I 
116TH CONGRESS 
2D SESSION 
H. R. 8544 
To amend the Public Health Service Act to support the development and 
implementation of programs using data analysis to identify and facilitate 
strategies to improve outcomes for children in geographic areas with 
a high prevalence of trauma from exposure to adverse childhood experi-
ences, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 6, 2020 
Ms. PRESSLEY (for herself and Mrs. CAROLYN B. MALONEY of New York) 
introduced the following bill; which was referred to the Committee on En-
ergy and Commerce 
A BILL 
To amend the Public Health Service Act to support the 
development and implementation of programs using data 
analysis to identify and facilitate strategies to improve 
outcomes for children in geographic areas with a high 
prevalence of trauma from exposure to adverse childhood 
experiences, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Services and Trauma- 
informed Research of Outcomes in Neighborhoods Grants 
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for Support for Children Act of 2020’’ or the ‘‘STRONG 
Support for Children Act of 2020’’. 
SEC. 2. FINDINGS. 
Congress finds that— 
(1) childhood trauma is a pervasive public 
health issue with long-term negative effects that 
costs the United States thousands of lives and bil-
lions of dollars; 
(2) addressing childhood and adolescent trauma 
requires a comprehensive Federal approach that rec-
ognizes its severe impact and prioritizes trauma-in-
formed prevention and treatment that is reparative, 
healing-centered, gender-responsive, culturally spe-
cific, and community-based; 
(3) adults who have suffered from adverse 
childhood experiences are at much greater risk of 
death, including as the result of heart disease, lung 
disease, cancer, substance use disorder, and suicide; 
(4) childhood and adolescent exposures to ad-
verse childhood experiences are generational and 
persistent and can lead to complex trauma and toxic 
stress impacting brain development and triggering 
epigenetics; 
(5) any Federal effort to prevent and treat 
trauma must acknowledge and address the impact of 
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historic and systemic causal factors, which include, 
but are not limited to, the trauma of— 
(A) historical and ongoing systemic racism, 
sexism, xenophobia, homophobia, transphobia, 
and ableism that have led to generations of vio-
lence and injustice and have robbed commu-
nities of their health, freedom, and peace of 
mind; 
(B) police brutality, racial profiling, and 
criminalization, as well as heightened police ac-
tivity and surveillance in some areas with high-
er police-reported crime, whether as a result of 
community violence or of racial profiling; 
(C) poverty and other systemic inequities, 
including lack of health care, housing insta-
bility, poor housing conditions, hunger and food 
instability and the accompanying malnutrition, 
and environmental injustice resulting from gen-
erations of racist policies, historic redlining, 
lending discrimination, and workplace discrimi-
nation; 
(D) gender-based violence, including sexual 
harassment and assault and discriminatory 
school discipline policies, especially for Black 
girls and girls of color; 
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(E) western colonization and systemic di-
vestment in native communities; 
(F) family separation policies, including 
‘‘zero-tolerance’’ immigration enforcement poli-
cies that have resulted in the deportation or the 
threat of deportation for countless immigrant 
families and have led to community mistrust 
and fear of reporting injustices; and 
(G) war and military presence, including 
the increased militarization of local, State, and 
Federal law enforcement agencies; and 
(6) the COVID–19 global health pandemic has 
increased and exacerbated the trauma inflicted on 
young people, specifically young people who— 
(A) live in communities with higher rates 
of infection and mortality; 
(B) have parents who are essential workers 
or first responders; 
(C) have parents who have lost their 
sources of income; 
(D) have witnessed death; 
(E) have had their education interrupted; 
(F) are living without access to green 
space and space for physical exercise; 
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(G) have become housing insecure and lack 
access to nutritious food; and 
(H) are isolated amidst increased domestic 
violence and sexual assault. 
SEC. 3. DATA ANALYSIS AND STRATEGY IMPLEMENTATION 
TO PREVENT AND MITIGATE CHILDHOOD 
TRAUMA. 
Title XXXI of the Public Health Service Act (42 
U.S.C. 300kk) is amended by adding at the end the fol-
lowing: 
‘‘SEC. 3102. DATA ANALYSIS AND STRATEGY IMPLEMENTA-
TION TO PREVENT AND MITIGATE CHILD-
HOOD TRAUMA. 
‘‘(a) IN GENERAL.—The Secretary shall establish a 
program— 
‘‘(1) to support the development and implemen-
tation of programs that use data analysis methods 
to identify and facilitate strategies for early inter-
vention and prevention, in order to prevent and miti-
gate childhood trauma and support communities and 
families, including— 
‘‘(A) improving connections through care 
coordination; 
‘‘(B) aligning community initiatives in tar-
geted areas of need; and 
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‘‘(C) 
expanding 
community 
capacity 
through cross-sector collaboration; and 
‘‘(2) to evaluate the effectiveness of these pro-
grams in improving outcomes for children. 
‘‘(b) GRANTS.—The Secretary shall award grants to 
up to 5 eligible entities to carry out the activities described 
in subsection (a). 
‘‘(c) USE OF FUNDS.—A grant for activities under 
this section shall be used to support the development and 
implementation of programs that use data analysis meth-
ods to identify and facilitate strategies for early interven-
tion and prevention, in order to prevent and mitigate 
childhood trauma and support communities and families, 
including as follows: 
‘‘(1) Utilize data analysis methods to— 
‘‘(A) identify specific geographic areas, 
such as census tracts, with a high prevalence of 
adverse childhood experiences and significant 
risk factors for poor outcomes for children 
(such as increased risk of experiencing adverse 
childhood experiences), including areas with 
high rates of— 
‘‘(i) poor public health outcomes in-
cluding illness, disease, suicide, and mor-
tality; 
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‘‘(ii) exclusionary discipline practices, 
including suspensions, expulsions, and re-
ferrals to law enforcement, as well as low 
graduation rates; 
‘‘(iii) substance use disorders; 
‘‘(iv) poverty; 
‘‘(v) foster system involvement or re-
ferrals; 
‘‘(vi) housing instability and homeless-
ness; 
‘‘(vii) food insecurity; 
‘‘(viii) inequity, including disparities 
in income, wealth, employment, educational 
attainment, health care access, and public 
health outcomes, along lines of race, sex, 
sexuality and gender identity, ethnicity, or 
nationality; 
‘‘(ix) incarceration rates; or 
‘‘(x) other indicators of adversity as 
defined by the Secretary; and 
‘‘(B) identify strategies to improve out-
comes for children aged 0 through 17 that build 
on strengths in communities that could be fur-
ther supported, including— 
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‘‘(i) existing support networks for 
families; and 
‘‘(ii) enhanced connections to commu-
nity-based organizations. 
‘‘(2) Implement strategies identified pursuant 
to paragraph (1)(B) to facilitate outreach and in-
volvement of children and their caregivers in Fed-
eral, State, or local programs that provide repar-
ative, gender-responsive, culturally specific, and 
trauma-informed prevention services, and for which 
children and their caregivers are eligible, including— 
‘‘(A) home visiting programs; 
‘‘(B) training and education on parenting 
skills; 
‘‘(C) substance use disorder prevention and 
treatment that is voluntary and noncoercive; 
‘‘(D) mental health supports and care that 
is voluntary and noncoercive; 
‘‘(E) family and intimate partner violence 
prevention services; 
‘‘(F) child advocacy center programming; 
‘‘(G) economic and nutrition support serv-
ices; 
‘‘(H) housing support services, including 
emergency and temporary shelter for those ex-
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periencing homelessness and housing insecurity, 
as well as stable, long-term housing; 
‘‘(I) voluntary, noncoercive, gender-respon-
sive, and culturally specific mental health sup-
ports in school and early childhood education 
center-based settings; 
‘‘(J) 
wraparound 
programs 
for 
transitioning youth and youth currently in the 
foster system; 
‘‘(K) programming to support the health 
and 
well-being 
of 
lesbian, 
gay, 
bisexual, 
transgender, and intersex children and their 
families; and 
‘‘(L) family resource center services. 
‘‘(d) SPECIAL RULES.— 
‘‘(1) PRIMARY PAYER RESTRICTION.—The Sec-
retary may not award a grant under this section to 
an eligible entity for a service if the service to be 
provided is available pursuant to the State plan ap-
proved under title XIX of the Social Security Act for 
the State in which the program funded by the grant 
is being conducted unless the State and all eligible 
subdivisions involved— 
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‘‘(A) will enter into agreements with public 
or nonprofit private entities under which the 
entities will provide the service; and 
‘‘(B) demonstrate that the State and all el-
igible subdivisions will ensure that the entities 
providing the service— 
‘‘(i) will seek payment for each such 
service rendered in accordance with the 
usual payment schedule under the State 
plan; and 
‘‘(ii) the entities have entered into a 
participation agreement and are qualified 
to receive payments under such plan. 
‘‘(2) IMPLEMENTATION.—An eligible entity that 
receives a grant under this section may use— 
‘‘(A) not more than 25 percent of the 
amounts made available through the grant for 
the first 24 months of the grant period to uti-
lize data analysis methods to— 
‘‘(i) identify specific geographic areas 
where care coordination, prevention and 
early intervention, and facilitation services 
will be provided; and 
‘‘(ii) identify support and intervention 
services to improve outcomes for children 
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located in a geographic area identified 
under subsection (c)(1)(A); and 
‘‘(B) not more than 10 percent of the 
grant in each subsequent year to continue data 
analysis activities. 
‘‘(3) ADMINISTRATION.—An eligible entity that 
receives a grant under this section may not use more 
than 5 percent of amounts received through the 
grant for administration, reporting, and program 
oversight functions, including the development of 
systems to improve data collection and data sharing 
for the purposes of improving services and the provi-
sion of care. 
‘‘(4) PRIORITY.— 
‘‘(A) IN
GENERAL.—In awarding grants 
under this section, the Secretary shall give pri-
ority, to the extent practical, to eligible entities 
that use community-based system dynamic 
modeling as the primary data analysis method. 
‘‘(B) SYSTEM
DYNAMIC
MODELING
DE-
FINED.—The term ‘system dynamic modeling’ 
means a method of data analysis and predictive 
modeling that includes— 
‘‘(i) utilization of community-based 
participatory research methods for involv-
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ing community in the process of under-
standing and changing systems and evalu-
ating outcomes of grants; 
‘‘(ii) consideration of a multitude of 
environmental risk factors and ascertain-
ment of the significance of contributing 
community risk factors for purposes of 
identifying strategies to reduce adverse 
child outcomes, including— 
‘‘(I) maltreatment cases; 
‘‘(II) involvement with the juve-
nile criminal legal system or foster 
system; 
‘‘(III) exclusionary school dis-
cipline; or 
‘‘(IV) exposure to violence; and 
‘‘(iii) identification of cross-sector re-
sponses involving reparative, trauma-in-
formed, culturally specific, gender-respon-
sive, and community-based organizations 
to reduce adverse child outcomes. 
‘‘(5) SUBGRANT.— 
‘‘(A) IN GENERAL.—An eligible entity that 
receives a grant under this section shall use at 
least 25 percent of the total amount of the 
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grant to make subgrants to organizations that 
aide in implementing the strategy identified 
under subsection (c)(1)(B) for preventing and 
mitigating childhood trauma and supporting 
communities and families. 
‘‘(B) ELIGIBILITY.—To be eligible to re-
ceive a subgrant under this paragraph, an orga-
nization shall prepare and submit to the eligible 
entity an application in such form, and con-
taining such information, as the eligible entity 
may require, including evidence that the— 
‘‘(i) needs of the population to be 
served are urgent and are not met by the 
services currently available in the geo-
graphic area; and 
‘‘(ii) the organization has the capacity 
to provide the services listed in subsection 
(c)(2). 
‘‘(C) 
SUPPLEMENT
NOT
SUPPLANT.— 
Subgrant funds received pursuant to this para-
graph by an organization shall be used to sup-
plement and not supplant State or local funds 
provided to the partnership organization for 
services listed in subsection (c)(2). 
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‘‘(e) APPLICATION.—To be eligible to receive a grant 
under this section, an eligible entity shall submit to the 
Secretary an application in such form, and containing 
such information, as the Secretary may require, to include 
the following: 
‘‘(1) A demonstration that— 
‘‘(A) the applicant utilizes trauma-in-
formed, culturally specific, and gender-respon-
sive practices, including a demonstration of the 
extent to which the applicant has trained staff 
in these practices; 
‘‘(B) the applicant has the capacity to ad-
minister the grant, including conducting all re-
quired data analysis activities; and 
‘‘(C) services will be provided to children 
and families in an accessible, culturally rel-
evant, and linguistically specific manner con-
sistent with local needs. 
‘‘(2) A preliminary analysis of how the appli-
cant will use the grant to— 
‘‘(A) identify the geographic area or areas 
to be served using data analysis methods; 
‘‘(B) utilize data analysis methods to iden-
tify strategies to improve outcomes for children 
in the geographic area; 
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‘‘(C) facilitate strategies identified through 
care coordination efforts; and 
‘‘(D) track data for evaluation of out-
comes. 
‘‘(3) A detailed project plan for the use of the 
grant that includes anticipated technical assistance 
needs. 
‘‘(4) Additional funding sources, including State 
and local funds, supporting the prevention and miti-
gation of adverse childhood experiences. 
‘‘(f) GRANT AMOUNT.—The amount of a grant under 
this section shall not exceed $9,500,000. 
‘‘(g) PERIOD OF A GRANT.—The period of a grant 
under this section shall not exceed 7 years. 
‘‘(h) SERVICE PROVISION WITHOUT REGARD
TO 
ABILITY TO PAY.—As a condition on receipt of a grant 
under this section, an eligible entity shall agree that any 
assistance provided to an individual through the grant will 
be provided without regard to— 
‘‘(1) the ability of the individual to pay for such 
services; 
‘‘(2) the current or past health condition of the 
individual to be served; 
‘‘(3) the immigration status of the individual to 
be served; 
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‘‘(4) the sexual orientation and gender identity 
of the individual to be served; and 
‘‘(5) any prior involvement of the individual in 
the criminal legal system. 
‘‘(i) PROHIBITIONS.—In addition to any other prohi-
bitions determined by the Secretary, an eligible entity may 
not use a grant under this section to— 
‘‘(1) use data analysis methods to inform indi-
vidual case decisions, including child removal or 
placement decisions, or to target services at certain 
individuals or families; 
‘‘(2) require any individual or family to partici-
pate in any service or program as a condition of re-
ceipt of a benefit to which the individual or family 
is otherwise eligible; 
‘‘(3) increase the presence or funding of law en-
forcement surveillance, involvement, or activity in 
implementing the strategies identified under sub-
section (c)(1)(B); or 
‘‘(4) enable the practice of conversion therapy. 
‘‘(j) EVALUATION.— 
‘‘(1) DATA
MODEL
EVALUATION.—Not later 
than 36 months after the date of enactment of this 
section, the Assistant Secretary for Planning and 
Evaluation of the Department of Health and Human 
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Services, in coordination with the grantees receiving 
a grant under this section, shall complete an evalua-
tion of the effectiveness of the data model accuracy 
of the grant program under this section to address 
each of the following: 
‘‘(A) Determining the effectiveness of the 
grantees’ use of data analysis methods to iden-
tify geographic areas pursuant to subsection 
(c)(1). 
‘‘(B) Examining the grantees’ development 
and utilization of data analysis methods. 
‘‘(C) Examining the grantees’ ability to ef-
fectively utilize data analysis methods in future 
prevention work. 
‘‘(D) Establishing a method for rigorously 
evaluating the activities of grantees and com-
paring the reduction of child and family expo-
sure to adverse experiences in other commu-
nities with similar demographics. 
‘‘(E) Examining the grantees’ utilization of 
community-based system dynamics modeling 
methods and other community engagement 
methods. 
‘‘(2) PROGRAM EVALUATION.—Not later than 6 
years after the date of enactment of this section, the 
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‘‘(I) children and adolescents’ 
health and well-being; 
‘‘(II) the number of children who 
enter into or depart from foster serv-
ices; and 
‘‘(III) homelessness and housing 
insecurity. 
‘‘(B) STUDY.— 
‘‘(i) IN GENERAL.—Not later than 7 
years after the date of enactment of this 
section, the Assistant Secretary for Plan-
ning and Evaluation of the Department of 
Health and Human Services shall— 
‘‘(I) complete a study on the re-
sults of the grant program under this 
section using the community-based 
participatory action research method, 
which focuses on social, structural, 
and physical environmental inequities 
through active involvement of commu-
nity members, clients, organizational 
representatives, and researchers in all 
aspects of the research process; and 
‘‘(II) submit a report on the re-
sults of the study to the Congress. 
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‘‘(ii) PARTNERS.—In conducting the 
study under clause (i), the Assistant Sec-
retary for Planning and Evaluation of the 
Department of Health and Human Serv-
ices shall ensure that partners and persons 
that have participated in the grant pro-
gram under this section on every level, es-
pecially those such partners or persons re-
ceiving services and support through the 
program, have an opportunity to contribute 
their expertise to evaluating the strategy 
and outcomes. 
‘‘(k) REPORT.—Not later than three months after the 
completion of the evaluation required by subsection (j)(2), 
the Assistant Secretary for Planning and Evaluation of 
the Department of Health and Human Services shall sub-
mit to Congress and make available to the public on the 
internet website of the Department of Health and Human 
Services a report based upon the evaluation under sub-
section (j)(2), to include— 
‘‘(1) the impact of the program under this sec-
tion on homelessness and housing insecurity, sub-
stance use disorder and drug deaths, incarceration, 
foster system involvement, and other child and fam-
ily outcomes as identified by the Assistant Secretary 
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for Planning and Evaluation of the Department of 
Health and Human Services; 
‘‘(2) an analysis of which elements of the pro-
gram should be replicated and scaled by govern-
mental or non-governmental entities; and 
‘‘(3) such recommendations for legislation and 
administrative action as the Secretary determines 
appropriate. 
‘‘(l) DEFINITION.—In this section: 
‘‘(1) The term ‘adverse childhood experience’ 
means a potentially traumatic experience that occurs 
in childhood and can have a tremendous impact on 
the child’s lifelong health and opportunity outcomes, 
such as any of the following: 
‘‘(A) Abuse, such as any of the following: 
‘‘(i) 
Emotional 
and 
psychological 
abuse. 
‘‘(ii) Physical abuse. 
‘‘(iii) Sexual abuse. 
‘‘(B) Household challenges such as any of 
the following: 
‘‘(i) A household member is treated 
violently. 
‘‘(ii) A household member has a sub-
stance use disorder. 
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‘‘(iii) A household member has a men-
tal health condition. 
‘‘(iv) Parental separation or divorce. 
‘‘(v) A household member is incarcer-
ated, placed in immigrant detention, or has 
been deported. 
‘‘(vi) A household member has a life- 
threatening illness such as COVID–19. 
‘‘(C) Neglect. 
‘‘(D) Living in— 
‘‘(i) impoverished communities that 
lack access to human services; 
‘‘(ii) areas of high unemployment 
neighborhoods; or 
‘‘(iii) communities experiencing de 
facto segregation. 
‘‘(E) Experiencing food insecurity and 
poor nutrition. 
‘‘(F) Witnessing violence. 
‘‘(G) Involvement with the foster system. 
‘‘(H) Experiencing discrimination. 
‘‘(I) Dealing with historical and ongoing 
traumas due to systemic and interpersonal rac-
ism. 
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‘‘(J) Dealing with historical and ongoing 
traumas regarding systemic and interpersonal 
sexism, homophobia, biphobia, and transphobia. 
‘‘(K) Dealing with the threat of deporta-
tion or detention as a result of immigration sta-
tus. 
‘‘(L) The impacts of multigenerational pov-
erty resulting from limited educational and eco-
nomic opportunities. 
‘‘(M) Living through natural disasters 
such as earthquakes, forest fires, floods, or hur-
ricanes. 
‘‘(2) The term ‘eligible entity’ means a State or 
local health department. 
‘‘(3) The term ‘practice of conversion ther-
apy’— 
‘‘(A) means any practice or treatment by 
any person that seeks to change another indi-
vidual’s sexual orientation or gender identity, 
including efforts to change behaviors or gender 
expressions, or to eliminate or reduce sexual or 
romantic attractions or feelings toward individ-
uals of the same gender, if such person receives 
monetary compensation in exchange for any 
such practice or treatment; and 
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‘‘(B) does not include any practice or 
treatment that does not seek to change sexual 
orientation or gender identity and— 
‘‘(i) provides assistance to an indi-
vidual undergoing a gender transition; or 
‘‘(ii) provides acceptance, support, 
and understanding of a client or facilita-
tion of a client’s coping, social support, 
and identity exploration and development. 
‘‘(m) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section 
for the period of fiscal years 2020 through 2027— 
‘‘(1) to carry out subsection (a)(1) through the 
award of grants under subsection (b)— 
‘‘(A) $47,500,000 for grants; and 
‘‘(B) such sums as may be necessary for 
the administrative costs of carrying out such 
subsection; and 
‘‘(2) $7,500,000 to carry out the evaluation 
under subsection (a)(2).’’. 
SEC. 4. CARE COORDINATION GRANTS. 
Part E of title XII of the Public Health Service Act 
(42 U.S.C. 300d–51 et seq.) is amended by adding at the 
end the following new section: 
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‘‘SEC. 1255. CARE COORDINATION GRANTS. 
‘‘(a) IN
GENERAL.—The Secretary shall award 
grants to eligible entities to establish or expand trauma- 
informed care coordination services to support— 
‘‘(1) children aged 0 through 5 at risk of ad-
verse childhood experiences; and 
‘‘(2) their caregivers, including prenatal people 
of any age. 
‘‘(b) NUMBER OF GRANTS.—Subject to the avail-
ability of appropriations, the Secretary shall award not 
fewer than 9 and not more than 40 grants under this sec-
tion. 
‘‘(c) AMOUNT OF GRANTS.—Subject to the avail-
ability of appropriations, the amount of a grant under this 
section for a fiscal year shall be— 
‘‘(1) not less than $250,000; and 
‘‘(2) not more than $1,000,000. 
‘‘(d) ELIGIBLE ENTITIES.—To be eligible to receive 
a grant under this section, an entity shall be a local gov-
ernment or Indian Tribe, acting through the public health 
department thereof if such government or Tribe has a 
public health department. 
‘‘(e) PRIORITY.— 
‘‘(1) IN GENERAL.—In awarding grants under 
this section, the Secretary shall give priority to eligi-
ble entities proposing to serve communities with a 
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high need for trauma-informed care coordination 
services, as demonstrated by indicators such as— 
‘‘(A) pregnant people who face barriers to 
prenatal care; 
‘‘(B) mortality or morbidity of people giv-
ing birth or infants; 
‘‘(C) caretakers and parents who are living 
with a mental health condition or substance use 
disorder; 
‘‘(D) a high prevalence of community vio-
lence, including domestic violence, as dem-
onstrated by instances of homicide and public 
health statistics, including treatment of injury 
or trauma; 
‘‘(E) high proportions of low-income chil-
dren; 
‘‘(F) a high prevalence of child fatalities or 
near fatalities related to child abuse and ne-
glect; 
‘‘(G) significant disparities in health out-
comes for people giving birth and infants; 
‘‘(H) a high rate of exclusionary discipline 
and referrals to law enforcement; and 
‘‘(I) a high rate of homelessness and hous-
ing instability. 
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‘‘(2) DATA
FROM
TRIBAL
AREAS.—The Sec-
retary, acting through the Director of the Indian 
Health Service, shall consult with Indian Tribes to 
establish criteria to measure indicators of need, for 
purposes of paragraph (1), with respect to Tribal 
areas. 
‘‘(f) USE OF FUNDS.— 
‘‘(1) REQUIRED USES.— 
‘‘(A) IN
GENERAL.—A grant received 
under this section shall be used to establish or 
expand gender-responsive, culturally specific, 
trauma-informed care coordination services, in-
cluding by instituting and conducting risk and 
needs assessments including— 
‘‘(i) using strengths-based approaches 
focused on protective factors for children 
and their caregivers, including prenatal 
people of any age; and 
‘‘(ii) inputting screening results into a 
centralized intake system to promote a sin-
gle point of access system across providers 
and services. 
‘‘(B) TRAINING.—A grant received under 
this section shall be used to ensure that individ-
uals employed through the grant funds, in 
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whole or in part, have received sufficient and 
up-to-date training on trauma-informed care 
and strategies that are reparative, culturally 
sensitive, gender-responsive, and healing-cen-
tered. 
‘‘(2) PERMISSIBLE
USES.—A grant received 
under this section may be used for any of the fol-
lowing: 
‘‘(A) Employing care coordinators, case 
managers, community health workers, certified 
infant mental health specialists, and outreach 
and engagement specialists to work with chil-
dren and their caregivers, including prenatal in-
dividuals, to prevent and respond to adverse 
childhood experiences by connecting clients with 
culturally specific, trauma-informed care treat-
ment services, including economic, social, food, 
and housing supports. 
‘‘(B) Providing training described in para-
graph (1)(B) to community health providers 
and community partners. 
‘‘(C) Expanding, enhancing, modifying, 
and connecting the existing network of commu-
nity programs and services to achieve a more 
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comprehensive and coordinated system of care 
approach, including— 
‘‘(i) developing local infrastructure to 
bolster and shape community support sys-
tems and map and build access to services 
in a coordinated and comprehensive way; 
and 
‘‘(ii) creating infrastructure to con-
duct outreach to children and families, in-
cluding those experiencing homelessness 
and housing instability, so they acquire ac-
cess to the services and supports they need 
and the benefits to which they are entitled. 
‘‘(D) Compiling information on resources 
(including 
any 
referral 
services) 
available 
through community-based organizations and 
local, State, and Federal agencies, such as— 
‘‘(i) programs addressing social deter-
minants of health, including— 
‘‘(I) emergency, temporary, and 
long-term housing; 
‘‘(II) programs that offer free or 
affordable and nutritious food; 
‘‘(III) vocational and workforce 
development; and 
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‘‘(IV) transportation supports; 
‘‘(ii) home visiting programs for new 
parents and their infants; 
‘‘(iii) workforce development programs 
to support caregivers in skill building; 
‘‘(iv) 
trauma-responsive, 
parenting 
skills-building programs; 
‘‘(v) the continuum of substance use 
prevention, intervention, and treatment 
programs and mental health support pro-
grams, including programs with trauma-in-
formed, gender-responsive, and culturally 
specific counseling; and 
‘‘(vi) childcare support and early 
childhood education, including Head Start 
and Early Head Start programs. 
‘‘(E) Subject to subsection (g)(2), estab-
lishing or updating a database that compiles 
data used to track the effectiveness of the care 
coordination services funded through the grant. 
‘‘(F) Developing and implementing referral 
partnership agreements with community-based 
organizations, parent organizations, substance 
use disorder treatment providers and facilities, 
housing and shelter providers, health care pro-
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viders, mental health care providers, and Fed-
eral and State offices and programs that imple-
ment practices to support children ages 0 
through 5 who are at risk of adverse childhood 
experiences and their caregivers, including pre-
natal people. Such practices shall include— 
‘‘(i) a bilateral ‘warm handoff’ system 
whereby a grantee understands the needs 
of the children and their families, and fam-
ilies are involved in addressing these needs; 
and 
‘‘(ii) an active service connection 
whereby the children and families are each 
actively connected with a resource in a 
well-coordinated way that ensures avail-
ability and direct contact. 
‘‘(G) Supporting cross-system planning 
and collaboration among employees who may 
work in emergency medical services, health care 
services, public health, early childhood edu-
cation, and substance use disorder treatment 
and recovery support. 
‘‘(H) Providing or subsidizing services to 
address barriers that children, prenatal individ-
uals, and caregivers face to utilizing community 
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resources and services, such as by providing or 
subsidizing transportation or childcare costs as 
applicable and within reasonable amounts. 
‘‘(I) Creating or expanding infrastructure 
and investing in technology, including the provi-
sion of communications technology and internet 
service to children and their caregivers, to en-
able increased telemedicine capabilities to reach 
participants. 
‘‘(3) INDIAN TRIBES.—In the case of an eligible 
entity that is an Indian tribe, the Secretary may 
waive such provisions of this subsection as the Sec-
retary determines appropriate. 
‘‘(4) PROHIBITIONS.—In addition to any other 
prohibitions determined by the Secretary, an eligible 
entity may not use a grant under this section to— 
‘‘(A) use data analysis methods to inform 
individual case decisions, including child re-
moval or placement decisions, or to target serv-
ices at certain individuals or families; 
‘‘(B) require any individual or family to 
participate in any service or program as a con-
dition of receipt of a benefit to which the indi-
vidual or family is otherwise eligible; or 
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‘‘(C) increase the presence or funding of 
law enforcement surveillance, involvement, or 
activity in connection with trauma-informed 
care coordination services supported pursuant 
to this section. 
‘‘(g) REQUIREMENTS.—As a condition on receipt of 
a grant under this section, an eligible entity shall agree 
to each of the following funding conditions: 
‘‘(1) RESTRICTION OF FUNDING ALLOCATION.— 
The eligible entity will not use more than 30 percent 
of the funds made available to the entity through the 
grant (for the total grant period) to establish or up-
date a database pursuant to subsection (f)(2)(E). 
‘‘(2) ACCESSIBLE SETTING.— 
‘‘(A) IN GENERAL.—The eligible entity will 
ensure that all care coordination services pro-
vided through the grant are provided in a set-
ting that is accessible, including through mobile 
settings, to— 
‘‘(i) low-income or no-income individ-
uals, including individuals experiencing 
homelessness or housing instability; and 
‘‘(ii) individuals in rural areas. 
‘‘(B) COMMUNITY
OUTREACH.—In com-
plying with subparagraph (A), the eligible entity 
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will ensure that at least 50 percent of the care 
coordination services provided through the 
grant occur in community settings that are con-
venient to the children and caregivers who are 
being served, such as homes, schools, and shel-
ters, whether for initial outreach or as part of 
long-term care. 
‘‘(3) SUPPLEMENT NOT SUPPLANT.—The grant 
will be used to supplement not supplant other Fed-
eral, State, or local funds available for care coordi-
nation services. 
‘‘(4) CONFIDENTIALITY.—The eligible entity 
will maintain the confidentiality of individuals receiv-
ing services through the grant in a manner con-
sistent with applicable law. 
‘‘(5) PARTNERING; RISK STRATIFICATION.—In 
providing care coordination services through the 
grant, the eligible entity will— 
‘‘(A) partner with community-based orga-
nizations with experience serving child popu-
lations prenatally through age 5; 
‘‘(B) coordinate with the local agency re-
sponsible for administering the State plan ap-
proved under title XIX of the Social Security 
Act; and 
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‘‘(C) employ risk stratification to develop 
different effective models of care for different 
populations based on their needs. 
‘‘(h) APPLICATION.— 
‘‘(1) IN GENERAL.—To seek a grant under this 
section, an eligible entity shall submit an application 
to the Secretary at such time, in such manner, and 
containing such information, as the Secretary may 
require. 
‘‘(2) CONTENTS.—An application under para-
graph (1) shall, at a minimum, contain each of the 
following: 
‘‘(A) Goals to be achieved through the 
grant, including the activities that will be un-
dertaken to achieve those goals. 
‘‘(B) The number of individuals likely to 
be served through the grant, including demo-
graphic data on the populations to be served. 
‘‘(C) Existing programs and services that 
can be used to significantly increase the propor-
tion of children and families who receive needed 
supports and services. 
‘‘(D) A plan for expanding, coordinating, 
or modifying the existing network of programs 
and services to meet the needs of children and 
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