H. R. 6—152 
‘‘(E) Provide onsite access to medication, as appro-
priate, and toxicology services; for purposes of carrying 
out this section. 
‘‘(F) Operate a secure, confidential, and interoperable 
electronic health information system. 
‘‘(G) Offer family support services such as child care, 
family counseling, and parenting interventions to help sta-
bilize families impacted by substance use disorder, as 
appropriate. 
‘‘(2) OUTREACH.—Each Center shall carry out outreach 
activities regarding the services offered through the Centers, 
which may include— 
‘‘(A) training and supervising outreach staff, as appro-
priate, to work with State and local health departments, 
health care providers, the Indian Health Service, State 
and local educational agencies, schools funded by the Indian 
Bureau of Education, institutions of higher education, State 
and local workforce development boards, State and local 
community action agencies, public safety officials, first 
responders, Indian Tribes, child welfare agencies, as appro-
priate, and other community partners and the public, 
including patients, to identify and respond to community 
needs; 
‘‘(B) ensuring that the entities described in subpara-
graph (A) are aware of the services of the Center; and 
‘‘(C) disseminating and making publicly available, 
including through the internet, evidence-based resources 
that educate professionals and the public on opioid use 
disorder and other substance use disorders, including co- 
occurring substance use and mental disorders. 
‘‘(h) DATA REPORTING AND PROGRAM OVERSIGHT.—With respect 
to a grant awarded under subsection (a), not later than 90 days 
after the end of the first year of the grant period, and annually 
thereafter for the duration of the grant period (including the dura-
tion of any renewal period for such grant), the entity shall submit 
data, as appropriate, to the Secretary regarding— 
‘‘(1) the programs and activities funded by the grant; 
‘‘(2) health outcomes of the population of individuals with 
a substance use disorder who received services from the Center, 
evaluated by an independent program evaluator through the 
use of outcomes measures, as determined by the Secretary; 
‘‘(3) the retention rate of program participants; and 
‘‘(4) any other information that the Secretary may require 
for the purpose of—ensuring that the Center is complying with 
all the requirements of the grant, including providing the full 
continuum of services described in subsection (g)(1)(B). 
‘‘(i) PRIVACY.—The provisions of this section, including with 
respect to data reporting and program oversight, shall be subject 
to all applicable Federal and State privacy laws. 
‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—There is authorized 
to be appropriated $10,000,000 for each of fiscal years 2019 through 
2023 for purposes of carrying out this section.’’. 
(b) REPORTS TO CONGRESS.— 
(1) PRELIMINARY
REPORT.—Not later than 3 years after 
the date of the enactment of this Act, the Secretary of Health 
and Human Services shall submit to Congress a preliminary
H. R. 6—153 
report that analyzes data submitted under section 552(h) of 
the Public Health Service Act, as added by subsection (a). 
(2) FINAL REPORT.—Not later than 2 years after submitting 
the preliminary report required under paragraph (1), the Sec-
retary of Health and Human Services shall submit to Congress 
a final report that includes— 
(A) an evaluation of the effectiveness of the comprehen-
sive services provided by the Centers established or oper-
ated pursuant to section 552 of the Public Health Service 
Act, as added by subsection (a), with respect to health 
outcomes of the population of individuals with substance 
use disorder who receive services from the Center, which 
shall include an evaluation of the effectiveness of services 
for treatment and recovery support and to reduce relapse, 
recidivism, and overdose; and 
(B) recommendations, as appropriate, regarding ways 
to improve Federal programs related to substance use dis-
orders, which may include dissemination of best practices 
for the treatment of substance use disorders to health 
care professionals. 
Subtitle N—Trauma-Informed Care 
SEC. 7131. CDC SURVEILLANCE AND DATA COLLECTION FOR CHILD, 
YOUTH, AND ADULT TRAUMA. 
(a) DATA COLLECTION.—The Director of the Centers for Disease 
Control and Prevention (referred to in this section as the ‘‘Director’’) 
may, in cooperation with the States, collect and report data on 
adverse childhood experiences through the Behavioral Risk Factor 
Surveillance System, the Youth Risk Behavior Surveillance System, 
and other relevant public health surveys or questionnaires. 
(b) TIMING.—The collection of data under subsection (a) may 
occur biennially. 
(c) DATA FROM RURAL AREAS.—The Director shall encourage 
each State that participates in collecting and reporting data under 
subsection (a) to collect and report data from rural areas within 
such State, in order to generate a statistically reliable representa-
tion of such areas. 
(d) DATA FROM TRIBAL AREAS.—The Director may, in coopera-
tion with Indian Tribes (as defined in section 4 of the Indian 
Self-Determination and Education Assistance Act) and pursuant 
to a written request from an Indian Tribe, provide technical assist-
ance to such Indian Tribe to collect and report data on adverse 
childhood experiences through the Behavioral Risk Factor Surveil-
lance System, the Youth Risk Behavior Surveillance System, or 
another relevant public health survey or questionnaire. 
(e) AUTHORIZATION OF APPROPRIATIONS.—To carry out this sec-
tion, there is authorized to be appropriated $2,000,000 for each 
of fiscal years 2019 through 2023. 
SEC. 7132. TASK FORCE TO DEVELOP BEST PRACTICES FOR TRAUMA- 
INFORMED IDENTIFICATION, REFERRAL, AND SUPPORT. 
(a) ESTABLISHMENT.—There is established a task force, to be 
known as the Interagency Task Force on Trauma-Informed Care 
(in this section referred to as the ‘‘task force’’) that shall identify, 
evaluate, and make recommendations regarding—
H. R. 6—154 
(1) best practices with respect to children and youth, and 
their families as appropriate, who have experienced or are 
at risk of experiencing trauma; and 
(2) ways in which Federal agencies can better coordinate 
to improve the Federal response to families impacted by sub-
stance use disorders and other forms of trauma. 
(b) MEMBERSHIP.— 
(1) COMPOSITION.—The task force shall be composed of 
the heads of the following Federal departments and agencies, 
or their designees: 
(A) The Centers for Medicare & Medicaid Services. 
(B) The Substance Abuse and Mental Health Services 
Administration. 
(C) The Agency for Healthcare Research and Quality. 
(D) The Centers for Disease Control and Prevention. 
(E) The Indian Health Service. 
(F) The Department of Veterans Affairs. 
(G) The National Institutes of Health. 
(H) The Food and Drug Administration. 
(I) The Health Resources and Services Administration. 
(J) The Department of Defense. 
(K) The Office of Minority Health of the Department 
of Health and Human Services. 
(L) The Administration for Children and Families. 
(M) The Office of the Assistant Secretary for Planning 
and Evaluation of the Department of Health and Human 
Services. 
(N) The Office for Civil Rights of the Department of 
Health and Human Services. 
(O) The Office of Juvenile Justice and Delinquency 
Prevention of the Department of Justice. 
(P) The Office of Community Oriented Policing Services 
of the Department of Justice. 
(Q) The Office on Violence Against Women of the 
Department of Justice. 
(R) The National Center for Education Evaluation and 
Regional Assistance of the Department of Education. 
(S) The National Center for Special Education Research 
of the Institute of Education Science. 
(T) The Office of Elementary and Secondary Education 
of the Department of Education. 
(U) The Office for Civil Rights of the Department of 
Education. 
(V) The Office of Special Education and Rehabilitative 
Services of the Department of Education. 
(W) The Bureau of Indian Affairs of the Department 
of the Interior. 
(X) The Veterans Health Administration of the Depart-
ment of Veterans Affairs. 
(Y) The Office of Special Needs Assistance Programs 
of the Department of Housing and Urban Development. 
(Z) The Office of Head Start of the Administration 
for Children and Families. 
(AA) The Children’s Bureau of the Administration for 
Children and Families. 
(BB) The Bureau of Indian Education of the Depart-
ment of the Interior.
H. R. 6—155 
(CC) Such other Federal agencies as the Secretaries 
determine to be appropriate. 
(2) DATE OF APPOINTMENTS.—The heads of Federal depart-
ments and agencies shall appoint the corresponding members 
of the task force not later than 60 days after the date of 
enactment of this Act. 
(3) CHAIRPERSON.—The task force shall be chaired by the 
Assistant Secretary for Mental Health and Substance Use, or 
the Assistant Secretary’s designee. 
(c) TASK FORCE DUTIES.—The task force shall— 
(1) solicit input from stakeholders, including frontline 
service providers, educators, mental health professionals, 
researchers, experts in infant, child, and youth trauma, child 
welfare professionals, and the public, in order to inform the 
activities under paragraph (2); and 
(2) identify, evaluate, make recommendations, and update 
such recommendations not less than annually, to the general 
public, the Secretary of Education, the Secretary of Health 
and Human Services, the Secretary of Labor, the Secretary 
of the Interior, the Attorney General, and other relevant cabinet 
Secretaries, and Congress regarding— 
(A) a set of evidence-based, evidence-informed, and 
promising best practices with respect to— 
(i) prevention strategies for individuals at risk of 
experiencing or being exposed to trauma, including 
trauma as a result of exposure to substance use; 
(ii) the identification of infants, children and youth, 
and their families as appropriate, who have experi-
enced or are at risk of experiencing trauma; 
(iii) the expeditious referral to and implementation 
of trauma-informed practices and supports that pre-
vent and mitigate the effects of trauma, which may 
include 
whole-family 
and 
multi-generational 
approaches; and 
(iv) community based or multi-generational prac-
tices that support children and their families; 
(B) a national strategy on how the task force and 
member agencies will collaborate, prioritize options for, 
and implement a coordinated approach, which may 
include— 
(i) data sharing; 
(ii) providing support to infants, children, and 
youth, and their families as appropriate, who have 
experienced or are at risk of experiencing trauma; 
(iii) identifying options for coordinating existing 
grants that support infants, children, and youth, and 
their families as appropriate, who have experienced, 
or are at risk of experiencing, exposure to substance 
use or other trauma, including trauma related to sub-
stance use; and 
(iv) other ways to improve coordination, planning, 
and communication within and across Federal agen-
cies, offices, and programs, to better serve children 
and families impacted by substance use disorders; and 
(C) existing Federal authorities at the Department of 
Education, Department of Health and Human Services, 
Department of Justice, Department of Labor, Department
H. R. 6—156 
of the Interior, and other relevant agencies, and specific 
Federal grant programs to disseminate best practices on, 
provide training in, or deliver services through, trauma- 
informed practices, and disseminate such information— 
(i) in writing to relevant program offices at such 
agencies to encourage grant applicants in writing to 
use such funds, where appropriate, for trauma- 
informed practices; and 
(ii) to the general public through the internet 
website of the task force. 
(d) BEST PRACTICES.—In identifying, evaluating, and recom-
mending the set of best practices under subsection (c), the task 
force shall— 
(1) include guidelines for providing professional develop-
ment and education for front-line services providers, including 
school personnel, early childhood education program providers, 
providers from child- or youth-serving organizations, housing 
and homeless providers, primary and behavioral health care 
providers, child welfare and social services providers, juvenile 
and family court personnel, health care providers, individuals 
who are mandatory reporters of child abuse or neglect, trained 
nonclinical providers (including peer mentors and clergy), and 
first responders, in— 
(A) understanding and identifying early signs and risk 
factors of trauma in infants, children, and youth, and their 
families as appropriate, including through screening proc-
esses and services; 
(B) providing practices to prevent and mitigate the 
impact of trauma, including by fostering safe and stable 
environments and relationships; and 
(C) developing and implementing policies, procedures, 
or systems that— 
(i) are designed to quickly refer infants, children, 
youth, and their families as appropriate, who have 
experienced or are at risk of experiencing trauma to 
the appropriate trauma-informed screening and sup-
port and age-appropriate treatment, and to ensure such 
infants, children, youth, and family members receive 
such support; 
(ii) utilize and develop partnerships with early 
childhood education programs, local social services 
organizations, such as organizations serving youth, and 
clinical mental health or other health care providers 
with expertise in providing support services and age- 
appropriate trauma-informed and evidence-based treat-
ment aimed at preventing or mitigating the effects 
of trauma; 
(iii) educate children and youth to— 
(I) understand and identify the signs, effects, 
or symptoms of trauma; and 
(II) build the resilience and coping skills to 
mitigate the effects of experiencing trauma; 
(iv) promote and support multi-generational prac-
tices that assist parents, foster parents, and kinship 
and other caregivers in accessing resources related to, 
and developing environments conducive to, the preven-
tion and mitigation of trauma; and
H. R. 6—157 
(v) collect and utilize data from screenings, refer-
rals, or the provision of services and supports to 
evaluate outcomes and improve processes for trauma- 
informed services and supports that are culturally sen-
sitive, linguistically appropriate, and specific to age 
ranges and sex, as applicable; 
(2) recommend best practices that are designed to avoid 
unwarranted custody loss or criminal penalties for parents 
or guardians in connection with infants, children, and youth 
who have experienced or are at risk of experiencing trauma; 
and 
(3) recommend opportunities for local- and State-level part-
nerships that— 
(A) are designed to quickly identify and refer children 
and families, as appropriate, who have experienced or are 
at risk of experiencing exposure to trauma, including 
related to substance use; 
(B) utilize and develop partnerships with early child-
hood education programs, local social services organiza-
tions, and health care services aimed at preventing or 
mitigating the effects of exposure to trauma, including 
related to substance use; 
(C) 
offer 
community-based 
prevention 
activities, 
including educating families and children on the effects 
of exposure to trauma, such as trauma related to substance 
use, and how to build resilience and coping skills to miti-
gate those effects; 
(D) in accordance with Federal privacy protections, 
utilize non-personally-identifiable data from screenings, 
referrals, or the provision of services and supports to 
evaluate and improve processes addressing exposure to 
trauma, including related to substance use; and 
(E) are designed to prevent separation and support 
reunification of families if in the best interest of the child. 
(e) OPERATING PLAN.—Not later than 120 days after the date 
of enactment of this Act, the task force shall hold the first meeting. 
Not later than 2 years after such date of enactment, the task 
force shall submit to the Secretary of Education, Secretary of Health 
and Human Services, Secretary of Labor, Secretary of the Interior, 
the Attorney General, and Congress an operating plan for carrying 
out the activities of the task force described in subsection (c)(2). 
Such operating plan shall include— 
(1) a list of specific activities that the task force plans 
to carry out for purposes of carrying out duties described in 
subsection (c)(2), which may include public engagement; 
(2) a plan for carrying out the activities under subsection 
(c)(2); 
(3) a list of members of the task force and other individuals 
who are not members of the task force that may be consulted 
to carry out such activities; 
(4) an explanation of Federal agency involvement and 
coordination needed to carry out such activities, including any 
statutory or regulatory barriers to such coordination; 
(5) a budget for carrying out such activities; 
(6) a proposed timeline for implementing recommendations 
and efforts identified under subsection (c); and
H. R. 6—158 
(7) other information that the task force determines appro-
priate as related to its duties. 
(f) FINAL REPORT.—Not later than 3 years after the date of 
the first meeting of the task force, the task force shall submit 
to the general public, Secretary of Education, Secretary of Health 
and Human Services, Secretary of Labor, Secretary of the Interior, 
the Attorney General, other relevant cabinet Secretaries, the Com-
mittee on Energy and Commerce and the Committee on Education 
and the Workforce of the House of Representatives and the Com-
mittee on Health, Education, Labor, and Pensions of the Senate, 
and Congress, a final report containing all of the findings and 
recommendations required under this section, and shall make such 
report available online in an accessible format. 
(g) ADDITIONAL REPORTS.—In addition to the final report under 
subsection (f). the task force shall submit— 
(1) a report to Congress identifying any recommendations 
identified under subsection (c) that require additional legisla-
tive authority to implement; and 
(2) a report to the Governors describing the opportunities 
for local- and State-level partnerships, professional develop-
ment, or best practices recommended under subsection (d)(3). 
(h) DEFINITIONS.—In this section— 
(1) the term ‘‘early childhood education program’’ has the 
meaning given such term in section 103 of the Higher Education 
Act of 1965 (20 U.S.C. 1003); 
(2) The term ‘‘Governor’’ means the chief executive officer 
of a State; and 
(3) the term ‘‘State’’ means each of the several States, 
the District of Columbia, the Commonwealth of Puerto Rico, 
the Virgin Islands, Guam, American Samoa, and the Common-
wealth of the Northern Mariana Islands. 
(i) SUNSET.—The task force shall sunset on the date that is 
60 days after the submission of the final report under subsection 
(f), but not later than September 30, 2023. 
SEC. 7133. NATIONAL CHILD TRAUMATIC STRESS INITIATIVE. 
Section 582(j) of the Public Health Service Act (42 U.S.C. 
290hh–1(j)) (relating to grants to address the problems of persons 
who experience violence-related stress) is amended by striking 
‘‘$46,887,000 for each of fiscal years 2018 through 2022’’ and 
inserting ‘‘$63,887,000 for each of fiscal years 2019 through 2023’’. 
SEC. 7134. GRANTS TO IMPROVE TRAUMA SUPPORT SERVICES AND 
MENTAL HEALTH CARE FOR CHILDREN AND YOUTH IN 
EDUCATIONAL SETTINGS. 
(a) GRANTS, CONTRACTS, 
AND
COOPERATIVE
AGREEMENTS 
AUTHORIZED.—The Secretary, in coordination with the Assistant 
Secretary for Mental Health and Substance Use, is authorized 
to award grants to, or enter into contracts or cooperative agreements 
with, State educational agencies, local educational agencies, Indian 
Tribes (as defined in section 4 of the Indian Self-Determination 
and Education Assistance Act) or their tribal educational agencies, 
a school operated by the Bureau of Indian Education, a Regional 
Corporation, or a Native Hawaiian educational organization, for 
the purpose of increasing student access to evidence-based trauma 
support services and mental health care by developing innovative 
initiatives, activities, or programs to link local school systems with
H. R. 6—159 
local trauma-informed support and mental health systems, 
including those under the Indian Health Service. 
(b) DURATION.—With respect to a grant, contract, or cooperative 
agreement awarded or entered into under this section, the period 
during which payments under such grant, contract or agreement 
are made to the recipient may not exceed 4 years. 
(c) USE OF FUNDS.—An entity that receives a grant, contract, 
or cooperative agreement under this section shall use amounts 
made available through such grant, contract, or cooperative agree-
ment for evidence-based activities, which shall include any of the 
following: 
(1) Collaborative efforts between school-based service sys-
tems and trauma-informed support and mental health service 
systems to provide, develop, or improve prevention, screening, 
referral, and treatment and support services to students, such 
as providing trauma screenings to identify students in need 
of specialized support. 
(2) To implement schoolwide positive behavioral interven-
tions and supports, or other trauma-informed models of support. 
(3) To provide professional development to teachers, teacher 
assistants, school leaders, specialized instructional support per-
sonnel, and mental health professionals that— 
(A) fosters safe and stable learning environments that 
prevent and mitigate the effects of trauma, including 
through social and emotional learning; 
(B) improves school capacity to identify, refer, and 
provide services to students in need of trauma support 
or behavioral health services; or 
(C) reflects the best practices for trauma-informed 
identification, referral, and support developed by the Task 
Force under section 7132. 
(4) Services at a full-service community school that focuses 
on trauma-informed supports, which may include a full-time 
site coordinator, or other activities consistent with section 4625 
of the Elementary and Secondary Education Act of 1965 (20 
U.S.C. 7275). 
(5) Engaging families and communities in efforts to increase 
awareness of child and youth trauma, which may include 
sharing best practices with law enforcement regarding trauma- 
informed care and working with mental health professionals 
to provide interventions, as well as longer term coordinated 
care within the community for children and youth who have 
experienced trauma and their families. 
(6) To provide technical assistance to school systems and 
mental health agencies. 
(7) To evaluate the effectiveness of the program carried 
out under this section in increasing student access to evidence- 
based trauma support services and mental health care. 
(8) To establish partnerships with or provide subgrants 
to Head Start agencies (including Early Head Start agencies), 
public and private preschool programs, child care programs 
(including home-based providers), or other entities described 
in subsection (a), to include such entities described in this 
paragraph in the evidence-based trauma initiatives, activities, 
support services, and mental health systems established under 
this section in order to provide, develop, or improve prevention,
H. R. 6—160 
screening, referral, and treatment and support services to young 
children and their families. 
(d) APPLICATIONS.—To be eligible to receive a grant, contract, 
or cooperative agreement under this section, an entity described 
in subsection (a) shall submit an application to the Secretary at 
such time, in such manner, and containing such information as 
the Secretary may reasonably require, which shall include the fol-
lowing: 
(1) A description of the innovative initiatives, activities, 
or programs to be funded under the grant, contract, or coopera-
tive agreement, including how such program will increase 
access to evidence-based trauma support services and mental 
health care for students, and, as applicable, the families of 
such students. 
(2) A description of how the program will provide linguis-
tically appropriate and culturally competent services. 
(3) A description of how the program will support students 
and the school in improving the school climate in order to 
support an environment conducive to learning. 
(4) An assurance that— 
(A) persons providing services under the grant, con-
tract, or cooperative agreement are adequately trained to 
provide such services; and 
(B) teachers, school leaders, administrators, specialized 
instructional support personnel, representatives of local 
Indian Tribes or tribal organizations as appropriate, other 
school personnel, and parents or guardians of students 
participating in services under this section will be engaged 
and involved in the design and implementation of the serv-
ices. 
(5) A description of how the applicant will support and 
integrate existing school-based services with the program in 
order to provide mental health services for students, as appro-
priate. 
(6) A description of the entities in the community with 
which the applicant will partner or to which the applicant 
will provide subgrants in accordance with subsection (c)(8). 
(e) INTERAGENCY AGREEMENTS.— 
(1) LOCAL
INTERAGENCY
AGREEMENTS.—To ensure the 
provision of the services described in subsection (c), a recipient 
of a grant, contract, or cooperative agreement under this sec-
tion, or their designee, shall establish a local interagency agree-
ment among local educational agencies, agencies responsible 
for early childhood education programs, Head Start agencies 
(including Early Head Start agencies), juvenile justice authori-
ties, mental health agencies, child welfare agencies, and other 
relevant agencies, authorities, or entities in the community 
that will be involved in the provision of such services. 
(2) CONTENTS.—In ensuring the provision of the services 
described in subsection (c), the local interagency agreement 
shall specify with respect to each agency, authority, or entity 
that is a party to such agreement— 
(A) the financial responsibility for the services; 
(B) the conditions and terms of responsibility for the 
services, including quality, accountability, and coordination 
of the services; and