II 

113TH CONGRESS 

1ST SESSION S. 380 

To amend the Public Health Service Act to reauthorize and update the 

National Child Traumatic Stress Initiative for grants to address the 

problems of individuals who experience trauma and violence related 

stress. 

IN THE SENATE OF THE UNITED STATES 

FEBRUARY 26, 2013 

Mrs. MURRAY introduced the following bill; which was read twice and referred 

to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To amend the Public Health Service Act to reauthorize and 

update the National Child Traumatic Stress Initiative 

for grants to address the problems of individuals who 

experience trauma and violence related stress. 

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 ‘‘Children’s Recovery 

5 from Trauma Act’’. 

6 SEC. 2. FINDINGS. 

7 Congress makes the following findings: 


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1 (1) According to a 2002 Government Account2 ability Office report (GAO–02–813), large numbers 

3 of children experience trauma-related mental health 

4 problems, while at the same time facing barriers to 

5 receiving appropriate mental health care. 

6 (2) According to the National Institute of Men7 tal Health, only 36 percent of youth with any mental 

8 disorder received services, and only half of these 

9 youth who were severely impaired by their mental 

10 disorder received any professional mental health 

11 treatment. Of those with anxiety disorders (including 

12 post traumatic stress disorder), only 18 percent re13 ceived services. Half of all lifetime cases of mental 

14 illness begin by age 14, and that despite effective 

15 treatments that have been developed, there are long 

16 delays, sometimes decades, between first onset of 

17 symptoms and when treatment is obtained. 

18 (3) Findings from the Adverse Childhood Expe19 riences Study have shown that adverse childhood ex20 periences predispose children towards negative tra21 jectories from infancy to adulthood. 

22 (4) The Great Smoky Mountains Study, a rep23 resentative longitudinal study of children, found that 

24 by age 16, more than 67 percent of the children had 

25 been exposed to one or more traumatic events, such 


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1 as child maltreatment, domestic violence, or sexual 

2 assault (Copeland et al, 2007). 

3 (5) According to the National Institute of Men4 tal Health, the lifetime prevalence of post-traumatic 

5 stress disorder for 13 to 18 year olds is 4 to 6 per6 cent (NIMH, 2010). In 2007, the National Institute 

7 of Mental Health reported that adults who were 

8 abused or neglected as children have increased risk 

9 of major depression, often beginning in childhood 

10 with long-lasting effects. 

11 (6) According to the Department of Defense, 

12 more than 700,000 children have experienced one or 

13 more parental deployments. Children’s reactions to a 

14 parent’s deployment vary by a child’s developmental 

15 stage, age, and presence of any preexisting psycho16 logical or behavioral problems. The mental health of 

17 the parent is often a key factor affecting the child’s 

18 distress level. Parents reporting clinically significant 

19 stress are more likely to have children identified as 

20 high risk for psychological and behavioral problems. 

21 (7) The National Intimate Partner and Sexual 

22 Violence Survey revealed that nearly 1 in 5 women 

23 reported having been the victim of a rape at some 

24 time during their lives. Forty-two percent experi25 enced their first rape before the age of 18. 


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1 (8) The National Child Traumatic Stress Net2 work collected data on 14,088 children and adoles3 cents served by 56 Network service centers across 

4 the country from 2004 to 2010, examining the prev5 alence of exposure to a wide range of trauma types, 

6 access to services, and child outcomes outcome. 

7 Nearly 80 percent of children referred for screening 

8 and evaluation reported experiencing at least one 

9 type of traumatic event. Of the 11,104 children and 

10 adolescents who reported trauma exposure, 77 per11 cent had experienced more than one type of trauma 

12 and 31 percent had experienced five or more types. 

13 (9) The children served by the National Child 

14 Traumatic Stress Network are involved with many 

15 different kinds of child-serving systems. Of those re16 ceiving service, 65 percent had received social serv17 ices and 35 percent had received school-based serv18 ices. After treatment, significant improvements were 

19 made in trauma symptoms, mental health diagnoses, 

20 and behavioral problems. 

21 SEC. 3. GRANTS TO ADDRESS THE PROBLEMS OF INDIVID22 UALS WHO EXPERIENCE TRAUMA AND VIO23 LENCE RELATED STRESS. 

24 Section 582 of the Public Health Service Act (42 

25 U.S.C. 290hh–1) is amended to read as follows: 


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1 ‘‘SEC. 582. GRANTS TO ADDRESS THE PROBLEMS OF INDI2 VIDUALS WHO EXPERIENCE TRAUMA AND VI3 OLENCE RELATED STRESS. 

4 ‘‘(a) IN GENERAL.—The Secretary shall award 

5 grants, contracts or cooperative agreements to public and 

6 nonprofit private entities, as well as to Indian tribes and 

7 tribal organizations, for the purpose of developing and 

8 maintaining programs that provide for— 

9 ‘‘(1) the continued operation of the National 

10 Child Traumatic Stress Initiative (referred to in this 

11 section as the ‘NCTSI’) that focus on the mental, 

12 behavioral, and biological aspects of psychological 

13 trauma response; and 

14 ‘‘(2) the development of knowledge with regard 

15 to evidence-based practices for identifying and treat16 ing mental, behavioral, and biological disorders of 

17 children and youth resulting from witnessing or ex18 periencing a traumatic event. 

19 ‘‘(b) PRIORITIES.—In awarding grants, contracts or 

20 cooperative agreements under subsection (a)(2) (related to 

21 the development of knowledge on evidence-based practices 

22 for treating mental, behavioral, and biological disorders 

23 associated with psychological trauma), the Secretary shall 

24 give priority to universities, hospitals, mental health agen25 cies, and other community-based child-serving programs 


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1 that have established clinical and research experience in 

2 the field of trauma-related mental disorders. 

3 ‘‘(c) CHILD OUTCOME DATA.—The NCTSI coordi4 nating center shall collect, analyze, and report NCTSI5 wide child outcome and process data for the purpose of 

6 establishing the effectiveness, implementation, and clinical 

7 utility of early identification and delivery of evidence-based 

8 treatment and services delivered to children and families 

9 served by the NCTSI grantees. 

10 ‘‘(d) TRAINING.—The NCTSI coordinating center 

11 shall oversee the continuum of interprofessional training 

12 initiatives in evidence-based and trauma-informed treat13 ments, interventions, and practices offered to NCTSI 

14 grantees and providers in all child-serving systems. 

15 ‘‘(e) DISSEMINATION.—The NCTSI coordinating 

16 center shall collaborate with the Secretary in the dissemi17 nation of evidence-based and trauma-informed interven18 tions, treatments, products, and other resources to all 

19 child-serving systems and policymakers. 

20 ‘‘(f) REVIEW.—The Secretary shall establish con21 sensus-driven, in-person or teleconference review of 

22 NCTSI applications by child trauma experts and review 

23 criteria related to expertise and experience related to child 

24 trauma and evidence-based practices. 


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1 ‘‘(g) GEOGRAPHICAL DISTRIBUTION.—The Secretary 

2 shall ensure that grants, contracts or cooperative agree3 ments under subsection (a) are distributed equitably 

4 among the regions of the United States and among urban 

5 and rural areas. Notwithstanding the previous sentence, 

6 expertise and experience in the field of trauma-related dis7 orders shall be prioritized in the awarding of such grants 

8 are required under subsection (b). 

9 ‘‘(h) EVALUATION.—The Secretary, as part of the 

10 application process, shall require that each applicant for 

11 a grant, contract or cooperative agreement under sub12 section (a) submit a plan for the rigorous evaluation of 

13 the activities funded under the grant, contract or agree14 ment, including both process and outcome evaluation, and 

15 the submission of an evaluation at the end of the project 

16 period. 

17 ‘‘(i) DURATION OF AWARDS.—With respect to a 

18 grant, contract or cooperative agreement under subsection 

19 (a), the period during which payments under such an 

20 award will be made to the recipient shall be 6 years. Such 

21 grants, contracts or agreements may be renewed. Exper22 tise and experience in the field of trauma-related disorders 

23 shall be a priority for new and continuing awards. 

24 ‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—There 

25 is authorized to be appropriated to carry out this section, 


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1 $100,000,000 for fiscal year 2014, and such sums as may 

2 be necessary for each of fiscal years 2015 through 2024.’’. 

Æ 


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