‘‘(5) SUDDEN
UNEXPECTED
INFANT
DEATH; 
SUID.—The terms ‘sudden unexpected infant death’ 
and ‘SUID’ mean the sudden death of an infant 
under 1 year of age that when first discovered did 
not have an obvious cause. Such terms include those 
deaths that are later determined to be from ex-
plained as well as unexplained causes. 
‘‘(6) SUDDEN UNEXPLAINED DEATH IN CHILD-
HOOD; SUDC.—The terms ‘sudden unexplained death 
in childhood’ and ‘SUDC’ mean the sudden death of 
a child older than 1 year of age which remains unex-
plained after a thorough case investigation that in-
cludes a review of the clinical history and cir-
cumstances of death and performance of a complete 
autopsy with appropriate ancillary testing. 
‘‘SEC. 399OO–1. DEATH SCENE INVESTIGATION AND AU-
TOPSY. 
‘‘(a) INVESTIGATIONS.— 
‘‘(1) GRANTS.—The Secretary, acting through 
the Director, shall award grants to States to enable 
such States to improve the completion of comprehen-
sive death scene investigations for sudden unex-
pected infant death and sudden unexplained death in 
childhood. 
VerDate Mar 15 2010 
22:29 Feb 21, 2013
Jkt 029200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H669.IH
H669
TKELLEY on DSK3SPTVN1PROD with BILLS
‘‘(2) APPLICATION.—To be eligible to receive a 
grant under paragraph (1), a State shall submit to 
the Secretary an application at such time, in such 
manner, and containing such information as the Sec-
retary may require. 
‘‘(3) USE OF FUNDS.— 
‘‘(A) IN
GENERAL.—A State shall use 
amounts received under a grant under para-
graph (1) to improve the completion of com-
prehensive death scene investigations for sud-
den unexpected infant death and sudden unex-
plained death in childhood, including through 
the awarding of subgrants to local jurisdictions 
to be used to implement standard death scene 
investigation protocols for sudden unexpected 
infant death and sudden unexplained death in 
childhood and conduct comprehensive, stand-
ardized autopsies. 
‘‘(B) 
PROTOCOLS.—A 
standard 
death 
scene protocol implemented under subparagraph 
(A) shall include the obtaining of information 
on current and past medical history of the in-
fant/child, the circumstances surrounding the 
death including any suspicious circumstances, 
the sleep position and sleep environment of the 
VerDate Mar 15 2010 
22:29 Feb 21, 2013
Jkt 029200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H669.IH
H669
TKELLEY on DSK3SPTVN1PROD with BILLS
infant/child, and whether there were any acci-
dental or environmental factors associated with 
the death. The Director in consultation with 
medical examiners, coroners, death scene inves-
tigators, law enforcement, emergency medical 
technicians and paramedics, public health agen-
cies, and other individuals or groups determined 
necessary by the Director shall develop a stand-
ard death scene protocol for children from 1 to 
4 years of age, using existing protocols devel-
oped for SUID. 
‘‘(b) AUTOPSIES.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director, shall award grants to States 
to enable such States to increase the rate at which 
comprehensive, standardized autopsies are per-
formed for sudden unexpected infant death and sud-
den unexplained death in childhood. 
‘‘(2) APPLICATION.—To be eligible to receive a 
grant under paragraph (1), a State shall submit to 
the Secretary an application at such time, in such 
manner, and containing such information as the Sec-
retary may require. 
‘‘(3) COMPREHENSIVE AUTOPSY.—For purposes 
of this subsection, a comprehensive autopsy shall in-
VerDate Mar 15 2010 
22:29 Feb 21, 2013
Jkt 029200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H669.IH
H669
TKELLEY on DSK3SPTVN1PROD with BILLS
clude a full external and internal examination, in-
cluding microscopic examination, of all major organs 
and 
tissues 
including 
the 
brain, 
complete 
radiographs, vitreous fluid analysis, photo docu-
mentation, selected microbiology when indicated, 
metabolic testing, and toxicology screening of the in-
fant or child involved. 
‘‘(4) GUIDELINES.—The Director, in consulta-
tion with board certified forensic pathologists, med-
ical examiners, coroners, pediatric pathologists, pedi-
atric cardiologists, pediatric neuropathologists and 
geneticists, and other individuals and groups deter-
mined necessary by the Director shall develop na-
tional guidelines for a standard autopsy protocol for 
sudden unexpected infant death and sudden unex-
plained death in childhood. The Director shall en-
sure that the majority of such consultation is with 
board certified forensic pathologists, medical exam-
iners, and coroners. The Director is encouraged to 
seek additional input from child abuse experts, be-
reavement specialists, parents, and public health 
agencies on nonmedical aspects of the autopsy guide-
lines. In developing such protocol, the Director shall 
consider autopsy protocols used by State and local 
jurisdictions. 
VerDate Mar 15 2010 
22:29 Feb 21, 2013
Jkt 029200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H669.IH
H669
TKELLEY on DSK3SPTVN1PROD with BILLS
‘‘(c) STUDY ON GENETIC TESTING.—The Director, 
in consultation with medical examiners, coroners, forensic 
pathologists, geneticists, researchers, public health offi-
cials, and other individuals and groups determined nec-
essary by the Director, shall commission a study to deter-
mine the benefits and appropriateness of genetic testing 
for infant and early childhood deaths that remain unex-
plained after a complete death scene investigation and 
comprehensive, standardized autopsy. Such study shall in-
clude recommendations on developing a standard protocol 
for use in determining when to utilize genetic testing and 
standard protocols for the collection and storage of speci-
mens suitable for genetic testing. 
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated $8,000,000 for each of 
fiscal years 2014 through 2018 to carry out this section. 
‘‘SEC. 399OO–2. TRAINING. 
‘‘(a) GRANTS.—The Secretary, acting through the 
Director, shall award grants to eligible entities for the pro-
vision of training on death scene investigation specific for 
SUID and SUDC. 
‘‘(b) ELIGIBLE ENTITIES.—To be eligible to receive 
a grant under subsection (a), an entity shall— 
‘‘(1) be— 
‘‘(A) a State or local government entity; or 
VerDate Mar 15 2010 
22:29 Feb 21, 2013
Jkt 029200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H669.IH
H669
TKELLEY on DSK3SPTVN1PROD with BILLS
‘‘(B) a nonprofit private entity; and 
‘‘(2) submit to the Secretary an application at 
such time, in such manner, and containing such in-
formation as the Secretary may require. 
‘‘(c) USE OF FUNDS.—An eligible entity shall use 
amounts received under a grant under this section to— 
‘‘(1) provide training to medical examiners, 
coroners, death scene investigators, law enforcement 
personnel, and emergency medical technicians or 
paramedics concerning death scene investigations for 
SUID and SUDC, including the use of standard 
death scene investigation protocols that include in-
formation on the current and past medical history of 
the infant/child, the circumstances surrounding the 
death including any suspicious circumstances, the 
sleep position and sleep environment of the infant/ 
child, and whether there were any accidental or envi-
ronmental factors associated with the death; 
‘‘(2) provide training directly to individuals who 
are responsible for conducting and reviewing death 
scene investigations for sudden unexpected infant 
death and sudden unexplained death in childhood; 
‘‘(3) provide training to multidisciplinary teams, 
including teams that have a medical examiner or 
coroner, death scene investigator, law enforcement 
VerDate Mar 15 2010 
22:29 Feb 21, 2013
Jkt 029200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H669.IH
H669
TKELLEY on DSK3SPTVN1PROD with BILLS
representative, and an emergency medical technician 
or paramedic; 
‘‘(4) in the case of national and State-based 
grantees that are comprised of medical examiners, 
coroners, death scene investigators, law enforcement 
personnel, or emergency medical technicians and 
paramedics, integrate training under the grant on 
death scene investigation of SUID and SUDC into 
professional accreditation and training programs; 
‘‘(5) in the case of State and local government 
entity grantees, obtain equipment, including com-
puter equipment, to aid in the completion of stand-
ard death scene investigation; or 
‘‘(6) conduct training activities for medical ex-
aminers, coroners, and forensic pathologists con-
cerning standard autopsy protocols for sudden unex-
pected infant death and sudden unexplained death in 
childhood and integrate the training under the grant 
on standard autopsy protocols in SUID and SUDC 
into professional accreditation and training pro-
grams. 
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section 
$2,000,000 for each of fiscal years 2014 through 2018. 
VerDate Mar 15 2010 
22:29 Feb 21, 2013
Jkt 029200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6201
E:\BILLS\H669.IH
H669
TKELLEY on DSK3SPTVN1PROD with BILLS
‘‘SEC. 399OO–3. CHILD DEATH REVIEW. 
‘‘(a) PREVENTION.— 
‘‘(1) CORE CAPACITY GRANTS.—The Secretary, 
acting through the Administrator, shall award 
grants to States to build and strengthen State ca-
pacity and implement State and local child death re-
view programs and prevention strategies. 
‘‘(2) PLANNING GRANTS.—The Secretary, act-
ing through the Administrator, shall award planning 
grants to States that have no existing child death re-
view program or States in which the only child death 
review programs are State-based, for the develop-
ment of local child death review programs and pre-
vention strategies. 
‘‘(3) APPLICATION.—To be eligible to receive a 
grant under paragraph (1) or (2), a State shall sub-
mit to the Secretary an application at such time, in 
such manner, and containing such information as 
the Secretary may require. 
‘‘(4) TECHNICAL ASSISTANCE.—The Secretary, 
acting through the Administrator, shall provide tech-
nical assistance to assist States— 
‘‘(A) in developing the capacity for com-
prehensive child death review programs, includ-
ing the development of best practices for the 
implementation of such programs; and 
VerDate Mar 15 2010 
22:29 Feb 21, 2013
Jkt 029200
PO 00000
Frm 00010
Fmt 6652
Sfmt 6201
E:\BILLS\H669.IH
H669
TKELLEY on DSK3SPTVN1PROD with BILLS
‘‘(B) in maintaining the national child 
death case reporting system. 
‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated $7,000,000 for each of 
fiscal years 2014 through 2018 to carry out subsection 
(a). 
‘‘SEC. 399OO–4. ENHANCING THE NATIONAL CHILD DEATH 
CASE REPORTING SYSTEM. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director and in consultation with the national child 
death case reporting system, national health organiza-
tions, and professional societies with experience and exper-
tise relating to reducing SUID and SUDC, shall modify 
such national death case reporting system, in accordance 
with subsection (b), to assure that such system provides 
for population-based data for ages 0 through 4 years of 
age and facilitates the understanding of the root causes, 
rates, and trends of SUID and SUDC with respect to such 
ages. 
‘‘(b) GOALS OF MODIFIED NATIONAL CHILD DEATH 
CASE REPORTING SYSTEM.—The modifications under 
subsection (a) to the national child death case reporting 
system shall facilitate the collection, analysis, and dissemi-
nation of data by— 
VerDate Mar 15 2010 
22:29 Feb 21, 2013
Jkt 029200
PO 00000
Frm 00011
Fmt 6652
Sfmt 6201
E:\BILLS\H669.IH
H669
TKELLEY on DSK3SPTVN1PROD with BILLS
‘‘(1) implementing a surveillance and moni-
toring system based on thorough and complete death 
scene investigation data, clinical history, and au-
topsy findings; 
‘‘(2) collecting standardized information about 
the environmental, medical, genetic, and social cir-
cumstances of death (including sleep environment 
and quality of the death scene investigation) if de-
termined that such may correlate with infant and 
early childhood deaths, as well as information from 
other law enforcement, medical examiner, coroner, 
emergency medical services (EMS), medical records, 
and vital records (if possible); 
‘‘(3) supporting multidisciplinary infant and 
early childhood death reviews such as those per-
formed by child death review committees to collect 
and review the standardized information and accu-
rately and consistently classify and characterize 
SUID and SUDC; 
‘‘(4) facilitating the sharing of information to 
improve the public reporting of surveillance and vital 
statistics describing the epidemiology of SUID and 
SUDC; and 
‘‘(5) utilizing current infrastructure of existing 
surveillance systems. 
VerDate Mar 15 2010 
22:29 Feb 21, 2013
Jkt 029200
PO 00000
Frm 00012
Fmt 6652
Sfmt 6201
E:\BILLS\H669.IH
H669
TKELLEY on DSK3SPTVN1PROD with BILLS
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section 
$3,000,000 for each of fiscal years 2014 through 2018. 
‘‘SEC. 399OO–5. PUBLIC AWARENESS AND EDUCATION CAM-
PAIGN. 
‘‘(a) 
ESTABLISHMENT.—The 
Secretary, 
acting 
through the Administrator and in consultation with the 
Director and the Director of the National Institutes of 
Health, shall establish and implement a culturally com-
petent research-based public health awareness and edu-
cation campaign to provide information that is focused on 
decreasing the risk factors that contribute to sudden unex-
pected infant death and sudden unexplained death in 
childhood, including educating individuals and organiza-
tions about safe sleep environments, sleep positions, and 
reducing exposure to smoking during pregnancy and after 
birth. 
‘‘(b) TARGETED
POPULATIONS.—The campaign 
under subsection (a) shall be designed to reduce health 
disparities through the targeting of populations with high 
rates of sudden unexpected infant death and sudden unex-
plained death in childhood. 
‘‘(c) CONSULTATION.—In establishing and imple-
menting the campaign under subsection (a), the Secretary 
shall consult with national organizations representing 
VerDate Mar 15 2010 
22:29 Feb 21, 2013
Jkt 029200
PO 00000
Frm 00013
Fmt 6652
Sfmt 6201
E:\BILLS\H669.IH
H669
TKELLEY on DSK3SPTVN1PROD with BILLS
health care providers, including nurses and physicians, 
parents, child care providers, children’s advocacy and safe-
ty organizations, maternal and child health programs and 
women’s, infants’, and children’s nutrition professionals, 
and other individuals and groups determined necessary by 
the Secretary for such establishment and implementation. 
‘‘(d) GRANTS.— 
‘‘(1) IN GENERAL.—In carrying out the cam-
paign under subsection (a), the Secretary shall 
award grants to national organizations, State and 
local health departments, and community-based or-
ganizations for the conduct of education and out-
reach programs for health care providers, parents, 
child care providers, public health agencies, and 
community organizations. 
‘‘(2) APPLICATION.—To be eligible to receive a 
grant under paragraph (1), an entity shall submit to 
the Secretary an application at such time, in such 
manner, and containing such information as the Sec-
retary may require. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section 
$7,000,000 for fiscal year 2014 and $5,000,000 for each 
of fiscal years 2015 through 2018. 
VerDate Mar 15 2010 
22:29 Feb 21, 2013
Jkt 029200
PO 00000
Frm 00014
Fmt 6652
Sfmt 6201
E:\BILLS\H669.IH
H669
TKELLEY on DSK3SPTVN1PROD with BILLS
‘‘SEC. 399OO–6. GRANTS FOR SUPPORT SERVICES. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Administrator, shall award grants to national organi-
zations, State and local health departments, and commu-
nity-based organizations, for the provisions of support 
services to families who have had a child die of sudden 
unexpected infant death and sudden unexplained death in 
childhood. 
‘‘(b) APPLICATION.—To be eligible to receive a grant 
under subsection (a), an entity shall submit to the Sec-
retary an application at such time, in such manner, and 
containing such information as the Secretary may require. 
‘‘(c) USE OF FUNDS.—Amounts received under a 
grant awarded under subsection (a) may be used to pro-
vide grief counseling, education, home visits, 24-hour hot-
lines, and support groups for families who have lost a child 
to sudden unexpected infant death or sudden unexplained 
death in childhood. 
‘‘(d) PREFERENCE.—In awarding grants under sub-
section (a), the Secretary shall give preference to commu-
nity-based applicants that have a proven history of effec-
tive direct support services and interventions for sudden 
unexpected infant death and sudden unexplained death in 
childhood and can demonstrate experience through col-
laborations and partnerships for delivering services 
throughout a State or region. 
VerDate Mar 15 2010 
22:29 Feb 21, 2013
Jkt 029200
PO 00000
Frm 00015
Fmt 6652
Sfmt 6201
E:\BILLS\H669.IH
H669
TKELLEY on DSK3SPTVN1PROD with BILLS
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section 
$500,000 for each of fiscal years 2014 through 2018. 
‘‘SEC. 399OO–7. EVALUATION OF STATE AND REGIONAL 
NEEDS. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director and in consultation with the Administrator, 
shall conduct a needs assessment on a State and regional 
basis of the availability of personnel, training, technical 
assistance, and resources for investigating and deter-
mining sudden unexpected infant death and sudden unex-
plained death in childhood and make recommendations to 
increase collaboration on a State and regional level for in-
vestigation and determination. 
‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section, 
$250,000 for each of fiscal years 2014 through 2018.’’. 
SEC. 3. ENHANCING PUBLIC HEALTH ACTIVITIES RELATED 
TO STILLBIRTH. 
Part P of title III of the Public Health Service Act 
(42 U.S.C. 280g et seq.) is amended by adding at the end 
the following: 
VerDate Mar 15 2010 
22:29 Feb 21, 2013
Jkt 029200
PO 00000
Frm 00016
Fmt 6652
Sfmt 6201
E:\BILLS\H669.IH
H669
TKELLEY on DSK3SPTVN1PROD with BILLS
‘‘SEC. 399V–6. ENHANCING PUBLIC HEALTH ACTIVITIES RE-
LATED TO STILLBIRTH. 
‘‘(a) GRANTS.—The Secretary, acting through the 
Director of the Centers for Disease Control and Preven-
tion, shall award grants to eligible States and metropolitan 
areas to enhance and expand surveillance efforts to collect 
thorough and complete epidemiologic information on still-
births, including through the utilization of the infrastruc-
ture of existing surveillance systems (including vital statis-
tics systems). 
‘‘(b) ELIGIBILITY.—To be eligible to receive a grant 
under subsection (a), an entity shall— 
‘‘(1) be a State or a major metropolitan area 
(as defined by the Secretary); and 
‘‘(2) submit to the Secretary an application at 
such time, in such manner, and containing such in-
formation as the Secretary may require, including— 
‘‘(A) an assurance that the applicant will 
implement the standardized surveillance pro-
tocol developed under subsection (c); and 
‘‘(B) a description of the infrastructure of 
existing surveillance systems in the State or 
major metropolitan area, as applicable. 
‘‘(c) SURVEILLANCE
PROTOCOL.—The Secretary, 
acting through the Director of the Centers for Disease 
Control and Prevention, shall— 
VerDate Mar 15 2010 
22:29 Feb 21, 2013
Jkt 029200
PO 00000
Frm 00017
Fmt 6652
Sfmt 6201
E:\BILLS\H669.IH
H669
TKELLEY on DSK3SPTVN1PROD with BILLS
‘‘(1) provide for the continued development and 
dissemination of a standard protocol for stillbirth 
data collection and surveillance, in consultation with 
representatives of health and advocacy organizations, 
State and local governments, and other interested 
entities determined appropriate by the Secretary; 
‘‘(2) monitor trends and identify potential risk 
factors for further study using existing sources of 
surveillance data and expanded sources of data from 
targeted surveillance efforts, and methods for the 
evaluation of stillbirth prevention efforts; and 
‘‘(3) develop and evaluate methods to link exist-
ing data to provide more complete information for 
research into the causes and conditions associated 
with stillbirth. 
‘‘(d) POSTMORTEM EVALUATION AND DATA COLLEC-
TION.—The Secretary, acting through the Director of the 
Centers for Disease Control and Prevention and in con-
sultation with physicians, nurses, pathologists, geneticists, 
parents, and other groups determined necessary by the Di-
rector, shall develop guidelines for increasing the perform-
ance and data collection of postmortem stillbirth evalua-
tion, including conducting and reimbursing autopsies, pla-
cental histopathology, and cytogenetic testing. The guide-
VerDate Mar 15 2010 
22:29 Feb 21, 2013
Jkt 029200
PO 00000
Frm 00018
Fmt 6652
Sfmt 6201
E:\BILLS\H669.IH
H669
TKELLEY on DSK3SPTVN1PROD with BILLS