I 
118TH CONGRESS 
1ST SESSION H. R. 5140 
To amend the Public Health Service Act to improve the health and well- 
being of maltreated infants and toddlers through the implementation 
of infant-toddler court teams within States, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
AUGUST 4, 2023 
Ms. DELAURO (for herself and Mr. BILIRAKIS) introduced the following bill; 
which was referred to the Committee on Energy and Commerce 
A BILL 
To amend the Public Health Service Act to improve the 
health and well-being of maltreated infants and toddlers 
through the implementation of infant-toddler court teams 
within States, 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 ‘‘Strengthening Amer-
ica’s Families Act of 2023’’. 
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SEC. 2. INFANT-TODDLER COURT TEAMS FOR CHILDREN 
EXPERIENCING OR AT RISK OF MALTREAT-
MENT. 
Part Q of title III of the Public Health Service Act 
(42 U.S.C. 280h et seq.) is amended by adding at the end 
the following: 
‘‘SEC. 330Z–3. INFANT-TODDLER COURT TEAMS FOR CHIL-
DREN EXPERIENCING OR AT RISK OF MAL-
TREATMENT. 
‘‘(a) CONTINUATION AND EXPANSION OF INFANT- 
TODDLER COURT PROGRAM.— 
‘‘(1) CONTINUATION AND EXPANSION OF PRO-
GRAM.—The Secretary, acting through the Adminis-
trator of the Health Resources and Services Admin-
istration— 
‘‘(A) shall continue in effect the Infant- 
Toddler Court Program; and 
‘‘(B) may, beginning with fiscal year 2024, 
carry out such program on a national basis. 
‘‘(2) INFANT-TODDLER
COURT
PROGRAM
DE-
FINED.—For purposes of paragraph (1), the term 
‘Infant-Toddler Court Program’ refers to the pro-
gram carried out pursuant to section 501(a)(2) of 
the Social Security Act that is designed— 
‘‘(A) to support research-based infant-tod-
dler court teams for purposes of changing child 
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welfare practices to improve well-being for in-
fants, toddlers, and their families, including ef-
forts to build on, and continue the work of, 
sites established through the Quality Improve-
ment Center for Research-Based Infant-Toddler 
Court Teams initiative funded by the Adminis-
tration for Children and Families; and 
‘‘(B) to provide training and technical as-
sistance in support of infant-toddler court 
teams’ efforts across the United States. 
‘‘(b) GRANTS TO STATES FOR IMPLEMENTATION OF 
INFANT-TODDLER COURT TEAMS.— 
‘‘(1) IN GENERAL.—The Secretary of Health 
and Human Services, acting through the Adminis-
trator of the Health Resources and Services Admin-
istration, may make grants to States for purposes of 
seeding the establishment of, or stabilizing and en-
hancing existing, infant-toddler court teams for chil-
dren experiencing or at risk of maltreatment. 
‘‘(2) USE
OF
FUNDS.—A State receiving a 
grant under this subsection may only use funds re-
ceived through the grant to— 
‘‘(A) designate a State lead agency as a 
focal point for statewide planning administra-
tion and coordination— 
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‘‘(i) to identify sites and leadership 
for, and establish, enhance, or stabilize, 
local 
community 
infant-toddler 
court 
teams; and 
‘‘(ii) to promote collaboration among 
State and local systems that address the 
needs of— 
‘‘(I) infants and toddlers and 
their families within the child welfare 
system; and 
‘‘(II) individuals in need of pre-
ventive family strengthening services 
to facilitate the provision of local serv-
ices; 
‘‘(B) provide funding to the sites identified 
under subparagraph (A)(i) to establish, en-
hance, or stabilize local community infant-tod-
dler court teams that meet the criteria specified 
in paragraph (8); and 
‘‘(C) ensure that local community court 
team projects— 
‘‘(i) provide for improved communica-
tion and coordination among the courts, 
child welfare agencies, and related child- 
serving organizations— 
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‘‘(I) to share information and ex-
pedite appropriate high-quality serv-
ices for young children and their fami-
lies in the child welfare system; and 
‘‘(II) to prevent recurrence of 
maltreatment, promote timely perma-
nency, and provide a community 
structure to help prevent entry into 
the child welfare system; 
‘‘(ii) protect young children in the 
child welfare system and at risk of enter-
ing the child welfare system from further 
maltreatment and developmental harm and 
address the damage already done; and 
‘‘(iii) identify and address the struc-
tural issues in the child welfare system 
that are harmful to infants and toddler de-
velopment and impede the ability to 
strengthen and stabilize families. 
‘‘(3) TERM
OF
GRANT.—A grant under this 
subsection shall be for a term of not less than 3 
years and may be renewed for a single term not to 
exceed 8 years. 
‘‘(4) APPLICATION PROCESS.— 
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‘‘(A) IN
GENERAL.—A State seeking a 
grant under this subsection shall submit an ap-
plication to the Secretary at such time, in such 
manner, and containing such information as the 
Secretary may require, including— 
‘‘(i) the information specified in para-
graph (5); and 
‘‘(ii) a plan for the establishment or 
enhancement and ongoing support of local 
community infant-toddler court teams in 
the State. 
‘‘(B) LEAD
STATE
AGENCY.—The Gov-
ernor of a State submitting an application 
under subparagraph (A) shall designate an ap-
propriate State lead agency, such as the State 
Court Improvement Program or the State agen-
cy that administers child welfare services, with 
the ability to carry out the activities specified in 
paragraph (2). 
‘‘(5) APPLICATION
CONTENTS.—The informa-
tion specified in this paragraph is— 
‘‘(A) a description of how the State lead 
agency designated pursuant to paragraph 
(4)(B) will implement infant-toddler court team 
projects that meet the criteria specified in para-
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graph (2)(C) and the communities in which 
local community infant-toddler court teams will 
be established, enhanced, or stabilized; 
‘‘(B) an assurance that the State lead 
agency will consult with representatives of State 
agencies providing services to infants, toddlers, 
and families, the State and local judiciary, and 
local communities and stakeholders, to develop 
a comprehensive plan for implementing infant- 
toddler court teams in the State, that includes 
a plan for determining how the court team 
structure and approach will inform and support 
building a family strengthening continuum, 
which may include using the infant-toddler 
court team structure in implementing preven-
tion and family services and programs under 
section 471(e) of the Social Security Act (42 
U.S.C. 671(e)); and 
‘‘(C) a certification that any infant-toddler 
court team established, enhanced, or imple-
mented using funds received through the grant 
meet the criteria specified in paragraph (8). 
‘‘(6) CONTINUUM
REQUIREMENTS.—The con-
tinuum referred to in paragraph (5)(B) shall— 
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‘‘(A) seek to ensure that children and their 
families, particularly families with histories of 
trauma and adversity, receive effective, timely 
services that strengthen protective factors; 
‘‘(B) begin as early as possible before fam-
ilies encounter the child welfare system— 
‘‘(i) to provide comprehensive sup-
portive community services to families with 
very young children in need of such serv-
ices; and 
‘‘(ii) to emphasize the social deter-
minants of health to strengthen families 
and prevent abuse and neglect; 
‘‘(C) for young children with substantiated 
cases of maltreatment, including those whose 
families have been placed in an alternative or 
differential response program, include a com-
prehensive approach to stabilizing and strength-
ening families and preventing children from 
being placed in foster care that provides serv-
ices and supports focused on in-home parent 
education and specialized programs that ad-
dress the risk factors for removal of infants and 
toddlers from the home; and 
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‘‘(D) use the community structure com-
bined with the judicial oversight within the in-
fant-toddler court team to improve outcomes for 
infants and toddlers who have been placed in 
foster care and their families through working 
with communities to ensure that— 
‘‘(i) parents receive intensive services 
and supports, including mental health and 
substance use disorder treatment, to in-
crease the likelihood of reunification; and 
‘‘(ii) young children receive intensive 
interventions that will address their devel-
opmental needs and heal the trauma of 
abuse, neglect, domestic violence, and sepa-
ration from their caregiver and family. 
‘‘(7) CONDITIONS.—A State selected to receive 
a grant under this subsection, shall, as a condition 
on receipt of such grant— 
‘‘(A) agree to work with the National In-
fant-Toddler Court Team Resource Center es-
tablished under subsection (c) to design or en-
hance and implement local infant-toddler court 
teams, including supporting data collection and 
continuous quality improvement; 
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‘‘(B) provide information to the National 
Infant-Toddler Court Team Resource Center on 
the plan developed pursuant to paragraph 
(5)(B), including the development of a con-
tinuum of family strengthening services that 
meets the conditions specified in paragraph (6); 
‘‘(C) commit to building sustainability into 
the State lead agency function and the plan re-
ferred to in subparagraph (B); and 
‘‘(D) ensure that any infant-toddler court 
team established, enhanced, or implemented 
using funds received through the grant meets 
the criteria specified in paragraph (8). 
‘‘(8) 
LOCAL
COMMUNITY
INFANT-TODDLER 
COURT TEAM CRITERIA.—The criteria specified in 
this paragraph with respect to a local community in-
fant-toddler court team established, enhanced, or im-
plemented using funds received through the grant 
are that the team— 
‘‘(A) organizes and promotes collaboration, 
with leadership from judges and the heads of 
child welfare agencies, among community stake-
holders and service providers to address the 
needs of families with infants and toddlers, 
through implementing trauma-informed prac-
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