1151
ing appropriately to the behavior of their
children;
‘‘(ii) services to facilitate the ability of
parents to serve as resources to one an-
other (such as through mutual support and
parent self-help groups);
‘‘(iii) early developmental screening of
children to assess any needs of children,
and to identify types of support that may
be provided;
‘‘(iv) 
outreach 
services 
provided
through voluntary home visits and other
methods to assist parents in becoming
aware of and able to participate in family
resources and support program activities;
‘‘(v) community and social services to
assist families in obtaining community re-
sources; and
‘‘(vi) followup services;
‘‘(B) provides, or arranges for the provi-
sion of, other core services through contracts or
agreements with other local agencies; and
‘‘(C) provides access to optional services,
directly or by contract, purchase of service, or
interagency agreement, including—
1152
‘‘(i) child care, early childhood devel-
opment and early intervention services;
‘‘(ii) self-sufficiency and life manage-
ment skills training;
‘‘(iii) education services, such as scho-
lastic tutoring, literacy training, and Gen-
eral Educational Degree services;
‘‘(iv) job readiness skills;
‘‘(v) child abuse and neglect preven-
tion activities;
‘‘(vi) services that families with chil-
dren with disabilities or special needs may
require;
‘‘(vii) community and social service re-
ferral;
‘‘(viii) peer counseling;
‘‘(ix) referral for substance abuse
counseling and treatment; and
‘‘(x) help line services.
‘‘(4) INDIAN
TRIBE
AND
TRIBAL
ORGANIZA-
TION.—The terms ‘Indian tribe’ and ‘tribal organi-
zation’ shall have the same meanings given such
terms in subsections (e) and (l), respectively, of sec-
tion 4 of the Indian Self-Determination and Edu-
cation Assistance Act (25 U.S.C. 450b (e) and (l)).
1153
‘‘(5) RESPITE
SERVICES.—The term ‘respite
services’ means short-term care services provided in
the temporary absence of the regular caregiver (par-
ent, other relative, foster parent, adoptive parent, or
guardian) to children who—
‘‘(A) are in danger of abuse or neglect;
‘‘(B) have experienced abuse or neglect; or
‘‘(C) have disabilities, chronic, or terminal
illnesses.
Such services shall be provided within or outside the
home of the child, be short-term care (ranging from
a few hours to a few weeks of time, per year), and
be intended to enable the family to stay together and
to keep the child living in the home and community
of the child.
‘‘(6) SECRETARY.—The term ‘Secretary’ means
the Secretary of Health and Human Services.
‘‘(7) SEXUAL ABUSE.—The term ‘sexual abuse’
includes—
‘‘(A) the employment, use, persuasion, in-
ducement, enticement, or coercion of any child
to engage in, or assist any other person to en-
gage in, any sexually explicit conduct or simula-
tion of such conduct for the purpose of produc-
ing a visual depiction of such conduct; or
1154
‘‘(B) the rape, molestation, prostitution, or
other form of sexual exploitation of children, or
incest with children.
‘‘(8) STATE.—The term ‘State’ means each of
the several States, the District of Columbia, the
Commonwealth of Puerto Rico, the Virgin Islands,
Guam, American Samoa, the Commonwealth of the
Northern Mariana Islands, and the Trust Territory
of the Pacific Islands.
‘‘(9) WITHHOLDING OF MEDICALLY INDICATED
TREATMENT.—The term ‘withholding of medically
indicated treatment’ means the failure to respond to
the infant’s life-threatening conditions by providing
treatment (including appropriate nutrition, hydra-
tion, and medication) which, in the treating physi-
cian’s or physicians’ reasonable medical judgment,
will be most likely to be effective in ameliorating or
correcting all such conditions, except that the term
does not include the failure to provide treatment
(other than appropriate nutrition, hydration, or
medication) to an infant when, in the treating physi-
cian’s or physicians’ reasonable medical judgment—
‘‘(A) the infant is chronically and irrevers-
ibly comatose;
1155
‘‘(B) the provision of such treatment
would—
‘‘(i) merely prolong dying;
‘‘(ii) not be effective in ameliorating
or correcting all of the infant’s life-threat-
ening conditions; or
‘‘(iii) otherwise be futile in terms of
the survival of the infant; or
‘‘(C) the provision of such treatment would
be virtually futile in terms of the survival of the
infant and the treatment itself under such cir-
cumstances would be inhumane.
‘‘TITLE I—GENERAL BLOCK
GRANT
‘‘SEC. 101. CHILD AND FAMILY SERVICES BLOCK GRANTS.
‘‘(a) ELIGIBILITY.—The Secretary shall award
grants to eligible States that file a State plan that is ap-
proved under section 102 and that otherwise meet the eli-
gibility requirements for grants under this title.
‘‘(b) AMOUNT OF GRANT.—The amount of a grant
made to each State under subsection (a) for a fiscal year
shall be based on the population of children under the age
of 18 residing in each State that applies for a grant under
this section.
1156
‘‘(c) USE
OF AMOUNTS.—Amounts received by a
State under a grant awarded under subsection (a) shall
be used to carry out the purposes described in section 3.
‘‘SEC. 102. ELIGIBLE STATES.
‘‘(a) IN GENERAL.—As used in this title, the term
‘eligible State’ means a State that has submitted to the
Secretary, not later than October 1, 1996, and every 3
years thereafter, a plan which has been signed by the chief
executive officer of the State and that includes the follow-
ing:
‘‘(1) OUTLINE
OF
CHILD
PROTECTION
PRO-
GRAM.—A written document that outlines the activi-
ties the State intends to conduct to achieve the pur-
pose of this title, including the procedures to be used
for—
‘‘(A) receiving and assessing reports of
child abuse or neglect;
‘‘(B) investigating such reports;
‘‘(C) with respect to families in which
abuse or neglect has been confirmed, providing
services or referral for services for families and
children where the State makes a determination
that the child may safely remain with the fam-
ily;
1157
‘‘(D) protecting children by removing them
from dangerous settings and ensuring their
placement in a safe environment;
‘‘(E) providing training for individuals
mandated to report suspected cases of child
abuse or neglect;
‘‘(F) protecting children in foster care;
‘‘(G) promoting timely adoptions;
‘‘(H) protecting the rights of families,
using adult relatives as the preferred placement
for children separated from their parents where
such relatives meet the relevant State child pro-
tection standards; and
‘‘(I) providing services to individuals, fami-
lies, or communities, either directly or through
referral, that are aimed at preventing the occur-
rence of child abuse and neglect.
‘‘(2) CERTIFICATION OF STATE LAW REQUIRING
THE REPORTING OF CHILD ABUSE AND NEGLECT.—
A certification that the State has in effect laws that
require public officials and other professionals to re-
port, in good faith, actual or suspected instances of
child abuse or neglect.
‘‘(3) CERTIFICATION
OF
PROCEDURES
FOR
SCREENING, SAFETY ASSESSMENT, AND PROMPT IN-
1158
VESTIGATION.—A certification that the State has in
effect procedures for receiving and responding to re-
ports of child abuse or neglect, including the reports
described in paragraph (2), and for the immediate
screening, safety assessment, and prompt investiga-
tion of such reports.
‘‘(4) CERTIFICATION
OF
STATE
PROCEDURES
FOR REMOVAL AND PLACEMENT OF ABUSED OR NE-
GLECTED CHILDREN.—A certification that the State
has in effect procedures for the removal from fami-
lies and placement of abused or neglected children
and of any other child in the same household who
may also be in danger of abuse or neglect.
‘‘(5) CERTIFICATION OF PROVISIONS FOR IMMU-
NITY FROM PROSECUTION.—A certification that the
State has in effect laws requiring immunity from
prosecution under State and local laws and regula-
tions for individuals making good faith reports of
suspected or known instances of child abuse or ne-
glect.
‘‘(6) CERTIFICATION OF PROVISIONS AND PRO-
CEDURES
RELATING
TO
APPEALS.—A certification
that not later than 2 years after the date of the en-
actment of this Act, the State shall have laws and
procedures in effect affording individuals an oppor-
1159
tunity to appeal an official finding of abuse or ne-
glect.
‘‘(7) CERTIFICATION
OF
STATE
PROCEDURES
FOR DEVELOPING AND REVIEWING WRITTEN PLANS
FOR PERMANENT PLACEMENT OF REMOVED CHIL-
DREN.—A certification that the State has in effect
procedures for ensuring that a written plan is pre-
pared for children who have been removed from their
families. Such plan shall specify the goals for achiev-
ing a permanent placement for the child in a timely
fashion, for ensuring that the written plan is re-
viewed every 6 months (until such placement is
achieved), and for ensuring that information about
such children is collected regularly and recorded in
case records, and include a description of such pro-
cedures.
‘‘(8) CERTIFICATION OF STATE PROGRAM TO
PROVIDE INDEPENDENT LIVING SERVICES.—A cer-
tification that the State has in effect a program to
provide independent living services, for assistance in
making the transition to self-sufficient adulthood, to
individuals in the child protection program of the
State who are 16, but who are not 20 (or, at the
option of the State, 22), years of age, and who do
not have a family to which to be returned.
1160
‘‘(9) CERTIFICATION
OF
STATE
PROCEDURES
TO RESPOND TO REPORTING OF MEDICAL NEGLECT
OF DISABLED INFANTS.—
‘‘(A) IN
GENERAL.—A certification that
the State has in place for the purpose of re-
sponding to the reporting of medical neglect of
infants (including instances of withholding of
medically indicated treatment from disabled in-
fants with life-threatening conditions), proce-
dures or programs, or both (within the State
child protective services system), to provide
for—
‘‘(i) coordination and consultation
with individuals designated by and within
appropriate health-care facilities;
‘‘(ii) prompt notification by individ-
uals designated by and within appropriate
health-care facilities of cases of suspected
medical neglect (including instances of
withholding of medically indicated treat-
ment from disabled infants with life-threat-
ening conditions); and
‘‘(iii) authority, under State law, for
the State child protective service to pursue
any legal remedies, including the authority
1161
to initiate legal proceedings in a court of
competent jurisdiction, as may be nec-
essary to prevent the withholding of medi-
cally indicated treatment from disabled in-
fants with life-threatening conditions.
‘‘(B) WITHHOLDING OF MEDICALLY INDI-
CATED TREATMENT.—As used in subparagraph
(A), the term ‘withholding of medically indi-
cated treatment’ means the failure to respond
to the infant’s life-threatening conditions by
providing treatment (including appropriate nu-
trition, hydration, and medication) which, in the
treating physician’s or physicians’ reasonable
medical judgment, will be most likely to be ef-
fective in ameliorating or correcting all such
conditions, except that such term does not in-
clude the failure to provide treatment (other
than appropriate nutrition, hydration, or medi-
cation) to an infant when, in the treating physi-
cian’s or physicians’ reasonable medical judg-
ment—
‘‘(i) the infant is chronically and irre-
versibly comatose;
‘‘(ii) the provision of such treatment
would—
1162
‘‘(I) merely prolong dying;
‘‘(II) not be effective in amelio-
rating or correcting all of the infant’s
life-threatening conditions; or
‘‘(III) otherwise be futile in
terms of the survival of the infant; or
‘‘(iii) the provision of such treatment
would be virtually futile in terms of the
survival of the infant and the treatment it-
self under such circumstances would be in-
humane.
‘‘(10) IDENTIFICATION OF CHILD PROTECTION
GOALS.—The quantitative goals of the State child
protection program.
‘‘(11) CERTIFICATION OF CHILD PROTECTION
STANDARDS.—With respect to fiscal years beginning
on or after April 1, 1996, a certification that the
State—
‘‘(A) has completed an inventory of all
children who, before the inventory, had been in
foster care under the responsibility of the State
for 6 months or more, which determined—
‘‘(i) the appropriateness of, and neces-
sity for, the foster care placement;
1163
‘‘(ii) whether the child could or should
be returned to the parents of the child or
should be freed for adoption or other per-
manent placement; and
‘‘(iii) the services necessary to facili-
tate the return of the child or the place-
ment of the child for adoption or legal
guardianship;
‘‘(B) is operating, to the satisfaction of the
Secretary—
‘‘(i) a statewide information system
from which can be readily determined the
status, demographic characteristics, loca-
tion, and goals for the placement of every
child who is (or, within the immediately
preceding 12 months, has been) in foster
care;
‘‘(ii) a case review system for each
child receiving foster care under the super-
vision of the State;
‘‘(iii) a service program designed to
help children—
‘‘(I) where appropriate, return to
families from which they have been
removed; or
1164
‘‘(II) be placed for adoption, with
a legal guardian, or if adoption or
legal guardianship is determined not
to be appropriate for a child, in some
other planned, permanent living ar-
rangement; and
‘‘(iv) a preplacement preventive serv-
ices program designed to help children at
risk for foster care placement remain with
their families; and
‘‘(C)(i) has reviewed (or not later than Oc-
tober 1, 1997, will review) State policies and
administrative and judicial procedures in effect
for children abandoned at or shortly after birth
(including policies and procedures providing for
legal representation of such children); and
‘‘(ii) is implementing (or not later than Oc-
tober 1, 1997, will implement) such policies and
procedures as the State determines, on the
basis of the review described in clause (i), to be
necessary to enable permanent decisions to be
made expeditiously with respect to the place-
ment of such children.
‘‘(12) CERTIFICATION
OF
REASONABLE
EF-
FORTS BEFORE PLACEMENT OF CHILDREN IN FOS-
1165
TER CARE.—A certification that the State in each
case will—
‘‘(A) make reasonable efforts prior to the
placement of a child in foster care, to prevent
or eliminate the need for removal of the child
from the child’s home, and to make it possible
for the child to return home; and
‘‘(B) with respect to families in which
abuse or neglect has been confirmed, provide
services or referral for services for families and
children where the State makes a determination
that the child may safely remain with the fam-
ily.
‘‘(13) CERTIFICATION
OF
CONFIDENTIALITY
AND
REQUIREMENTS
FOR
INFORMATION
DISCLO-
SURE.—
‘‘(A) IN
GENERAL.—A certification that
the State has in effect and operational—
‘‘(i) requirements ensuring that re-
ports and records made and maintained
pursuant to the purposes of this part shall
only be made available to—
‘‘(I) individuals who are the sub-
ject of the report;
1166
‘‘(II) Federal, State, or local gov-
ernment entities, or any agent of such
entities, having a need for such infor-
mation in order to carry out their re-
sponsibilities under law to protect
children from abuse and neglect;
‘‘(III) child abuse citizen review
panels;
‘‘(IV) child fatality review panels;
‘‘(V) a grand jury or court, upon
a finding that information in the
record is necessary for the determina-
tion of an issue before the court or
grand jury; and
‘‘(VI) other entities or classes of
individuals statutorily authorized by
the State to receive such information
pursuant to a legitimate State pur-
pose; and
‘‘(ii) provisions that allow for public
disclosure of the findings or information
about cases of child abuse or neglect that
have resulted in a child fatality or near fa-
tality.
1167
‘‘(B) LIMITATION.—Disclosures made pur-
suant to clause (i) or (ii) shall not include the
identifying information concerning the individ-
ual initiating a report or complaint alleging sus-
pected instances of child abuse or neglect.
‘‘(C) DEFINITION.—For purposes of this
paragraph, the term ‘near fatality’ means an
act that, as certified by a physician, places the
child in serious or critical condition.
‘‘(b) DETERMINATIONS.—The Secretary shall deter-
mine whether a plan submitted pursuant to subsection (a)
contains the material required by subsection (a), other
than the material described in paragraph (9) of such sub-
section. The Secretary may not require a State to include
in such a plan any material not described in subsection
(a).
‘‘SEC. 103. DATA COLLECTION AND REPORTING.
‘‘(a) NATIONAL CHILD ABUSE AND NEGLECT DATA
SYSTEM.—The Secretary shall establish a national data
collection and analysis program—
‘‘(1) which, to the extent practicable, coordi-
nates existing State child abuse and neglect reports
and which shall include—
1168
‘‘(A) standardized data on substantiated,
as well as false, unfounded, or unsubstantiated
reports; and
‘‘(B) information on the number of deaths
due to child abuse and neglect; and
‘‘(2) which shall collect, compile, analyze, and
make available State child abuse and neglect report-
ing information which, to the extent practical, is uni-
versal and case-specific and integrated with other
case-based foster care and adoption data collected by
the Secretary.
‘‘(b) ADOPTION AND FOSTER CARE AND ANALYSIS
AND REPORTING SYSTEMS.—The Secretary shall imple-
ment a system for the collection of data relating to adop-
tion and foster care in the United States. Such data collec-
tion system shall—
‘‘(1) avoid unnecessary diversion of resources
from agencies responsible for adoption and foster
care;
‘‘(2) assure that any data that is collected is re-
liable and consistent over time and among jurisdic-
tions through the use of uniform definitions and
methodologies;
‘‘(3) provide comprehensive national informa-
tion with respect to—
1169
‘‘(A) the demographic characteristics of
adoptive and foster children and their biological
and adoptive or foster parents;
‘‘(B) the status of the foster care popu-
lation (including the number of children in fos-
ter care, length of placement, type of place-
ment, availability for adoption, and goals for
ending or continuing foster care);
‘‘(C) the number and characteristics of—
‘‘(i) children placed in or removed
from foster care;
‘‘(ii) children adopted or with respect
to whom adoptions have been terminated;
and
‘‘(iii) children placed in foster care
outside the State which has placement and
care responsibility; and
‘‘(D) the extent and nature of assistance
provided by Federal, State, and local adoption
and foster care programs and the characteris-
tics of the children with respect to whom such
assistance is provided; and
‘‘(4) utilize appropriate requirements and incen-
tives to ensure that the system functions reliably
throughout the United States.
1170
‘‘(c) ADDITIONAL
INFORMATION.—The Secretary
may require the provision of additional information under
the data collection system established under subsection (b)
if the addition of such information is agreed to by a major-
ity of the States.
‘‘(d) ANNUAL REPORT BY THE SECRETARY.—Within
6 months after the end of each fiscal year, the Secretary
shall prepare a report based on information provided by
the States for the fiscal year pursuant to this section, and
shall make the report and such information available to
the Congress and the public.
‘‘TITLE 
II—RESEARCH, 
DEM-
ONSTRATIONS, 
TRAINING,
AND TECHNICAL ASSISTANCE
‘‘SEC. 201. RESEARCH GRANTS.
‘‘(a) IN GENERAL.—The Secretary, in consultation
with appropriate Federal officials and recognized experts
in the field, shall award grants or contracts for the con-
duct of research in accordance with subsection (b).
‘‘(b) RESEARCH.—Research projects to be conducted
using amounts received under this section—
‘‘(1) shall be designed to provide information to
better protect children from abuse or neglect and to
improve the well-being of abused or neglected chil-
1171
dren, with at least a portion of any such research
conducted under a project being field initiated;
‘‘(2) shall at a minimum, focus on—
‘‘(A) the nature and scope of child abuse
and neglect;
‘‘(B) the causes, prevention, assessment,
identification, treatment, cultural and socio-
economic distinctions, and the consequences of
child abuse and neglect;
‘‘(C) appropriate, effective and culturally
sensitive investigative, administrative, and judi-
cial procedures with respect to cases of child
abuse; and
‘‘(D) the national incidence of child abuse
and neglect, including—
‘‘(i) the extent to which incidents of
child abuse are increasing or decreasing in
number and severity;
‘‘(ii) the incidence of substantiated
and unsubstantiated reported child abuse
cases;
‘‘(iii) the number of substantiated
cases that result in a judicial finding of
child abuse or neglect or related criminal
court convictions;
1172
‘‘(iv) the extent to which the number
of unsubstantiated, unfounded and false
reported cases of child abuse or neglect
have contributed to the inability of a State
to respond effectively to serious cases of
child abuse or neglect;
‘‘(v) the extent to which the lack of
adequate resources and the lack of ade-
quate training of reporters have contrib-
uted to the inability of a State to respond
effectively to serious cases of child abuse
and neglect;
‘‘(vi) the number of unsubstantiated,
false, or unfounded reports that have re-
sulted in a child being placed in substitute
care, and the duration of such placement;
‘‘(vii) the extent to which unsubstan-
tiated reports return as more serious cases
of child abuse or neglect;
‘‘(viii) the incidence and prevalence of
physical, sexual, and emotional abuse and
physical and emotional neglect in sub-
stitute care;
‘‘(ix) the incidence and outcomes of
abuse allegations reported within the con-
1173
text of divorce, custody, or other family
court proceedings, and the interaction be-
tween this venue and the child protective
services system; and
‘‘(x) the cases of children reunited
with their families or receiving family pres-
ervation services that result in subsequent
substantiated reports of child abuse and
neglect, including the death of the child;
and
‘‘(3) may include the appointment of an advi-
sory board to—
‘‘(A) provide recommendations on coordi-
nating Federal, State, and local child abuse and
neglect activities at the State level with similar
activities at the State and local level pertaining
to family violence prevention;
‘‘(B) consider specific modifications needed
in State laws and programs to reduce the num-
ber of unfounded or unsubstantiated reports of
child abuse or neglect while enhancing the abil-
ity to identify and substantiate legitimate cases
of abuse or neglect which place a child in dan-
ger; and
1174
‘‘(C) provide recommendations for modi-
fications needed to facilitate coordinated na-
tional and Statewide data collection with re-
spect to child protection and child welfare.
‘‘SEC. 202. NATIONAL CLEARINGHOUSE FOR INFORMATION
RELATING TO CHILD ABUSE.
‘‘(a) 
ESTABLISHMENT.—The 
Secretary 
shall,
through the Department of Health and Human Services,
or by one or more contracts of not less than 3 years dura-
tion provided through a competition, establish a national
clearinghouse for information relating to child abuse.
‘‘(b) FUNCTIONS.—The Secretary shall, through the
clearinghouse established by subsection (a)—
‘‘(1) maintain, coordinate, and disseminate in-
formation on all programs, including private pro-
grams, that show promise of success with respect to
the prevention, assessment, identification, and treat-
ment of child abuse and neglect;
‘‘(2) maintain and disseminate information re-
lating to—
‘‘(A) the incidence of cases of child abuse
and neglect in the United States;
‘‘(B) the incidence of such cases in popu-
lations determined by the Secretary under sec-
tion 105(a)(1) of the Child Abuse Prevention,
1198
ment and Budget, the Secretary of Health and
Human Services shall prepare and submit to the
Congress a legislative proposal in the form of an im-
plementing bill containing technical and conforming
amendments to reflect the repeals made by this sec-
tion.
(2) SUBMISSION TO CONGRESS.—Not later than
6 months after the date of enactment of this sub-
chapter, the Secretary of Health and Human Serv-
ices shall submit the implementing bill referred to
under paragraph (1).
Subtitle G—Child Care
SEC. 4801. SHORT TITLE AND REFERENCES.
(a) SHORT TITLE.—This subtitle may be cited as the
‘‘Child Care and Development Block Grant Amendments
of 1996’’.
(b) REFERENCES.—Except as otherwise expressly
provided, whenever in this subtitle an amendment or re-
peal is expressed in terms of an amendment to, or repeal
of, a section or other provision, the reference shall be con-
sidered to be made to a section or other provision of the
Child Care and Development Block Grant Act of 1990 (42
U.S.C. 9858 et seq.).