```

[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5140 Introduced in House (IH)]

<DOC>

118th CONGRESS
  1st Session
                                H. R. 5140

 To amend the Public Health Service Act to improve the health and well-
being of maltreated infants and toddlers through the implementation of 
   infant-toddler court teams within States, and for other purposes.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                             August 4, 2023

 Ms. DeLauro (for herself and Mr. Bilirakis) introduced the following 
    bill; which was referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL

 
 To amend the Public Health Service Act to improve the health and well-
being of maltreated infants and toddlers through the implementation of 
   infant-toddler court teams within States, and for other purposes.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Strengthening America's Families Act 
of 2023''.

SEC. 2. INFANT-TODDLER COURT TEAMS FOR CHILDREN EXPERIENCING OR AT RISK 
              OF MALTREATMENT.

    Part Q of title III of the Public Health Service Act (42 U.S.C. 
280h et seq.) is amended by adding at the end the following:

``SEC. 330Z-3. INFANT-TODDLER COURT TEAMS FOR CHILDREN EXPERIENCING OR 
              AT RISK OF MALTREATMENT.

    ``(a) Continuation and Expansion of Infant-Toddler Court Program.--
            ``(1) Continuation and expansion of program.--The 
        Secretary, acting through the Administrator of the Health 
        Resources and Services Administration--
                    ``(A) shall continue in effect the Infant-Toddler 
                Court Program; and
                    ``(B) may, beginning with fiscal year 2024, carry 
                out such program on a national basis.
            ``(2) Infant-toddler court program defined.--For purposes 
        of paragraph (1), the term `Infant-Toddler Court Program' 
        refers to the program carried out pursuant to section 501(a)(2) 
        of the Social Security Act that is designed--
                    ``(A) to support research-based infant-toddler 
                court teams for purposes of changing child welfare 
                practices to improve well-being for infants, toddlers, 
                and their families, including efforts to build on, and 
                continue the work of, sites established through the 
                Quality Improvement Center for Research-Based Infant-
                Toddler Court Teams initiative funded by the 
                Administration for Children and Families; and
                    ``(B) to provide training and technical assistance 
                in support of infant-toddler court teams' efforts 
                across the United States.
    ``(b) Grants to States for Implementation of Infant-Toddler Court 
Teams.--
            ``(1) In general.--The Secretary of Health and Human 
        Services, acting through the Administrator of the Health 
        Resources and Services Administration, may make grants to 
        States for purposes of seeding the establishment of, or 
        stabilizing and enhancing existing, infant-toddler court teams 
        for children experiencing or at risk of maltreatment.
            ``(2) Use of funds.--A State receiving a grant under this 
        subsection may only use funds received through the grant to--
                    ``(A) designate a State lead agency as a focal 
                point for statewide planning administration and 
                coordination--
                            ``(i) to identify sites and leadership for, 
                        and establish, enhance, or stabilize, local 
                        community infant-toddler court teams; and
                            ``(ii) to promote collaboration among State 
                        and local systems that address the needs of--
                                    ``(I) infants and toddlers and 
                                their families within the child welfare 
                                system; and
                                    ``(II) individuals in need of 
                                preventive family strengthening 
                                services to facilitate the provision of 
                                local services;
                    ``(B) provide funding to the sites identified under 
                subparagraph (A)(i) to establish, enhance, or stabilize 
                local community infant-toddler court teams that meet 
                the criteria specified in paragraph (8); and
                    ``(C) ensure that local community court team 
                projects--
                            ``(i) provide for improved communication 
                        and coordination among the courts, child 
                        welfare agencies, and related child-serving 
                        organizations--
                                    ``(I) to share information and 
                                expedite appropriate high-quality 
                                services for young children and their 
                                families in the child welfare system; 
                                and
                                    ``(II) to prevent recurrence of 
                                maltreatment, promote timely 
                                permanency, and provide a community 
                                structure to help prevent entry into 
                                the child welfare system;
                            ``(ii) protect young children in the child 
                        welfare system and at risk of entering the 
                        child welfare system from further maltreatment 
                        and developmental harm and address the damage 
                        already done; and
                            ``(iii) identify and address the structural 
                        issues in the child welfare system that are 
                        harmful to infants and toddler development and 
                        impede the ability to strengthen and stabilize 
                        families.
            ``(3) Term of grant.--A grant under this subsection shall 
        be for a term of not less than 3 years and may be renewed for a 
        single term not to exceed 8 years.
            ``(4) Application process.--
                    ``(A) In general.--A State seeking a grant under 
                this subsection shall submit an application to the 
                Secretary at such time, in such manner, and containing 
                such information as the Secretary may require, 
                including--
                            ``(i) the information specified in 
                        paragraph (5); and
                            ``(ii) a plan for the establishment or 
                        enhancement and ongoing support of local 
                        community infant-toddler court teams in the 
                        State.
                    ``(B) Lead state agency.--The Governor of a State 
                submitting an application under subparagraph (A) shall 
                designate an appropriate State lead agency, such as the 
                State Court Improvement Program or the State agency 
                that administers child welfare services, with the 
                ability to carry out the activities specified in 
                paragraph (2).
            ``(5) Application contents.--The information specified in 
        this paragraph is--
                    ``(A) a description of how the State lead agency 
                designated pursuant to paragraph (4)(B) will implement 
                infant-toddler court team projects that meet the 
                criteria specified in paragraph (2)(C) and the 
                communities in which local community infant-toddler 
                court teams will be established, enhanced, or 
                stabilized;
                    ``(B) an assurance that the State lead agency will 
                consult with representatives of State agencies 
                providing services to infants, toddlers, and families, 
                the State and local judiciary, and local communities 
                and stakeholders, to develop a comprehensive plan for 
                implementing infant-toddler court teams in the State, 
                that includes a plan for determining how the court team 
                structure and approach will inform and support building 
                a family strengthening continuum, which may include 
                using the infant-toddler court team structure in 
                implementing prevention and family services and 
                programs under section 471(e) of the Social Security 
                Act (42 U.S.C. 671(e)); and
                    ``(C) a certification that any infant-toddler court 
                team established, enhanced, or implemented using funds 
                received through the grant meet the criteria specified 
                in paragraph (8).
            ``(6) Continuum requirements.--The continuum referred to in 
        paragraph (5)(B) shall--
                    ``(A) seek to ensure that children and their 
                families, particularly families with histories of 
                trauma and adversity, receive effective, timely 
                services that strengthen protective factors;
                    ``(B) begin as early as possible before families 
                encounter the child welfare system--
                            ``(i) to provide comprehensive supportive 
                        community services to families with very young 
                        children in need of such services; and
                            ``(ii) to emphasize the social determinants 
                        of health to strengthen families and prevent 
                        abuse and neglect;
                    ``(C) for young children with substantiated cases 
                of maltreatment, including those whose families have 
                been placed in an alternative or differential response 
                program, include a comprehensive approach to 
                stabilizing and strengthening families and preventing 
                children from being placed in foster care that provides 
                services and supports focused on in-home parent 
                education and specialized programs that address the 
                risk factors for removal of infants and toddlers from 
                the home; and
                    ``(D) use the community structure combined with the 
                judicial oversight within the infant-toddler court team 
                to improve outcomes for infants and toddlers who have 
                been placed in foster care and their families through 
                working with communities to ensure that--
                            ``(i) parents receive intensive services 
                        and supports, including mental health and 
                        substance use disorder treatment, to increase 
                        the likelihood of reunification; and
                            ``(ii) young children receive intensive 
                        interventions that will address their 
                        developmental needs and heal the trauma of 
                        abuse, neglect, domestic violence, and 
                        separation from their caregiver and family.
            ``(7) Conditions.--A State selected to receive a grant 
        under this subsection, shall, as a condition on receipt of such 
        grant--
                    ``(A) agree to work with the National Infant-
                Toddler Court Team Resource Center established under 
                subsection (c) to design or enhance and implement local 
                infant-toddler court teams, including supporting data 
                collection and continuous quality improvement;
                    ``(B) provide information to the National Infant-
                Toddler Court Team Resource Center on the plan 
                developed pursuant to paragraph (5)(B), including the 
                development of a continuum of family strengthening 
                services that meets the conditions specified in 
                paragraph (6);
                    ``(C) commit to building sustainability into the 
                State lead agency function and the plan referred to in 
                subparagraph (B); and
                    ``(D) ensure that any infant-toddler court team 
                established, enhanced, or implemented using funds 
                received through the grant meets the criteria specified 
                in paragraph (8).
            ``(8) Local community infant-toddler court team criteria.--
        The criteria specified in this paragraph with respect to a 
        local community infant-toddler court team established, 
        enhanced, or implemented using funds received through the grant 
        are that the team--
                    ``(A) organizes and promotes collaboration, with 
                leadership from judges and the heads of child welfare 
                agencies, among community stakeholders and service 
                providers to address the needs of families with infants 
                and toddlers, through implementing trauma-informed 
                practices for infants and toddlers and their families 
                in the child welfare system and for creating a 
                community structure that can provide a continuum of 
                services;
                    ``(B) works to strengthen families to prevent 
                foster care placement, promote timely permanency, 
                prevent recurrence of maltreatment, and promote 
                positive early development;
                    ``(C) is coordinated through a local community 
                coordinator;
                    ``(D) is composed of community stakeholders that 
                include legal and child welfare professionals involved 
                with families of infants and toddlers and community 
                service providers that--
                            ``(i) have experience solving problems and 
                        filling gaps at the community systems level, 
                        including with respect to evidence-based 
                        interventions appropriate for infants and 
                        toddlers and their families;
                            ``(ii) receive training on the science of 
                        early childhood development, the impact of 
                        trauma, and the implications for child welfare 
                        and family strengthening practice;
                            ``(iii) work to build a community structure 
                        for strengthening families across sectors, 
                        including work support, education, health 
                        (including mental health), and social supports;
                            ``(iv) undergo a period of preparation and 
                        training before taking families into the 
                        infant-toddler court program;
                            ``(v) provide a team of professionals that 
                        provides support to an individual family to 
                        ensure the needs of individual children within 
                        such family and such family as a whole are met;
                            ``(vi) focus on infants and toddlers under 
                        the court's jurisdiction or under in-home 
                        supervision; and
                            ``(vii) as resources and team structure 
                        permit, work with families of infants and 
                        toddlers outside the child welfare system to 
                        provide preventive services to strengthen 
                        families of young children and avoid child 
                        welfare involvement;
                    ``(E) supports parents' strengths and needs in a 
                compassionate, respectful, holistic, and individualized 
                way;
                    ``(F) prevents children from entering and 
                reentering the child welfare system;
                    ``(G) addresses community service gaps and 
                disparities using evidence-based strategies;
                    ``(H) commits to working toward sustainability for 
                the infant-toddler court team program;
                    ``(I) removes barriers to racial equity and social 
                justice, and prevents disparate outcomes for racial and 
                ethnic minorities, Tribes, and lesbian, gay, bisexual, 
                transgender, and queer individuals;
                    ``(J) integrates family support services to meet 
                family needs in a comprehensive way, including--
                            ``(i) developmentally appropriate evidence-
                        based interventions for very young children and 
                        their families, including developmental 
                        screening, early intervention services, high-
                        quality early care and learning programs such 
                        as Early Head Start, and multigenerational 
                        mental health treatment focused on the child-
                        caregiver relationship; and
                            ``(ii) assessments of parents' needs, 
                        including past trauma, high-quality health 
                        services, including mental health services, for 
                        parents, including prenatal and postnatal care, 
                        screening for depression, well-woman care, 
                        mental health treatment, and evidence-based 
                        substance use disorder treatment;
                    ``(K) infuses a trauma-informed approach in the 
                delivery of family support services that supports 
                children, families, and professionals across systems of 
                care;
                    ``(L) provides for a continuum of parenting 
                interventions and mental health and substances use 
                prevention and treatment services consistent with 
                paragraph (7);
                    ``(M) uses continuous quality improvement 
                practices, including collecting project data elements 
                established by the National Infant-Toddler Court Team 
                Resource Center under subsection (c) for case 
                management and assessing progress; and
                    ``(N) where placement of an infant or toddler in 
                foster care is necessary, uses--
                            ``(i) concurrent planning upon removal and 
                        limits the number of placements;
                            ``(ii) mentoring and coparenting between 
                        birth and foster parents and kin caregivers and 
                        supports;
                            ``(iii) preremoval conferences and monthly 
                        family team meetings to ensure support for 
                        family and child from the beginning as well as 
                        timely action and services to address child and 
                        family needs; and
                            ``(iv) frequent, quality family time 
                        interaction or visitation in settings where 
                        families normally interact and coaches to 
                        support parent-child interactions.
    ``(c) National Infant-Toddler Court Team Resource Center Grant.--
            ``(1) Grant authorized.--The Secretary shall award to an 
        eligible entity a grant to establish a national center to carry 
        out the activities specified in paragraph (3) to serve as a 
        resource for infant-toddler court teams (to be known as and 
        referred to in this section as the `National Infant-Toddler 
        Court Team Resource Center'). The term of a grant under this 
        subsection shall be for not less than 3 years, renewable for up 
        to 8 years.
            ``(2) Eligible entities.--An entity is eligible to receive 
        a grant under this subsection if the entity is a national early 
        childhood development organization with--
                    ``(A) recognized experience as a training 
                organization in infant-toddler development, infant-
                early childhood mental health, and other related 
                topics;
                    ``(B) experience working in collaboration with, and 
                providing training to, court officials, child welfare 
                agencies, attorneys, guardians, court-appointed special 
                advocates, and other individuals and community 
                organizations providing services to infants and 
                toddlers in the child welfare system, including--
                            ``(i) specific expertise in educating 
                        judges, attorneys, child welfare staff, and 
                        community service providers about the impacts 
                        of child maltreatment and trauma on early 
                        development and family functioning; and
                            ``(ii) experience in incorporating the 
                        expertise described in clause (i) into the 
                        court and child-family service systems to 
                        promote change in the way courts and 
                        communities address cases involving maltreated 
                        infants and toddlers and support other families 
                        with infants and toddlers in need of family 
                        strengthening services;
                    ``(C) the capacity to carry out the activities of 
                the National Infant-Toddler Court Team Resource Center;
                    ``(D) a proven ability to provide training and 
                technical assistance, collect data and support its use 
                for continuous quality improvement and evaluation, and 
                other tasks; and
                    ``(E) a demonstrated ability to bring the 
                collective impact of other national organizations 
                together to address the needs of infants and toddlers 
                that touch the child welfare system or are in need of 
                preventive services to strengthen families and avoid 
                the child welfare system.
            ``(3) Activities of national infant-toddler court team 
        resource center.--The National Infant-Toddler Court Team 
        Resource Center shall carry out the following activities:
                    ``(A) Provide technical assistance to States and 
                communities with infant-toddler court teams receiving 
                funding under subsection (a) established through the 
                Infant-Toddler Court Program, or through other means in 
                building the systemic team structure to identify and 
                address the needs of at-risk children and families 
                before maltreatment occurs.
                    ``(B) Provide technical assistance and training to 
                States and local jurisdictions--
                            ``(i) in selecting sites, coordinating 
                        systems, planning, and implementing, enhancing, 
                        or stabilizing evidence-based infant-toddler 
                        court teams, including embedding a child 
                        development approach to promote the healthy 
                        development and mitigate trauma of infants and 
                        toddlers experiencing or at risk of 
                        experiencing maltreatment and their families, 
                        so that such court teams meet the criteria 
                        specified in subsection (b)(7); and
                            ``(ii) in determining how to use the court 
                        team community structure to inform and support 
                        the continuum of family strengthening services 
                        described in paragraph (6).
                    ``(C) Develop materials to guide judges in the 
                decision-making process regarding infants and toddlers, 
                and train members of local infant-toddler court teams 
                and others in the community regarding the appropriate 
                care of infants and toddlers, including the importance 
                of--
                            ``(i) understanding early brain 
                        development, the impact of abuse and neglect 
                        and placement in foster care, and the need for 
                        preventing such occurrences;
                            ``(ii) the social determinants of health;
                            ``(iii) placement stability and caregiver 
                        continuity for very young children;
                            ``(iv) supporting the parent-child 
                        relationship;
                            ``(v) comprehensive services for children 
                        and parents to reduce the recurrence of abuse 
                        and neglect;
                            ``(vi) comprehensive services to monitor 
                        and improve the health, development, and well-
                        being of infants and toddlers in foster care or 
                        in in-home placements;
                            ``(vii) for children placed in foster care, 
                        timely permanent placement frequent parent-
                        child visitation, and concurrent planning; and
                            ``(viii) implementing a comprehensive 
                        service delivery plan addressing the needs of 
                        children and parents at the proximate time of a 
                        child's removal from the care of the child's 
                        biological parents.
                    ``(D) Provide information to States, communities, 
                and courts around the United States seeking to adopt an 
                infant-toddler court team approach grounded in the 
                science of early childhood development, including 
                information related to--
                            ``(i) the incorporation of knowledge about 
                        infant and toddler development into the 
                        resolution of cases by judges with jurisdiction 
                        over children in foster care and by child 
                        welfare agencies overseeing children under in-
                        home supervision; and
                            ``(ii) methods to change State and local 
                        government systems to better address the needs 
                        of infants and toddlers in the child welfare 
                        system and their families.
                    ``(E) Coordinate and facilitate peer learning 
                opportunities for judges, community coordinators, and 
                other personnel through communities of practice, 
                learning communities, conferences, and other means.
                    ``(F) Ensure local infant-toddler court teams 
                collect and report data specified under subparagraph 
                (H) and provide technical assistance in--
                            ``(i) ensuring quality data collection and 
                        reporting; and
                            ``(ii) using the data collected for case 
                        and site monitoring, to establish a continuous 
                        quality improvement process to identify areas 
                        that need strengthening, to develop a plan for 
                        such improvements, and to monitor progress.
                    ``(G) Provide technical assistance to States and 
                communities--
                            ``(i) in evidence-based methods to change 
                        policies and practices to better address the 
                        needs of infants and toddlers experiencing 
                        maltreatment and their families as well as 
                        infants, toddlers, and families in need of 
                        services to strengthen families and prevent the 
                        likelihood of entry into the child welfare 
                        system; and
                            ``(ii) through onsite implementation 
                        assistance to local infant-toddler court teams 
                        tailored to the needs of each unique 
                        jurisdiction, using a process of assessing and 
                        building on community strengths.
                    ``(H) Define key metrics and collect data from 
                local infant-toddler court teams related to the 
                operation and outcomes of the projects supported by 
                States receiving a grant under subsection (b) and other 
                existing infant-toddler court team sites on elements 
                that include--
                            ``(i) data on child and parent demographics 
                        and relevant family history;
                            ``(ii) adult health care services, 
                        including prenatal and postnatal care, 
                        depression screening, mental health services, 
                        substance use treatment, and well-woman care;
                            ``(iii) child services, including 
                        multigenerational mental health treatment 
                        focused on the relationship, developmental 
                        screening, early intervention services, well-
                        child care and medical homes, and early 
                        childhood education;
                            ``(iv) family engagement activities, such 
                        as family team meetings and court hearings;
                            ``(v) family well-being, including health 
                        equity and health insurance;
                            ``(vi) court practices, such as frequency 
                        of hearings, family team meetings, and 
                        stakeholder meetings; and
                            ``(vii) foster care practices that support 
                        development and stable relationships, including 
                        placement type, visitation frequency, and 
                        permanency outcomes and timeliness, with an 
                        emphasis on reunification.
                    ``(I) Compile such data annually and report to the 
                Secretary together with information from State planning 
                processes reported under subsection (b)(7)(B).
                    ``(J) In developing data elements under 
                subparagraph (H), consult with the organization awarded 
                a contract under paragraph (4).
            ``(4) Evaluation.--The National Infant-Toddler Court Team 
        Resource Center shall enter into a contract with an 
        organization experienced in conducting a child welfare national 
        evaluation over the course of the grant period of the 
        effectiveness of local evidence-based infant-toddler court 
        teams supported by States receiving a grant under subsection 
        (b) as well as other infant-toddler court team sites that may 
        participate in such evaluation in--
                    ``(A) linking children and families to appropriate 
                services and supports that prevent foster care 
                placements, expedite permanency where placements occur, 
                and strengthen families in improving family well-being 
                and support for positive child development;
                    ``(B) preventing, or reducing the recurrence of, 
                abuse and neglect;
                    ``(C) promoting access to timely, high-quality 
                primary health care and oral health care in a medical 
                home for children and parents;
                    ``(D) promoting quality parent education, 
                mentoring, and coaching to strengthen parenting skills;
                    ``(E) promoting timely assessment, referral to, and 
                receipt of, mental health treatment and substance use 
                treatment for parents of infants and toddlers;
                    ``(F) promoting timely permanent placements of 
                maltreated infants and toddlers; and
                    ``(G) reducing costs through system improvements.
    ``(d) Definitions.--In this section:
            ``(1) The term `child welfare system' includes all services 
        and supports provided through a State's child welfare system.
            ``(2) The term `State' means each State of the United 
        States, the District of Columbia, each territory or possession 
        of the United States, and each federally recognized Indian 
        Tribe (as defined in section 4 of the Indian Self-Determination 
        and Education Assistance Act (25 U.S.C. 5304)).
    ``(e) Authorization of Appropriations.--
            ``(1) In general.--There are authorized to be appropriated 
        to carry out this section, $25,000,000 for each of fiscal years 
        2024, 2025, 2026, and 2027.
            ``(2) Reservation of funds.--Of the amounts made available 
        under paragraph (1) for a fiscal year, the Secretary shall 
        reserve--
                    ``(A) in the case of a fiscal year in which the 
                amount made available under paragraph (1) does not 
                exceed $15,000,000, not less than $5,000,000 for the 
                National Infant-Toddler Court Team Resource Center 
                established pursuant to subsection (c); and
                    ``(B) in the case of a fiscal year in which the 
                amount made available under paragraph (1) equals or 
                exceeds $15,000,000 but does not exceed $25,000,000, 
                not less than $7,000,000 for such Center.''.

SEC. 3. REPORTS TO CONGRESS.

    Not later than 3 years after the date of the enactment of this Act, 
and not later than 5 years after such date of enactment, the Secretary 
shall submit to Congress a report addressing the implementation and 
effectiveness of the infant-toddler court teams pursuant to section 
330Z-3 of the Public Health Service Act, as added by section 2, 
including--
            (1) a compilation of the data on local community infant-
        toddler court teams included in the annual report from the 
        National Infant-Toddler Court Team Resource Center established 
        pursuant to such section; and
            (2) interim or final results from the national evaluation 
        of infant-toddler court teams conducted under such section.
                                 <all>
```