IIB 
116TH CONGRESS 
2D SESSION 
H. R. 2271 
IN THE SENATE OF THE UNITED STATES 
SEPTEMBER 22, 2020 
Received; read twice and referred to the Committee on Health, Education, 
Labor, and Pensions 
AN ACT 
To amend the Public Health Service Act to improve the 
health of children and help better understand and en-
hance awareness about unexpected sudden death in early 
life. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Scarlett’s Sunshine 
on Sudden Unexpected Death Act’’. 
SEC. 2. ADDRESSING SUDDEN UNEXPECTED INFANT DEATH 
AND SUDDEN UNEXPECTED DEATH IN CHILD-
HOOD. 
Part B of title XI of the Public Health Service Act 
(42 U.S.C. 241 et seq.) is amended— 
(1) in the part heading, by striking ‘‘SUDDEN 
INFANT DEATH SYNDROME’’ and inserting ‘‘SUD-
DEN UNEXPECTED INFANT DEATH, SUDDEN IN-
FANT DEATH SYNDROME, AND SUDDEN UNEX-
PECTED DEATH IN CHILDHOOD’’; and 
(2) by inserting before section 1122 the fol-
lowing: 
‘‘SEC. 1121. ADDRESSING SUDDEN UNEXPECTED INFANT 
DEATH AND SUDDEN UNEXPECTED DEATH IN 
CHILDHOOD. 
‘‘(a) IN GENERAL.—The Secretary may develop, sup-
port, or maintain programs or activities to address sudden 
unexpected infant death and sudden unexpected death in 
childhood, including by— 
‘‘(1) continuing to support the Sudden Unex-
pected Infant Death and Sudden Death in the 
Young Case Registry of the Centers for Disease 
Control and Prevention and other fatality case re-
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porting systems that include data pertaining to sud-
den unexpected infant death and sudden unexpected 
death in childhood, as appropriate, including such 
systems supported by the Health Resources and 
Services Administration, in order to— 
‘‘(A) increase the number of States and ju-
risdictions participating in such systems; or 
‘‘(B) improve the utility of such systems, 
which may include— 
‘‘(i) making summary data available 
to the public in a timely manner on the 
internet website of the Department of 
Health and Human Services, in a manner 
that, at a minimum, protects personal pri-
vacy to the extent required by applicable 
Federal and State law; and 
‘‘(ii) making the data submitted to 
such systems available to researchers, in a 
manner that, at a minimum, protects per-
sonal privacy to the extent required by ap-
plicable Federal and State law; and 
‘‘(2) awarding grants or cooperative agreements 
to States, Indian Tribes, and Tribal organizations 
for purposes of— 
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‘‘(A) supporting fetal and infant mortality 
and child death review programs for sudden un-
expected infant death and sudden unexpected 
death in childhood, including by establishing 
such programs at the local level; 
‘‘(B) improving data collection related to 
sudden unexpected infant death and sudden un-
expected death in childhood, including by— 
‘‘(i) improving the completion of death 
scene investigations and comprehensive au-
topsies that include a review of clinical his-
tory and circumstances of death with ap-
propriate ancillary testing; and 
‘‘(ii) training medical examiners, coro-
ners, death scene investigators, law en-
forcement personnel, emergency medical 
technicians, paramedics, emergency depart-
ment personnel, and others who perform 
death scene investigations with respect to 
the deaths of infants and children, as ap-
propriate; 
‘‘(C) identifying, developing, and imple-
menting best practices to reduce or prevent 
sudden unexpected infant death and sudden un-
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expected death in childhood, including practices 
to reduce sleep-related infant deaths; 
‘‘(D) increasing the voluntary inclusion, in 
fatality case reporting systems established for 
the purpose of conducting research on sudden 
unexpected infant death and sudden unexpected 
death in childhood, of samples of tissues or ge-
netic materials from autopsies that have been 
collected pursuant to Federal or State law; or 
‘‘(E) disseminating information and mate-
rials to health care professionals and the public 
on risk factors that contribute to sudden unex-
pected infant death and sudden unexpected 
death in childhood, which may include informa-
tion on risk factors that contribute to sleep-re-
lated sudden unexpected infant death or sudden 
unexpected death in childhood. 
‘‘(b) APPLICATION.—To be eligible to receive a grant 
or cooperative agreement under subsection (a)(2), a State, 
Indian Tribe, or Tribal organization shall submit to the 
Secretary an application at such time, in such manner, 
and containing such information as the Secretary may re-
quire, including information on how such State will ensure 
activities conducted under this section are coordinated 
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with other federally-funded programs to reduce infant 
mortality, as appropriate. 
‘‘(c) TECHNICAL ASSISTANCE.—The Secretary shall 
provide technical assistance to States, Tribes, and Tribal 
organizations receiving a grant or cooperative agreement 
under subsection (a)(2) for purposes of carrying out ac-
tivities funded through the grant or cooperative agree-
ment. 
‘‘(d) REPORTING FORMS.— 
‘‘(1) IN GENERAL.—The Secretary shall, as ap-
propriate, encourage the use of sudden unexpected 
infant death and sudden unexpected death in child-
hood reporting forms developed in collaboration with 
the Centers for Disease Control and Prevention to 
improve the quality of data submitted to the Sudden 
Unexpected Infant Death and Sudden Death in the 
Young Case Registry, and other fatality case report-
ing systems that include data pertaining to sudden 
unexpected infant death and sudden unexpected 
death in childhood. 
‘‘(2) UPDATE OF FORMS.—The Secretary shall 
assess whether updates are needed to the sudden un-
expected infant death investigation reporting form 
used by the Centers for Disease Control and Preven-
tion in order to improve the use of such form with 
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other fatality case reporting systems supported by 
the Department of Health and Human Services, and 
shall make such updates as appropriate. 
‘‘(e) SUPPORT SERVICES.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Administrator, shall award grants to 
national organizations, State and local health de-
partments, community-based organizations, and non-
profit organizations for the provision of support 
services to families who have had a child die of sud-
den unexpected infant death or sudden unexpected 
death in childhood. 
‘‘(2) APPLICATION.—To be eligible to receive a 
grant under subsection (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. 
‘‘(3) USE OF FUNDS.—Amounts received under 
a grant awarded under paragraph (1) may be 
used— 
‘‘(A) to provide grief counseling, education, 
home visits, 24-hour hotlines, or information, 
resources, and referrals; 
‘‘(B) to ensure access to grief and bereave-
ment services; 
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‘‘(C) to build capacity in professionals 
working with families who experience a sudden 
death; or 
‘‘(D) to support peer-to-peer groups for 
families who have lost a child to sudden unex-
pected infant death or sudden unexpected death 
in childhood. 
‘‘(4) PREFERENCE.—In awarding grants under 
paragraph (1), the Secretary shall give preference to 
applicants that— 
‘‘(A) have a proven history of effective di-
rect support services and interventions for sud-
den unexpected infant death and sudden unex-
plained death in childhood; and 
‘‘(B) demonstrate experience through col-
laborations and partnerships for delivering serv-
ices described in paragraph (3). 
‘‘(f) DEFINITIONS.—In this section: 
‘‘(1) SUDDEN UNEXPECTED INFANT DEATH.— 
The term ‘sudden unexpected infant death’— 
‘‘(A) means the sudden death of an infant 
under 1 year of age that when first discovered 
did not have an obvious cause; and 
‘‘(B) includes— 
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‘‘(i) such deaths that are explained; 
and 
‘‘(ii) such deaths that remain unex-
plained (which are known as sudden infant 
death syndrome). 
‘‘(2) SUDDEN UNEXPECTED DEATH IN CHILD-
HOOD.—The term ‘sudden unexpected death in 
childhood’— 
‘‘(A) means the sudden death of a child 
who is at least 1 year of age but not more than 
17 years of age that, when first discovered, did 
not have an obvious cause; and 
‘‘(B) includes— 
‘‘(i) such deaths that are explained; 
and 
‘‘(ii) such deaths that remain unex-
plained (which are known as sudden unex-
plained death in childhood). 
‘‘(3) SUDDEN UNEXPLAINED DEATH IN CHILD-
HOOD.—The term ‘sudden unexplained death in 
childhood’ means a sudden unexpected death in 
childhood that remains unexplained after a thorough 
case investigation. 
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there is authorized 
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to be appropriated $33,000,000 for each of fiscal years 
2021 through 2024.’’. 
SEC. 3. REPORT TO CONGRESS. 
(a) IN GENERAL.—Not later than 2 years after the 
date of enactment of this Act, and biennially thereafter, 
the Secretary of Health and Human Services shall submit 
to the Committee on Energy and Commerce of the House 
of Representatives and the Committee on Health, Edu-
cation, Labor, and Pensions of the Senate a report that 
contains, with respect to the reporting period— 
(1) information regarding the incidence and 
number of sudden unexpected infant deaths and 
sudden unexpected deaths in childhood (including 
the number of such infant and child deaths that re-
main unexplained after investigation), including, to 
the extent practicable— 
(A) a summary of such information by ra-
cial and ethnic group, and by State; 
(B) aggregate information obtained from 
death scene investigations and autopsies; and 
(C) recommendations for reducing the inci-
dence of sudden unexpected infant death and 
sudden unexpected death in childhood; 
(2) an assessment of the extent to which var-
ious approaches of reducing and preventing sudden 
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unexpected infant death and sudden unexpected 
death in childhood have been effective; and 
(3) a description of the activities carried out 
under section 1121 of the Public Health Service Act 
(as added by section 2). 
(b) DEFINITIONS.—In this section, the terms ‘‘sud-
den unexpected infant death’’ and ‘‘sudden unexpected 
death in childhood’’ have the meanings given such terms 
in section 1121 of the Public Health Service Act (as added 
by section 2). 
Passed the House of Representatives September 21, 
2020. 
Attest: 
CHERYL L. JOHNSON, 
Clerk. 
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