IIB 

116TH CONGRESS 

2D SESSION H. R. 2271 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 22, 2020 

Received; read twice and referred to the Committee on Health, Education, 

Labor, and Pensions 

AN ACT 

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. 

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


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Scarlett’s Sunshine 

3 on Sudden Unexpected Death Act’’. 

4 SEC. 2. ADDRESSING SUDDEN UNEXPECTED INFANT DEATH 

5 AND SUDDEN UNEXPECTED DEATH IN CHILD6 HOOD. 

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

8 (42 U.S.C. 241 et seq.) is amended— 

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

10 INFANT DEATH SYNDROME’’ and inserting ‘‘SUD11 DEN UNEXPECTED INFANT DEATH, SUDDEN IN12 FANT DEATH SYNDROME, AND SUDDEN UNEX13 PECTED DEATH IN CHILDHOOD’’; and 

14 (2) by inserting before section 1122 the fol15 lowing: 

16 ‘‘SEC. 1121. ADDRESSING SUDDEN UNEXPECTED INFANT 

17 DEATH AND SUDDEN UNEXPECTED DEATH IN 

18 CHILDHOOD. 

19 ‘‘(a) IN GENERAL.—The Secretary may develop, sup20 port, or maintain programs or activities to address sudden 

21 unexpected infant death and sudden unexpected death in 

22 childhood, including by— 

23 ‘‘(1) continuing to support the Sudden Unex24 pected Infant Death and Sudden Death in the 

25 Young Case Registry of the Centers for Disease 

26 Control and Prevention and other fatality case reVerDate Sep 11 2014 03:52 Sep 23, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2271.RFS H2271

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1 porting systems that include data pertaining to sud2 den unexpected infant death and sudden unexpected 

3 death in childhood, as appropriate, including such 

4 systems supported by the Health Resources and 

5 Services Administration, in order to— 

6 ‘‘(A) increase the number of States and ju7 risdictions participating in such systems; or 

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

9 which may include— 

10 ‘‘(i) making summary data available 

11 to the public in a timely manner on the 

12 internet website of the Department of 

13 Health and Human Services, in a manner 

14 that, at a minimum, protects personal pri15 vacy to the extent required by applicable 

16 Federal and State law; and 

17 ‘‘(ii) making the data submitted to 

18 such systems available to researchers, in a 

19 manner that, at a minimum, protects per20 sonal privacy to the extent required by ap21 plicable Federal and State law; and 

22 ‘‘(2) awarding grants or cooperative agreements 

23 to States, Indian Tribes, and Tribal organizations 

24 for purposes of— 


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1 ‘‘(A) supporting fetal and infant mortality 

2 and child death review programs for sudden un3 expected infant death and sudden unexpected 

4 death in childhood, including by establishing 

5 such programs at the local level; 

6 ‘‘(B) improving data collection related to 

7 sudden unexpected infant death and sudden un8 expected death in childhood, including by— 

9 ‘‘(i) improving the completion of death 

10 scene investigations and comprehensive au11 topsies that include a review of clinical his12 tory and circumstances of death with ap13 propriate ancillary testing; and 

14 ‘‘(ii) training medical examiners, coro15 ners, death scene investigators, law en16 forcement personnel, emergency medical 

17 technicians, paramedics, emergency depart18 ment personnel, and others who perform 

19 death scene investigations with respect to 

20 the deaths of infants and children, as ap21 propriate; 

22 ‘‘(C) identifying, developing, and imple23 menting best practices to reduce or prevent 

24 sudden unexpected infant death and sudden unVerDate Sep 11 2014 03:52 Sep 23, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2271.RFS H2271

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1 expected death in childhood, including practices 

2 to reduce sleep-related infant deaths; 

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

4 fatality case reporting systems established for 

5 the purpose of conducting research on sudden 

6 unexpected infant death and sudden unexpected 

7 death in childhood, of samples of tissues or ge8 netic materials from autopsies that have been 

9 collected pursuant to Federal or State law; or 

10 ‘‘(E) disseminating information and mate11 rials to health care professionals and the public 

12 on risk factors that contribute to sudden unex13 pected infant death and sudden unexpected 

14 death in childhood, which may include informa15 tion on risk factors that contribute to sleep-re16 lated sudden unexpected infant death or sudden 

17 unexpected death in childhood. 

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

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

20 Indian Tribe, or Tribal organization shall submit to the 

21 Secretary an application at such time, in such manner, 

22 and containing such information as the Secretary may re23 quire, including information on how such State will ensure 

24 activities conducted under this section are coordinated 


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1 with other federally-funded programs to reduce infant 

2 mortality, as appropriate. 

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

4 provide technical assistance to States, Tribes, and Tribal 

5 organizations receiving a grant or cooperative agreement 

6 under subsection (a)(2) for purposes of carrying out ac7 tivities funded through the grant or cooperative agree8 ment. 

9 ‘‘(d) REPORTING FORMS.— 

10 ‘‘(1) IN GENERAL.—The Secretary shall, as ap11 propriate, encourage the use of sudden unexpected 

12 infant death and sudden unexpected death in child13 hood reporting forms developed in collaboration with 

14 the Centers for Disease Control and Prevention to 

15 improve the quality of data submitted to the Sudden 

16 Unexpected Infant Death and Sudden Death in the 

17 Young Case Registry, and other fatality case report18 ing systems that include data pertaining to sudden 

19 unexpected infant death and sudden unexpected 

20 death in childhood. 

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

22 assess whether updates are needed to the sudden un23 expected infant death investigation reporting form 

24 used by the Centers for Disease Control and Preven25 tion in order to improve the use of such form with 


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1 other fatality case reporting systems supported by 

2 the Department of Health and Human Services, and 

3 shall make such updates as appropriate. 

4 ‘‘(e) SUPPORT SERVICES.— 

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

6 through the Administrator, shall award grants to 

7 national organizations, State and local health de8 partments, community-based organizations, and non9 profit organizations for the provision of support 

10 services to families who have had a child die of sud11 den unexpected infant death or sudden unexpected 

12 death in childhood. 

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

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

15 the Secretary an application at such time, in such 

16 manner, and containing such information as the Sec17 retary may require. 

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

19 a grant awarded under paragraph (1) may be 

20 used— 

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

22 home visits, 24-hour hotlines, or information, 

23 resources, 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 

5 families who have lost a child to sudden unex6 pected infant death or sudden unexpected death 

7 in 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 di12 rect support services and interventions for sud13 den unexpected infant death and sudden unex14 plained 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 

8 childhood’— 

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

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

11 17 years of age that, when first discovered, did 

12 not 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 

22 childhood that remains unexplained after a thorough 

23 case investigation. 

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

25 purpose of carrying out this section, there is authorized 


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

2 2021 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, 

6 the Secretary of Health and Human Services shall submit 

7 to the Committee on Energy and Commerce of the House 

8 of Representatives and the Committee on Health, Edu9 cation, Labor, and Pensions of the Senate a report that 

10 contains, with respect to the reporting period— 

11 (1) information regarding the incidence and 

12 number of sudden unexpected infant deaths and 

13 sudden unexpected deaths in childhood (including 

14 the number of such infant and child deaths that re15 main unexplained after investigation), including, to 

16 the extent 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 var25 ious approaches of reducing and preventing sudden 


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1 unexpected infant death and sudden unexpected 

2 death in 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 ‘‘sud7 den unexpected infant death’’ and ‘‘sudden unexpected 

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

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

10 by section 2). 

Passed the House of Representatives September 21, 

2020. 

Attest: CHERYL L. JOHNSON, 

Clerk. 


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