and bereave25 ment services; 


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1 ‘‘(C) to build capacity in professionals 

2 working with families who experience a sudden 

3 death; or 

4 ‘‘(D) to support peer-to-peer groups for fam5 ilies who have lost a child to sudden unexpected 

6 infant death or sudden unexpected death in 

7 childhood. 

8 ‘‘(4) PREFERENCE.—In awarding grants under 

9 paragraph (1), the Secretary shall give preference to 

10 applicants that— 

11 ‘‘(A) have a proven history of effective direct 

12 support services and interventions for sudden 

13 unexpected infant death and sudden unexplained 

14 death in childhood; and 

15 ‘‘(B) demonstrate experience through col16 laborations and partnerships for delivering serv17 ices described in paragraph (3). 

18 ‘‘(f) DEFINITIONS.—In this section: 

19 ‘‘(1) SUDDEN UNEXPECTED INFANT DEATH.— 

20 The term ‘sudden unexpected infant death’— 

21 ‘‘(A) means the sudden death of an infant 

22 under 1 year of age that when first discovered 

23 did not have an obvious cause; and 

24 ‘‘(B) includes— 


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1 ‘‘(i) such deaths that are explained; 

2 and 

3 ‘‘(ii) such deaths that remain unex4 plained (which are known as sudden infant 

5 death syndrome). 

6 ‘‘(2) SUDDEN UNEXPECTED DEATH IN CHILD7 HOOD.—The term ‘sudden unexpected death in child8 hood’— 

9 ‘‘(A) means the sudden death of a child who 

10 is at least 1 year of age but not more than 17 

11 years of age that, when first discovered, did not 

12 have an obvious cause; and 

13 ‘‘(B) includes— 

14 ‘‘(i) such deaths that are explained; 

15 and 

16 ‘‘(ii) such deaths that remain unex17 plained (which are known as sudden unex18 plained death in childhood). 

19 ‘‘(3) SUDDEN UNEXPLAINED DEATH IN CHILD20 HOOD.—The term ‘sudden unexplained death in 

21 childhood’ means a sudden unexpected death in child22 hood that remains unexplained after a thorough case 

23 investigation. 

24 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—For the 

25 purpose of carrying out this section, there is authorized to 


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1 be appropriated $33,000,000 for each of fiscal years 2021 

2 through 2024.’’. 

3 SEC. 3. REPORT TO CONGRESS. 

4 (a) IN GENERAL.—Not later than 2 years after the 

5 date of enactment of this Act, and biennially thereafter, the 

6 Secretary of Health and Human Services shall submit to 

7 the Committee on Energy and Commerce of the House of 

8 Representatives and the Committee on Health, Education, 

9 Labor, and Pensions of the Senate a report that contains, 

10 with respect to the reporting period— 

11 (1) information regarding the incidence and 

12 number of sudden unexpected infant deaths and sud13 den unexpected deaths in childhood (including the 

14 number of such infant and child deaths that remain 

15 unexplained after investigation), including, to the ex16 tent practicable— 

17 (A) a summary of such information by ra18 cial and ethnic group, and by State; 

19 (B) aggregate information obtained from 

20 death scene investigations and autopsies; and 

21 (C) recommendations for reducing the inci22 dence of sudden unexpected infant death and 

23 sudden unexpected death in childhood; 

24 (2) an assessment of the extent to which various 

25 approaches of reducing and preventing sudden unexVerDate Sep 11 2014 22:25 Sep 21, 2020 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6203 E:\BILLS\H2271.RH H2271

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1 pected infant death and sudden unexpected death in 

2 childhood have been effective; and 

3 (3) a description of the activities carried out 

4 under section 1121 of the Public Health Service Act 

5 (as added by section 2). 

6 (b) DEFINITIONS.—In this section, the terms ‘‘sudden 

7 unexpected infant death’’ and ‘‘sudden unexpected death in 

8 childhood’’ have the meanings given such terms in section 

9 1121 of the Public Health Service Act (as added by section 

10 2). 


pamtmann on DSKBC07HB2PROD with BILLS

pamtmann on DSKBC07HB2PROD with BILLS
Union Calendar No. 424 

116TH CONGRESS 

2D SESSION H. R. 2271 

[Report No. 116–524] 

A BILL 

To amend the Public Health Service Act to improve 

death in early life. and enhance awareness about unexpected sudden the health of children and help better understand 

SEPTEMBER 21, 2020 

Reported with an amendment, committed to the Comand ordered to be printed mittee of the Whole House on the State of the Union, 


pamtmann on DSKBC07HB2PROD with BILLS